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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 1) ward only and 2) ward, home or elsewhere.  
|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
|created_raw=Created
| created_raw = Created 
|Program=Critical Care
| program = Critical Care
|DataDependencies=Palliative care; Palliative Service; Palliative patient; Comfort Care; AMA; Admit Type for APACHE II; Dispo; Dispo DtTm; Admit date and time; Person ID field
| indicator_start_date =  
|indicator_name=Readmission Rate to ICU
| indicator_end_date =  
|program=Critical Care
}}
}}
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==
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===Inclusion Criteria===
===Inclusion Criteria===
We report these in two ways:  
We report these in two ways:  
* Definition1 :100% of all ICU patients [[Dispo|discharged to]] ward
* Definition1: 100% of all ICU patients [[Dispo|discharged to]] ward
* Definition2 :100% of all ICU patients [[Dispo|discharged to]] ward, home or elsewhere
* Definition2: 100% of all ICU patients [[Dispo|discharged to]] ward, home or elsewhere


===Exclusion Criteria===
===Exclusion Criteria===
* Definition1 & 2 : 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.
* Definition2 : Excluding patients who left [[AMA]] or [[palliative patient]]s in the count of readmission.
 
** Elective surgery
*** [[Admit Type for APACHE II]] is not 'Elect.Surg'
** Palliative in this context means at least one of the following is present:
*** based on ICD10 [[Palliative care]] where available
*** tmp [[Comfort Care]]


* Elective surgery
** [[Admit Type for APACHE II]] is 'Elect.Surg'
{{palliative patient}}
* AMA - see [[AMA]]


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


==Definition and Derivation==
==Definition and Derivation==
{{DJ |
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.  
I moved the following here from [[Readmission]] to avoid duplication in two places. It should either be integrated or cleaned out:
* Definition1 : Number of ICU readmission within 72 hours per 100 discharges to any ward  
== ICU Definition ==
* Definition2 : Number of ICU readmission within 72 hours per 100 discharges to any ward, home or elsewhere
For ICU, a readmission is a patient where
* (admit date/time) - (most recent ICU discharge date/time to ward or home) <= 48 hours
{{Discuss | who = Julie | question =
* that said 72 before... was it related to [[72hr Readmission Rate to ICU]]? If so I will change the name and wiki links but we need to also review that content is right.
* will it be "...first [[Service tmp entry|ICU Service Start DtTm]]" instead of admit date/time going forward?
}}
* is '''not''' an [[Admit Type for APACHE II]] "elective surgery"
* might be readmitted from Ward within or outside Winnipeg hospitals or home or nursing home
** can also specify to include only from any ward within the region.
}}
 
* 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 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 readmission within 72 hours coming from ward, home or 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===
* 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 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 %


==Data Sources==
==Data Sources==
The following fields from L_Log table  are being used
See infobox in top left
* [[Person_ID]]
* [[Accept_DtTm field]] or [[Arrive DtTm field]]
* [[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==
==SAS Program==
X:\Julie\SAS_CFE\CFE_macros\readmfromward.sas and/or CFE_macros\ccreadm.sas   
S:\MED\MED_CCMED\Julie\SAS_CFE\CFE_macros\ccreadm_starting1Oct2020.sas   


==Report Users==
==Report Users==
Retrieved from "https://ccmdb.kuality.ca/index.php?title=Readmission_Rate_to_ICU"