Registry Patient Type

Data Element (edit)
Field Name:	R_Type
CCMDB Label:	Pt Type
CCMDB tab:	Dispo
Table:	L_Log table
Data type:	string
Length:	10
Program:	Med and CC
Created/Raw:	Raw
Start Date:	1988-07-11
End Date:	2300-01-01
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

This is currently being reviewed.

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. Template:Discussion What does apply now, then? Do we need to keep what used to apply, ie does it affect review of old data? If so, should it go into a legacy section at the end of the article, rather than here where it could confuse new collectors? Ttenbergen 22:22, 2017 April 2 (CDT)
• 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

See STB Cardiac Care patients

Data Use

Population

Conversion from our old diagnosis schema to ICD10/CCI

Automation of this for ICD10 - taking to steering

• SMW

• Cargo

• Categories

Why do we collect this, is it still the right info, and is there a better way to get this info?

• SMW

• Cargo

• Categories

Given that the way that disorders are treated evolves over time (some things that were surgical in the past are now non-surgical) Allan proposes this:

1. Figure out if it's cardiac
   • admitted to ICCS OR primary admission dx is within the cardiac segments of the ICD10 chapter on cardiovascular disorders. If so, you're done, if not.....
     • Template:Discussion do you mean ‘Previous Location is ICCS (STB_CICU) prior to admission to ICU/ward’ OR ‘has been admitted in ICCS during the hospitalization and not necessarily the Previous Location’? how about those with Previous Location = CCU /ACCU - will these be assigned based on primary admission? (Julie, by email, 2018-01-24)
2. Figure out if it's noncardiac surgical
   • defined as Previous Location is OR or PACU. If so, you're done, if not.....
3. It's medical.

stored vs query generated on the fly

• Are you going to populate the same field ‘R_type’ or create a new field with the data in field ‘R_type’ transferred to the new field ? (Julie)
  • R_Type would just be a column in a query I think. If generating it turn sout to be really slow I can implement it as a stored field with a query that updates it on demand. You’d have to run the query once before you want the field so all new records are populated. Ttenbergen 15:26, 2018 March 8 (CST)

Is this actually still what management wants/needs?

Template:Discussion This element is part of reporting and that management does ask about it. That might only mean that they don't know we might be able to do better. What would they actually like to see? Regardless of what that is, can/should we change this to a system where the admission diagnosis codes and pre-ICU location are used to create this field, rather than manual entry?

Template:CCMDB Data Integrity Checks

• entry is mandatory
• Check OR from but not Surgical Type

Discussion

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.

Task meeting discussion

Allan with Boyan P about details in regards to pre admit service type if detailed (ortho, neuro etc) or not. This is stuck together with the locations discussion, will address as we deal with that.

Discussed today, we will review this when ICD10 comes in, it should make these questions go away. Ttenbergen 13:19, 2017 April 28 (CDT) Template:ICD10