Processes around changing a PatientFollow assignment

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Patients are assigned to collectors using the PatientFollow Project. This page explains what needs to happen when an assignment is changed. The collector/laptop that used to collect a number needs to phase out that number, the collector/laptop who gains that number needs to start them, and we need to be sure that Julie will report on them continuously. We need a process where the time frame for the transition is limited.

Since PatientFollow Project assignments are based on the Service Start DtTm (collected as Service tmp entry), the transition is based on of the Service Start/Change dttms.

Process for the collector who will no longer be collecting the chart number ending

  • for patients with a service start DtTm after the transition date, a line will not show up in Cognos2 Service Starter on the laptops that are no longer collecting them (they will show up on the new laptop, see next section)
  • If the next service change would lead to a discharge from the affected laptop's, do a regular discharge.
  • If the next service change would not lead to a discharge from the affected laptop's (ie would just lead to another Service tmp entry), then discharge the patient to the Dispo location appropriate for their next unit (ie use the Dispo that someone from another site would use if they sent a pt there). This might mean that you are setting Dispo to the same value as Service/Location.
  • enter Comorbid Diagnoses, Admit Diagnoses,Acquired Diagnoses and Admit Procedures,Acquired Procedures that happen before the transition dttm

Process for the collector who will now be collecting the chart number ending

Cross-threshold records that persist for a long time

A change in service will trigger a re-assignment, but a patient could remain on the same service for a long time after a PatientFollow change. If the change was just done for workload re-distribution reasons this may not matter and collection can continue on the original laptop. If the re-assingment was done to wind down a laptop entirely the the remaining records should be discussed with main office on a regular basis to decide if collection should continue on that laptop, or if the record should be moved to the new laptop (ie. manually re-entered there, and deleted from old laptop). This will be a case-by-case decision.

Cross-check triggers during transition

CCMDB.accdb runs Check function preAdmit_NE_Location (and others) to make sure that the Service/Location is not the same as the Pre-admit Inpatient Institution, Previous Location or Dispo. This cross check will wrongly trigger for patients who are currently transitioning from one laptop to another because of a change in PatientFollow assignment.

Just accept and ignore the error.

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The error is annoying because it comes up repeatedly. There is an email exchange between Pam, Julie and Tina to find out how best to deal with this. Ttenbergen 20:56, 2021 January 14 (CST)

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What needs to be changed in CCMDB.mdb every time there are assignment changes

The S PatientFollow distribution table needs to be updated to set an ending time for the earlier laptop. A new line needs to be added for the later laptop, with the same start DtTm as the end DtTm for the earlier one.

Process Julie uses to re-connect the data

If we use the Visit Admit DtTm field to define Hospital stays, and the Boarding Locs and Service tmp entry instead of old Service/Location etc, then e.g. LOS and Bed occupancy would be the same, whether they come from one laptop or several.

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  • We discussed this today and you would need to make changes to how you derive these markers. A number of them probably need to be re-defined and revised after all the changes we have made because they would still be based around the old concepts of Accept DtTm, Arrive DtTm etc that should really not be used any longer for calculations. What would it take, and where are these things documented? Ttenbergen 16:50, 2020 November 23 (CST)
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To Do

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Fix the cross checks so this can work; one way would be to exempt records with a visit admit dttm before follow-ending and a dispo (or now) after a follow-ending; messy query for messy times.

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Background

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