Pre-admit Inpatient Institution field: Difference between revisions

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''This field is currently being implemented, please check the instructions and put a discussion for anything that isn't clear. ''
{{Data_element
 
| field_name = Pre_admit_Inpatient_Institution
The [[Pre-admit Inpatient Institution field]] identifies the '''previous ''inpatient'' location''' of patients who were already '''inpatients''' elsewhere and who have been under medical care continuously before coming to our unit. This does not include patients who just arrived at an ER elsewhere and were not admitted as inpatient there.
| CCMDB_label = Pre-admit Inpatient Institution
 
| CCMDB_tab = Dispo
For example, a patient arriving from Selkirk Hospital ward via the local ER would have the ER coded in the [[Previous Location field]] and Selkirk ward coded in the [[Pre-admit Inpatient Institution field]].
| element_description = The most recent '''previous ''inpatient'' location''' of patients who were already '''inpatients''' elsewhere and who have been under medical care continuously before coming to our unit.
| in_table = L_Log table
| data_type = number
| datafield_length = long integer
| program_collecting = Med and CC
| created_raw = Raw
| data_element_start_date = 2016-07-01
| data_element_sort_index = 36
}}


== Collection Instruction ==
== Collection Instruction ==
For each patient,  
* For each patient, enter the most recent '''in-patient''' location where the patient has been admitted during this continuous episode of hospitalization at this or other hospitals
* enter the most recent '''in-patient''' location where the patient has been admitted during this continuous episode of hospitalization at this or other hospitals.
{{PrePrevDispo listing}}
{{Ex |
*HSC MICU --- family medicine ward at the Vic --- HSC_ER --- STB_ER --- cath lab --- HSC_MICU.
**Code the Pre-admit Inpatient Institution field as: VIC_Ward}}
* if you know the situation but nothing on the list matches closely, enter '''other - known but not listed'''
* if you know the situation but nothing on the list matches closely, enter '''other - known but not listed'''
* if the situation is unknown, enter '''location missing/unknown'''
* if the situation is unknown, enter '''location missing/unknown'''
* if the patient did not come from an '''in'''patient location, enter "not applicable", for example if they came from home or a clinic. The ER is '''not''' an inpatient location.
* if the patient did not come from an '''in'''patient location, enter "not applicable"  
{{discussion}}
for example if they came from home or a clinic. The ER (at your site or elsewhere) is '''not''' an inpatient location, so enter "not applicable" for these
If you know how we code the location exactly, you can type it. Otherwise press the "?" button to take you to the [[S dispo chooser‎]] to help filter options if desired.


=== Where to find this information ===
=== Where to find this information ===
If patient came from a different Winnipeg hospital this will be recorded in the  “Visit History” on the EPR.
If patient came from a different Winnipeg hospital this will be recorded in the  “Visit History” on the EPR.
=== [[EMIP]]/[[Bed borrow]] ===
see those articles


=== Ambiguous locations ===
=== Ambiguous locations ===
The following '''are''' considered inpatient locations in this context:
*The following '''ARE NOT''' considered inpatient locations, enter "NA / not applicable"
* day-surgery patients ending up on our unit directly
** care homes, including units with higher levels of care at any '''[[Chronic Health Facility]]'''
 
** [[Grace Nursing Home Ward]] - We consider admissions from there as readmissions, so would be coded as if they had come from home. Consistent with that we will consider these '''not''' inpatient locations, so code them as "NA / not applicable". (As per meeting with Dr Roberts 2016-05-05)
The following are '''not''' considered inpatient locations, enter "NA / not applicable"
** Day-surgery locations
* care homes, including units with higher levels of care at Deer Lodge or Riverview


=== intra-facility and inter-facility transfers  ===
=== intra-facility and inter-facility transfers  ===
If a patient gets transferred to another ward on the same or different hospital, enter the previous ward as both the [[Previous Location field]] and the [[Pre-admit Inpatient Institution field]].
If a patient gets transferred to another ward in the same or different hospital, enter <site>_Med, <site>_Ward or <site>_CC (as appropriate) as both the [[Previous Location field]] and the [[Pre-admit Inpatient Institution field]].


=== Cath lab confusion ===
=== arrivals from a borrowed bed ===
We did not use to collect cath lab and would instead code the location before, usually ER. We will now allow cath lab. If a patient comes from the cath lab it does not result in any other exceptional collection instructions. If they were an inpatient before, without interruption, code that location as [[Pre-admit Inpatient Institution field]]. If they were not an '''inpatient''' code it as not available.
See and follow [[Previous Location field#Borrowed Bed Or Boarding Loc]]


===Code Readmission from Grace/HSC Nursing Home as NA ===
=== several pre-admit locations ===
We consider admissions from there as re-admissions, so would be coded as if they had come from home. Consistent with that we will consider these '''not''' inpatient locations, so code them as "NA / not applicable".
If a patient travels through several pre-admit inpatient locations we will only have data on the last one. We understand that. Just to be clear.
(As per meeting with Dr Roberts 2016-05-05)


=== Example ===
{{Ex |  Pt was on a ward as an inpatient then went to ICU, then was transferred to the ward you are collecting on. Previous location would be ICU and previous inpatient institution would also be ICU.}}
*ICU Vic---family medicine ward at the Vic---ED HSC---ED STB---cath lab---ICU HSC.
**The PrevInptLocation field is: VIC_Ward


=== Question - VIC_ER->STB_EMIP->VIC_ER->VIC_Ward ===
{{Location dropdown cleanup}}
{{discussion}}
I am posting the following scenario for feedback please, is this correct? Thanks! [[User:Ppiche|Pamela Piche]] 15:43, 2016 May 20 (CDT)
 
*VIC ER under ER Medicine Service---STB ER admitted as inpatient under B Service Medicine received thrombolytic for CVA, did not leave ER Department---VIC ER; accepted by Medicine Service and transferred to inpatient unit.
**The PrevInptLocation field is: STB EMIP
**The Previous Service is: Emergency Medicine
*** I think the Previous Service is Medicine, nor Emergency Medicine. [[User:JMojica|JMojica]] 10:15, 2016 May 24 (CDT)
****OK, to clarify........a patient discharged as STB EMIP returning to VIC ER and cared for under ER physican/service until Medicine consulted and accepts patient....the most recent Previous Service caring for the patient in the example is Emergency Medicine not Medicine? Or is this wrong? Thanks, [[User:Ppiche|Pamela Piche]] 11:36, 2016 May 24 (CDT)
****The case of VIC ER to STB EMIP to VIC ER to VIC Ward is a bit tricky because STB EMIP signify being an inpatient under Medicine service before going to VIC ER.  WIKI defines Previous Service as the "originating service" for those patient's who where already in a prior inpatient location. It would be easier to define the previous service if this is a case of direct transfer to VIC Medicine service and parked only in VIC ER. This is a good question - which to use, Emergency Medicine or Medicine?  Since it is known that there is  prior inpatient service,  I am more on the second one 'Medicine'.  This can be a similar case when the previous location is Operating or Recovery and  the responsible surgical service is coded as previous service. If coming from home to another ER to own ER to own Ward, then previous service is clearly Emergency medicine.  Let us discuss, any suggestions/thoughts by anyone? [[User:JMojica|JMojica]] 13:44, 2016 May 24 (CDT)
****On the basis of WIKI instructions and examples, I agree the Previous Service in the scenario should be Medicine. Thanks for the clarification [[User:Ppiche|Pamela Piche]] 14:52, 2016 June 7 (CDT)
 
=== several pre-admit locations ===
If a patient travels through several pre-admit inpatient locations we will only have data on the last one. We understand that. Just to be clear.


== Data Use / Purpose ==
== Data Use / Purpose ==
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The information will also give our administrators a better idea of which other hospitals are sending us patients, which they will use for planning.
The information will also give our administrators a better idea of which other hospitals are sending us patients, which they will use for planning.


== {{CCMDB Data Integrity Checks}} ==
== Cross Checks ==
* Can not be blank
{{Data Integrity Check List}}
* preAdmit_NE_Location() - [[Pre-admit Inpatient Institution field]] can't be same as [[Service/Location field]]
 
* query check_prev_pre-admit_consistent: for inpatient transfers within the region, [[Previous Location field]] and [[Pre-admit Inpatient Institution field]] should be same.


== Reports ==
== Reports ==
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We used to collect nursing stations in [[hospital previous]] but would not include them under the new scheme because they are not inpatient locations. Julie and Tina met with Randy Martin 2016-04 and he confirmed he doesn't need them.   
We used to collect nursing stations in [[hospital previous]] but would not include them under the new scheme because they are not inpatient locations. Julie and Tina met with Randy Martin 2016-04 and he confirmed he doesn't need them.   


== Related articles ==
{{Related Articles}}


[[Category: 2016 Time and Place changes]]
[[Category: 2016 Time and Place changes]]
[[Category: Admit/Discharge]]
[[Category: Admit/Discharge]]
[[Category: Data Collection Guide]]

Latest revision as of 10:37, 2021 August 5

Data Element (edit)
Field Name: Pre_admit_Inpatient_Institution
CCMDB Label: Pre-admit Inpatient Institution
CCMDB tab: Dispo
Table: L_Log table
Data type: number
Length: long integer
Program: Med and CC
Created/Raw: Raw
Start Date: 2016-07-01
End Date: 2300-01-01
Sort Index: 36

The most recent previous inpatient location of patients who were already inpatients elsewhere and who have been under medical care continuously before coming to our unit.

  • SMW

Legacy implementation right in the table

  • Cargo


  • Categories
  • Forms


Collection Instruction

  • For each patient, enter the most recent in-patient location where the patient has been admitted during this continuous episode of hospitalization at this or other hospitals
Example:   
  • HSC MICU --- family medicine ward at the Vic --- HSC_ER --- STB_ER --- cath lab --- HSC_MICU.
    • Code the Pre-admit Inpatient Institution field as: VIC_Ward
  • if you know the situation but nothing on the list matches closely, enter other - known but not listed
  • if the situation is unknown, enter location missing/unknown
  • if the patient did not come from an inpatient location, enter "not applicable"

for example if they came from home or a clinic. The ER (at your site or elsewhere) is not an inpatient location, so enter "not applicable" for these

Where to find this information

If patient came from a different Winnipeg hospital this will be recorded in the “Visit History” on the EPR.

Ambiguous locations

  • The following ARE NOT considered inpatient locations, enter "NA / not applicable"
    • care homes, including units with higher levels of care at any Chronic Health Facility
    • Grace Nursing Home Ward - We consider admissions from there as readmissions, so would be coded as if they had come from home. Consistent with that we will consider these not inpatient locations, so code them as "NA / not applicable". (As per meeting with Dr Roberts 2016-05-05)
    • Day-surgery locations

intra-facility and inter-facility transfers

If a patient gets transferred to another ward in the same or different hospital, enter <site>_Med, <site>_Ward or <site>_CC (as appropriate) as both the Previous Location field and the Pre-admit Inpatient Institution field.

arrivals from a borrowed bed

See and follow Previous Location field#Borrowed Bed Or Boarding Loc

several pre-admit locations

If a patient travels through several pre-admit inpatient locations we will only have data on the last one. We understand that. Just to be clear.

Example:    
 Pt was on a ward as an inpatient then went to ICU, then was transferred to the ward you are collecting on. Previous location would be ICU and previous inpatient institution would also be ICU.

"Can we remove the items that are no longer Service/Locations, Previous Locations, Pre-admit Inpatient Institutions or dispo locations from the dropdowns?"

We can and will remove them, but that can only happen once no more laptops use them. We will need to keep track of this and then remove them when ready. If I removed them now, then any box that currently has them enter would misbehave.

query of what is currently available

SQL    
SELECT s_dispo.location_name, s_dispo.Site, s_dispo.active, s_dispo.inpatient, s_dispo.previous_location, s_dispo.s_location, s_dispo.dispo
FROM s_dispo
WHERE (((s_dispo.Site)>"") AND ((s_dispo.active)=True) AND ((s_dispo.inpatient)=True)) OR (((s_dispo.Site)>"") AND ((s_dispo.active)=True) AND ((s_dispo.previous_location)=True)) OR (((s_dispo.Site)>"") AND ((s_dispo.active)=True) AND ((s_dispo.s_location)=True)) OR (((s_dispo.Site)>"") AND ((s_dispo.active)=True) AND ((s_dispo.dispo)=True));

Query of what is currently used

query z_s_dispo_inactivatable

Data Use / Purpose

To document where those patients who were inpatients immediately before arriving on our ward/unit came from.

The detailed information will allow us also to distinguish between patients who were or were not inpatients before arrival. This is relevant to a patient's risk of bad outcomes.

The information will also give our administrators a better idea of which other hospitals are sending us patients, which they will use for planning.

Cross Checks

Data Integrity Checks (automatic list)

 AppStatus
Query check prev pre-admit consistentCCMDB.accdbimplemented
Function Validate Pre admit Inpatient InstitutionCCMDB.accdbimplemented
Check function preAdmit NE LocationCCMDB.accdbimplemented
Check Accept Loc ParkCCMDB.accdbretired
Link suspect mismatch pre inpt ours incomplete queryCentralized data front end.accdbimplemented
Link suspect not same visitAdmitDtTm queryCentralized data front end.accdbimplemented

Reports

  • The information will be part of the Inter-facility transfer report (i.e. inpatients coming from other facility outside the region or within the region). Also the information will be useful for research projects where a patient will be tagged if already an inpatient before arrival to the unit or ward. JMojica 11:45, 2016 June 6 (CDT)

Implementation

The field is populated with options from the s_dispo table.

Legacy

This field is part of the 2016 Time and Place changes and did not previously exist.

Nursing stations

We used to collect nursing stations in hospital previous but would not include them under the new scheme because they are not inpatient locations. Julie and Tina met with Randy Martin 2016-04 and he confirmed he doesn't need them.

Related articles

Related articles:
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