Task Team Meeting - Rolling Agenda and Minutes 2021

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List of items to bring to task meeting

Add to this by adding the following to the article where the problem is documented:

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ADL General Collection Information 22 October 2020 01:58:49
Acquired Diagnosis / Complicationthis relates to Attribution of infections and we need to be sure to have it consistent.27 October 2020 22:19:02
Attribution of infections
  • I finally figured out how to ask this at task: I was worried that we might apply the delay at the data entry end and also at the reporting end (i.e. the delay might be included twice or not at all, so we need to phrase and then link this correctly so it's clear whether the delay is considered at collection or at reporting. Ttenbergen 21:37, 2020 August 27 (CDT)


  • Is the following correct, then:

A decided that an infection that is discovered within the first 48 hrs after admission should be coded as an Admit Diagnosis, and an infection discovered after that as an Acquired Diagnosis.


When this is all settled, the details need to be integrated into Template: ICD10 Guideline Infection, Lab and culture reports, Infections in ICD10
28 August 2020 02:37:43
CCI Volumes 2019There have been concerns about the volume of work generated by CCI entries. Since we had already reduced certain entries earlier in 2019, the numbers referenced here are only for pts admitted during the third quarter of 2019.4 December 2019 19:40:14
COVID-19 (SARS-COV-2)
  • how should this be done now under PatientFollow Project / Boarding Loc ? Is it even still applicable? Likely should live under Boarding Loc instead and just be linked from here? Ttenbergen 12:24, 2020 October 29 (CDT)
    • It seems this instruction is more related to differentiating between Admit Diagnosis & Acquired Diagnosis. The note about transferring location could be taken out because what we're doing for patient follow will capture the move, but the rest of the instruction still applies I would think.


  • What are we doing for COVID recovered cases? So if MB Health considers someone to be non-infectious after 14 days, if someone is admitted to hospital >14 days from their swab date are we still coding them COVID POS? Are we using whether they are/are not isolated on admission as the deciding factor in how these are coded? Do we need a code for the recovered folks who are still needing acute care (for example patients admitted to medicine from ICU after the 14 day isolation period) Surbanski 08:21, 2020 December 10 (CST)
    • I have changed this to a Task discussion because we will need Julie and Allan for this. Could you bring it up there, please? Ttenbergen 11:26, 2020 December 10 (CST)
12 January 2021 21:40:24
Task Questions

Also see Task Team Meeting - Rolling Agenda and Minutes 2020

ICU Database Task Group Meeting – January 7, 2021

  • Present: Allan, Tina, Julie, Trish, Pam, Lisa, Sherry, Val
  • Minutes prepared by: AG
  • Action items in BOLD

1. Continued discussion of patients admitted to an ICU service.

  • Collectors relate that the COGNOS listings are pretty accurate at HSC and Grace, and improving at St. B.
  • Tina spoke to Chantal Plaetinck (manager of Admitting at St. B) about the ongoing issues there. After discussion we agreed that Tina will create a button on the laptops that will allow collectors to send a templated email to St. B admitting when they identify an error regarding an ICU admission by either service or location. Furthermore, she’ll ensure that we can count the number of these. We’ll do this for at most a few months, with the hope that this feedback will allow St. B admitting to improve their processes and reduce these errors. (see Process for bad data in Cognos)
  • In order to finish mapping COGNOS HSC Critical Care services to either MICU or SICU, Julie will add additional months to the following:
    • HSC Critical Care / Adult General -- 0 of these
    • HSC Critical Care / Amputee -- 0 of these
    • HSC Critical Care / General -- 2 of these, both in SICU
    • HSC Critical Care / Intensive Care -- 3 of these, 2 in MICU, 1 in SICU
    • HSC Critical Care / Obstetrics -- 1 of these, in MICU
    • HSC Critical Care / Oncology -- 1 of these, in SICU
  • In response to discussion, Allan indicated that while we DO want to get locations, services and timing all correct, that it is not the end of the world if we are off by 1-2 hours in the actual timing of when a change occurred.

2. Update regarding having data collectors do all TISS coding -- Tina, Trish and the collectors are still working to get this going at all sites.

3. Update on the discrepancy between collection of PRBC transfusions in CCI vs. the Transfusion guideline. After discussion we agreed (largely for simplicity of coding) that the rule will be: Code the 1st date of PRBC administration and the total number of units of PRBC given from that point onward. Tina fixed this discrepancy and Val will look at the Wiki information about it to ensure it is correct.

4. Update on “locations” listed in Cognos that are variously called “Swap” or “Swing” at the different hospitals. These may or may not actually related to a change in physical locations. Clearly we need to sort out how we are going to handle these. Tina will review and we’ll discuss further at the next Task meeting.

5. New questions

  • (a) It was identified that there can be discrepancies between the time a transfer (of location or of service) is noted in COGNOS vs. when it truly occurs.
    • Example: ICU transfer to ward is listed earlier (and sometimes substantially earlier) in COGNOS then when it actually occurs. In this case the COGNOS time should be the “transfer-ready” time, while the actual time should be the service/location change time.
    • As per item#1, above, while we DO want to get timing correct, it is not a huge problem if a service or location time change is recorded an hour off from reality.
  • (b) It was pointed out that WHO has begun creating temporary, codes for newly-described COVID complications. An example is COVID-19–related multisystem inflammatory syndrome (U07.3).
    • This is a syndrome, so far only described in children, with numerous manifestations depending on which organ or organs are involved.
    • As we have only had ONE of these so far, we agreed that we will not give it its own ICD10 code, but instead code it by linking COVID-19–related multisystem inflammatory syndrome to the existing code Disorder of the immune system, NOS. Allan has added this to the COVID-19 Wiki article.

UPDATE: we are adding Post COVID-19 condition as per discussion with Allan 2021-01-12.

6. Followup on trying to get hospital-level data elements from EPR.

  • Allan provided Bojan/Ebi with a written explanation of what is being requested -- we need to followup on this item.

7. Followup about working to reduce collector workload. Things that need to be done:

  • After the COVID emergency passes, Allan to talk with Medicine leadership (including Ebi, Nick, Mary Anne, others) about precisely what information they need/want reported for Medicine ward patients within each hospital. The issue here is whether, within each hospital, they really need to distinguish data by ward, or by teaching vs. non-teaching.
  • Find a new hosting/software infrastructure that can be in full compliance with privacy requirements. Allan and Tina will followup with CHI and Digital Health to pursue new hosting possibilities.
  • Thereafter, work to obtain CBS TraceLine for all transfusion data. Margaret Ring again (margaret.ring@blood.ca).
  • Thereafter, work to obtain RIS data for radiology tests. Shared Health CIO Charles Conway [204-926-1400; cconway3@sharedhealthmb.ca].

ICU Database Task Group Meeting – December 16, 2020

Last from 2020, copied here as a starting point for the first meeting in 2021, these should be overwritten

1. Continued discussion of PatientFollow Project, Change from Service Location to Service, Boarding Loc and Transfer Ready DtTm tmp entry, Definition of a Medicine Laptop Admission

  • Further questions arose of which Onc, Renal, Neuro patients to include in the Medicine database. After discussion we recognized that the issue here is whether or not the patient is “using Medicine resources”, which include staff and beds. So, by this criterion:
    • We WILL include Onc, Renal, Neuro patients who are physically located on a mixed COVID ward (i.e. locations that have both Medicine and non-Medicine (e.g. surgery) beds). Rationale is that those beds ARE a Medicine resource.
    • We will NOT include Onc, Renal, Neuro patients who are in ED (e.g. EMIPs). Rationale is that those beds are NOT a Medicine resource.

2, Continued discussion of patients admitted to an ICU service.

  • Last meeting we mapped existing Cognos services to their respective ICUs in each site. This was possible with all except the following 7 services, for which Julie has now gone back and over the past 2 months identified patients with those services:
    • HSC Critical Care / Adult General -- 0 of these
    • HSC Critical Care / Amputee -- 0 of these
    • HSC Critical Care / General -- 2 of these, both in SICU
    • HSC Critical Care / Intensive Care -- 3 of these, 2 in MICU, 1 in SICU
      • HSC Critical Care / Obstetrics -- 1 of these, in MICU
    • HSC Critical Care / Oncology -- 1 of these, in SICU
  • So, there seem to few enough of these that categorization isn’t a big problem. HOWEVER, Tina identified that working with Chastity she has now come to recognized that Cognos has 3 concepts within it that relate to service. SO before we go further with assigning patients to ICU services, Tina/Julie will look further into this and we’ll discuss further at our next Task meeting.

3. Followup on the recent changes St. B admitting made as regards to identifying ICU services.

  • Collectors report that things have greatly improved, though some mistakes are still being made. In particular, there is use made of the service “SBGH Critical Care / General”. We hope that these errors will decline as Admitting office staff become more familiar.
  • But we also decided to defer further discussion of this to the next Task meeting, for same reason as the last point of item#2, above.

4. Followup regarding having data collectors do all TISS coding

  • Has only begun at St. B, not yet at HSC or Grace where pink sheets are still being used
  • Towards the goal of making this change in all sites, Tina and Trish will work with collectors to fine-tune the laptop tool for collecting TISS info, and to get them trained up to use it.

5. New questions

  • Whether and how to code someone who has recovered from COVID-19. After discussion we agreed this is no different from any infection, and that once active infection is gone (even if manifestations such as respiratory fibrosis and respiratory failure remain) that we will NOT code it. Specifically, as the WHO has not seen fit to create an ICD-10 code for past history of COVID-19, we won’t either.
  • It was pointed out that there is a discrepency between collection of PRBC transfusions in CCI vs. the Transfusion guideline. After discussion we agreed (largely for simplicity of coding) that the rule will be: Code the 1st date of PRBC administration and the total number of units of PRBC given from that point onwards. Tina to fix this discrepency.
  • There are “locations” listed in Cognos that are variously called “Swap” or “Swing” at the different hospitals. These may or may not actually related to a change in physical locations. Clearly we need to sort out how we are going to handle these. Tina will review and we’ll discuss further at the next Task meeting.
  • Discussion about what name to use for what has previously been called “Boarding Loc”. In Cognos it goes by the name “assigned unit”, but this may ambiguously imply the final destination. So we agreed to call this field “Unit”.

6. Followup on trying to get hospital-level data elements from EPR.

  • Allan provided Bojan/Ebi with a written explanation of what is being requested -- we need to followup on this item.

7. Followup about working to reduce collector workload. Things that need to be done:

  • Find a new hosting/software infrastructure that can be in full compliance with privacy requirements. Allan and Tina will followup with CHI and Digital Health to pursue new hosting possibilities.
  • Thereafter, work to obtain CBS TraceLine for all transfusion data. Margaret Ring again (margaret.ring@blood.ca).
  • Thereafter, work to obtain RIS data for radiology tests. Shared Health CIO Charles Conway [204-926-1400; cconway3@sharedhealthmb.ca].

ICU Database Task Group Meeting – December 11, 2019

See Task Team Meeting - Rolling Agenda and Minutes 2020#ICU Database Task Group Meeting – December 16, 2020