Task Team Meeting - Rolling Agenda and Minutes 2022

List of items to bring to task meeting

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	Question	Modification date"Modification date" is a predefined property that corresponds to the date of the last modification of a subject and is provided by Semantic MediaWiki.
CCI Guideline Vasoactive Drugs TISS	Can you please clarify if we are to include labetalol, as the above instruction would have us exclude it? Lisa Kaita 09:26, 2024 May 9 (CDT) Or could "negative" in this context mean that they are lowering ones? Ttenbergen 07:57, 2024 May 15 (CDT)	15 May 2024 12:57:05
Cardiac arrest	Could we please have some clarification around using this code and when to check as primary? example 1 patient arrests in ER, goes to OR and is admitted to ICU from the OR. Diagnosis, cardiac arrest (6-10 min downtime) abdominal compartment syndrome/obstruction/perforation/, acute liver failure from shock liver, shock, NOS when to carry it forward as an admit for subsequent profiles in the same episode of care? example 2 April 6, PEA arrest secondary to anaphylactic shock, April 19 melena, scope suspicious for ischemic gut, goes to the OR April 20 confirms gangrenous bowel/perforation, abscesses, to SICU post op (clinically in SS but doesn't have lactate high enough for our criteria) do we still include the cardiac arrest code? (In MICU no anoxic brain injury, A & O) Lisa Kaita 11:54, 2024 May 2 (CDT)	2 May 2024 16:54:06
Gangrene, NOS	can we use this code for necrosis or necrotic wounds? Lisa Kaita 11:57, 2024 April 17 (CDT) discussed at April 24 TASK Allan will give this thought and address it at next TASK Lisa Kaita 20:01, 2024 April 24 (CDT)	2 May 2024 16:03:55
ICD10 Guideline Sepsis	How hard of a rule is lactate >2? If they meet the criteria for septic shock with the exception of a high enough lactate, can we code septic shock Lisa Kaita 12:17, 2024 April 17 (CDT) discussed at TASK April 24, Dr Ziegler is researching various definitions of septic shock and will speak to this at next TASK Lisa Kaita 19:57, 2024 April 24 (CDT)	25 April 2024 00:57:46
Kidney, acute renal failure, postprocedural	could we please have some guidelines around when to use this code? how long after the procedure can we use this code? Lisa Kaita 11:37, 2024 May 2 (CDT)	2 May 2024 16:37:08
STB ICUs VAP Rate, CLIBSI Rate Summary	IIRC we collected CAM positive (TISS Item) specifically for this, right? If so, can we stop collecting it? And can we make sure a stoppage like this in the future results in reviewing what we collect? Ttenbergen 10:02, 2024 March 20 (CDT) Delirium rate per 1000 days per unit is being reported in the OIT Reports. ---JMojica 11:49, 2024 March 20 (CDT) As in Delirium days is reported in Critical Care Program Quality Indicator Report? But that doesn't mention anything about per-1000-days. Ttenbergen 17:00, 2024 March 20 (CDT) The rate is mentioned in the succeeding definition with the delirium days as numerator. Your proposal here is to stop collecting TISS item CAM positive which I disagree because that TISS item is being used and reported as rate in OIT Report. Besides, the reason why it was dropped in in the STB VAPCLI report is because the requestor has changed. Brett Hiebert who used to request this was involved in the VAP group and another Delirium group so he asked to have both as one request. Brett had left and the VAP group filled up a new request to continue the VAP data and not on the delirium data. --JMojica 13:58, 2024 March 25 (CDT)	8 April 2024 16:27:53
Sepsis (SIRS due to infection, without acute organ failure)	How hard of a rule is lactate >2? If they meet the criteria for septic shock with the exception of a high enough lactate, can we code septic shock Lisa Kaita 12:17, 2024 April 17 (CDT) discussed at TASK April 24, Dr Ziegler is researching various definitions of septic shock and will speak to this at next TASK Lisa Kaita 19:57, 2024 April 24 (CDT)	9 March 2019 21:24:42
Severe sepsis	How hard of a rule is lactate >2? If they meet the criteria for septic shock with the exception of a high enough lactate, can we code septic shock Lisa Kaita 12:17, 2024 April 17 (CDT) discussed at TASK April 24, Dr Ziegler is researching various definitions of septic shock and will speak to this at next TASK Lisa Kaita 19:57, 2024 April 24 (CDT)	31 October 2019 15:04:29
Shock, septic	How hard of a rule is lactate >2? If they meet the criteria for septic shock with the exception of a high enough lactate, can we code septic shock Lisa Kaita 12:17, 2024 April 17 (CDT) discussed at TASK April 24, Dr Ziegler is researching various definitions of septic shock and will speak to this at next TASK Lisa Kaita 19:57, 2024 April 24 (CDT)	10 January 2019 19:32:04
Stroke, NOS	we need clarification on when to use this code, eg. if there is a history where it says a history of stroke, or if on CT they comment remote lacunar infarcts? Lisa Kaita 12:01, 2024 April 17 (CDT)	17 April 2024 17:01:53
Vasoactive drug IV continuous-multiple simultaneous (TISS Item)	Can you please clarify if we are to include labetalol, as the above instruction would have us exclude it? Lisa Kaita 09:26, 2024 May 9 (CDT) Or could "negative" in this context mean that they are lowering ones? Ttenbergen 07:57, 2024 May 15 (CDT)	16 March 2022 21:26:08
Vasoactive drug IV continuous-single (TISS Item)	Can you please clarify if we are to include labetalol, as the above instruction would have us exclude it? Lisa Kaita 09:26, 2024 May 9 (CDT) Or could "negative" in this context mean that they are lowering ones? Ttenbergen 07:57, 2024 May 15 (CDT)	16 March 2022 21:27:20

Also see Task Team Meeting - Rolling Agenda and Minutes 2020

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ICU Database Task Group Meeting – January 6, 2022

... most recent minutes just for Allan's convenience, should be taken out after this meeting, I just put them here so we have something to edit.

ICU Database Task Group Meeting – November 30, 2021

• Present: Allan, Julie, Sherry, Lisa, Stephanie, Tina, Val, Barret, Pagasa, Pam, Mailah
• Minutes prepared by: AG
• Action items in BOLD

1. Update on new lab listings, which appear to duplicate prior listings. Allan has begun working on this. Nothing new to report.

2. Update on what Shared Health is planning with regards to the databases. Allan reported that a meeting will happen immediately after this one including Ebi, Bojan, Perry and himself. Update written after that meeting: It was decided to first address the migration of the databases to an e-Health server. To this end, Tina has supplied a technical description of what is needed, which Allan will give to Perry, which he will use to start discussion with e-Health.

3. Followup regarding if/how to ensure correctness of counts of intubations/extubations

• Plan is to implement this as a “soft crosscheck” query check_CCI_TISS_discontinuous_ETT. Tina has emailed Julie and Lisa further questions Dec 2.

4. Update on plan (4/15/2021 Task meeting) to implement automatic coding of APACHE comorbidities (i.e. from the documented ICD10 diagnoses, per the schema Allan gave to Julie some time ago). See Change for Apache Chronic to ICD10 from separate variable

• Tina started validation of the data and found various problems, see Change for Apache Chronic to ICD10 from separate variable.

5. We continued discussing the issue of what should constitute a record in the ICU database.

• We recognized that there are problems with both the old method (new record with each transfer of ICU service) and the new method (a single record representing an entire episode of ICU care, including ICU-to-ICU transfers).
• On the day following this meeting, Allan, Julie, Tina, Brynn and Lisa met to discuss further and finally decided to go back to the old system, which actually has only been implemented in regards to MICU to SICU or SICU to MICU transfers at HSC. To this end we will:
  • Re-do APACHE scoring with each transfer of ICU service.
  • Re-do admit diagnoses with each transfer of service.
  • Ensure all the relevant Wiki pages represent this decision -- Tina and Brynn to work on this
  • ”Unwind” the 10 records that contain such MICU to SICU or SICU to MICU transfers into separate records -- Julie will work with Brynn and Lisa to do this.
  • Maintain the current machinery, tied to the Boarding Loc temp entries to record TISS scores when a patient is in multiple locations on a single calendar day.
  • Main the current machinery with respect to the Service temp entries -- the rational has to do with the fact that it is initially obtained from COGNOS, and then verified by collectors.
  • Notify all collectors of this decision. Lisa email sent out Dec 7 to all collectors

6. Regarding prior discussion (see Nov 2 minutes) of: (a) whether or not to include incomplete charts in Julie’s reports (both quarterly reports, and the various monthly data she provides to various users), (b) reconsideration of what is included in the minimum dataset, and (c) whether or not to do crosschecks on incomplete charts.

• We did not get to this today, will discuss at next Task meeting:
  • Considerations include: making reports more easily interpretable for users; reducing complexity/variation in reporting; and reducing queries back to collectors due to crosschecks on incomplete charts.
  • Currently, Julie will report on an indicator once it is “mostly complete”, which due to how data is being collected during the pandemic, is at different times for different indicators.
  • Allan proposed that in the future all reporting be done only on complete charts (note we are approximately 3 months behind on ICU collection completion) and that crosschecks only be done on complete charts. Tina to implement this. Furthermore that alongside the results that for the time period in question Julie also routinely include the % of patients not included due to the charts being incomplete. Julie and Allan discussed this separately on Nov 5 and Julie has a good solution for reporting, wherein she will report both the % of missing patients, and % of missing patient-days.
  • As the current listing for the Minimal Data Set includes a potpourri of items that are really not “minimum”, Tina will modify that delineation and remove such items.

7. Item from a separate, ongoing discussion between Tina, Allan and Julie relating to creating Wiki page Data User Portal for the Manitoba Critical Care and Medicine Databases.

• Tina/Julie to create some explanatory text for the pages: Auto Data Dictionary, Projects, Indicators and Created Variables CC table.
• Allan to improve the section of this page on “What Constitutes a Single Record of Data”.

8. Julie reported that Dan is working on what amounts to a “data sharing agreement” having to do with data security and ethical use, which those requesting data will need to sign.

• Tina has written down some issues which she feels should be addressed in such an agreement and sent it to Allan Dec 1. Allan will communicate about it with Dan.
• The question arose about whether users should be able to use data for purposes beyond/other than what their request indicated. We agreed that in the research domain the answer is “no”, and that to do so users would be required to go back to REB to get approval of the additional analyses/purposes. However, it was not so clear in relation to QA and administrative purposes --- Allan will discuss with Bojan and Dan.

2021...

Also see Task Team Meeting - Rolling Agenda and Minutes 2021