Transfer Delay (Medicine): Difference between revisions
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|description='''Transfer Delay''' is the difference between [[Dispo_DtTm]] and [[#Time patient is ready for transfer]] in decimal days. | |description='''Transfer Delay''' is the difference between [[Dispo_DtTm]] and [[#Time patient is ready for transfer]] in decimal days. | ||
Other terms use to call it are '''Beds Occupied by transferable patients''', '''Wasted Beds''', '''Avoidable Days'''. | Other terms use to call it are '''Beds Occupied by transferable patients''', '''Wasted Beds''', '''Avoidable Days'''. | ||
|created_raw= | |created_raw=Created | ||
|Program=Medicine | |Program=Medicine | ||
|indicator_start_date=2003-10-01 | |indicator_start_date=2003-10-01 | ||
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*** to a [[Dispo]] location (ie [[Dispo DtTm]]) | *** to a [[Dispo]] location (ie [[Dispo DtTm]]) | ||
*** to a [[Boarding Loc]] with a ''different''(higher or lower) [[Level of care]] (ie the start of that next [[Boarding Loc]]) | *** to a [[Boarding Loc]] with a ''different''(higher or lower) [[Level of care]] (ie the start of that next [[Boarding Loc]]) | ||
**** transfer to another [[Boarding Loc]] at the ''same'' [[Level of care]] does not reset the clock/generate a new delay | |||
{{ex | | {{ex | | ||
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** three is no transfer ready between HOBS2 and home, so no additional delay | ** three is no transfer ready between HOBS2 and home, so no additional delay | ||
}} | }} | ||
== Calculation of Transfer Delay == | |||
* As agreed in JALT meeting March 22, 2023, transfer delays will be reported based on actual delays at each [[Level of care]] with no more allowances of less than n hours. | |||
*Before Jan 2023, Transfer delay calculation is done similarly with the Critical Care calculation which is substracting ''n'' hrs from all actual delay time and for Medicine, ''n'' is 4 hours. | |||
*In the meeting held Jan 11, 2023, Critical Care agreed to change the calculation of transfer delays which Medicine will do similarly for consistency as follows: (a) ignore such transfer delays < 4 hrs, but (b) for all delays >=4 hrs to use the actual delay time. The process is to be done on the transfer delay at each [[Level of care]]. | |||
== Implementation == | == Implementation == | ||
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It is not reported by ward, it is reported only per episode / profile. | It is not reported by ward, it is reported only per episode / profile. | ||
Julie sums up the multiple transfer delays that might be present. | Julie sums up the multiple transfer delays that might be present and reports them all aggregated to their [[Dispo DtTm]]. It is done this way because only once we have a complete record with a [[Dispo DtTm]] we have reliable Transfer Ready data, so it's the only way we can report on this without becoming inconsistent with data reported earlier. | ||
Start time is first transfer ready per level of care; end is either last of this level of care, or dispo. | Start time is first transfer ready per level of care; end is either last of this level of care, or dispo. | ||
*Before Oct 1, 2020, it is calculated by [[ | *Before Oct 1, 2020, it is calculated by [[Created_Variables_Common_maker_2021 query]] and stored in [[Created_Variables_Common_2021 table]] in [[CFE]]. | ||
*Starting Oct 1, 2020, it will be added but haven't started. | *Starting Oct 1, 2020, it will be added but haven't started. | ||
=== Implementation in CFE === | === Implementation in CFE === | ||
For now, a "Transfer Ready Med testing" button on the main form of CFE needs to be pressed to generate this data. Once we are comfortable with it this generating will be included in the | For now, a "Transfer Ready Med testing" button on the main form of CFE needs to be pressed to generate this data. Once we are comfortable with it this generating will be included in the [[Calc created variables button]]. | ||
[[Sub populate_created_transferDelay()]] loads [[created_TransferReady query]] (which generates transfer ready dates) and [[created_BoardingLoc_plus_historical query]] and writes delays to [[created_transferDelay table]]. | [[Sub populate_created_transferDelay()]] loads [[created_TransferReady query]] (which generates transfer ready dates) and [[created_BoardingLoc_plus_historical query]] and writes delays to [[created_transferDelay table]]. | ||
== Which Transfer Ready DtTm To Use? == | == Which Transfer Ready DtTm To Use? == | ||
This is now implemented in [[Created_TransferReady query]]. | |||
=== [[Admit DtTm]] or [[Dispo DtTm]] < 2020-10-01 00:00 === | === [[Admit DtTm]] or [[Dispo DtTm]] < 2020-10-01 00:00 === | ||
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* for example, a Med patient stays in high obs bed and then move to regular ward bed and then another regular ward bed. There are two [[Level of care hierarchy| levels of care]] - one for high obs and another which is lower, for the regular ward. At least two [[Transfer Ready DtTm]] intent are expected here - first intent for high obs ready to go to a regular ward and the second intent is from a regular ward to be discharged to another lower [[Level of care hierarchy| level of care]] or home or PCH. Assuming that there are transfer orders both at regular ward 1 and regular ward 2 and both are with same [[Level of care hierarchy| level of care]], the ''first'' [[Transfer Ready DtTm]] time will be used in calculating the wasted bed for that lower [[Level of care hierarchy| level of care]]. There will be another wasted bed to be calculated for the high Obs [[Level of care hierarchy| level of care]] from the [[Transfer Ready DtTm]] to the time the patient left the high obs bed (ie the [[Dispo DtTm]] or the next [[Boarding Loc]] start DtTm. Transfer delays for high obs and regular ward will be separately reported. | * for example, a Med patient stays in high obs bed and then move to regular ward bed and then another regular ward bed. There are two [[Level of care hierarchy| levels of care]] - one for high obs and another which is lower, for the regular ward. At least two [[Transfer Ready DtTm]] intent are expected here - first intent for high obs ready to go to a regular ward and the second intent is from a regular ward to be discharged to another lower [[Level of care hierarchy| level of care]] or home or PCH. Assuming that there are transfer orders both at regular ward 1 and regular ward 2 and both are with same [[Level of care hierarchy| level of care]], the ''first'' [[Transfer Ready DtTm]] time will be used in calculating the wasted bed for that lower [[Level of care hierarchy| level of care]]. There will be another wasted bed to be calculated for the high Obs [[Level of care hierarchy| level of care]] from the [[Transfer Ready DtTm]] to the time the patient left the high obs bed (ie the [[Dispo DtTm]] or the next [[Boarding Loc]] start DtTm. Transfer delays for high obs and regular ward will be separately reported. | ||
}} | }} | ||
== Reporting of Transfer Delays == | == Reporting of Transfer Delays == | ||
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== SAS Program== | == SAS Program== | ||
*S:\MED\MED_CCMED\Julie\SAS_CFE\CFE_macros\ | *S:\MED\MED_CCMED\Julie\SAS_CFE\CFE_macros\logphi_TR_Jan2023.sas | ||
** %Med_tready | ** %Med_tready | ||
*S:\MED\MED_CCMED\Julie\SAS_CFE\CFE_macros\prep_Tmp_BoardServiceTransfer.sas (macro %boardtransf) | *S:\MED\MED_CCMED\Julie\SAS_CFE\CFE_macros\prep_Tmp_BoardServiceTransfer.sas (macro %boardtransf) | ||