ER Delay: Difference between revisions

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{{Data_element

| field_name = ER Delay

| element_description = The ER Delay is the difference between the [[~~Accept DtTm~~]] and [[~~Arrive_DtTm~~]] for patients arriving from the ER.

| element_description = The ER Delay is the difference between the pre-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

| datafield_length = n/a

Line 10:

}}

It's is calculated by [[~~created_variables_common_maker query |''created_variables_common_maker''~~ query]] and stored in [[~~created_variables_common table |''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]].

== ~~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 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.

==~~{{CCMDB Data Integrity Checks| ready to implement}}~~ ==

== ER Delay Calculation ==

~~The data collector will receive an error~~ if ~~the~~ ER Delay is ~~greater than~~:

* Before Oct 2020 : If [[Previous Location]] is own ER

* CC - ~~8 hours~~

** Non-EMIP / Non-ECIP : [[Arrive DtTm]] - [[Accept DtTm]] and [[Accept DtTm missing]] is not marked

* Med – 44 hours

*** if [[Accept DtTm missing]] is marked then ER Delay is missing.

** EMIP/ECIP: [[Dispo DtTm]] - [[Accept DtTm]]

*Starting Oct 2020 : if first [[Boarding Loc]] is own ER

** 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

~~{{discussion}}~~

Implemented as

* as of 2017-10-17 Julie would like that cross check; Tina needs to implement it still.

:: ER_Delay:

** ~~Julie~~, ~~this warning~~, ~~it should only apply if the patient is from the location collection's own ER~~, ~~right? Or also if from other ER?Ttenbergen 17~~:51, ~~2017 December 6~~ (~~CST)~~

::: IIf(Not [PatientFollow],

*** Own ER only. ~~also I change the limits of CC from 9 to 8. I did a rerun on the corrected data after the audit. --~~[[~~User:JMojica|JMojica~~]~~] 09:29, 2017 December 7 (CST~~)

:::: IIf([location_name] Like "*EMIP*",[Dispo_DtTm],[Arrive_DtTm])-Nz([Accept_dttm],

**** How about [[~~EMIP~~]~~]s?~~

:::: [Arrive_dttm]),Nz([created_FirstNonER_BoardingLoc].[dttm],[Dispo_DtTm])-[created_FirstER_BoardingLoc].[dttm])

~~Implementation: started query ''check_ER_Delay_not_too_big''~~ to ~~exclude other sites and~~ include only from ~~this site~~. ~~Waiting~~ for ~~EMIP question~~. Ttenbergen 17:25, ~~2017 December 9~~ (~~CST~~)

=== 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.

== related fields ==

* [[~~Accept DtTm]]~~

* [[Boarding Loc]] DtTms

* [[Arrive_DtTm]]

* [[LOS]]

* [[Transfer Delay]]

== Reporting and Analysis ==

The SAS Program to read the data is in X:\Julie\SAS_CFE\CFE_macros\~~CFE_ERWait_Moves~~.sas

The SAS Program to read the data is in {{S:\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 ==

Used to be collected as [[ER Wait]] and before that as [[Moves for Medicine]].

* 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]].

== Related articles ==

[[Category: Reporting]]

[[Category:Reporting]]

[[Category: Admit/Discharge]]

[[Category:Admit/Discharge]]

[[Category:Created Variables]]

@@ Line 1: / Line 1: @@
 {{Data_element
 | field_name = ER Delay
-| element_description = The ER Delay is the difference between the [[Accept DtTm]] and [[Arrive_DtTm]] for patients arriving from the ER.
+| element_description = The ER Delay is the difference between the pre-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
 | datafield_length = n/a
@@ Line 10: / Line 10: @@
 }}
-It's is calculated by [[created_variables_common_maker query |''created_variables_common_maker'' query]] and stored in [[created_variables_common table |''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]].
-== 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 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.
-=={{CCMDB Data Integrity Checks| ready to implement}} ==
+== ER Delay Calculation ==
-The data collector will receive an error if the ER Delay is greater than:
+* Before Oct 2020 : If [[Previous Location]] is own ER
-* CC  - 8 hours
+** Non-EMIP / Non-ECIP :  [[Arrive DtTm]] - [[Accept DtTm]]  and  [[Accept DtTm missing]] is not marked
-* Med – 44 hours
+*** if [[Accept DtTm missing]] is marked then ER Delay is missing.
+** EMIP/ECIP: [[Dispo DtTm]] - [[Accept DtTm]]
+*Starting Oct 2020 : if first [[Boarding Loc]] is own ER
+** 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
-{{discussion}}
+Implemented as
-* as of 2017-10-17 Julie would like that cross check; Tina needs to implement it still.
+:: ER_Delay:
-** Julie, this warning, it should only apply if the patient is from the location collection's own ER, right? Or also if from other ER?Ttenbergen 17:51, 2017 December 6 (CST)
+::: IIf(Not [PatientFollow],
-*** Own ER only.  also I change the limits of CC from 9 to 8. I did a rerun on the corrected data after the audit. --[[User:JMojica|JMojica]] 09:29, 2017 December 7 (CST)
+:::: IIf([location_name] Like "*EMIP*",[Dispo_DtTm],[Arrive_DtTm])-Nz([Accept_dttm],
-**** How about [[EMIP]]s?
+:::: [Arrive_dttm]),Nz([created_FirstNonER_BoardingLoc].[dttm],[Dispo_DtTm])-[created_FirstER_BoardingLoc].[dttm])
-Implementation: started query ''check_ER_Delay_not_too_big'' to exclude other sites and include only from this site. Waiting for EMIP question. Ttenbergen 17:25, 2017 December 9 (CST)
+=== 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}}
 == related fields ==
-* [[Accept DtTm]]
+* [[Boarding Loc]] DtTms
-* [[Arrive_DtTm]]
 * [[LOS]]
 * [[Transfer Delay]]
 == Reporting and Analysis ==
-The SAS Program to read the data is in X:\Julie\SAS_CFE\CFE_macros\CFE_ERWait_Moves.sas
+The SAS Program to read the data is in {{S:\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 ==
-Used to be collected as [[ER Wait]] and before that as [[Moves for Medicine]].
+* 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]].
+== Related articles ==
+{{Related Articles}}
-[[Category: Reporting]]
+[[Category:Reporting]]
-[[Category: Admit/Discharge]]
+[[Category:Admit/Discharge]]
+[[Category:Created Variables]]