ER Delay

Data Element (edit)
Field Name:	ER Delay
CCMDB Label:	not stated
CCMDB tab:	not stated
Table:	Created_Variables_Common_2021 table
Data type:	date
Length:	n/a
Program:	Med and CC
Created/Raw:	Created
Start Date:	1988-07-11
End Date:	2300-01-01
Sort Index:	8

The ER Delay is the difference between the pre-ER Boarding Loc and first post-ER Boarding Loc, for patients arriving from the ER.

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Legacy implementation right in the table

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• Forms

It's is calculated by Created_Variables_Common_maker_2021 query and stored in Created_Variables_Common_2021 table in CFE. It is related to one of our Indicators, Length_of_Time_for_Transfer_from_ED_to_ICU_within_same_facility.

Data use

• Measure the time spent using ER bed/facilities/staff while already accepted under a Medicine or Critical Care Service.
• Measure the delay of movement of patient from ER bed to Medicine or Critical Care bed.

ER Delay Calculation

• Before Oct 2020 : If Previous Location is own ER
  • Non-EMIP / Non-ECIP : Arrive DtTm - Accept DtTm and Accept DtTm missing is not marked
    • if Accept DtTm missing is marked then ER Delay is missing.
  • EMIP/ECIP: Dispo DtTm - Accept DtTm
• Starting Oct 2020 : if first Boarding Loc is own ER
  • Only one ER Boarding Loc: Dispo DtTm - first ER Boarding Loc start Dttm
  • At least two Boarding Loc: First NonER Boarding Loc start Dttm - first ER Boarding Loc start Dttm

Implemented as

ER_Delay:

IIf(Not [PatientFollow],

IIf([location_name] Like "*EMIP*",[Dispo_DtTm],[Arrive_DtTm])-Nz([Accept_dttm],

[Arrive_dttm]),Nz([created_FirstNonER_BoardingLoc].[dttm],[Dispo_DtTm])-[created_FirstER_BoardingLoc].[dttm])

Outliers

ED stays in mid-hospitalization

• there are occasions where pts go back to the ED while under the care of ICU; we do not include these in ER Delays; discussed at JALT 2024-10-31...

Moves for Medicine

This data is problematic before 2011-Q2,the only reason there are any is because it derives them for EMIPs. Some data may be available in Moves for Medicine, but that would still leave a gap. Ttenbergen 23:09, 2024 November 16 (CST) OK, will be working on this getting data from Moves for Medicine from period Sept 2007 to June 3, 2011. will give to Pagasa for upload to Arrive DtTm field. I will update the WIKI as soon as done. Conclusion: for Medicine, prior Sept 2007, no ER delay while for Critical Care, no ER Delay prior July 1, 2016 -- these are treated as missing. --JMojica 16:35, 2024 December 11 (CST)

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Log

I have re-updated Created_Variables_Common_maker_2021 query, for some reason the change I had made was not reflected in the master version. Ready to test. Ttenbergen 13:25, 2022 June 28 (CDT) emailed Tina some inconsistencies found in ER Delays Aug 15,2022. --JMojica 13:21, 2022 August 29 (CDT) are these still an issue? Ttenbergen 11:15, 2024 May 1 (CDT) I will re-check again. Can't remember if have been resolved. --JMojica 14:40, 2024 October 2 (CDT)

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• 2022-06-28 - previous change got lost somehow, re-applied it; updated query to use query created_PatientFollow rather than in-query definition
• 2022-06-09 - updated Created_Variables_Common_maker_2021 query with the new definition.

Data Integrity Checks (automatic list)

	App	Status
Query s tmp Boarding Loc ER delay reasonable	CCMDB.accdb	implemented

related fields

• Boarding Loc DtTms
• LOS
• Transfer Delay

Reporting and Analysis

The SAS Program to read the data is in X:\Julie\SAS_CFE\CFE_macros\datetimes.sas

I just had a look at that sas file (they open as text files) to see how you define transfer delay. If that file is still being used we may have a problem, it still defines tdelay different if a pt goes to a higher level of care, goes AMA or dies, and we changed that some time ago. So is this still the reference of how you calculate this? Ttenbergen 22:50, 2024 November 16 (CST)

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Legacy

• Used to be just the difference between the Accept DtTm and Arrive_DtTm for patients arriving from the ER.
• Used to be collected as ER Wait and before that as Moves for Medicine.