Visit Admit DtTm field

This field is currently being implemented, please check the instructions and put a discussion for anything that isn't clear. 

The Visit Admit DtTm field contains the first entry in the visit location history in EPR for this visit.

Purpose

The field is used as an identifier, not so much a date, to allow us to:

• link together ICU and Ward admissions during the same hospital visit
• uniquely identify patient visits to Manitoba Health when we exchange data with them

Collection Instruction

(in progress. Any collector can continue to rewrite to help make clearer - Thank you!)

For each patient,

• In EPR find Patient name
• go to:
  • Registration
  • Visit Location
  • Location History
    • at the bottom of the page, you will see the specific hospital, and also the date/times in ER.
    • find the earliest date/time in the list; e.g. VGH-ED-Triage start. Use that date/time as your Visit Admit DtTm.
• enter that date into the Visit Admit DtTm field in ccmdb.mdb

Questions?

• patient transferred from ICMS to ward, ICU would have captured the first date and time in the EPR, what should medicine capture? the same date/time that ICU captured? Lisa Kaita 09:37, 2016 April 21 (CDT)
  • The first dttm in EPR. Ttenbergen 18:26, 2016 April 25 (CDT)

• Medicine would code the "Accept D/T" as admission to hospital D/T. Patients are not admitted until a service accepts them and admit orders are reflecting this as such.
  • • • My understanding is that no matter what, we put the first presentation to the hospital in the "visit admit dttm field". In Lisa's example, the visit admit date and time will be the same as the ICU one as the pt presented to the hospital at the same time. The accept date and time to medicine is not an issue for ICU transfers as this time is the same as the arrive time on the ward.--LKolesar 11:04, 2016 April 22 (CDT)

• Visit admit remains unclear to me...clients present to ER and are waiting to be seen etc prior their actual admission point...do you want this field representing the D/T when they present to ER?--Llemoine 11:20, 2016 April 21 (CDT)
  • The first dttm in EPR. Ttenbergen 18:26, 2016 April 25 (CDT)

• Suggestion is to name this field HospAdmit DtTm. -Trish Ostryzniuk 15:00, 2016 April 22 (CDT)
  • It is confusing keeping the "Admit" word in title-perhaps "To ER Time" ?--Llemoine 07:51, 2016 April 25 (CDT)
    • Definitely not ER time, because pt could bypass ER entirely. Think of this not as the time that something happens to the patient, but as an entry in the EPR. we want the dttm for the first entry in the EPR during this visit. This is important; you guys do admit times and stuff differently for ICU and Medicine and even per site, and this part needs to be consistent and based on data because we want to use it to link together a patient's stay, and to link our data to Manitoba Health data. So, please use the first in EPR and that should shed all confusion, no? The field was called visit dttm to make clear this is relating to the visit date time in EPR. Ttenbergen 18:26, 2016 April 25 (CDT)

Inter-Hospital Transfer

• If a patient is a direct admission from a different hospital (ie STB ward) to your ward (ie VIC ward), is your Arrive_DtTm field the same as your Visit Admit DtTm field?
  • Use the EPR admit time to hospital. Some of you get your Admit DtTm from somewhere different. We want the Visit Admit DtTm to come from the EPR because then the exact same will be used throughout the admission, not something that might be slightly off. This may be the same, or it may not. Ttenbergen 17:44, 2016 April 25 (CDT)

Background

Right now you guys collect detailed to/from info in Var1/2. The details are primarily used for linking. Collecting the Hospital Admit DtTm will make that information irrelevant for wards where we don't collect, so we will be able to code "from" for wards where we don't collect just as "HSC Ward"(eg).

Data Use

This data is used to understand Length of Stay and for linking.

Template:CCMDB Data Integrity Checks

• must be <= Arrive DtTm field

Legacy

This field is part of the 2016 Time and Place changes.

It is being added to simplify the old linking - if we have the hospital admit date and time, we are done linking, none of the previous complex process will be needed any longer.