CCMDB Wiki

ER Delay: Difference between revisions

← Older edit
mNo edit summary
No edit summary
 
(43 intermediate revisions by 3 users not shown)
Line 1: Line 1:
{{Reporting Indicators
|description=The ER Delay is the difference between the initial ER [[Boarding Loc]] and first post-ER [[Boarding Loc]], for patients arriving from the ER.
|created_raw=Created
|Program=Critical Care
|DataDependencies=Transfer Ready DtTm; Admit DtTm; Boarding Loc
|indicator_name={{PAGENAME}}
|program=Critical Care
}}
{{Data_element
{{Data_element
| field_name = ER Delay
| field_name = ER Delay
| element_description = The ER Delay is the difference between the [[Accept DtTm]] and [[Arrive_DtTm]], or ER [[Boarding Loc]] and first post-ER [[Boarding Loc]], for patients arriving from the ER.
| element_description = The ER Delay is the difference between the initial ER [[Boarding Loc]] and first post-ER [[Boarding Loc]], for patients arriving from the ER.
| in_table = Created_Variables_Common table
| in_table = Created_Variables_Common_2021 table
| data_type = date
| data_type = date
| datafield_length = n/a
| datafield_length = n/a
Line 10: Line 19:
}}
}}


It's is calculated by [[Created_Variables_Common_maker query]] and stored in [[Created_Variables_Common table]] in [[CFE]].  
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]].  
 
It is also calculated and checked by [[query check_ER_Delay_not_too_big]].  


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


{{Discuss |
{{DJ |  
*Lisa replied    ‘when boarding loc is only ER the arrivedttm equals accept dttm equals first service dttm, dispo time should be the discharge dttm'. I have thought the same – that  this is how we were doing it with EMIPs. Can’t find this rule in WIKI.
* This measure is not referenced by any of the Reports pages. Which reports actually use this? Is it wrapped into a specifically stratified indicator like beds lost or similar? [[User:Ttenbergen|Ttenbergen]] 15:14, 7 December 2025 (CST)
*Before we move to tmp service and boarding loc. I calculated ER delay equals Arrive dttm – accept dttm.    Now we added another or second way, ER Delay equals first post-ER Boarding Loc dttm -  ER Boarding Loc dttm.
** This is reported in ICU quarter report [[Length_of_Time_for_Transfer_from_ED_to_ICU_within_same_facility]] but not in Medicine. ER delay is reported as requested. --[[User:JMojica|JMojica]] 10:32, 8 December 2025 (CST) }}
*This caused an issue for boarding loc only ER.  There is no post-ER boarding loc. if I follow the first way, ER delay is ZERO since arrive dttm is the same as accept dttm. 
 
*Should the whole stay at ER be considered as an ER delay or NOT?  If yes, then in the past I was underestimating it because all EMIPs have ZERO delay.
== ER Delay Calculation ==
*If YES in the question above, then we should add this rule for EMIP or ECIP cases
* Before Oct 2020 : If [[Previous Location]] is own ER  
#Arrive dttm equals dispo dttm
** Non-EMIP / Non-ECIP : [[Arrive DtTm]] - [[Accept DtTm]]  and [[Accept DtTm missing]] is not marked
#first post-ER Boarding Loc dttm equals dispo dttm
*** if [[Accept DtTm missing]] is marked then ER Delay is missing.
in this way, ER Delay will be consistent in both formulas.
** EMIP/ECIP: [[Dispo DtTm]] - [[Accept DtTm]]
*For discussion. --[[User:JMojica|JMojica]] 10:17, 2022 March 9 (CST)
*Starting Oct 2020 : if first [[Boarding Loc]] is own ER
** Discussed at [[Task Team Meeting - Rolling Agenda and Minutes 2022#ICU Database Task Group Meeting – March 9, 2022]] - Julie and Lisa will bring more data to next task meeting Apr 6. [[User:Ttenbergen|Ttenbergen]] 22:27, 2022 March 9 (CST)
** 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_Meeting_-_Rolling_Agenda_and_Minutes_2023#JALT_Meeting_%E2%80%93_October_31,_2024 | JALT 2024-10-31]]...
 
==== Moves for Medicine ====
{{DJ |
* 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. [[User:Ttenbergen|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.  --[[User:JMojica|JMojica]] 16:35, 2024 December 11 (CST)}}
 
== Log ==
{{Discuss |
* 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. [[User:Ttenbergen|Ttenbergen]] 13:25, 2022 June 28 (CDT)
** emailed Tina some inconsistencies found in ER Delays Aug 15,2022. --[[User:JMojica|JMojica]] 13:21, 2022 August 29 (CDT)
*** are these still an issue? [[User:Ttenbergen|Ttenbergen]] 11:15, 2024 May 1 (CDT)
**** I will re-check again.  Can't remember if have been resolved. --[[User:JMojica|JMojica]] 14:40, 2024 October 2 (CDT)}}
 
* 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 Check List}}
{{Data Integrity Check List}}


== related fields ==
== related fields ==
* [[Accept DtTm]]
* [[Boarding Loc]] DtTms
* [[Arrive_DtTm]]  
* [[LOS]]
* [[LOS]]
* [[Transfer Delay]]
* [[Transfer Delay]]


== Reporting and Analysis ==
== Reporting and Analysis ==
The SAS Program to read the data is in X:\Julie\SAS_CFE\CFE_macros\datetimes.sas
The SAS Program to read the data is in {{S:\MED\MED_CCMED}}Julie\SAS_CFE\CFE_macros\datetimes.sas
 
{{DJ|
* 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? [[User:Ttenbergen|Ttenbergen]] 22:50, 2024 November 16 (CST)
}}


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


Retrieved from "https://ccmdb.kuality.ca/index.php?title=ER_Delay"