Task Team Meeting - Rolling Agenda and Minutes 2024
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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| wiki page | question | Last modified |
|---|---|---|
| wiki page | question | Last modified |
| Gangrene, NOS | can we use this code for necrosis or necrotic wounds? Lisa Kaita 11:57, 2024 April 17 (CDT)
| 2024-04-25 1:01:29 AM |
| 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)
| 2019-03-09 9:24:42 PM |
| 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)
| 2019-10-31 3:04:29 PM |
| 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)
| 2022-02-17 10:56:05 PM |
| 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)
| 2019-01-10 7:32:04 PM |
| STB ICUs VAP Rate, CLIBSI Rate Summary |
| 2024-04-08 4:27:53 PM |
| 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) | 2024-04-17 5:01:53 PM |
| Template: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)
| 2024-04-25 12:57:46 AM |
Also see Task Team Meeting - Rolling Agenda and Minutes 2022
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ICU Database Task Group Meeting – November 23, 2023
- Present: Allan, Pagasa, Pam, Joanna, Barret, Julie, Brynn, Mailah, Val, Gail
- Minutes prepared by: AG
- Action items in BOLD
1. Regarding the prior idea to expand our ICD-10 coding to include ALL actual ICD-10-CA codes.
- Lisa reports that while this was generally supported in talking to the data collectors, there was also a sense that we should delay further discussion on this until a more opportune time.
2. Julie reports that she has noted some patients who have different or otherwise contradictory postal codes during a single episode of care.
- We note that postal codes derive from the ADT/Cognos system.
- As it's unlikely that more than a trivial number of patients are moving residences over such a short timespan, we need more details about this and Julie will obtain such information for us to discuss at the next Task meeting.
3. An issue arose about patients who present to ED at a given hospital and have ICU team involvement while there, but subsequently either die in ED or are transferred to another hospital (e.g. from Grace ED to Gold surgery at HSC). Specifically the question is about if/how to include them in the ICU database, and if so exactly when to code the ICU team as beginning to provide care.
- This question is complicated by a wide range of types of care provided by the ICU team in ED. It continuously spans from consultation with small actual involvement, all the way up to functionally taking over care while in ICU. While the latter should be included in the ICU database, the former should not. And of course there's everything in between.
- Part of this is that putting in an ICU admission for such a patient in ED results in the ICU team having to write a discharge summary and transfer note -- which is paperwork we'd seek to avoid.
- For Grace we discussed 2 possible solutions, both involving the ICU attending making a judgement for ED patients in whom they are contributing to care whether or not to count that person as "being on the ICU service" even if she/he never gets to an ICU in that hospital:
- Actually put in an ICU admission
- Don't put in an ICU admission, but record such patients in a separate portion of the ICU logbook.
- Barret will discuss this with Heather Smith and report back at the next Task meeting.
- After we come up with a solution for Grace, we will need to discuss solutions for HSC and St. B.
4. About coding decubitus ulcers.
- We validated that when an acquired diagnosis should be entered for both de novo decubs that develop in ICU, and for progression of pre-existing decubs (e.g. from Stage 2 to Stage 3).
- We also looked at data on ICU-acquired decubs from Grace over time. This arose because the rate of such ulcers developing or worsening in the Grace ICU seem much higher than in other ICUs. It is not clear whether Grace is high or other ICUs are low. Upon further assessment, these rates rose precipitously from last quarter of 2021 to the 1st quarter of 2022. Most likely this coincides with some change in how decubs are recorded.
- Gail will seek information about if/how such changes in recording of decubs may have happened from Jan 2022 onwards.
ICU Database Task Group Meeting – October 26, 2023
- Present: Allan, Pagasa, Pam, Joanna, Brynn, Mindy, Stephanie, Val,
- Minutes prepared by: AG
- Action items in BOLD
1. New question about A81.2 Progressive Multifocal Leukoencephalopathy (PML) (caused by JC virus). A recent case highlighted (as already listed in the Wiki) that there are causes other than JC virus. Accordingly, we agreed that: we will change the name to remove the "caused by JC virus" portion. Also, Allan altered the Wiki accordingly.
2. There was a discussion about the idea of expanding our ICD10 coding to include ALL codes, not just the reduced version we've been using. Various collectors commented that it is not rare that they find a specific ICD10 code online for a given entity, but have to "shoehorn" it into some "NOS" code or other. On the other hand, it would mean expanding and needing collectors to know the full list of 16,000 ICD10 codes. Allan will notify Lisa of this, and ask her to discuss it with the collector group.. The collectors met on Nov 9, 2023 with Julie present, Tina was not available but discussed it with Lisa and Julie at another meeting. In general, all collectors agree it is a good idea, however given all the changes it was felt it was best to defer this to a later date. Consideration needs to be given to wiki articles, reporting etc.
3. Next meeting will be Nov 23@1100
New Items:
- 4. Postal codes
- 5. Revisit first service time for ICU admissions see https://ccmdb.kuality.ca/index.php?title=Definition_of_a_Critical_Care_Laptop_Admission for current instructions
- 6 coding progression of decubitus ulcers
2023...
Also see Task Team Meeting - Rolling Agenda and Minutes 2023