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p:Julie Mojica is the full time Statistician for the Critical Care and Medicine Database.

She provides Statistical Analysis and Reporting using our data.

The Statistician is a member of the Steering Committee & the Task Team.

Questions on wiki

Here is a list of questions driven by the Template:Discuss that have been flagged for Julie.


edit page question
edit LOS Medicine per hospital admission "None yet." What does that mean in the context of "Target"? And how does "Target" fit in with the structure you described in Template:Reporting Indicators?
edit Check pre acute consistent
  • ... unless they are discharged somewhere else entirely, like another ward. So what do we really mean with this? That they can't come from one PCH and go to another or maybe "home" after all?
    • I realize this maybe hard to do. what I mean here is that if one is already a PCH resident, when leaving the hospital, the dispo location must be a PCH location too. or is a patient is already in CHF, the destination when leaving the hospital must either be a CHF or another PCH.
edit Query TISS Errors ETT consistent
  • A patient might arrive intubated, so there would be no intubation. Does this check really make sense? Ttenbergen 23:23, 2019 March 25 (CDT)
    • I have revised the conditions, pls check if they now make sense.--JMojica 16:38, 2019 July 9 (CDT)
edit CAM positive (TISS Item)
  • Did these ever get better? Ttenbergen 12:44, 2017 May 11 (CDT) Does anything need to be done about this? Ttenbergen 20:15, 2018 November 27 (CST)
edit Reporting from ICD10/CCI
  • Different procedures would be listed with the same CCI code; will Julie easily interpret and utilize CCI codes for reporting?
  • Do we care that we will not be able to differentiate between a Blakemore tube from an Upper GI scope with banding or hemostasis, when in CCI they both look the same: (T) Stomach, pylorus... and Control of Bleeding. --LKolesar 14:11, 2018 May 1 (CDT)
    • discussed at task 14:08, 2018 June 20 (CDT), Julie to review what she needs and we will discuss again Ttenbergen 14:08, 2018 June 20 (CDT)
edit Continuous Stay
edit Check pre acute consistent
  • from a data perspective, what do you mean by "admitted directly"? If I were to build a check, where would I find that? OR maybe I don't need to know, but then I need to have a definition of what combination of data would be an error.

Integrity check

edit STB Medicine workload splitting
  • How does that work for Julie's reporting?
edit Previous Location field
  • In the event that both the bed and the service are borrowed: ie. STB MICU borrows a bed in CICU under CICU service then patient is transferred to STB medicine units-for the medicine profile does the Previous Location mean Pre Admit Inpatient Institution ie. STB_MICU? Does previous service mean Critical care in these instances?
    • Good question. I think for the service borrowed, we still need to use the collection location for the Previous Location is equal to Pre-admit Inpatient Institution. For the Previous Service, I am not so sure but for your example the Critical Care makes more sense to enter than Cardiac surgery and so we need to check with Tina if this is allowed in her integrity checks. --JMojica 09:59, 2020 January 23 (CST)
      • If I understand you right you suggest that the first entry will be Service/Location STB_MICU with a Boarding Loc entry telling that they are in CICU, and the second entry will be Service/Location STB_MICU and Previous Service would be "Critical Care". If so, that is the same as any normal STB_MICU patient, no? So, yes this should work as far as queries are concerned. But is this really the thing we want to enter? How is this patient at all still a STB_MICU patient if both service and bed have moved on? How is this not a transferred patient?
edit Template:ICD10 Guideline Transplant Failure
  • Is "don't code history of transplant when coding transplant rejection because it's implied" something you are aware of? It's not something I would have thought of if you had asked me to write a query that lists all records with previous transplants. If we want to change this could you bring it to task meeting? Ttenbergen 16:41, 2020 January 31 (CST)
edit Attribution of infections
  • Julie, the above question specifically affects some projects you work with as well - do you think unifying this rule will be a problem for any of them?
  • if there are specific rules already in place (e.g. VAP, CLI, etc.) we should follow them. Those which don't have perhaps those are the ones we can unify. --JMojica 14:51, 2020 March 20 (CDT)
edit Manitoba Health Crosschecking Background
  • Need to know how this arrives to set up processing. Where will this data live? Ttenbergen 16:11, 2014 August 25 (CDT)
    • Actually, I think you have not been getting those for ages, right? We would just need to update that. We may or may not blow away this page, depending on whether we think we will ever get this again.
edit Continuous Stay
  • That last line seems to be obvious in new schema from the other definitions... is AMA still at all relevant here or can it be taken out?
edit Check pre acute consistent
  • The listed postal codes are correlated to the items ‘PCH’ and ‘Chronic Health facility’ of the Pre-Acute Living Situation. Since the data collectors are collecting the postal code from the patient’s address, will it be possible to automatically fill up the Pre-Acute Living Situation as PCH or Chronic Health facility if the PCH postal codes are entered or ‘other ways’ to link the two fields and make them consistent. Info about PCH is now getting more attention/request. Tina, Will this be hard to do? Any suggestions?
    • I have changed my mind to add the PCH postal code to the Postal_Code_Master due to the possible effect on its size (when adding a new column containing text where most of the records will only be blanks). It is better to have it in separate table since this pertains to Winnipeg area only. I have added the exact address of these PCH facilities - link to table in email sent on Jan 12.18 at 1224 hrs from p:Julie Mojica
      • Is any change to CFE still required then? If not, please remove this discussion and heading. Ttenbergen 15:47, 2019 July 4 (CDT)
edit Re-admission
edit Care levels in the community
  • There usually isn't much info in the charts about the "type" of group home or level of care provided there, so in those cases we have been coding "other - known but not listed". Please clarify --Jvelasco 13:47, 2019 September 4 (CDT)
    • Julie, how do we use this, and how should this be coded in unclear cases? If you are not sure about the answer either, could you bring it to Task?
edit Palliative Service
  • there was a question about palliation at beginning vs end of stay. It was discussed at task but never cleaned up. Could you have a look a this page? If this is all no longer an option, please delete the section. If it was resolved, then what did we decide? Or was that why we starte Comfort Care? Ttenbergen 00:01, 2018 November 27 (CST)
edit Continuous Stay
  • This def of Bed holds is not consistent with the one in Bed holds; they probably should be, i.e. the same definition should be used throughout. Are they actually consistent in your program? Can we remove the detail from here and link to bed hold?
edit Continuous Stay
  • This will likely have changed when we eliminated the 5 minute rule for local transfers; Julie, could you confirm that this was also changed wherever it has an impact?
  • Does this use Arrive DtTm or Accept DtTm in the new schema?
edit HD (Hemodialysis)
  • We used to have a special procedure for indicating if a renal transplant patient received dialysis post transplant under the tasks. If we are now only coding HD once, it will often be missed if the patient required HD post renal transplant. Do we care about collecting this information? There is the post procedural renal failure code that will be coded in the acquireds, but this does not automatically mean that they received dialysis.
    • AG REPLY -- I don't see any special reason to need this info. Unless Julie tells us it's being requested, I think we can do without it.
      • Julie, what are your thoughts on this? Ttenbergen 11:53, 2019 February 13 (CST)
edit Medical Assistance In Dying
  • When we started out this dx used code U23, but then as of 2018-07-17 ICD10 actually added a code for this so we changed ours to that code. I don't really think we are interested in keeping that very early test data, so this comment can probably just go, and we can delete them. I am removing the code from our s_ICD10 table.
edit ICU Acquired Sepsis
  • which dxs are used?
edit Continuous Stay
  • would it make sense to take out the ICU requirement for this? The same might be rarer for Medicine patients but would still be true. I will implement Encounter processing like that for now unless I hear otherwise. Ttenbergen 12:06, 2015 January 22 (CST)
    • Glad you put that in Tina, I was going to make a similar comment.--CMarks 12:48, 2015 January 22 (CST)
edit L ICD10 APACHE Dx query
  • You and Allan discussed what should be on the list. At some point we will need to integrate the result into this query. Did you end up including Acquireds? Since the first 24hrs might include them, but they might happen later, and the difference is not clear from Dx_Date? Ttenbergen 20:20, 2018 November 24 (CST)
edit Central Line Associated Blood-Stream Infection (CLA-BSI) rate
    • A central lines (CL) is a central venous catheters (CVC) that terminates at or close to the heart or one of the great vessels. Great vessels include the pulmonary artery, superior vena cava, inferior vena cava, brachiocephalic, internal jugular, subclavian, external iliac and the common femoral veins.
      • Could we link to Central Line for details instead so that if we change any they will remain consistent?
edit Check CRF vs ARF across multiple encounters
  • Using the ICD10 renal codes, we still need to know when the transition from acute to chronic occurs - so we can decide whether the multiple encounters consistency checking is still relevant. --JMojica 11:51, 2018 November 14 (CST)
    1. is the transition on the next hospital stay? Example in this hospital stay, patient is diagnosed with ARF and stayed continuously in both ICU and ward in same or different hospital. On the next hospital stay, he is now chronic renal patient.
    2. Or the transition is on the next ICU or ward stay? Ex. the first stay is ICU and diagnosed with ARF. then patient was transferred in a ward of same or diff hospital - is he now a chronic renal patient?
    • The data collection instructions are in the related pages, and additional info is in Renal Coding Considerations for ICD10, but they are a beast of a network of concepts. Those might tell you how we currently propose to collect the renal codes, but not necessarily what you or the users of the data would want. Usually these cross checks would be driven by what you need for data requests, so do our proposed instructions line up with how you want to use this? Or is this maybe too case-by-case of a concept to even make a cross check? Ttenbergen 18:59, 2019 January 6 (CST)
edit Mortality and readmission report
  • who is this report given to? thank you--TOstryzniuk 18:40, 30 November 2010 (CST) Ttenbergen 23:43, 2017 June 7 (CDT)
edit Task Team Meeting - Rolling Agenda and Minutes 2019 Actually, I think Julie decided to re-claim these from backups, no?
edit ICU Mortality Allan says don't include Brain death admits in the numerator or denominator ?
edit Eliminating distinction between different ward types any of Julie's Reporting that use this concept? I no longer used the hierarchy level when computing transfer delays. I assume that if transfer ready datetime is present, DC follows the rule and they are included in the computation. In Medicine Report, there is no more tables showing teaching vs. non teaching. --JMojica 11:10, 2020 January 30 (CST)
edit Query s ICD10 Chapter block dxs any other plans for these?
edit Nursing Workload Average or mean? Different in description and definition.
edit Risk factors for seizures in cardiac surgery ICU Patients Can't find any reference to this paper. The Pubmed link instead goes to an article "A survival benefit of combination antibiotic therapy for serious infections associated with sepsis and septic shock is contingent only on the risk of death: a meta-analytic/meta-regression study." how did we support this publication?
edit Project Borrow arrive did they ever get back to us? no response from HSC SICU --JMojica 10:14, 2019 May 6 (CDT)
edit ICU Var 6 - AMA Did we transition the following into tmp or otherwise? Ttenbergen 13:58, 2017 June 6 (CDT) If we did not then this question can just be removed, but if we did move this elsewhere we should explain where to.
edit S dispo.service type Do you know what is the description? Especially in contrast to S dispo.loc_type. How do you use this? Please put the answer in the element_description above
edit ICU Mortality Does this also consider any of the Diagnosis implying death?
edit LOS Medicine per hospital admission Does this mean time spent in an ICU between wards is included in the LOS? If not, can we tweak the text so that is clearer?
edit S dispo.service type entries in s_dispo table might be inconsistent with entries on wiki. Which are right? These are mostly used by you for Reporting so could you please make sure wiki and dispo are consistent? Or, we could take them out of wiki if you would rather not maintain them in two places.
edit Query NDC VAP no TISS FYI Maybe
edit LOS Medicine per ward stay Hi Dr. Garland,A thought came up after the last Task meeting related to the discussion on using Service LOS vs. Physical bed LOS (location). We also have A/D/H service patients go to the ward D5. This ward is typically less acute and patients will transfer to D5 from all of the medicine wards (A4/H4/D4/B3/H7). The patients retain their service (A/D/H) while they are on D5, some patients will switch attending (to the D5 Attending), others will stay with the same Attending they had prior to arrival on D5, but the service will remain the same. The Attendings on D5 do not have a specific service and, there is no rule as to which patients switch to the D5 attending. Some patients will be discharged from D5 still under the same Attending that cared for them prior to arrival on D5.

When patients leave A4/D4/H4/B3/H7 their profiles are completed (discharged) by the designated ward collector and a new profile is created by the D5 collector.Thanks, Val Penner, May 16.19

  • AG THOUGHTS -- given the variability in where a ward patients is/goes and which service takes care of them, dealing with this issue requires us to know what the powers that be want as respect to how we keep track of LOS. Do they WANT by physical ward, or service, or something else?
edit Severe Sepsis I don't think this was ever implemented, can't find any evidence of it. Do we need it? Ttenbergen 11:04, 2018 September 25 (CDT)
edit AaDO2 I wonder if "null" is actually intended here, or if it was supposed to be 0. Ttenbergen 14:44, 2017 January 8 (CST)
  • AaDO2 is null if there is no data for FIO2, PaO2 and PaCO2. However, no data was set to zero value instead of null. In addition, AaDO2 and the corresponding score are required only when FIO2 >= 50%, otherwise should be treated as null. (Similarly with PO2 score, it is required when FIO2 < 50% and otherwise should be treated as null. When FIO2 =0, both AaDO2 and its score and PO2 score should be null.) Are we setting null to zero to facilitate the programming calculation? Is it possible to differentiate null from valid zero in both L_LOG and created_variables_CC - will the work be big? In L_LOG, these are the FIO2, CO2, PO2 and SerCO2. 14:49, 2017 March 16 (CDT)
edit QA Septic Shock If we ever pick this back up we need to answer: Is "Every entry for project QA Septic must have either a date or a time." a request for a cross check? or does that check exist already?
edit S dispo.loc type Indeed, what is the description? Especially in contrast to S dispo.service type; when you give the answer, please put it behind "element_description" above and delete this question.
edit Charlson Comorbidity Index Is that the Annual report?
edit Bed occupancy Is this about Bed census.mdb or a different thing?
edit Severity of illness Is this average as in description or mean as in definition?
edit LOS Medicine per hospital admission is this Arrive DtTm or Accept DtTm?
edit ICU Resource Utilization - Creatinine Tests Is this DSM Lab Extract?
edit ICU Resource Utilization - Chest Xrays Is this DSM Lab Extract?
edit Critical Care Vital Signs Monitoring It says that CCVSM is in Quarterly report. If CCVSM is no longer, is it still in quarterly?
edit Bed holds Julie seems to set the limit at 1 day - emailed Julie Ttenbergen 10:07, 2016 November 10 (CST)
edit ICU Acquired Sepsis Just to be clear, is it number of cases (possibly >1 per pt) or once per pt as mentioned above?
edit ICU Acquired Catheter-associated Urinary Tract Infection (CAUTI) rate Just to be clear, is it number of cases (possibly >1 per pt) or once per pt as mentioned above?
edit Length of Time for Transfer from ED to ICU within same facility No significance in your ppt?
edit ICU Acquired Sepsis Nothing was listed in your power point, what is the significance?
edit SAS Data Integrity Checks Now that we have a structure for cross-checks we should add those you do in SAS to here as well, using the same structure as for those listed in Data Integrity Checks Ttenbergen 20:46, 2018 October 26 (CDT)
edit Project Discharge Documentation pls fill in once you set it up
edit Length of Stay (ICU Report) Right now this is slightly inconsistent with Definition of an ICU admission which doesn't explicitly exclude the ER pts. I have flagged that page for task review. Once that is done, can we just use that definition here as well to ensure consistency?
edit ICU Acquired Catheter-associated Urinary Tract Infection (CAUTI) rate There was no significance in your PPT.
edit Statistical Analysis This article will likely be one of the more common landing points for external users. What do we want to tell them? Do we have any project articles we want to link in that especially highlight what we can do? ALERT Scale?Ttenbergen 22:50, 2017 June 7 (CDT)
edit Chart Review Lists This is linked from the front page and intended to give an idea of how one could use our data. Is there anything on Publications that would be a good example for how our DB was used for this? If not, should we take it out? With nothing here it doesn't look very good coming from front page.
edit Pre op Admit-Cardiovasc Patient This is not coded under ICD10 or CCI. Do we report this, and therefore need to accommodate otherwise, or how will we treat this? We have Preparatory care (incl preop optimization) but that doesn't capture the full concept. Ttenbergen 22:45, 2018 November 27 (CST)
edit Pre-OP Admit - Research Patient - Cardiovascular This is not coded under ICD10 or CCI. Do we report this, and therefore need to accommodate otherwise, or how will we treat this? We have Preparatory care (incl preop optimization) but that doesn't capture the full concept. Ttenbergen 22:45, 2018 November 27 (CST)
edit Base Population for Research This page is linked from the front page, so we should either make it good or get rid of that. Is there anything on Publications that would be a good example for how our DB was used for this?
edit Validation against Patient Registry Data This page was started long ago to keep track of our attempt to get access to the registry. I think it would be good to re-convene on it so we have a central point where past efforts and current efforts can be tracked. That would also make it easier to take it to task or steering and have consistent info. Do you have a log of this somewhere? We can rename it if you want.
edit LOS Medicine per hospital admission this still talks about TMSX... what is the new status of this field?
edit Check VAP acquired only first encounter We decided that VAP can actually happen in medicine if pt admitted from ICU. How would we deal with that for this check?
edit Nursing Workload What are the details?
edit Delirium days What are the details?
edit Severity of illness What are the details?
edit ICU Mortality What are the details?
edit Over Census at Midnight What are the details?
edit ICU Interfacility Transfer What are the details?
edit ICU Resource Utilization - Creatinine Tests What are the details?
edit ICU Resource Utilization - Chest Xrays What are the details?
edit Length of Time for Transfer from ED to ICU within same facility What are the details?
edit Check pre acute consistent what exactly do we want to check for? Please also have a look at the stuff below that doesn't specifically have your name. This requested check ties into a bunch of things and if we want the check we need to be sure that instructions stay consistent and lose ends are tied up.
edit Requested TISS changes for the next version What is the intended use of these reports?
edit Mortality and readmission report What is the Mortality and readmission report report?
edit Quarterly report What is the Quarterly report report?
edit Query TISS Errors missing days which report/s are these actually included in?
edit Night Time Discharges Why only to wards? How about to home?
edit QA Infection VAP will we still need to collect this in ICD10, since I think all the data now lives in the dx codes as well. I am holding off on implementing Query s tmp QAInf tmp no dx until resolved. same reply as in QA CLI. --JMojica 12:04, 2018 December 27 (CST)
edit Bed occupancy with TMSX not having been around for a while, is this still relevant? Do you provide this data otherwise? Do we need to implement this?
edit Check CCI CXR vs LOS would we not use Accept DtTm here? Because we could have CXRs on days before arrival...
edit LOS LOS Medicine per hospital admission and LOS Medicine per ward stay may duplicate content above. Do they? If we ever split these out into reporting documentation indicator pages we will need to make sure these are not duplicated.
edit LOS Medicine per hospital admission p:Dr. Dan Roberts You had this as "PRESCRIBED BY: "; which is not how you set it in Template:Reporting Indicators. Also, Dan is likely no longer the user of this, so it should probably be updated. If we use a title rather than a name it will be self updating.

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