Previous Service field: Difference between revisions
Ttenbergen (talk | contribs) (partial answer) |
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=== admission from a nursing station === | === admission from a nursing station === | ||
*For direct admission from a nursing station, put "other (known, but not on list)". | |||
* | *If from a nursing station, patient dropped by ER , put "Emergency Medicine". | ||
* | |||
== Data Use == | == Data Use == | ||
Revision as of 12:54, 2017 August 22
| Data Element (edit) | |
| Field Name: | Previous_Service |
| CCMDB Label: | Previous Service |
| 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: | 38 |
The most recent "originating service" for those patient's who where already in a prior inpatient location before coming to their current service location.
- This definition seems to exclude Emergency so why is emergency medicine even in the previous service list? Emergency is not an inpatient location).
- CCMDB makes sure nothing is left blank, so we needed to enter something in here. You are right, though, we should adjust the defnition accordingly. Could you please and then take this out? Ttenbergen 18:10, 2017 July 26 (CDT)
Collection Instruction
For each patient,
- enter the option that most closely matches
- for medicine ward-to-ward moves, code "medicine" as previous service
- for ICU-to-ICU moves, code "Critical Care" if no other specific service is documented
- for pt from ER, code "Emergency Medicine" unless a different service had accepted them and is handing them off to Medicine
- for pt direct from ambulatory care not via ER, code "not applicable"
- if the service is not listed, code "other (known but not on list)"
- in these cases we don't care about the details; if we see too many others we may add additional options in future
From Cardiac Cath Lab
- A patient goes to emergency, then is sent to the cardiac cath lab for an angiogram. Julie would like the sending service to be Emergency Medicine in these cases (not cardiology). Discussed at the task group meeting on July 20, 2017.
- Most patients come to CCU or ICU via the heart cath as a code stemi, in which case the previous service is cardiology because they bypass ER and go direct to the heart cath lab.
- The previous service is who was looking after the pt before the heart cath in some situations. For example, if ECMO is done in the heart cath lab : If the pt was on a ward or unit prior to the procedure, the service is whatever ward or unit it was that sent the pt there. If ER sends a pt for a VV ECMO, the ER is the sending service, unless ICU takes over the pt prior to the ECMO. (They would need to consult cardiac surgery for the ecmo procedure but it would be the ICU that takes over the care ultimately).
This was discussed at the task group meeting on June 21, 2017.
from OR
If a patient comes from an OR/RR, code the responsible surgical service as previous service.
Nursing Home Wards (HSC/GRA)
We treat patients that went through the HSC/GRA Nursing Home as having been discharged. So, admission from there should be as if admitted from home, so put "not applicable" into the Previous Service field. This does not affect the Visit Admit DtTm field definition - remember, that is defined by EPR entry.
Admit from home
For an admission directly from home bypassing the ER enter Previous Service = 'Not applicable'.
from EMIP via ER
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.
admission from a unit partly collected by us
see Previous_Location_field#from_a_unit_that_is_partly_collected_by_us.2C_and_partly_not.
admission from a nursing station
- For direct admission from a nursing station, put "other (known, but not on list)".
- If from a nursing station, patient dropped by ER , put "Emergency Medicine".
Data Use
Patients with Previous Location field critical care must have Previous Service field critical care, and patients from medicine must have previous service medicine.
Sending service to ICU will be reported to the Critical Care Director.
Template:CCMDB Data Integrity Checks
- Can't be empty.
- 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".
Not sure if the following makes sense in new context, but moved here from the tmp article: Template:Discussion
- Query s_tmp_Service_Sending_to_ICU - Error if:
- not admitted from inpatient location ((S AdmitDischarge.inpatient = true)) but has "Srv to ICU" entry
- admitted from inpatient location and one of
- no "Srv to ICU" entry
- has "Srv to ICU" = "z_not applicable" and no comment
Right now our consistency check would not allow someone from other hosp via ER. We won't be able to do this check until we have Pre-admit Inpatient Institution field. I will take that check out for now. Ttenbergen 11:50, 2015 June 24 (CDT) Template:Discussion
Implementation
The field is populated with options from the s_previous_service table.
Legacy
For medicine this concept is related to ER Wait.
For critical care this concept is related to Service Sending to ICU.