Visits to temporary locations

• This refers to how to handle when a patient is sent to a temporary location
  • Temporary locations includes OR, procedure suites of all types, imaging suites/radiology, etc.
    • They do NOT include beds that are actually functioning in the nature of a ward or ICU bed -- i.e. Boarding Locations
• There are 3 situations handled differently in these cases:
  1. The patient returns to the sending unit: Here everything (procedures and diagnoses) that happened in the temporary location is coded in the record of the sending site. So, do not discharge and readmit the patient, collect as a continuous stay.
  2. The patient does not return to the sending unit but survives it and goes elsewhere after the procedure: Here the Dispo for the sending site is the temporary location (or possibly "Other Procedure Location") (and the Dispo DtTm is when the patient actually left the sending unit in contrast to what EPR might say ) and things that happened in that temporary location are NOT included in the record of the sending site; also enter BedHeldEnd DtTm
  3. The patient dies in the temporary site. In this case the Dispo of the sending site is the death (and the Dispo DtTm is as usual for Deceased patients) and you should code the other diagnoses or procedures that occurred in the temporary site; also enter BedHeldEnd DtTm
• for example, patient transferred from ICU to the OR, and dies in the OR. Dispo DtTm would be the date and time of death to the morgue, tmp would have a BedHeldEnd DtTm of the date and time sent to the OR and the reason would be "weird reason", procedure done in OR is an Acquired Procedure
• second example: medicine patient sent to Misericordia for an eye procedure, while there deteriorates, arrests, is taken to the ER and dies in the ER. Dispo DtTm would be death to the morgue, the ER would be a Boarding Loc, tmp would have a BedHeldEnd DtTm of the date and time they were sent to the Misericordia and the reason would be "weird reason", if they had a procedure at the Misericordia, this would be an Acquired Procedure and the arrest would be an Acquired Diagnoses

temporary locations between initial ER and first admission to one of our units

• A few Boarding Loc entries have shown up for the Cath Lab. They probably should not have been entered at all, but they raised the question of how to calculate ER Delay when this happens. See ER_Delay#ER_Delay_when_there_are_Visits_to_temporary_locations_between_initial_ER_and_first_unit for more.

AMA

AMA is a different scenario, but very similar rules apply.