Project Borrow arrive

Projects
Active?:	legacy
Program:	CC
Requestor:	Critical Care program (Allan Garland)
Collection start:	2018-07-19
Collection end:	2019-09-20

All remaining "Borrow arrive" entries were changed to "Boarding Loc" 2020-08-05.

Legacy Content

This page contains Legacy Content.

• Explanation: Changed collection to more general Boarding Loc
• Successor: Boarding Loc

Click Expand to show legacy content.

Use of this field is likely inconsistent after 2019-09; we started Boarding Loc which implies the content of this field but failed to properly phase out this field at the time.

This project tracks where and when a patient arrives into a "borrowed bed".

A "borrowed bed" is when a patient is not physically located in the place designated by the Service/Location.

• Critical Care will track all instances of bed borrows
• Medicine is not included in this project.

This new project replaces ACCU borrow.

This project does not replace ICUotherService; we will still need this item in the event that both the bed and the service are both borrowed. Administration at STB want this data.

Data Collection Instructions

In TMP, a "no borrow" entry will automatically be added to every new Critical Care patient's record.

If the patient never ends up in a "borrowed bed" during their stay then, leave the default in Item as no borrow and also put a check mark in the checkbox. (this is to verify that there was no bed borrow, otherwise no one is sure is missed or not). If the patient does end up in a "borrowed bed", change the item to the location of the borrow and enter the rest as per below: #How to enter this.

Add a new tmp entry for every additional move/borrow within your centre that a patient makes during their stay at your Service/Location; including moves from borrowed location to your actual unit.

How to enter this

• Use tmp fields:
  • Project: Borrow arrive
  • Item: no borrow is the default (check off the box under column B for all patients not borrowing a bed).
  • Item: borrow arrive (select the ward/unit where the bed was borrowed):
    • CON - recovery
    • GRA - recovery
    • GRA - ER (see GRA ER use as borrow location) - added May 2.19
      • will update March 30.19 profile GRA_MICU_10422 master database to reflect this event.
    • HSC - recovery
    • HSC_CCU
    • HSC_IICU
    • HSC_MICU
    • HSC_SICU
    • OAK - recovery
    • STB - recovery
    • STB_ACCU
    • STB_CICU
    • STB_MICU
      • If a location borrowed from is not available in the drop down, email Tina and Trish to have them added.
  • Enter start_dt: arrival date at borrowed bed, under column E.
  • Enter start_tm: arrival time at borrowed bed, under column M.
  • checkbox: to be checked only in case of "no borrow"

• If the patient moves back to their "home unit", or "intended unit", make another borrow arrive entry and select your home unit. Enter the date/time for this move, as above.

• Dispo Tab
  • Service/Location field enter: home ward/unit

Special Case - original arrival is in "borrowed bed"

If pt is admitted to your physician service but the original location is from an off-ward bed, code that location Arrive DtTm = borrow date and time.

The APACHE elements time frame will start in the off-ward bed location and TISS starts from the off-ward bed as well.

Special Case - PACU

If a bed is borrowed in PACU / post-anesthesia care / recovery unit, code this as a borrow. (i.e. <hosp> - recovery, e.g. "HSC - recovery").

If the decision to accept to the service happens in PACU, the Arrive DtTm = the borrow date and time. The APACHE elements are collected at PACU stay and TISS starts at PACU.

Special Case - From ER

Not included in this project.

• The time spent/waiting in ER is done using Arrive DtTm vs Accept DtTm.
  • March 30.19: own ward, to own ER (under ICU physician care) then to own ICU when bed available. Started occurring at Grace- March 30.19

Special Case - Parked

Not included.

• For patients who are Parked in ER, no need an entry for these, since the ER delay will take care of them.

Start/End Dates

• End: there is no planned end date

considerations about continuing collection

Continue collection for now, just keeping you in the loop about discussions in main office.

• --JMojica 11:17, 2018 November 15 (CST) -- Added some more as shown by the data. Just a note - only 30 out of 1807 (2%) records have shown borrowed location while 98% have no borrow. This is expected since STB ACCU has stopped borrowing bed and instead, now borrowing service from ICMS /ICCS which is being collected in another tmp project. The site with most frequent borrower is HSC SICU (i.e. borrowing bed from PACU). How much work will it take to do all these integrity checks? Also with very few useful data, I think we should not collect this project for all admissions but restore the use of Off ward field checkbox and collect only for those with YES Off ward.

Data Integrity Checks (automatic list)

	App	Status
Query s tmp Borrow no borrow on own unit	CCMDB.accdb	not feasible
Query s tmp Borrow duplicates	CCMDB.accdb	retired
Query s tmp Borrow sensible DtTm vs no borrow	CCMDB.accdb	retired

Data Use

Critical care program wants to know this to better understand patient flow and bed utilization.

SAS Program

The SAS program calculates the time spent in a borrowed bed at each ICU stay and summarize the total bed-days in a given interval that are taken up by boarders from elsewhere and how much a certain unit is boarding elsewhere.

Time spent in borrowed bed = Next Arrival Date_time - First Arrival Date_time

where Next Arrival Date_time = Dispo Date_time if there is no more next arrival date_time.

The SAS program is saved in X:\Julie\SAS_CFE\CFE_macros\Bed_Borrow.sas

Background

Will replace Off ward field to provide more meaningful data.

We used to collect Moves for Medicine but this was too much work because there are too many administrative moves. Also, the data wasn't being used.