Previous Location field: Difference between revisions

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| CCMDB_label = Previous Location
| CCMDB_label = Previous Location
| CCMDB_tab = Dispo
| CCMDB_tab = Dispo
| element_description = The most recent previous '''physical location''' of a patient before arriving at the collection location.
| element_description = The most recent previous '''physical location''' (with [[#exceptions]]) of a patient before arriving at the collection location.
| in_table = L_Log
| in_table = L_Log table
| data_type = number
| data_type = number
| datafield_length = long integer
| datafield_length = long integer
Line 12: Line 12:
| data_element_sort_index = 37
| data_element_sort_index = 37
}}
}}
For exceptions, see
* [[EMIP]]
* [[HSC Community and Clinical Decision Unit (CCDU)]], [[CAU]]
* [[Parked in ER]]


== Collection Instruction ==
== Collection Instruction ==
For each patient,  
For each patient,  
* enter the option that most closely matches
* enter the option that most closely matches:
* if you know the situation but nothing on the list matches closely, enter '''other - known but not listed''
{{PrePrevDispo listing}}
* if the situation is unknown, enter '''location missing/unknown'''
* 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 press the "?" button to take you to the [[S dispo chooser‎]] to help filter options if desired.
If you know the location exactly, you can type it, otherwise click on the dropdown button to view the options


For wards where we don't collect, enter e.g. HSC_ward. For wards where we do collect enter the actual ward as available in the dropdown.  
=== 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 ===
# 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.
# 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.
# 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.
#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.  


=== Example ===
 
For example, a patient arriving from Selkirk Hospital via the local ER would have the ER coded in the [[Previous Location field]] and Selkirk coded in the [[Pre-admit Inpatient Institution field]].
{{Location dropdown cleanup}}


=== Where to find this information ===
=== 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.
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.


=== direct transfer ===
=== Exceptions ===
For patients who get [[ICU Var 4 - Parked in ER|parked in the ER]] during a inter-facility transfer, enter the previous ward in [[Pre-admit Inpatient Institution field]] and enter your ER in [[Previous Location field]].
==== Data collection units that have a '''mix''' of different physician serve types ====
(In the past you would have entered the hospital and ward as the "admit from".)
We have a few units in the Region that have a mix of different services (internal medicine, surgical, family medicine etc).  


{{discussion}}
*HSC_B3 - is a mix of day surgery & internal medicine patients
There should be a way to distinguish the cases who are from other hospital in Wpg, in other city, province, country, went to ER, assessed at ER and then decision to admit occurred at ER versus those who are direct admits but parked at ER. Suggestions to determine direct admits are 1) add a check box 'Direct Admit' 2)  Visit_admit_DtTm is the same as Accept_DtTm but this does not always happens 3) if the previous service is not 'Emergency Medicine' but there are also other services accepting patients at ER before handling over to Medicine ward/ ICU (e.g. neurology, cardiology, Nephrology). When this issue was presented to the 28Sept2017 Team Meeting, the group finds option 1 to be the clearest data and the easiest to implement for the data collector and for the analysis/reporting purposes. Tina needs to add the check box for 'Direct Admit' in CCMDB. --[[User:JMojica|JMojica]] 10:00, 2017 September 29 (CDT)
* any others?


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


=== Dialysis unit as previous location===
==== 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.  
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.
{{discussion}}
 


=== Heart Cath Lab vs OR as previous location ===
==== 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.
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.
We are aware that this may affect categorization under [[APACHE II]] but will collect like this for now. This will need to be dealt with when we move to [[ICD10]]. {{ICD10}}


=== Data collection units that have a '''mix''' of different physician serve types ===
==== Patients from day surgery ====  
We have a few units in the Region that have a mix of 2 different services (internal medicine, surgical, family medicine etc).
For patients admitted from day surgery units, enter:
*VIC_S3 - is a mix of family medicine and internal medicine patients
*[[Previous Location]] - <site>_Ward, e.g. HSC Ward
*HSC_B3 - is a mix of day surgery & internal medicine patients
* any others?


For patients from these units:
==== [[HSC Stepdown Units]] ====
* If patient is an internal medicine patient: enter the unit name (eg. VIC_S3)
* If patient is '''not''' a internal medicine patient, enter the generic hospital ward (e.g. VIC Ward); this will allow you to enter the [[Previous Service field]] with a physician service other than "Medicine".


=== Patients from day surgery===
==== [[Homeless]] Patients ====  
For patients admitted from day surgery units, enter:
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.
*Previous Location - <your hospital> Ward, e.g. HSC Ward
*[[Previous Service]] - General Surgery (or other surgical service listed in drop down.


=== [[Homeless]] Patients ===
==== [[Prison / Jail / Correctional Institution]] ====  
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.
If a patient is admitted from prison, jail or a correctional institution, code this as an admission from '''"Institution NOS"'''.  


=== [[Prison / Jail / Correctional Institution]] ===
See [[Prison / Jail / Correctional Institution]] for additional info.
If a patient is admitted from prison, jail or a correctional institution, under the circumstances that would qualify as an admission from home, code this as an admission from home.


== Data Use ==
== 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.  
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.  


== {{CCMDB Data Integrity Checks}} ==
== Cross Checks ==
Implemented:
{{Data Integrity Check List}}
* Can not be blank
* previous_NE_Location() - [[Previous Location field]] can't be same as [[Service/Location field]]
* Patients with [[Previous Location field]] critical care must have [[Previous Service field]] critical care, and patients from medicine must have previous service medicine.
 
* query check_prev_pre-admit_consistent: for inpatient transfers within the region, [[Previous Location field]] and [[Pre-admit Inpatient Institution field]] should be same.
 
* query check_previous_location_vs_service_inconsistent: patients with [[Previous Location field]] in medicine must have [[Previous Service field]] medicine; patients from ICU (except CCU) must have previous service "critical care".
 
Following might still need to be implemented:
* [[Check ORDx]]; or not? Would have to be done for ICD10, so can it wait? Ttenbergen 16:26, 2016 May 25 (CDT) 
** discussing with Julie, she seems open to waiting, told her I am starting [[:Category:ICD10]] and [[:Template:ICD10]] for stuff like this. Ttenbergen 10:56, 2016 June 2 (CDT)
{{ICD10}}


== Implementation ==
== Implementation ==
Line 102: Line 87:
* [[Hospital previous]]
* [[Hospital previous]]
* [[Var 1 - Admit-from Ward]]
* [[Var 1 - Admit-from Ward]]
== Related articles ==
{{Related Articles}}


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

Latest revision as of 13:17, 2024 March 6

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:
  • 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:

HSC Stepdown Units

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.

Cross Checks

Data Integrity Checks (automatic list)

 AppStatus
Check pre acute consistentCCMDB.accdbdeclined
Query check tmp ER Boarding Loc should exist if from ERCCMDB.accdbdeclined
Function Validate Previous LocationCCMDB.accdbimplemented
Query check prev pre-admit consistentCCMDB.accdbimplemented
Check function previous NE LocationCCMDB.accdbimplemented
Query check CCI from OR no CCICCMDB.accdbimplemented
Query check pt from ERCCMDB.accdbimplemented
Query check previous location vs service inconsistentCCMDB.accdbretired
Check Accept Loc ParkCCMDB.accdbretired
Query check VAP admit must be from ICUCCMDB.accdbretired
Link suspect mismatch from ours incomplete queryCentralized data front end.accdbimplemented
Link suspect not same visitAdmitDtTm queryCentralized data front end.accdbimplemented
Query cardiac arrest throughout admissionCentralized data front end.accdbneeds 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

Related articles

Related articles:
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