Registry Patient Type: Difference between revisions

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==Medicine==
{{Data element
The Patient Type on your registry page can take one of two values:
|field_name=R_Type
|CCMDB_label=Pt Type
|data_type=string
|datafield_length=10
|program_collecting=Med and CC
|created_raw=Raw
|data_element_start_date=1997-04-01
|data_element_end_date=2018-05-09
|data_element_sort_index=18
|element_description=Service of the attending physician for medicine data, and the type of admit diagnosis for critical care patients.
|CCMDB_tab=Dispo
}}


=== '''S''' for Surgical ===
The use of this field had changed over time, and it was found to no longer contain what was originally intended and was removed 2018-05-09.  
*Patients Admitted from OR (operating room) or RR (recovery room) under Medicine physician service care.


*The medicine database is not tracking Surgical patients under surgeon care who are on a medicine ward
Related data we continue to collect is:
*If there is a surgical patient under surgical service in a medicine bed, we exclude from medicine database.  This is not a medicine service patient [[User:TOstryzniuk|TOstryzniuk]] 19:15, 6 October 2008 (CDT)
* [[Previous Service field]]
 
* [[ICUotherService]]
=== '''M''' for Medical ===
Patients admitted under a medical attending physician for medical reasons.


==Medicine Wards==
The Patient Type on your registry page can take one of two values:


== Critical Care ==
===M-Medical Type===  
=== Note for HSC and STB only ===
Patient who is admitted under the care of a Medical Service attending physician
Patients in MICU under MICU attending physician service are that are "cardiac" type patients should always be coded as "M" for medical whether they are stable or not. The only exception is if a patient is a surgical patient, then mark as “S” and in [[ICU Var 5 - Overflow|Var 5]] put "SM".


=== '''S''' for Surgical ===
===S-Surgical Type===
* Patients Admitted from OR (operating room) or RR (recovery room) 
*admitted from the OR but is under the care of the Medicine Service Attending Physician.
* All trauma
*admitted from the RR and is under the care of the Medicine Service Attending Physician.
* All Burns
* Upper GI Bleeds
* Intracerebral Bleeds
* Patients who undergo a surgery related to primary ICU admit reasonwithin 48 hrs of admission to ICU
* Patients Admitted from a surgical ward
* Pancreatitis in SICU patient


NOTE: if there is a surgical patient on an medicine ward bed that is under a Surgical Service care, we exclude from the database.  This is not a medicine service care patient.


=== '''M''' for Medical ===
== Critical Care Units ==
* Cardiac Arrests
===S-Surgical Type===
* Cardiogenic Shock
*admit from OR
* Patients whose Diagnosis does not fall into surgical or cardiac categories
*admit from RR
* CCU Patients that are intubated or too sick for CCU (i.e. need inotropes or IABP**)
*all Trauma (fall, MVA, stabbing, etc)
* Pancreatits in MICU patient (label as S = surgical if patient goes for surgery for this organ in 1st 48 hrs in ICU)
*all burns
*all upper GI bleeds
*all intracerebral bleeds
*Pt who undergoes a surgery related to primary reason to ICU in the first 48 hrs of admission to ICU.
*Pt admitted from a SURGICAL WARD
*Pancreatitis if surgery < =48 hrs of admission to unit


=== '''C''' for Cardiac ===
===M-Medical Type===
* MI
*Cardiac or respiratory arrest
* Rhythm Disturbances
*Cardiogenic shock
* Unstable Angina
*Pancreatitis if surgery >48 hrs of admission to unit
* CHF
*don't fall into Surgical or Cardiac type category
* Post angiogram or angiolasty - Stable
* Pacemaker insertions (temporary or permanent)


== Discussion ==
===C-Cardiac Type===
* Which of these codes takes precedence? I.e. an MI who arrests becomes a...
*STB in both MICU and CICU - if under the Care of Cardiology Service. This no longer applies when [[STB ACCU]] started July 6, 2016.
** Whether the patient is cardiac or medical really depends upon the attending physician.  If cardiology is covering, the  pt is cardiac whether they have a cardiac arrest, cardiogenic shock or really any diagnosis.[[User:LKolesar|LKolesar]]
*HSC in the MICU unit - if under the Care of Cardiology Service
*** Is this the case for HSC as well, or only for STB?[[User:Ttenbergen|Ttenbergen]] 19:49, 6 May 2008 (CDT)
* the ICU PATIENT type guide states the PATIENT TYPE.  If you come from the OR to ICU with a bowel resection, and you arrest, you are surgical.  [[User:TOstryzniuk|TOstryzniuk]] 19:11, 6 October 2008 (CDT)'


* Clarification about pancreatitis - label "S" even if 1st 48hr surgery is not related? 
Other ICU's
** I don't code pancreatitis as surgical unless the attending physician is a surgeon upon admission to the ICU. [[User:LKolesar|LKolesar]]
*MI
*** The criteria above are straight from the manual. We'll need to find a definition that is the same for everyone. So, I'll post this for discussion specifically with all HSC and STB ICU DCs, and Julie and Trish. This may be a case of the data being used differently than perceived. [[User:Ttenbergen|Ttenbergen]] 19:49, 6 May 2008 (CDT)
*rhythm disturbances
** the pancreatitis definition was made by Dr. Gray and Roberts.  The reason for this was that MICU took many patients that should have gone to surgery service.  There were issues in being able to track those patient that were really surgical population that SICU could not take because they were full.[[User:TOstryzniuk|TOstryzniuk]] 19:11, 6 October 2008 (CDT)
*unstable angina / ACS
*CHF
*post angio/plasty
*pacemaker insertions (temp or perm)


* how about post angio... unstable?
==== Note for ICU at HSC and STB only ====
** Again, if attending is cardiology it is under CCU, if a medical attending, it is under medicine.
Patients in MICU under MICU attending physician service that have a cardiac diagnosis should always be coded as medical type  whether they are stable or not. The only exception is if a patient is a surgical patient, then mark as surgical type.
*** The criteria above are straight from the manual. We'll need to find a definition that is the same for everyone. So, I'll post this for discussion specifically with all HSC and STB ICU DCs, and Julie and Trish. This may be a case of the data being used differently than perceived. [[User:Ttenbergen|Ttenbergen]] 19:49, 6 May 2008 (CDT)


* Pacemaker insertions (temporary or permanent) - are ther other than those two? If not, unnecessary to mention. 
==== StB Cardiac patients ====
** There are pacemaker wires inserted during cardiac surgery also which are epicardial temporary wires, these are not seen in CCU.  More precise wording for CCU should be transvenous, transcutaneous and permanent pacemakers, however you can have any of these pacemakers in medical patients as well. [[User:LKolesar|LKolesar]]
Special rules used to apply
*** Are there any pacemakers that would '''not''' fall under cardiac? I think we would need a comprehensive list only if there are exceptions. Even then, "all new pacemakers except xxx" should say it all. If we list specifics, then we are vulnerable if we miss any one or if a new one arises. If we stay general and use summary terms where possible, this risk is lower. [[User:Ttenbergen|Ttenbergen]] 19:49, 6 May 2008 (CDT)


* I don't know if all would be in agreement with me but these categories of patient type do not depend on the diagnosis at all but instead should reflect the service that the patient is admitted under (attending physician) only.  [[User:LKolesar|LKolesar]]
== Data Use ==
** That is an interesting question, and I guess it depends on the usage of this data. Julie? [[User:Ttenbergen|Ttenbergen]] 19:49, 6 May 2008 (CDT)
Population
==Memo==
**It was never the intention to track the physician service.  We are currently investigating the need to continue to track Patient type.  I will let you know if there is a change. Current guide still stands until further notice[[User:TOstryzniuk|TOstryzniuk]] 19:11, 6 October 2008 (CDT)


●'''Registry Patient Type''' – we will stop collection. I will let you know when. Need to access the impact on other programs before we withdraw element from collection.[[User:TOstryzniuk|TOstryzniuk]] 17:41, 9 December 2008 (CST)
== CCMDB Data Integrity Checks ==
have been removed when collection discontinued


== Removal of field==
The discussion at task meeting in past was to wait until we migrate to ICU10 DX code then Julie and Garland can decide on pt type category.
*2018-May-7: [[Steering Committee]] meeting - reviewed and agreed to stop Registry Pt Type. Field removed from [[CCMDB.accdb]]. See [[CCMDB.mdb Change Log 2018#2018-05-09]].


[[Category:Data Collection Guide]]
[[Category:Legacy Data Collection]]
}}

Latest revision as of 16:19, 2019 November 24

 
 
 
 

Legacy Content

This page contains Legacy Content.
  • Explanation: This is a legacy data field, its DataElementEndDate is in the past.
  • Successor: No successor was entered

Click Expand to show legacy content.

Data Element (edit)
Field Name: R_Type
CCMDB Label: Pt Type
CCMDB tab: Dispo
Table: N/A
Data type: string
Length: 10
Program: Med and CC
Created/Raw: Raw
Start Date: 1997-04-01
End Date: 2018-05-09
Sort Index: 18

Service of the attending physician for medicine data, and the type of admit diagnosis for critical care patients.

  • SMW

Legacy implementation right in the table

  • Cargo


  • Categories
  • Forms


The use of this field had changed over time, and it was found to no longer contain what was originally intended and was removed 2018-05-09.

Related data we continue to collect is:

Medicine Wards

The Patient Type on your registry page can take one of two values:

M-Medical Type

Patient who is admitted under the care of a Medical Service attending physician

S-Surgical Type

  • admitted from the OR but is under the care of the Medicine Service Attending Physician.
  • admitted from the RR and is under the care of the Medicine Service Attending Physician.

NOTE: if there is a surgical patient on an medicine ward bed that is under a Surgical Service care, we exclude from the database. This is not a medicine service care patient.

Critical Care Units

S-Surgical Type

  • admit from OR
  • admit from RR
  • all Trauma (fall, MVA, stabbing, etc)
  • all burns
  • all upper GI bleeds
  • all intracerebral bleeds
  • Pt who undergoes a surgery related to primary reason to ICU in the first 48 hrs of admission to ICU.
  • Pt admitted from a SURGICAL WARD
  • Pancreatitis if surgery < =48 hrs of admission to unit

M-Medical Type

  • Cardiac or respiratory arrest
  • Cardiogenic shock
  • Pancreatitis if surgery >48 hrs of admission to unit
  • don't fall into Surgical or Cardiac type category

C-Cardiac Type

  • STB in both MICU and CICU - if under the Care of Cardiology Service. This no longer applies when STB ACCU started July 6, 2016.
  • HSC in the MICU unit - if under the Care of Cardiology Service

Other ICU's

  • MI
  • rhythm disturbances
  • unstable angina / ACS
  • CHF
  • post angio/plasty
  • pacemaker insertions (temp or perm)

Note for ICU at HSC and STB only

Patients in MICU under MICU attending physician service that have a cardiac diagnosis should always be coded as medical type whether they are stable or not. The only exception is if a patient is a surgical patient, then mark as surgical type.

StB Cardiac patients

Special rules used to apply

Data Use

Population

CCMDB Data Integrity Checks

have been removed when collection discontinued

Removal of field

The discussion at task meeting in past was to wait until we migrate to ICU10 DX code then Julie and Garland can decide on pt type category.

}}

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