The Veterinary Medical Teaching Hospital is administratively a single unit and is generally referred to as The Hospital. However, patient care and student rotations are often aligned with the Small Animal and Large Animal departments. Patients that are admitted to the Large Animal Hospital are typically managed by Small or Large Animal departmental faculty in Clinical Service areas. Caseload and many financial reports are therefore organized to report activity separately by Small or Large Animal hospitals. VMIS also organizes some screens and selection lists to be contextually aware of the user's currently selected default Hospital.
The Hospital organizes its revenue and expenses into accounts called Responsibility Centers (also known as support accounts in the University accounting system). All hospital expenses and revenue is attributable to an RC. Revenue is attributed to an RC for each individual charge on invoices. Expenses are designated when purchase orders are issued or employees are hired. One of the goals of the RC is to group revenue into the same RC as the expenses that were used to generate that revenue. It also allows responsibility and accountability to be assigned to the supervisors that oversee those areas.
Visit Caseload
Visit Caseload (also known as Discharge Caseload) is the primary measurement of hospital and clinical activity. Patients are typically admitted, treated, and then discharged. When this occurs, we refer to it as one Visit. If the patient returns after being discharged, that is considered a separte visit. The number of Visits over a period is referred to as Visit Caseload. Visit Caseload can be reported for the Hospital as a whole, per Large or Small Animal Hospital, per clinician, or per Clinical Service. Since more than one Clinical Service or Clinician may participate in the care of a patient during the visit, we credit the discharging service and clinician with the Visit when reporting by Visit Caseload by Clinical Service or Clinician. Since Visit Caseload is based on the discharging service orclinician, the total Visits for all services or clinicians will equal the total Visit Caseload for the Hospital.
Accession Caseload
Visit Caseload alone is not always adequate to measure a Clinical Service's activity. If a service such as Emergency admits and stabilizes a patient, and then transfers the patient to another service, the admitting service would not be credited for the Visit, even though it may have been a major participant. Also, Responsibility Centers such as Radiology and Clinical Pathology do not discharge patients and would not be credited with any Visit Caseload. Accession Caseload is intended to credit each service that participated in the care of a patient's visit. If an RC or service adds one or more charges to the patient's invoice, that service/RC gets credit for on Accession. Since multiple services and RC's get credit for the same visit, the total service accessions would not equal the total Hospital Visit Caseload.
Animals Treated Caseload Visit Caseload and Accession Caseload are based on the admission/discharge process. Herds, mare/foal pairs, and litters are often admitted as a single “patient” for record-keeping simplicity. The number of animals in the herd/pair/litter are recorded with the admission, but are not counted in Visit and Accession Caseload. Animals Treated Caseload takes the herd/pair/litter size into account. This measure of clinical activity is well-suited for ambulatory services.
The Census is a list of all patients that are currently admitted (and not discharged). Patients that appear on the Census reports should be physically in the hospital, under the care of Hospital faculty and staff.
The Fee Schedule is a list of fees and prices. Every line item that appears on an invoice comes from either the fee schedule or the pharmacy product list. Since there is a large number of fees and products, and each Responsibility Center typically charges a small subset of those fees, the Fee Schedule is organized into a number of Charge Forms - usually corresponding to Responsibility Centers. A Charge Form is simply a subset of the Fee Schedule, used by Responsibility Centers to locate and organize the fees they charge. The Charge Form also determines which Responsibility Center will get credit for the revenue that is charged from it.