Previous Location field

Data Element (edit)
Field Name:	Previous_Location
CCMDB Label:	Previous Location
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:	37

The most recent previous physical location (with #exceptions) of a patient before arriving at the collection location.

• SMW

Legacy implementation right in the table

• Cargo

• Categories

• Forms

Collection Instruction

For each patient,

• enter the option that most closely matches:
  • for places where we collect, use the Service/Location used by the counterpart laptop: <site>_Med, GH-CC, HSC MICU , HSC SICU, HSC_IICU, STB MICU, STB_ICCS, STB_ACCU
  • for wards where we don't collect: <site>_Ward or other external entry e.g. home
• if you know the situation but nothing on the list matches closely, enter other - known but not listed
• if the situation is unknown, enter Not known
• if the patient is in ER under a service we do not collect ie. cardiology, surgery etc use <site>_ER

If you know the location exactly, you can type it, otherwise click on the dropdown button to view the options

Borrowed Bed Or Pt Boarding On Other Unit

For direct transfers within the Winnipeg region, should we enter the Last Boarding Location as the Previous Location ? No because these are only temporary location. Use the service taking care of the patient : <site>_Med, GH-CC, HSC_MICU, HSC_SICU, HSC_IICU, STB MICU, STB_ICCS, STB_ACCU.

Direct Transfers Scenarios

1. From Outside Winnipeg facilities - whether inpt or not, if they went to <own site> ER (e.g. STB ER) for triage, previous location is <own site> ER (e.g. STB ER). If they just stop by only at <own site> ER, then previous location is the outside facility service - it does not matter if from ICU (e.g. Thompson ICU) or ER (e.g. Thompson ER) service of that outside facility as long as the pre-admit inpt has been filled up correctly (e.g. Thompson ICU) , then in TMP Boarding, put <own site> ER (e.g. STB ER) as first boarding loc.
2. From Within Winnipeg facilities - For transfers among HSC/STB/GRA, we are linking all the admissions so we need to be specific for the sending and receiving service. If already inpatients, and no in-between procedures, pre-admit inpt is the same as previous location. if there is temporary location in-between, then previous location is equal to the temporary location (e.g. ER, OR, RR, Cath Lab, Dialysis, Radiology). If not yet an inpt and coming from <other site> ER then previous location is <other site> ER.
3. When to use generic ward - If the patient from our sending service (e.g. HSC SICU) was discharged to a service we are not collecting (e.g. Step down ward) and then transfer again to the service (e.g. HSC Med) we are collecting, having no in-between procedure then the dispo of sending service, pre-admit inpt and previous location are all generic ward (e.g. HSC ward). For the case having in-between procedure, say, sending service is HSC Med to a surgery ward, then OR, then to HSC SICU, the dispo of the sending and pre-admit inpt are generic ward (e.g. HSC ward) and previous location is the temporary location e.g. HSC OR.
4. For sites no longer collected ie. CON/OAK/VIC - inpatients from CON, OAK, VIC who are direct transfers to HSC/STB/GRA, the pre-admit inpt will not be N/A and the previous location is the same as the pre-admit inpt even if the patient spends time in site's UC prior to transfer. If not yet an inpt from CON/OAK/VIC and transfers only from their UC triage, then previous location is the CON/OAK/VIC UC.

"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

Where to find this information

If patient came from a different Winnipeg hospital this should be recorded in the “Visit History” on the EPR, but sometimes it is missing. Can also use paper chart sent to your hospital from the sending hospital for information.

Exceptions

Data collection units that have a mix of different physician serve types

We have a few units in the Region that have a mix of different services (internal medicine, surgical, family medicine etc).

• HSC_B3 - is a mix of day surgery & internal medicine patients
• any others?

For patients from these units:

• If patient was an internal medicine there, enter <site>_Med
• If not a internal medicine patient, enter the <site>_Ward

from HSC psych unit

Code patient from POU (pysch evaluation unit @ HSC) as "HSC ambulatory care" - it's not an inpatient ward.

Dialysis unit as previous location

For patient from Dialysis unit, use that unit as previous location. Pre acute living situation field would be the unit they came from right before, if applicable.

Heart Cath Lab vs OR as previous location

When a procedure (e.g valve replacement) is done in the cath lab before the pt arrives on your unit, enter Cath Lab if done in Cath Lab and put OR if done in OR.

Patients from day surgery

For patients admitted from day surgery units, enter:

• Previous Location - <site>_Ward, e.g. HSC Ward

Homeless Patients

If a homeless patient is admitted directly then code them as admitted from home. Usually they would be via ER, of course, and you'd code them as that.

Prison / Jail / Correctional Institution

If a patient is admitted from prison, jail or a correctional institution, code this as an admission from "Institution NOS".

See Prison / Jail / Correctional Institution for additional info.

Data Use

This data is used for tracking where most of the traffic on our units/wards comes from. For starters it will be reported to Critical Care (Randy Martin), who was also the requestor of this data.

Data Integrity Checks (automatic list)

	App	Status
Check pre acute consistent	CCMDB.accdb	declined
Query check tmp ER Boarding Loc should exist if from ER	CCMDB.accdb	declined
Function Validate Previous Location	CCMDB.accdb	implemented
Query check prev pre-admit consistent	CCMDB.accdb	implemented
Check function previous NE Location	CCMDB.accdb	implemented
Query check CCI from OR no CCI	CCMDB.accdb	implemented
Query check pt from ER	CCMDB.accdb	implemented
Query check previous location vs service inconsistent	CCMDB.accdb	retired
Check Accept Loc Park	CCMDB.accdb	retired
Query check VAP admit must be from ICU	CCMDB.accdb	retired
Link suspect mismatch from ours incomplete query	Centralized data front end.accdb	implemented
Link suspect not same visitAdmitDtTm query	Centralized data front end.accdb	implemented
Query cardiac arrest throughout admission	Centralized data front end.accdb	needs review

Implementation

The field is populated with options from the s_dispo table.

Legacy

This field is part of the 2016 Time and Place changes.

It a combination of our previous

• Admit from
• Hospital previous
• Var 1 - Admit-from Ward