Readmission Rate to ICU: Difference between revisions

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m removed links to accept and arrive dttm
 
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| indicator_end_date =  
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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==
* [[QualityDomain::Safe]]
* [[QualityDomain::Safe]]
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* Definition2 : Excluding patients who left [[AMA]] or palliative in the count of readmission.
* Definition2 : Excluding patients who left [[AMA]] or palliative in the count of readmission.
** Elective surgery
** Elective surgery
*** [[Admit Type for APACHE II]] is not 'Elect.Surg'
*** [[Admit Type for APACHE II]] is 'Elect.Surg'
** Palliative in this context means at least one of the following is present:  
** Palliative in this context means at least one of the following is present:  
*** based on ICD10 [[Palliative care]] where available
*** based on ICD10 [[Palliative care]]
*** tmp [[Comfort Care]]  
*** tmp [[Comfort Care]]
** AMA - see [[AMA]]


===Frequency===
===Frequency===
All the time
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 %
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The following fields from L_Log table  are being used  
The following fields from L_Log table  are being used  
* [[Person_ID]]
* [[Person_ID]]
* [[Accept_DtTm field]] or [[Arrive DtTm field]]
* [[Admit DtTm]]
* [[Dispo DtTm field]]
* [[Dispo DtTm field]]
* [[Dispo field]]
* [[Dispo field]]
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==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==

Latest revision as of 12:48, 2022 April 21

Number of ICU readmission within 72 hours per 100 discharges to 1) ward only and 2) ward, home or elsewhere.

Indicators
Indicator: Readmission Rate to ICU
Created/Raw: Created
Program: Critical Care
Start Date:
End Date:
Reports: Critical Care Program Quality Indicator Report, HSC ICUs Data by Patient


  • Cargo


  • SMW:
  • Categories
  • Default form:

Used in aggregate form as "per location" and/or "per timeframe", e.g. by month/quarter/year x Ward/Unit x Hospital.

QI domain

  • Safe

Reported as

  • Definition1 : Percent of total discharges to ward
  • Definition2 : Percent of total discharges to ward, home and elsewhere

Significance

Unplanned readmissions are associated with worse patient outcomes. Most factors associated with an increased risk of readmission are patient and admission-specific. System related risk factors include discharge at night and ICU occupancy at the time of discharge. Readmission may reflect premature transfer out of ICU due to errors in clinical judgment or system constraints.

Sampling Plan / Procedure

Inclusion Criteria

We report these in two ways:

  • Definition1: 100% of all ICU patients discharged to ward
  • Definition2: 100% of all ICU patients discharged to ward, home or elsewhere

Exclusion Criteria

  • 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.

Frequency

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

Definition and Derivation

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.

  • Definition1 : Number of ICU readmission within 72 hours per 100 discharges to any ward
  • Definition2 : Number of ICU readmission within 72 hours per 100 discharges to any ward, home or elsewhere

Numerator

  • Num1 = Number of ICU patients discharged to any ward and readmitted to any ICU within 72 hours coming from 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

  • Denom1 =Total Number of discharges who went to any ward
  • Denom2 =Total Number of discharges who went to any ward, home or elsewhere

Formula

Readmission Rate(%) = Num / Denom * 100

Example

  • Time Reference: Discharge Dates from Jan 1, 2017 to March 31, 2017
  • Total readmission within 72 hours of patients previously discharged to any ward= 5
  • Total discharges who went to ward = 102
  • Readmission Rate(%) = 5 / 102 * 100= 4.9 %

Data Sources

The following fields from L_Log table are being used

SAS Program

S:\MED\MED_CCMED\Julie\SAS_CFE\CFE_macros\ccreadm_starting1Oct2020.sas

Report Users

  • Critical Care Directors and Site Managers
  • Critical Care Quality Improvement Team (QIT)

Related articles

Related articles:
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