Task Team Meeting - Rolling Agenda and Minutes 2026
List of items to bring to task meeting
Add to this by adding the following to the article where the problem is documented:
{{DiscussTask | explanation}}Toggle columns: Last modified
| wiki page | question | Last modified |
|---|---|---|
| wiki page | question | Last modified |
| Collection of data on homelessness | JALT
* who should we clarify with, I would think if they have a MB PHIN or are self pay then you would choose MB, if they don't then I would choose Not known Lisa Kaita 21:25, 6 September 2025 (CDT)
| 2026-03-10 1:20:00 AM |
| Decubitus (pressure) ulcer, stage not indicated, of heel |
| 2025-10-23 7:56:14 PM |
| Decubitus (pressure) ulcer, stage not indicated, of other area |
| 2025-10-23 7:56:19 PM |
| Decubitus (pressure) ulcer, stage not indicated, of sacral area |
| 2025-10-23 7:56:12 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)
| 2026-05-15 6:29:30 PM |
| Glasgow Coma Scale | Can we please revisit this and expand our examples, for example, patient arrives in ER with a GCS of 15, arrests and is then sedated to A RASS -5 for days or dies within 24 hours of admission. Should we be putting the APACHE GCS as Aler and intubated appears oriented? or assume the worst GCS of 3? Lisa Kaita 12:06, 20 April 2026 (CDT) | 2026-04-30 11:16:45 PM |
| Guidelines for coding sex and gender | I had a discussion with the manager of admitting and she relayed to me that what the staff in admitting enter in ADT is based soley on what is on the patient's MHSC card. She also said that any uncertainty should be listed as "unknown" and not undifferentiated, and they will soon be using the "x" determination, but she wasn't certain when that change would occur. Lisa Kaita 10:43, 12 May 2026 (CDT) | 2026-05-12 3:43:41 PM |
| John or Jane Doe patient | JALT
| 2026-03-14 1:38:21 AM |
| Pre acute living situation field | JALT
| 2026-04-26 12:31:03 PM |
| Publications, abstracts, presentations using the Critical Care and Medicine Database |
| 2025-12-31 8:13:08 PM |
| Selkirk Mental Health Centre | JALT - Mental Health Facilities in Addition to Selkirk
| 2026-04-14 4:56:36 PM |
| Sex field |
| 2026-05-06 5:30:52 PM |
| St.Amant | Since 2022:
Pre acute living situation for patients where Dispo is St Amant has been recorded as:
Pre acute living situation for patients where Previous Location is St Amant has been recorded as:
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 |
| 2026-03-11 6:46:51 AM |
| Tracheostomy, has one | If that applies to this Category:Has one code then should it apply to all, or at least to all that are reversible (and could still apply to the non-reversible ones since the case would just never happen...)?Ttenbergen 13:06, 8 May 2026 (CDT)
| 2026-05-14 1:49:17 PM |
| Transfer for bed management | JALT
| 2026-04-30 5:09:08 PM |
ICU Database Task Group Meeting – April 30, 2026
- Present: Allan, Lisa, Jen, Jennifer, Tina, Steph, Mindy, Maria, Joanna, Mailah, Pagasa
- Minutes prepared by: AG
- Action items in BOLD
1. Regarding Transfer for bed management
- After discussion we recognized that the exception in this item for transfer from ward to LAU should be expanded to "for transfer from ward or ICU to LAU" -- DONE
2. Regarding database replatforming -- no update now.
3. 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 -- no update as Julie was not able to be at today's meeting, but we hope that at the next meeting she'll present the temp data collection.
4. New issue: in regards to labs and vital signs for APACHE physiological variable collection, should values in the OR during the first 24 hours be included?
- After discussion we agreed that values from OR will be excluded, but values in PACU will be included -- change made in Wiki
5. New item: Glasgow Coma Scale scoring nuance. Example is a patient who on arrival to ED had GCS=15 (normal) but then arrests and is sedated until he dies.
- The rule about sedation is to ignore GCS scores done while on sedatives and use values prior to sedation. The nuance with this example is that the GCS of 15 done prior to the arrest may not reflect the post-arrest status. IF the patient had any information after the arrest but before sedation was begun, then use THAT pre-sedations information to try and deduce the post-arrest GCS. But with this example, there was no post-arrest/pre-sedation information and so we would default to the GCS sedation rule that in that case we code a normal GCS of 15.
6. New item: Does the picklist CCI code for Plasmapheresis apply to leukopheresis?
- Yes, per the CCI book, that code is used for leukophoresis, platelet pheresis and erythropheresis also.
7. New item: In light of the fact that we only code the first time that Plasmapheresis is done, should we also only code the plasma transfusion once? Currently we track every unit of plasma used during plasmapheresis.
- After discussion, we agreed to make this change
8. New item: Currently, for coding Guidelines for coding sex and gender and Sex field we only code M or F and refer to the biologic sex at birth. Question arose of the much more nuanced aspect of this delineation, including transgender, trans-sexualism, etc.
- We noted that separate from the more complex issue of gender, Manitoba Health now codes sex as M, F or X, and Tina indicated that Cognos now includes "undifferentiated" for the sex field.
- We agreed in principle, pending further discussion including Julie, that we will change guidelines for this as M, F or X, where "X" includes all unclear or ambiguous designations of biologic sex (again, separate from gender identity).
- One important issue here relates to reconciling this field between older and newer database records, and as this relates to how Julie reports things, we decided to NOT yet implement any change pending the JJALT meeting scheduled for next week
9. New item: Questions about coding Transfer Ready DtTm tmp entry
- Two situations were discussed:
- (i) In relation to change to ACP-C. The issue here arises because often after a patient is made ACP-C, there could be a delay until life support is withdrawn and another delay until the patient does or the decision is made to actually transfer the patient out of ICU. After discussion, in recognition of the fact that these delays are quite variable and depend on multiple considerations, and the only unambiguous time is when life support is actually withdrawn, we agreed that the assigned timing of transfer ready should be at the point that life support is terminally withdrawn.
- (ii) In relation to a patient being accepted for the Long-term vent program (usually from IICU). As there are often many non-ventilator issues that need to be dealt with before the patient actually leaves ICU, we agreed that data collectors should use the available written notes to try their best to deduce when all those other issues have been resolved and the patient is actually ready to leave. The main message here is that it is often not at the point of acceptance into the long-term vent program, but some time thereafter.
10. Next meeting May 28, 2026
ICU Database Task Group Meeting – April 30, 2026
- Present: Allan, Lisa, Jen, Jennifer, Tina, Steph, Mindy, Maria, Joanna, Mailah, Pagasa
- Minutes prepared by: AG
- Action items in BOLD
1. The collectors were asked about their comfort/confidence in coding [Transfer for bed management]] and Intended1stSrvc
- There seem to be no major problems
2. Update on database replatforming -- Allan reported that a meeting is being set up with Dr. Hajadiacos, Bojan, Dan and Allan to discuss.
3. 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 temp data collection is completed, and Julie will organize/analyze it to discuss at our next Task meeting in April.
4. New question: If a person with diabetes gets a successful pancreas/islet transplant, should subsequent database records list DM as a chronic comorbidity?
- We recognized that independent of that, if the person has diabetic complications (e.g. retinopathy, neuropathy, nephropathy) that those should be included as chronic conditions.
- After discussion, we agreed that before deciding on this, that Allan sought information about the survival of such persons
- Publication DOI:10.2337/dc20-2458: 10 year survival was 100%, 20 year survival was 80%
- Publication DOI:10.1016/S2213-8587(22)00114-0: About 50% maintain normal HbA1C at 15-20 years
- Based on this information, it appears that successful transplant does NOT return Type I diabetics to the same health course as non-diabetics and we SHOULD probably still code DM as a chronic comorbid condition
5. New question: regarding coding prior stroke and stroke sequelae
- After discussion we agreed that both the prior stroke and ongoing stroke sequelae should be coded as chronic comorbid conditions
- As regards trivial or very minor sequelae, it is perfectly OK to code them, although we recognize that the less significant are such sequelae, the less important it becomes to capture them in the database
- Lisa to add this to the Wiki - Done
6. New Questions:
- APACHE physiological variable collection If a pt goes to the OR in the first 24hrs of an admission, can or should we be including these VS variables in our APACHE?
- Glasgow Coma Scale - Can we please revisit this and expand our examples, for example, patient arrives in ER with a GCS of 15, arrests and is then sedated to a RASS -5 for days or dies within 24 hours of admission. Should we be putting the APACHE GCS as Alert and intubated appears oriented? or assume the worst GCS of 3?
- Plasmapheresis - should we also use this code for Leukapheresis, or is leukapheresis something that we should not bother coding? it seems rare
- Template:CCI Guideline Transfusions - can we please reconsider if we should count all plasma given during plasmapheresis? We only count the first time plex is done, so is it relevant how many are given during plasma?
- Sex field - The instructions above actually don't address Intersex individuals whose physical or chromosomal situation is not clear. We could change the instructions to "assigned at birth" and remove any reference to "biological", which would mean we collect something other than their biological status. The current instructions don't address all possibilities.
7. Next meeting May 28, 2026
ICU Database Task Group Meeting – March 4, 2026
- Present: Allan, Lisa, Julie, Val, Joanna, Michelle, Mindy, Jen, Mailah, Pagasa
- Minutes prepared by: AG
- Action items in BOLD
1. The collectors were asked about their confort/confidence in coding [Transfer for bed management]] and Intended1stSrvc
- There seem to be no major problems
2. Update on database replatforming -- Allan reported that a meeting is being set up with Dr. Hajadiacos, Bojan, Dan and Allan to discuss.
3. 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 temp data collection is completed, and Julie will organize/analyze it to discuss at our next Task meeting in April.
4. New question: If a person with diabetes gets a successful pancreas/islet transplant, should subsequent database records list DM as a chronic comorbidity?
- We recognized that independent of that, if the person has diabetic complications (e.g. retinopathy, neuropathy, nephropathy) that those should be included as chronic conditions.
- After discussion, we agreed that before deciding on this, that Allan sought information about the survival of such persons
- Publication DOI:10.2337/dc20-2458: 10 year survival was 100%, 20 year survival was 80%
- Publication DOI:10.1016/S2213-8587(22)00114-0: About 50% maintain normal HbA1C at 15-20 years
- Based on this information, it appears that successful transplant does NOT return Type I diabetics to the same health course as non-diabetics and we SHOULD probably still code DM as a chronic comorbid condition
5. New question: regarding coding prior stroke and stroke sequelae
- After discussion we agreed that both the prior stroke and ongoing stroke sequelae should be coded as chronic comorbid conditions
- As regards trivial or very minor sequelae, it is perfectly OK to code them, although we recognize that the less significant are such sequelae, the less important it becomes to capture them in the database
- Lisa to add this to the Wiki
6. Next meeting April 16.
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 -- see ICU Utilization Report
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
- New sed line see https://ccmdb.kuality.ca/index.php?title=List_of_CCI_procedures_we_don%27t_code
- Primary admit dx clarification for post op patients - https://ccmdb.kuality.ca/index.php?title=Primary_Admit_Diagnosis
2025...
Also see Task Team Meeting - Rolling Agenda and Minutes 2025