Docstoc

114. Disposition Date Definition The date the main service

Document Sample
114. Disposition Date Definition The date the main service Powered By Docstoc
					114.    Disposition Date


                           Specifications
Field Length       Eight (8) characters
Field Status       Mandatory for Emergency Department and Surgical
                   Day/Night Care visits
Field Type         Numeric
Justification      N/A
Valid Format       YYYYMMDD

Definition
The date the main service provider makes the decision about
the patient’s disposition.

Collection Guidelines:
• The best available marker for the Disposition Date is the
   date when the service provider issues the disposition order
   or request.

•   It is the ‘end point’ for an Emergency Department and/or
    Surgical Day/Night Care visit . In some instances the
    emergency department physician may document the date
    when they are finished assessing and treating the patient
    but indicate that further care must be provided by the nurse
    or other health care provider before the patient can leave.
    This would be called a "conditional" disposition order. The
    Disposition Date or "end point" of the visit in these
    instances is not when the doctor wrote the “conditional”
    disposition order, but when all the additional
    treatment/care specified by the physician has been
    administered and the patient is now deemed ready to leave
    the unit.
•   When Disposition Date is unknown and the patient is
    admitted, use admission date. Otherwise, use last noted
    date in Emergency Department or Surgical Day/Night Care
    health record.

Purpose(s)
Data on the Disposition Date/Time can be compared with data
on the Date/Time Patient Left the Emergency Department to
determine time waiting for an inpatient bed.

Data on the Disposition Date/Time can be compared with
Date/Time of Registration or Triage Date/Time to determine the
visit length of stay.
Example:   Mrs. J. arrives at the Emergency Department on
           June 23, 2006 at 8:50 pm with chest pain. After a full
           workup, the physician decides to admit the patient
           to the Coronary Care Unit (CCU). The admission
           order is issued on June 24, 2006 at 1:25 am.

Disposition Date
 2     0    0      6   0    6     2    4
115.    Disposition Time

                           Specifications
Field Length         Four (4) characters
Field Status         Mandatory for Emergency Department and
                     Surgical Day/Night Care visits
Field Type           Numeric
Valid Format         HHMM
Valid Codes          0000 (midnight)–2359, 9999 (unknown)

Definition
The time the main service provider makes the decision about
the patient’s disposition.

Collection Guidelines
• The best available marker for the Disposition Time is the
   time when the service provider issues the disposition order
   or request.

•   It is the “end point” for an Emergency Department and/or
    Surgical Day/Night Care visit. In some instances the
    emergency department physician may document the time
    when they are finished assessing and treating the patient
    but indicate that further care must be provided by the nurse
    or other health care provider before the patient can leave.
    This would be called a "conditional" disposition order. The
    Disposition Time or "end point" of the visit in these
    instances is not when the doctor wrote the “conditional”
    disposition order, but when all the additional
    treatment/care specified by the physician has been
    administered and the patient is now deemed ready to leave
    the unit.
•   For patients that leave without being seen/against medical
    advice, abstract the time to the highest level of certainty
    (i.e. 1st recorded time patient absent).
•   For death in the Emergency Department (DIE) or death on
    arrival (DOA), abstract the time the service provider
    pronounces death.
•   When Disposition Time is unknown and the patient is
    admitted, use admission time.
•       When unknown use 9999.



Purpose(s)
Data on the Disposition Date/Time can be compared with data
on the Date/Time Patient Left the Emergency Department to
determine time waiting for an inpatient bed.

Data on the Disposition Date/Time can be compared with
Date/Time of Registration or Triage Date/Time to determine the
visit length of stay.
Example: Mrs. R. attended the Surgical Day/Night Care Unit
              for a laparoscopy. The surgeon decides to admit the
              patient for observation due to elevated blood
              pressure recorded in the recovery room. The
              admission order is issued on August 29, 2006 at 4:18
              pm.

Disposition Time
    1      6   1     8




Example:       Mr. P. is seen in the Emergency Department with a
               severe headache. The ED physician assesses the
               patient and writes an order at 1300 to administer
               IM Demerol and Gravol and patient may go home
               once headache subsides. The nurse administers the
               medication at 1305 and notes at 1415 that patient is
               feeling much better and wants to go home.

Disposition Time
    1      4   1     5



Example:       A 34 year-old man with known prostate cancer
               presents to the Emergency Department with
               urinary retention. After examining the patient, the
               ED physician states “catherization and discharge
               home when ready”. The nurse’s notes indicate that
               patient was successfully catheterized at 0910 and is
               getting ready to go home.

Disposition Time
 0     9     1     0



Data Quality Check
’9999’ must be recorded when Disposition Time is not recorded or
unknown. Use of default values such as 23:58 or 23:59 must cease and
clients are encouraged to run a data quality check to evaluate this. CIHI
will continue to generate a warning message with 23:59 for 2007–2008.

				
DOCUMENT INFO
Shared By:
Categories:
Tags:
Stats:
views:7
posted:3/18/2011
language:English
pages:6