Pre-admit Inpatient Institution field: Difference between revisions

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**The L2 area is a preparatory area for the Operating Room.  However, they do admit the patient there, it is not an outpatient area.  The surgical service that is planning the surgery would be writing the orders and looking after the patient. This area is for patients coming in from home for surgery that same day. --[[User:LKolesar|LKolesar]] 14:25, 2017 August 21 (CDT)
**The L2 area is a preparatory area for the Operating Room.  However, they do admit the patient there, it is not an outpatient area.  The surgical service that is planning the surgery would be writing the orders and looking after the patient. This area is for patients coming in from home for surgery that same day. --[[User:LKolesar|LKolesar]] 14:25, 2017 August 21 (CDT)
**As I recall Pre-admit institution is being collected because it has been noted to be affecting outcome/acuity (i.e. between already an in-patient vs a new patient). Is being in 'L2 prior to OR on the same day' a valid scenario for in-patient cases?  I think this is more of 'NA/not applicable'. --[[User:JMojica|JMojica]] 14:48, 2017 August 21 (CDT)


=== intra-facility and inter-facility transfers  ===
=== intra-facility and inter-facility transfers  ===

Revision as of 14:48, 2017 August 21

Data Element (edit)
Field Name: Pre_admit_Inpatient_Institution
CCMDB Label: Pre-admit Inpatient Institution
CCMDB tab: Dispo
Table: L_Log
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 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


This does not include patients who just arrived at an ER elsewhere and were not admitted as inpatient there.

If that location is already an inpatient location, then the pre admit inpatient institution will be the same the Previous Location.

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.

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.
  • 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 is not an inpatient location.

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

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

The following are considered inpatient locations in this context:

  • day-surgery patients ending up on our unit directly

The following are not considered inpatient locations, enter "NA / not applicable"

  • Question: When a patient goes for elective surgery and comes in the day of their surgery, they are admitted to a pre-operative area (at STB it is called L2 pre-op). Then they go to the OR from there and later to the ICU or ward. Some are day surgery but I am asking about all surgical patients here. The previous location will be the Operating Room, should we put STB ward in the pre-admit inpatient institution slot? I just see that not everyone is doing this so just checking. Thanks. --LKolesar 13:02, 2017 August 21 (CDT)
    • Is this admission from pre-operative area a part of the process when a patient is admitted to a surgical service or it is entirely a separate service, a stand alone service and not just a waiting zone or preparatory location prior to OR? what do you call that service? I can see from the database ICMS patient having previous location = 'STB - OR' with pre-admit inpatient = STB_ward (16) / STB_A4 stepdown (4) / STB E5 / STB_E6/ not applicable (20). --JMojica 13:43, 2017 August 21 (CDT)
    • The L2 area is a preparatory area for the Operating Room. However, they do admit the patient there, it is not an outpatient area. The surgical service that is planning the surgery would be writing the orders and looking after the patient. This area is for patients coming in from home for surgery that same day. --LKolesar 14:25, 2017 August 21 (CDT)
    • As I recall Pre-admit institution is being collected because it has been noted to be affecting outcome/acuity (i.e. between already an in-patient vs a new patient). Is being in 'L2 prior to OR on the same day' a valid scenario for in-patient cases? I think this is more of 'NA/not applicable'. --JMojica 14:48, 2017 August 21 (CDT)

intra-facility and inter-facility transfers

If a patient gets transferred to another ward in the same or different hospital, enter the previous ward as both the Previous Location field and the Pre-admit Inpatient Institution field.

patients discharged to Oaks ER

see Parked in ER

Code Readmission from Grace/HSC Nursing Home as NA

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". (As per meeting with Dr Roberts 2016-05-05)

Example

  • ICU Vic---family medicine ward at the Vic---ED HSC---ED STB---cath lab---ICU HSC.
    • The PrevInptLocation field is: VIC_Ward

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.

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.

Template:CCMDB Data Integrity Checks

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.