Transfer Ready DtTm field: Difference between revisions

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{{Data_element
{{Data element
| field_name = Transfer_Ready_DtTm
|field_name=Transfer_Ready_DtTm
| CCMDB_label = Transfer Ready DtTm
|CCMDB_label=Transfer Ready DtTm
| CCMDB_tab = Dispo
|CCMDB_tab=Dispo
| element_description = Date and time the '''intent to discharge''' a patient to a lower level in the [[Level of care hierarchy]] was documented.
|in_table=L_Log table
| in_table = L_Log table
|data_type=date
| data_type = date
|program_collecting=Med and CC
| program_collecting = Med and CC
|created_raw=Raw
| created_raw = Raw
|data_element_start_date=1999-06-01
| data_element_start_date = 2016-07-01
|data_element_end_date=2020-10-15
| data_element_sort_index = 47
|data_element_sort_index=47
|element_description=Date and time the '''intent to discharge''' a patient to a lower level in the [[Level of care hierarchy]] was documented.
}}
}}
See [[Level of care hierarchy]] for meaning of "lower level of care".
See [[Transfer Ready DtTm tmp entry]]


{{TT | '''For Transfer Ready DtTms after 2020-10-15 this will be entered as a [[Transfer Ready DtTm tmp entry]] instead of using this field.'''}}
The data in this field will be retained in [[Centralized_data.accdb]]'s [[L_Log table]] since it doesn't follow the same pattern as the new entry. The field no longer exists in [[CCMDB data.mdb]].  


== Purpose ==
The purpose is to determine the '''avoidable days or bed wasted''' by patients who are '''deemed ready to leave the unit or ward''' and then '''either move to a lower level of care or leave the hospital'''. This is used as part of the concept [[Avoidable Days in ICU]].


What is being sought here is the ''intent'' to send someone to a lower level of care only. Thus, it doesn’t matter what actually happened after this intent occurs (e.g. patient getting sicker and the transfer intent cancelled). <!-- Clarified at the 11Sept2017 Steering Committee meeting -->
 
See [[Transfer Ready DtTm tmp entry]] for what this field is about, or see the history of this page for how it has been used at different times before moving to the new field.  


== Collection Instruction ==
== Collection Instruction ==
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For each patient,  
For each patient,  
* enter the first date/time of '''intent''' to transfer to lower level in the [[Level of care hierarchy]] is documented into the Transfer Ready Date and Time Field; see [[#status changing back and forth]]
* enter the first date/time of '''intent''' to transfer to lower level in the [[Level of care hierarchy]] is documented into the Transfer Ready Date and Time Field; see [[#status changing back and forth]]
** if a patient '''arrives transfer-ready''' to a [[Level of care hierarchy | lower level]] of care '''than ''the current'' ward''' enter the same date into [[Transfer Ready DtTm field]] as in [[Arrive_DtTm field]].
** if a patient '''arrives transfer-ready''' to a [[Level of care hierarchy | lower level]] of care '''than ''the current'' ward''' enter the same date into [[Transfer Ready DtTm field]] as in ''Arrive_DtTm field''.
* if not available because the patient was '''clearly not transfer ready''', leave the date/time '''empty''' and enter "'''not transfer ready'''" into the "'''[[TR info status field]]'''"
* if not available because the patient was '''clearly not transfer ready''', leave the date/time '''empty''' and enter "'''not transfer ready'''" into the "'''[[TR info status field]]'''"
* if not available but the patient probably was transfer ready and it just wasn't documented, leave the date/time '''empty''' and enter '''"not available"''' into the "'''[[TR info status field]]'''"  
* if not available but the patient probably was transfer ready and it just wasn't documented, leave the date/time '''empty''' and enter '''"not available"''' into the "'''[[TR info status field]]'''"  
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}}
}}
=== What is transfer ready? ===
=== What is transfer ready? ===
{{Discuss|
moved to [[Transfer Ready DtTm tmp entry#Transfer Ready]]
* I believe this contradicts the information on the Transfer Ready DtTm tmp entry page, not sure which is correct. I thought we were doing a transfer ready line for every physical location, not just lower levels of care?
** The distinction is between what means transfer ready (that is a matter of '''intent to discharge''') and the things that actually happen (pt became worse and went to a higher level of care). The definition below is right for what defines when pt is transfer ready. The explanation in [[Transfer Ready DtTm tmp entry]] essentially just says when the clock re-sets, and that could either be because pt was successfully moved to a lower level of care, or because they died (still no longer taking up a bed) or because they became worse and went to a higher level of care (again no longer waiting for that initial lower level of care). Ttenbergen 14:19, 2020 October 19 (CDT)}}
Any of these criteria, for a patient going to a '''lower''' level of care, as per hierarchy below:
*The goal here is to identify the intention of the team to send the patient to a lower level if there was an available bed there.
**Obviously we don't always know the team's intentions, but if they do write them down, then USE THAT INFO.
*Regarding the statement that the patient is "medically stable"
**This phrase could mean that the person is improved enough to go elsewhere, but it does NOT necessarily mean that.  For example it could technically indicate that the condition is not changing lately, which may or may NOT mean that they're ready to go elsewhere.
**Thus, by itself that phrase cannot be used alone to suggest the patient is transfer ready
**e.g. Deconditioned patient may be medically stable but intention can be to leave them where they are for now to re-condition
**e.g. Patient is medically stable but still needs a sitter --> another situation in which just being "medically stable" isn't sufficient to tell us if they're transfer ready
*In an ICU setting, you CAN take the following to indirectly indicate transfer ready to a lower level of care when nothing has been written:
**care is stepped down to WARD FREQUENCY (q4hrs or less) of vitals, off ALL forms of life support except possibly intermittent dialysis
**[[HSC_IICU]] consult is written
*In a ward setting, you can take the following to indirectly indicate transfer ready to a lower level of care when nothing has been written:
**care is stepped down to change iv meds to po, remove monitoring
*In either ICU or ward setting being made [[ACP C|ACP-C]] can be taken as indirect evidence of being transfer ready.


=== Hierarchy of levels of care ===
=== Hierarchy of levels of care ===
We require an entry in this field when the intent is to transfer from higher to lower level of care. See [[Level of care hierarchy]] for a list.
We require an entry in this field when the intent is to transfer from higher to lower level of care. See [[Level of care hierarchy]] for a list.


=== status changing back and forth ===
=== Collection Start Dates ===
If a patient changes from being transfer ready back to not being transfer ready, collect the '''first''' time they are transfer ready on their current [[Level of care hierarchy|level of care]]. If they become no longer transfer ready, leave it alone, and if they become transfer ready again at the same level of care, retain only the original Transfer Ready DtTm for that level.
* Critical Care: all units on board June 1, 1999
 
* Medicine : all wards on board Jan 1, 2005
If the patient moves to a different (higher or lower) level of care, then enter an additional [[Transfer Ready DtTm tmp entry]].
** Temporary Stopped Date in all wards: May 1, 2010 to Nov 30, 2011
 
== Data Use ==
Used to generate [[Transfer_Delay]], see [[Transfer_Delay#data use]].


== Cross Checks ==
== Cross Checks ==
{{Data Integrity Check List}}
{{Data Integrity Check List}}
== Related Articles ==
{{Related Articles}}


== Legacy ==
== Legacy ==
{{LegacyContent
|explanation= legacy
|content=
Similar to the old [[Transfer Ready date and time]], but we eliminated special cases and differences between medicine and critical care. Going forward the entry will be collected even if pt dies or goes to ER etc. It's the intent that counts, not what ended up happening.  
Similar to the old [[Transfer Ready date and time]], but we eliminated special cases and differences between medicine and critical care. Going forward the entry will be collected even if pt dies or goes to ER etc. It's the intent that counts, not what ended up happening.  
Resp. field names L_Log.R_TRDate and L_Log.R_TRTime
Resp. field names L_Log.R_TRDate and L_Log.R_TRTime
}}


[[Category: 2016 Time and Place changes]]
== Related Articles ==
[[Category: Admit/Discharge]]
{{Related Articles}}
[[Category: Transfer Ready]]
 
[[Category: Data Collection Guide]]
[[Category:2016 Time and Place changes]]
[[Category: Registry Data]]
[[Category:Admit/Discharge]]
[[Category: Transfer Ready| *]]
[[Category:Transfer Ready]]
[[Category:Service/Location check]]
[[Category:Registry Data]]

Latest revision as of 12:10, 30 July 2025

 
 
 
 

Legacy Content

This page contains Legacy Content.

  • Explanation: This is a legacy data field, its DataElementEndDate is in the past.
  • Successor: No successor was entered

Click Expand to show legacy content.

Data Element (edit)
Field Name: Transfer_Ready_DtTm
CCMDB Label: Transfer Ready DtTm
CCMDB tab: Dispo
Table: L_Log table
Data type: date
Length: not stated
Program: Med and CC
Created/Raw: Raw
Start Date: 1999-06-01
End Date: 2020-10-15
Sort Index: 47
Data Dependencies(Reports/Indicators/Data Elements): No results

Date and time the intent to discharge a patient to a lower level in the Level of care hierarchy was documented.

  • SMW

Legacy implementation right in the table

  • Cargo


  • Categories
  • Forms


See Transfer Ready DtTm tmp entry

The data in this field will be retained in Centralized_data.accdb's L_Log table since it doesn't follow the same pattern as the new entry. The field no longer exists in CCMDB data.mdb.


See Transfer Ready DtTm tmp entry for what this field is about, or see the history of this page for how it has been used at different times before moving to the new field.

Collection Instruction

Entering a Transfer Ready DtTm

Follow the instructions in Transfer Ready DtTm tmp entry.

Before 2020-10-15   

For each patient,

  • enter the first date/time of intent to transfer to lower level in the Level of care hierarchy is documented into the Transfer Ready Date and Time Field; see #status changing back and forth
  • if not available because the patient was clearly not transfer ready, leave the date/time empty and enter "not transfer ready" into the "TR info status field"
  • if not available but the patient probably was transfer ready and it just wasn't documented, leave the date/time empty and enter "not available" into the "TR info status field"

This entry is about the time of an intent, nothing to do with what actually happened to the patient after.

What is transfer ready?

moved to Transfer Ready DtTm tmp entry#Transfer Ready

Hierarchy of levels of care

We require an entry in this field when the intent is to transfer from higher to lower level of care. See Level of care hierarchy for a list.

Collection Start Dates

  • Critical Care: all units on board June 1, 1999
  • Medicine : all wards on board Jan 1, 2005
    • Temporary Stopped Date in all wards: May 1, 2010 to Nov 30, 2011

Cross Checks

Data Integrity Checks (automatic list)

 AppStatus
Check Function Panelling admit transfer sameCCMDB.accdbretired
Query check dispo lower acuity than locationCCMDB.accdbretired
Link suspect transfer ready before arrive dateCentralized data front end.accdbretired

Legacy

Similar to the old Transfer Ready date and time, but we eliminated special cases and differences between medicine and critical care. Going forward the entry will be collected even if pt dies or goes to ER etc. It's the intent that counts, not what ended up happening. Resp. field names L_Log.R_TRDate and L_Log.R_TRTime

Related Articles

Related articles:
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