Readmission Rate to ICU: Difference between revisions

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{{Reporting Indicators
{{Reporting Indicators
| description = Number of ICU readmission within 72 hours per 100 discharges to ward.
| description = Number of ICU readmission within 72 hours per 100 discharges to 1) ward only and 2) ward, home or elsewhere.  
| indicator_name = Readmission Rate to ICU
| indicator_name = Readmission Rate to ICU
| created_raw = Created   
| created_raw = Created   
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| indicator_end_date =  
| indicator_end_date =  
}}
}}
 
Used in aggregate form as "per location" and/or "per timeframe", e.g. by month/quarter/year x Ward/Unit x Hospital.
==QI domain==
==QI domain==
* [[QualityDomain::Safe]]
* [[QualityDomain::Safe]]


==Reported as==
==Reported as==
Percent of total discharges to ward
* Definition1 : Percent of total discharges to ward
* Definition2 : Percent of total discharges to ward, home and elsewhere
 
==Significance==
==Significance==
Unplanned readmissions are associated with worse patient outcomes. Most factors associated with an increased risk of readmission are patient and admission-specific. System related risk factors include discharge at night and ICU occupancy at the time of discharge. Readmission may reflect premature transfer out of ICU due to errors in clinical judgment or system constraints.
Unplanned readmissions are associated with worse patient outcomes. Most factors associated with an increased risk of readmission are patient and admission-specific. System related risk factors include discharge at night and ICU occupancy at the time of discharge. Readmission may reflect premature transfer out of ICU due to errors in clinical judgment or system constraints.
==Sampling Plan / Procedure==
==Sampling Plan / Procedure==
===Inclusion Criteria===
===Inclusion Criteria===
100% of all ICU patients discharged to ward
We report these in two ways:
{{discuss | who=Julie | question= Not those that were discharged home or elsewhere? }}
* Definition1: 100% of all ICU patients [[Dispo|discharged to]] ward
* Definition2: 100% of all ICU patients [[Dispo|discharged to]] ward, home or elsewhere


===Exclusion Criteria===
===Exclusion Criteria===
Excluding patients with planned and scheduled surgery (e.g. [[Admit Type for APACHE II]] is not 'Elect.Surg' ) in the count of readmission.
* Definition1 & 2 : Excluding patients with planned and scheduled surgery in the count of readmission.
* Definition2 : Excluding patients who left [[AMA]] or palliative in the count of readmission.
** Elective surgery
*** [[Admit Type for APACHE II]] is 'Elect.Surg'
** Palliative in this context means at least one of the following is present:
*** based on ICD10 [[Palliative care]]
*** tmp [[Comfort Care]]
** AMA - see [[AMA]]


===Frequency===
===Frequency===
Monthly, quarterly or yearly based on either admission dates or discharge dates


==Definition and Derivation==
==Definition and Derivation==
Number of ICU readmission within 72 hours per 100 discharges to ward
Readmission means the patient left/discharged out of ICU to '''elsewhere''' and came back to ICU in the same or different facility  from '''elsewhere'''. Readmission count is accounted to the unit discharging the patient the first time and not to the unit admitting the patient the second time.
 
* Definition1 : Number of ICU readmission within 72 hours per 100 discharges to any ward  
* Definition2 : Number of ICU readmission within 72 hours per 100 discharges to any ward, home or elsewhere
===Numerator===
===Numerator===
Num = Number of ICU readmission within 72 hours coming from ward
* Num1 = Number of ICU patients discharged to any ward  and readmitted to any ICU within 72 hours coming from elsewhere
* Num2 = Number of ICU patients discharged to any ward, home or elsewhere and readmitted to any ICU within 72 hours coming from elsewhere
===Denominator===
===Denominator===
Denom =Total Number of discharges who went to ward  
* Denom1 =Total Number of discharges who went to any ward  
* Denom2 =Total Number of discharges who went to any ward, home or elsewhere
===Formula===
===Formula===
Readmission Rate(%) = Num / Denom * 100
Readmission Rate(%) = Num / Denom * 100
===Example===
===Example===
*Time Reference: Discharge Dates from Jan 1, 2017 to March 31, 2017
*Time Reference: [[Discharge Date]]s from Jan 1, 2017 to March 31, 2017
*Total readmission within 72 hours coming from ward= 5
*Total readmission within 72 hours of patients previously discharged to any ward= 5
*Total discharges who went to ward  = 102
*Total discharges who went to ward  = 102
*Readmission Rate(%)  = 5 / 102 * 100= 4.9 %
*Readmission Rate(%)  = 5 / 102 * 100= 4.9 %
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==Data Sources==
==Data Sources==
The following fields from L_Log table  are being used  
The following fields from L_Log table  are being used  
* [[Accept_DtTm field]] or [[Arrive DtTm field]]
* [[Person_ID]]
* [[Admit DtTm]]
* [[Dispo DtTm field]]
* [[Dispo DtTm field]]
* [[Dispo field]]
* [[Dispo field]]
* [[Admit Type for APACHE II]]
* [[Admit Type for APACHE II]]
 
* the Project [[Comfort Care]] from L_TmpV2 table,  diagnosis code [[Palliative Service]] from L_DXs table, ICD10 code Z51.5 [[Palliative care]] from L_ICD10 table
== Duplication? ==
{{discuss| who = Julie | question =
* Is this the same as [[Re-admission]]? Ttenbergen 12:03, 2017 July 5 (CDT)
** similar but specific with ICU. I will do a separate one for Med and  delete the [[Re-admission]] after.}}


==SAS Program==
==SAS Program==
X:\Julie\SAS_CFE\CFE_macros\readmfronward.sas
S:\MED\MED_CCMED\Julie\SAS_CFE\CFE_macros\ccreadm_starting1Oct2020.sas


==Report Users==
==Report Users==

Latest revision as of 12:48, 2022 April 21

Number of ICU readmission within 72 hours per 100 discharges to 1) ward only and 2) ward, home or elsewhere.

Indicators
Indicator: Readmission Rate to ICU
Created/Raw: Created
Program: Critical Care
Start Date:
End Date:
Reports: Critical Care Program Quality Indicator Report, HSC ICUs Data by Patient


  • Cargo


  • SMW:
  • Categories
  • Default form:

Used in aggregate form as "per location" and/or "per timeframe", e.g. by month/quarter/year x Ward/Unit x Hospital.

QI domain

  • Safe

Reported as

  • Definition1 : Percent of total discharges to ward
  • Definition2 : Percent of total discharges to ward, home and elsewhere

Significance

Unplanned readmissions are associated with worse patient outcomes. Most factors associated with an increased risk of readmission are patient and admission-specific. System related risk factors include discharge at night and ICU occupancy at the time of discharge. Readmission may reflect premature transfer out of ICU due to errors in clinical judgment or system constraints.

Sampling Plan / Procedure

Inclusion Criteria

We report these in two ways:

  • Definition1: 100% of all ICU patients discharged to ward
  • Definition2: 100% of all ICU patients discharged to ward, home or elsewhere

Exclusion Criteria

  • Definition1 & 2 : Excluding patients with planned and scheduled surgery in the count of readmission.
  • Definition2 : Excluding patients who left AMA or palliative in the count of readmission.

Frequency

Monthly, quarterly or yearly based on either admission dates or discharge dates

Definition and Derivation

Readmission means the patient left/discharged out of ICU to elsewhere and came back to ICU in the same or different facility from elsewhere. Readmission count is accounted to the unit discharging the patient the first time and not to the unit admitting the patient the second time.

  • Definition1 : Number of ICU readmission within 72 hours per 100 discharges to any ward
  • Definition2 : Number of ICU readmission within 72 hours per 100 discharges to any ward, home or elsewhere

Numerator

  • Num1 = Number of ICU patients discharged to any ward and readmitted to any ICU within 72 hours coming from elsewhere
  • Num2 = Number of ICU patients discharged to any ward, home or elsewhere and readmitted to any ICU within 72 hours coming from elsewhere

Denominator

  • Denom1 =Total Number of discharges who went to any ward
  • Denom2 =Total Number of discharges who went to any ward, home or elsewhere

Formula

Readmission Rate(%) = Num / Denom * 100

Example

  • Time Reference: Discharge Dates from Jan 1, 2017 to March 31, 2017
  • Total readmission within 72 hours of patients previously discharged to any ward= 5
  • Total discharges who went to ward = 102
  • Readmission Rate(%) = 5 / 102 * 100= 4.9 %

Data Sources

The following fields from L_Log table are being used

SAS Program

S:\MED\MED_CCMED\Julie\SAS_CFE\CFE_macros\ccreadm_starting1Oct2020.sas

Report Users

  • Critical Care Directors and Site Managers
  • Critical Care Quality Improvement Team (QIT)

Related articles

Related articles:
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