Readmission Rate to ICU: Difference between revisions
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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]] | ||
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===Frequency=== | ===Frequency=== | ||
Monthly, quarterly or yearly based on either admission dates or discharge dates | |||
==Definition and Derivation== | ==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 | |||
* Definition1 : Number of ICU readmission within 72 hours per 100 discharges to ward | |||
* Definition2 : Number of ICU readmission within 72 hours per 100 discharges to ward, home or elsewhere | |||
===Numerator=== | ===Numerator=== | ||
* Num1 = Number of ICU | * Num1 = Number of ICU patients discharged to any ward and readmitted to any ICU within 72 hours coming from elsewhere | ||
* Num2 = Number of ICU | * 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=== | ||
* Denom1 =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 ward, home or elsewhere | * 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 | *Time Reference: [[Discharge Date]]s from Jan 1, 2017 to March 31, 2017 | ||
*Total readmission within 72 hours | *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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The following fields from L_Log table are being used | The following fields from L_Log table are being used | ||
* [[Person_ID]] | * [[Person_ID]] | ||
* [[ | * [[Admit DtTm]] | ||
* [[Dispo DtTm field]] | * [[Dispo DtTm field]] | ||
* [[Dispo field]] | * [[Dispo field]] | ||
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==SAS Program== | ==SAS Program== | ||
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 |
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.
- 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
- Elective surgery
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
- Person_ID
- Admit DtTm
- Dispo DtTm field
- Dispo field
- 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
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
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