Task Team Meeting - Rolling Agenda and Minutes 2026

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List of items to bring to task meeting

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Chronic Health Facility 2025-11-28 1:43:16 PM
Diabetes mellitus chronic complication: Nephropathy I have a patient that has had a pancreas transplant and this has cured his diabetes. He still has retinopathy, neuropathy, etc. Can I code all of the complications of diabetees without linking them to Diabetes mellitus type 1, with chronic complication (code complications separately)"Mlagadi 09:17, 4 February 2026 (CST)
  • The program should let you do it - I added the tag that would flag cross checks for this diagnosis to the bottom of this wiki page and it finds nothing. I'll leave for Task to answer whether that is how we want to code it. Ttenbergen 09:59, 4 February 2026 (CST)
 2026-02-04 3:59:30 PM
Dispo field JALT

I thought we had decided at JALT to collect this as presented by EPR... do I remember this wrong? I had already added it in CCMDB.accdb Change Log 2025#2025-03-11-1. Ttenbergen 22:52, 11 March 2025 (CDT)

  • Yes, I saw that, come to think of it I don't think we decided, not in my notes, but we can use it and I will change the wiki instructions Lisa Kaita 11:25, 13 March 2025 (CDT)
  • If we are going to collect this detail for dispo, should we consider whether or not to also look at SH in preadmit living situation?, currently lumped with community facility with support. Lisa Kaita 14:45, 16 April 2025 (CDT)
  • The entry name includes "TRSF" - is the entry for the previous location equivalent in EPR? Ttenbergen 23:30, 16 April 2025 (CDT)
  • no because the previous location would usually be <site>_ER Lisa Kaita 09:53, 28 May 2025 (CDT)
    • Sorry, I should have asked about "pre-hospital location in ADT". Ttenbergen 16:21, 28 May 2025 (CDT)
 2026-01-27 5:10:08 PM
Pre acute living situation field
  • We found some cases where, during the same hospitalization, there are different values for this. For example, the first ward admission may have "house" and the immediate next ICU admission may have "PCH". I think there is no scenario where that makes sense. If you can think of one, tell me.
  • For existing data like this, how would we best treat it heuristically. Would the first record be more likely to be right because the chart is still cleaner and easier to follow? Or would a later record be more likely to be correct since more of the patient's story would have emerged? Thoughts?
  • This may arise when we complete the profiles separately ie. medicine done before ICU or vice versa, and more information may be more available in the chart, or it may have been an error where one was updated the other was not Lisa Kaita 15:32, 26 November 2025 (CST)
    		•  2025-12-17 6:07:30 PM
    Publications, abstracts, presentations using the Critical Care and Medicine Database
  • This page is an indicator of how we fulfill the research component of the CCMDB#Purpose and Mission. To keep it useful and representative of current work, entries need to be added on an ongoing basis as new outputs occur. To make this reliable, how do we build this into our workflow (e.g., as part of the Database Request Process), so the record stays current with minimal overhead? At present this relies on post-hoc updates from requestors, which has had limited uptake.
    		•  2025-12-31 8:13:08 PM
    Selkirk Mental Health Centre JALT - Mental Health Facilities in Addition to Selkirk
  • Should we add Eden Mental Health Centre as well? Are there others, like addiction treatment facilities (eg Bruce Oake), that we should code either as a group or individually?
    • If we don't think this information is needed, should we also de-list our entry for Selkirk for consistency? Another option is to rename the selkirk entry and use it as an aggregate location going fwd.
    		•  2025-12-17 6:03:11 PM
    Selkirk Mental Health Centre JALT - Mental Health Facility Coding vs PCH
  • currently aggregated as "PCH" because S dispo.loc type is PCH. That seems wrong. Should it be changed to “unknown/other” or to a new category “Mental Health”? And should we add Eden Mental Health Centre as well? Ttenbergen 16:21, 29 October 2025 (CDT)
    • Julie reviewed, only 6 cases in our data (are we coding this consistently?). Julie emailed OK with “unknown/other”, but also raised how Pre acute living situation should be coded.
    		•  2025-12-17 6:03:11 PM
    Sex field
  • I just came across an incomplete record (from S9 laptop) that has a sex entry "Undiff". Our dropdown doesn't contain this so this likely came from Cognos. If this is now being coded in EPR, and considering that this would affect the "biological sex" we use in defining this, should we introduce this as an option? If we do not want to introduce this as an option, do our cross checks catch this? They might not, since this could not have been entered manually. Ttenbergen 00:16, 12 November 2025 (CST)
    		•  2025-11-12 6:16:35 AM
    St.Amant Since 2022:

    Pre acute living situation for patients where Dispo is St Amant has been recorded as:

    • 23 Chronic Health Facility
    • 14 Community Facility with support
    • 5 Personal Care Home
    • 2 House
    • 1 other - known but not listed
    • 1 Apartment

    Pre acute living situation for patients where Previous Location is St Amant has been recorded as:

    • 1 Apartment
    • 1 Personal Care Home

    How are we using this code, and how should we use it? Ttenbergen 16:07, 29 October 2025 (CDT)

    * When I have seen this in a chart the address is usually 440 River Road, which is the St Amant facility, I code it as per the wiki instructions, as a chronic care facility. I know that St Amant has several group homes as well, but I wouldn't know their addresses and the documentation is usually not that specific to include who manages the group home. With the new dispo options, group homes would be transfer to group/supportive housing Lisa Kaita 15:46, 26 November 2025 (CST)    		 2025-11-26 9:46:22 PM
    Template:Decubitus Stage not indicated Details
    • This instruction is taken from old dx Decubitus (pressure) ulcer, stage not indicated; since we will now have a series of codes for suspected deep tissue injury, we need to change this, but what should be here, and what should move into Template:Decubitus Deep Tissue Damage Details? Ttenbergen 15:29, 30 June 2025 (CDT)
    • This page should remain the same, deep tissue injury is really considered to be a different way to stage/document decubitus ulcers An unstageable ulcer is still used in documentation and grading of decubitus ulcers Lisa Kaita 20:23, 7 October 2025 (CDT)
    		 2025-10-08 1:25:23 AM
    Template:Decubitus Stage not indicated Details
  • This instruction is taken from old dx Decubitus (pressure) ulcer, stage not indicated; since we will now have a series of codes for suspected deep tissue injury, we need to change this, but what should be here, and what should move into Template:Decubitus Deep Tissue Damage Details? Ttenbergen 15:29, 30 June 2025 (CDT)
  • This page should remain the same, deep tissue injury is really considered to be a different way to stage/document decubitus ulcers An unstageable ulcer is still used in documentation and grading of decubitus ulcers Lisa Kaita 20:23, 7 October 2025 (CDT)
    		•  2025-10-24 2:28:08 PM


    ICU Database Task Group Meeting – January 29, 2026

    • Present: Allan, Lisa, Julie, Val, Joanna, Steph, Michelle, Mindy, Jen, Mailah
    • Minutes prepared by: AG
    • Action items in BOLD

    1. This short meeting is entirely to clarify issues around Transfer for bed management and Intended1stSrvc

    • See those 2 Wiki pages for full rules around these 2 items, but briefly:
    • Intended1stSrvc should only be used for initial ICU service records, i.e. it does not apply to direct ICU service-to-ICU service transfers
    • Transfer for bed management can be used for ICU, IICU or ward services, but only applies to direct service-to-service transfers, i.e. not to initial admission (such as from ED, OR, cath lab, transfer from hospitals outside the WRHA).
      • except for transfers from ward to LAU, it only applies to transfers at the same level (e.g. ICU-to-ICU, ward-to-ward, not ICU service to ward service; Ward service to ICU service; ICU service to IICU service)
      • a transfer is for medical necessity if it was to directly benefit that patient because she/he could not get the medical care she/he needed from the sending service or location -- if not then consider it to be for bed management

    2. Tina had expressed concern that all this is a lot of work if these kinds of things happen quite rarely. The collectors present validated that they are not rare.

    3. After discussion, we agreed that for patients officially transferred from 1 ICU to another ICU for a procedure, and then officially transferred back (e.g. went from Grace ICU to MICU for EEG), that we WILL record these as 3 separate ICU database records, with the initial transfer being for medical necessity, and the transfer back being Transfer for bed management.

    • We recognize and accept that this is different than what we do when somebody goes from Grace or HSC to St B for a cath, and then comes right back.

    4. Julie will use these variables to report on the 5 types of ICU service-days and ICU physical unit-days

    • For initial admission to an ICU service this is according to:
    Group Service should be on Actual service Actual location Meaning
    A mine mine my ICU my natural patients
    B mine mine different ICU my boarders elsewhere
    C different different my ICU somebody else's boarders in my ICU
    D mine different different my "double boarders" elsewhere
    E different mine my ICU somebody else's "double boarders" in my ICU
    • For the receiving ICU service in direct ICU service-to-ICU service transfers this is according to:
      • If the transfer was for bed management, then the days on that receiving ICU service time are category E
      • If the transfer was for medical necessity, then:
        • the the days on the receiving ICU service time are category A if Boarding Loc is the receiving service's physical ICU (e.g. patient transferred from Grace ICU service to MICU service in MICU)
        • the the days on the receiving ICU service time are category B if Boarding Loc is NOT the receiving service's physical ICU (e.g. patient transferred from Grace ICU service to MICU service but physically goes to SICU)

    ICU Database Task Group Meeting – January 14, 2026

    • Present: Allan, Mindy, Maria, Stephanie, Tina, Julie, Jen, Lisa, Mailah, Michelle, Joanna, Dan
    • Minutes prepared by: AG
    • Action items in BOLD

    1. Update regarding: [i] Collection of data on homelessness, [ii] the Collection of locations on the spectrum between home and PCH, and [iii] seeking to deal with the current difference in lists of locations for Pre acute living situation and Dispo

    • We extended the temp data collection on this to Jan 31, 2026

    2. Regarding database Re-platforming

    • Dan and Tina informed the group that they met with the University's REDCap people. That it seemed encouraging and that the REDCap personnel are creating an infrastructure for us to test out that should take 2-3 months
    • Dan will follow up with them

    3. Most of today's meeting was taken up with trying to resolve confusion about use of Transfer for bed management and Intended1stSrvc

    • To deal with the confusion everyone should send Allan specific scenarios that they see as confusing. He will try to resolve them and then provide clearer guidelines for their use.

    4. Lisa raised the question of identifying the main reason for ICU admission after cardiac surgery. Mainly this involves whether or not to code cardiogenic shock (or something other than Coronary artery disease, chronic) as the primary ICU admit diagnosis for postop patients who were stable pre-op but are on pressors postop.

    • What seems clear is that there is a continuum of such situations. Postop hearts come out of PACU: (a) completely stable, (b) on a relatively short course of relatively low dose pressors or inotropes that really reflect postop physiology rather than "true" cardiogenic shock, (c) very unstable with what is clearly new onset cardiogenic shock requiring prolonged use of pressors or inotropes, and (d) everything else in between.
    • The key messages about this are: (i) make sure to code everything that was actually present, but (ii) make a judgement call about whether or not to code cardiogenic shock in situations 'b' and 'd'.

    5. Lisa brought up the use of special EEG monitoring postop at St B.

    • It appears this is a noninvasive monitoring modality and thus we agreed we will NOT code it.

    6. It was agreed that for the ICU charts from 2025 that have not yet been encoded, that collectors SHOULD use the new, Intended1stSrvc reporting.

    7. Regarding use of Transfer for bed management for patients going from regular ward to LAU -- we WILL use that code, per a specific request by Dan.

    8. As Lisa is away the entire month of February, our next meeting will be a 30 min followup on item #3 (above) on January 29, with a full meeting March 5

    ICU Database Task Group Meeting – November 27, 2025 (copied for continuity, will be removed once the first minutes for 2026 are here)

    • Present: Lisa, Pagasa, Julie, Tina, Val, Jen, Michelle, Joanna, Mailah, Dan, Allan
    • Minutes prepared by: AG
    • Action items in BOLD

    1. Update regarding: [i] Collection of data on homelessness, [ii] the Collection of locations on the spectrum between home and PCH, and [iii] seeking to deal with the current difference in lists of locations for Pre acute living situation and Dispo

    • The coding of these 3 issues are related
    • We are currently doing a 2 month temporary data collection project (ending Jan 17, 2026), on Non-traditional locations: Project NonTradLoc
      • It will provide us with a more complete understanding of source and disposition locations.
      • We will use that information to devise a not-too-large list of location categories, and for rare locations use a category of "other"
      • We have extended collection of this project to January 31, 2026, due to some collection inconsistencies Lisa Kaita 12:35, 13 January 2026 (CST)

    2. Regarding database Re-platforming -- Allan informed the group that we are looking into using REDCap. More to come.

    3. Allan presented the updated plan for tracking ICU service (see Minutes from November 27, 2025 JALT Meeting)

    4. Allan presented the plan for keeping track of transfers for bed management using a new ICD10 diagnosis Transfer for bed management

    5. New Items

    2025...

    Also see Task Team Meeting - Rolling Agenda and Minutes 2025

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