Transfer Delay (Critical Care): Difference between revisions

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{{Reporting Indicators
{{Reporting Indicators
|description='''Transfer Delay''' is the difference between [[Dispo_DtTm]] and [[#Transfer Ready DtTm in use at different times]] in decimal days.
|description='''Transfer Delay''' is the difference between [[Dispo_DtTm]] and [[#Transfer Ready DtTm in use at different times]] in decimal days.
|created_raw=created
|created_raw=Created
|Program=Critical Care
|Program=Critical Care
|indicator_start_date=1999-01-15
|indicator_start_date=1999-01-15
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|program=Critical Care and Medicine
|program=Critical Care and Medicine
}}   
}}   
There is a similar concept in medicine, [[Transfer Delay (Medicine)]].  
There is a similar concept in medicine, [[Transfer Delay (Medicine)]].  


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* The purpose is to determine the amount of time the patient is occupying a bed in an ICU setting when the patient no longer needs that [[Level of care hierarchy| level of care]] (also referred to as wasted bed) from the [[#Transfer Ready DtTm in use at different times]] until the [[Dispo DtTm]].
* The purpose is to determine the amount of time the patient is occupying a bed in an ICU setting when the patient no longer needs that [[Level of care hierarchy| level of care]] (also referred to as wasted bed) from the [[#Transfer Ready DtTm in use at different times]] until the [[Dispo DtTm]].
== Calculation of Transfer Delay ==
== Calculation of Transfer Delay ==
*Transfer Delay is the difference between Dispo DtTm and first Transfer Ready DtTm.
*Transfer Delay is the difference between [[Dispo DtTm]] and first [[Transfer Ready DtTm]].
{{Collapsable| always=see previous definitions| full=
*As agreed in JALT meeting March 22, 2023, transfer delays will be reported based on actual delay times with no more allowances of less than n hours.
*As agreed in JALT meeting March 22, 2023, transfer delays will be reported based on actual delay times with no more allowances of less than n hours.
*Initially, transfer delay calculation follows the national Vital Signs Monitoring program guideline which is substracting 2 hrs from all actual delay time.
*previously, transfer delay calculation followed the national Vital Signs Monitoring program guideline which subtracted 2 hrs from all actual delay time.
*In the meeting held Jan 11, 2023, it was decided as per approval from the Critical Care Director to define transfer delays as follows: (a) ignore such transfer delays <2 hrs, but (b) for all delays >=2 hrs to use the actual delay time.
*In the meeting held Jan 11, 2023, it was decided as per approval from the Critical Care Director to define transfer delays as follows: (a) ignore such transfer delays <2 hrs, but (b) for all delays >=2 hrs to use the actual delay time.
}}


== Transfer Ready DtTm in use at different times ==
== Transfer Ready DtTm in use at different times ==
===  [[Admit DtTm]] or [[Dispo DtTm]] < 2020-10-01 00:00 ===
===  [[Admit DtTm]] or [[Dispo DtTm]] < 2020-10-01 00:00 ===
* Use the DtTm in [[Transfer Ready DtTm field]]
* Use the DtTm in [[Transfer Ready DtTm field]]
{{Todo | who = Tina| question =
* Discussed with Julie that we will actually update these in the data rather than do these updates at reporting time. The query below should do it. Pagasa, could you apply it when you get a chance and update here when done? Thanks! [[User:Ttenbergen|Ttenbergen]] 09:46, 2022 June 29 (CDT)
** when I started to make the query to update this I came across TRs that were not on the same date as the dispo_dttm. I can understand why we would change times if the TR is on the Dispo Dt, but it doesn't seem to make sense to change them if they are earlier. So, I just want to make sure that you really would have reported e.g. the following with a changed time.
:: D_ID         Transfer_Ready_DtTm Dispo_DtTm            HrsMins    new_tr_dttm
:: GRA_N3-3089 2007-07-31         2007-08-23 15:30:00 00:00:00 2007-07-31 10:00:00
::* I only make a substitution if same date with Dispo date. Added that part now.  however when I have looked at my current code, I no longer have this substitution. Is it because you have combined the dttm together when we moved to access from Ed's and thus the time became 00:00.  how did you handle it when transitioning to ACCESS, those without time - did you make the transfer ready dttm blanks or made time to 00:00 ?  --[[User:JMojica|JMojica]] 11:37, 2022 September 21 (CDT)
**** This is one field in Access now, so leaving them blank isn't an option. So you treated blank and midnight differently? Would anyone reasonably become transfer ready at midnight? No rounds happening then. I guess it's possible.  So, really you haven't done this for some time, possibly since we moved form Ed's version? I am also prepared to take this whole thing out of the documentation and not do it at all...  [[User:Ttenbergen|Ttenbergen]] 16:20, 2022 September 22 (CDT)
***** I agree, let us drop this whole thing out about transfer time missing and do not do any substitution at all when time is missing.  --[[User:JMojica|JMojica]] 11:08, 2022 October 12 (CDT)
****** Will you stop doing them in SAS as well, then? Otherwise we are back to inconsistent definitions. [[User:Ttenbergen|Ttenbergen]] 11:55, 2022 October 12 (CDT) ****** OK. --[[User:JMojica|JMojica]] 08:53, 2022 October 19 (CDT)
***** I removed the sub article  ... with missing time.  --[[User:JMojica|JMojica]] 16:13, 2023 January 17 (CST)}}
{{DT|
* There were problems with the query I provided to Pagasa, this one doesn't seem to play nice if pasted as SQL. Waiting for reply from Julie on above before providing update since it might change. [[User:Ttenbergen|Ttenbergen]] 11:04, 2022 September 21 (CDT)
}}
Query to run if we really want to do this for all records w zero times even if different dates.
UPDATE L_Log INNER JOIN created_Program ON L_Log.D_ID = created_Program.D_ID SET L_Log.Transfer_Ready_DtTm = [transfer_ready_dttm]+IIf(TimeValue([dispo_dttm])<#12/30/1899 10:0:0#,#12/30/1899 0:1:0#,#12/30/1899 10:0:0#)
WHERE (((L_Log.Transfer_Ready_DtTm)>#1/1/1900#) AND ((created_Program.program)="cc") AND ((L_Log.Dispo_DtTm) Is Not Null) AND ((TimeValue(Nz([transfer_ready_dttm],#1/1/1900#))=#12/30/1899#)=True) AND ((DateValue(Nz([dispo_dttm],#1/2/1900#))=DateValue(Nz([transfer_ready_dttm],#1/1/1900#)))=True));


=== [[Admit DtTm]] or [[Dispo DtTm]] >= 2020-10-01 00:00 ===
=== [[Admit DtTm]] or [[Dispo DtTm]] >= 2020-10-01 00:00 ===
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== Data use ==
== Data use ==
* [[Transfer Delay (Critical Care)|Transfer Delay]]
* [[Avoidable Days (Critical Care)]]
* [[Avoidable Days (Critical Care)]]
* [[Beds occupied by transferrable patients (Critical Care)|Beds occupied by transferrable patients]]
* [[Beds occupied by transferrable patients (Critical Care)|Beds occupied by transferrable patients]]