Pre-admit Inpatient Institution field
| Data Element (edit) | |
| Field Name: | Pre_admit_Inpatient_Institution |
| CCMDB Label: | not stated |
| CCMDB tab: | not stated |
| Table: | L_Log table |
| Data type: | integer |
| Length: | long |
| Program: | Med and CC |
| Created/Raw: | raw"raw" is not in the list (Raw, Created, not entered) of allowed values for the "FieldCreatedRaw" property. |
| Start Date: | 1988-07-11 |
| End Date: | 2300-01-01 |
| Sort Index: | 999 |
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.
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"
- care homes, including units with higher levels of care at Deer Lodge or Riverview
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.
- Due to the new collection fields, it has been noted at SOGH that patients that are admitted to a ward at SOGH and become unstable may be transferred to the SOGH ER for determination of problem and disposition. If they are deemed critically ill and are an ICU candidate, they are then admitted from the ER to SOGH ICU. This is not a consistent practice but does occur on a regular basis. Main office notes that my pre-admit inpatient field is Oak-Ward but my previous location is Oak-ER and is an outlier compared to everyone else.
The question to other data collectors is: is this only a SOGH phenomenom? If it is occuring at your facility, does it occur only rarely which is why the data has not shown this elsewhere? Or is your coding different in these cases? --Lpruden2 14:37, 2016 October 13 (CDT)
- At the VIC, the only reason that I have seen patients making a stop in the ER is when they have been accepted to the ICU, but the bed is not yet available. They sometimes will be cared for in the ER until the ICU bed is ready. This is a rare occurrence-I would estimate that it only happens once or twice a year. Mlagadi 10:05, 2016 October 17 (CDT)
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
- Can not be blank
- 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
- 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.