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The Society of Thoracic Surgeons Frequently Asked Questions: Adult
Cardiac Surgery Database Version 2.52.1 August, 2006 How to use the interactive FAQ Document: 1. To
review all clinical questions in an individual section, click on the section
title below. |
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Section C:
seq# 220-340 |
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2.
To review an individual Seq# clinical question, click on the Seq# title
below. 1280 OpCAB
3090-3180 Section R. 3. CC/TM: Corrections/Clarifications to Training
Manual |
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NEW |
Date |
SeqNo |
FieldName |
Definition |
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220 |
Hospital Name |
Indicate the full name of the facility where the
procedure was performed. Values should
be full, official hospital name with no abbreviations or variations in spelling
for a single hospital. Values should
also be in mixed-case. |
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230 |
Hospital ZIP Code |
Indicate the ZIP Code of the hospital. Outside the |
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240 |
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Indicate the State in which the hospital is located. |
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250 |
Payor |
Indicate the patient's primary
insurance payor for this admission such as, but not limited to: 1.
Government: Government insurance refers to patients who are covered by
government-reimbursed care. In the 2.
Commercial: Commercial refers to all indemnity (fee-for-service) carriers and
Preferred Provider Organizations (PPOs) (e.g. Blue Cross/Blue Shield). 3. HMO:
HMO refers to a Health Maintenance Organization characterized by coverage
that provides health care services for members on a pre-paid basis. 4.
None: None refers to individuals with no or limited health insurance; thus,
the individual
is the payor regardless of ability to pay. Only mark "None" when
"self" or "none" is denoted as the first insurance in the
medical record. 5.
International patient: International patient refers to individuals who reside
in and have a health
insurance in another country and/or may be self pay. |
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260 |
Date of Admission |
Indicate the Date of Admission. For those patients who originally enter the
hospital in an out-patient capacity (i.e. catheterization), the admit date is
the date the patient's status changes to in-patient. |
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From version 2.41 |
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Is this the date the patient comes to the
hospital prior to surgery if the patient does not ever go home, or is it the
day they are declared an inpatient? We
have many surgical patients who come in for their caths as outpatients and
then are converted to inpatients when they are admitted for their surgery,
but never actually leave the hospital.
They never leave the hospital but their status changes. |
The date that the patient status changes
to an inpatient status is the date for admission. ( |
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270 |
Date of Surgery |
Indicate the date of surgery which equals the date the patient enter
the OR. |
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From version 2.41 |
7/03 |
Regarding
date of surgery: for surgeries that
start on one date and end on another, i.e. starts at 10pm and ends at 2am, is
the actual surgery date the date surgery begins or ends? |
The
date of surgery is the date the patient enters the OR suit. |
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340 |
Date of Discharge |
Indicate the date the patient was
discharged from the hospital (acute care). If the patient died in the
hospital, the discharge date is the date of death. |
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From version 2.41 |
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When a patient is transferred to our Rehab
unit prior to going home, is this the date of discharge, or is it the date
that they actually go home? |
The date of discharge would be considered
the date they leave the acute care facility.
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From version 2.41 |
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If the date of discharge is calculated
from the date that the patient leaves acute status, then is the readmit to
the Rehab unit considered a readmission within 30 days? They are considered an inpatient on the
Rehab unit. |
No, this is not considered a
readmit. A readmit is considered to
be to the acute care facility. ( |
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300 |
ICU Visit |
Indicate whether the patient spent time
in the ICU immediately following the initial surgery. Include post-anesthesia recovery and other
similar critical care environments. |
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310 |
Initial ICU hours |
Indicate the number of hours the patient was initially in the ICU
immediately following the initial surgery.
Include post-anesthesia recovery and other similar critical care
environments. |
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From version 2.41 |
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Our patients generally are in the recovery area and then
go straight to our telemetry floor. Do
we include the recovery area hours as the initial ICU stay or not? |
Yes, include. It appears you utilize your recovery area
as an ICU.( |
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From version 2.41 |
6/03 |
Do
the initial ICU hours begin when the patient gets to the open heart recovery
area or when the patient leaves the OR in transport? |
ICU
hours begin when the patient arrives in the ICU or your institutions
equivalent to an ICU. |
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From version 2.41 |
7/03 |
Patient
involved in a MVA with a subsequent repair of an Aortic Transection. Post-operatively went to the SICU and not
the Cardiothoracic surgery ICU. Should
we still count the SICU hours as ICU hours? |
Yes,
count the SICU hours as ICU hours. The
intent is to capture critical care environment hours. It does not matter what your institution
calls their critical care environment (ICU, CVICU, SICU, anesthesia recovery
unit). If the patient is in a critical
care environment then the hours need to be coded. |
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4/05 |
OR to ICU to
OR to ICU = no ICU readmission. Do not
count OR time as ICU hours. All ICU
hours in this example should be captured as initial ICU hours. |
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NEW! |
For future releases will there be a way to
submit data for sites that have single stay units. Our patients stay in the ICU in a step down
status until discharge. This makes our
ICU hours seem extreme. |
I share your concern but you are
collecting the data correctly |
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320 |
Readmission to ICU |
Indicate whether the patient spent time
in an ICU after having been transferred to a step-down unit (lower level
care). Specific situations are
described below: OR -> ICU -> OR -> ICU = No OR -> ICU -> STEP DOWN -> ICU = Yes OR -> STEP DOWN -> ICU = Yes |
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2/04 |
Patient undergoes reop including reintubated for surgery. Patient to ICU postop and is extubated in
less than 1 hour but stays in ICU overnight.
Do we count this as readmission to ICU? |
This answer depends on the level of care that the patient required
after the original surgery. See the
following examples: 1. OR to ICU to OR to ICU = no
re-admission to the ICU 2. OR to ICU to stepdown to OR
to ICU = yes, re-admission to ICU |
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330 |
Additional ICU Hours |
Indicate the number of additional hours spent in the Intensive Care
Unit. |
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340 |
Total Hrs ICU |
Indicate the total number of hours post operation for which the patient
was in the ICU. Leave blank if the patient expired in the OR. Enter zero (0) if patient was never in
post-anesthesia recovery or other similar critical care environment. |
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From version 2.41 |
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About 25% of our patients are ready to go
to a stop down unit and dont because there is no bed available. Also, our patients do not go to the
recovery room, making our ICU hours longer than institutions that use the
recovery room. Have other institutions
encountered this issue? |
Yes,
this issue has been raised by other sites.
The definition is intended to
capture the total number of hours that the patient actually remains in Acute Care, Critical Care, or
ICU Care. If there is a bed
availability issue and patient has to stay in the ICU, you need to continue
to monitor those hours. It would become
very gray in terns of when the actual ICU hours change (i.e. when were the
orders written? When did the staff
first find out there was no bed?) This
is a process issue that needs to be collected and monitored for future
improvement. Also, you could track the
number of hours the patient was in the ICU just waiting for a bed separately
in a custom field, or in a separate database/spreadsheet. The
issue of the patient coming to the ICU right from surgery, bypassing the
recovery room is very common and does cause some variance in reporting total
hours between sites where patients go to recovery first. If your site bypasses the recovery room,
you need to count the hours and know that other sites that are set up like
yours are reporting the same. ( |
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NEW! |
Does transfer of a patient to a
ventilator unit for weaning constitute and ICU? |
No |
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