Burn Center Admission - Introduction

Question: If a patient comes through the Emergency Room and is discharged from the Emergency Room do they go into the registry? Would it make a difference on inclusion if the patient had a Burn consult placed?

Answer: Outpatient only or ER visit only cases (unless they die in your ER) are not included in the registry at present. The ABA is working on possibly adding these in the future. If your center is interested in collecting this data, it is suggested that a separate file for these cases be started.

Admission Date

Question: Definition of admit date in the new BCQP data dictionary states the admission date to the Burn Service should be the date that the care is taken over by the Burn Service or the date the care is co-managed by the Burn Service with the other service involved. Shouldn’t the admission date be the same for all patients regardless of when burn team is consulted?

Answer: This is meant to define the admission date for patients who have conditions that are cared for by other services before the burn service is consulted (i.e. TEN), and the burn service had no input in their care prior to comanaging or managing the care for the patient. The burn service cannot be responsible for issues they had no control over before they assumed care of the patient. It is also for patients who sustain a burn injury while being cared for whatever brought them to the hospital in the first place. Again, the burn service cannot be responsible for whatever brought the patient to the hospital (i.e. cancer), but only for the care of the burn injury. This is true for many patients that may be transferred to the burn hospital from another hospital for care of the burn or other non-burn injury. The injury date will note what the date was that the burn injury or non-burn condition being cared for by the burn service occurred, whether are another hospital or the same hospital.

Admission Time

Question: If a patient that was admitted on the 16th for unrelated medical issues lit a cigarette and got flash burns to their face because they were on supplemental oxygen on the 17th what should be recorded as the admission time?

Answer: In this case put the time the burn service either assumed care or was co-managing care of the patient. If the burn service only consults on the patient, but does not write orders, manage the burn wounds, etc. then that is not co-managing care. If they do write orders, do patient notes and care of the burn wound then they are co-managing care, and you would find the time closest to when that actually starts to occur.

Admission Status

Question: If an acute patient is being transferred from another country should this be recorded in the registry as an anticipated admission?

Answer: First admission to burn center is ‘unanticipated. All acute patient transfers for a new injury should be considered unanticipated, even if there is planning involved related to how to get the patient transferred which may take several days.

Admission Source

Question: A patient was taken to another facility after their injury and was discharged with no follow up. Two weeks later, they called an ambulance and came to our facility for treatment of their injury. Would this be considered a transfer?

Answer: No, this would be a "direct from scene" admission as the patient was not transferred from another facility directly before admission to your facility. You will know the admission did not happen on the same day when you look at the date of injury versus the date of admission to your facility.