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Beds occupied by transferrable patients (Critical Care): Difference between revisions

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{{Reporting Indicators
{{Reporting Indicators
| description = Beds Occupied by Transferable Patients  is the average number of  ICU bed per day being occupied by the patient no longer requiring the intensity of care provided in an ICU setting.
| description = Beds Occupied by Transferable Patients  is the average number of  ICU bed per day being occupied by the patient no longer requiring the intensity of care provided in an ICU setting. Another term used to call it is '''Wasted beds'''.
 
| indicator_name = Beds occupied by transferrable patients (Critical Care)
| indicator_name = Beds occupied by transferrable patients (Critical Care)
| created_raw = Created   
| created_raw = Created   
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| indicator_end_date =  
| indicator_end_date =  
}}
}}
Also see [[Avoidable Days (Critical Care)|Avoidable Days]] for a similar concept.


==QI domain==
==QI domain==
* [[QualityDomain::Efficient]]
* [[QualityDomain::Efficient]]
==Reported as==
Percent of total patient days


==Significance==
==Significance==
Beds Occupied by Transferable Patients  is the  average number of  ICU bed occupied per day by patients no longer requiring the intensity of care provided in an ICU setting. It can identify and quantify issues around flow out of the ICU.
Beds Occupied by Transferable Patients  is the  average number of  ICU bed occupied per day by patients no longer requiring the intensity of care provided in an ICU setting. It can identify and quantify issues around flow out of the ICU.


==Sampling Plan / Procedure==
==Sampling Plan / Procedure==
===Inclusion Criteria===
===Inclusion Criteria===
100% of all  patients physically present in an ICU bed awaiting transfer out of the ICU and having a date value on the [[Transfer Ready DtTm field]]
100% of all  patients physically present in an ICU bed awaiting transfer out of the ICU and having a date value on the [[Transfer Ready DtTm field]]
*For the Critical Care Report, the Directors and QIT agreed to separate the transfer to IICU from the rest of the locations (to home,  to ward, to outside hospital ward, rehab, PCH and those who died but have transfer ready date_time) - start date Jan to March 2018 Qtr report.
*For the Critical Care Report in 2018 , the Directors and QIT agreed to have two transfer delay calculation
** when patient went to IICU or H6
** when patient went to home,  to other wards, to outside hospital ward, rehab, PCH and those who died


===Exclusion Criteria===
===Exclusion Criteria===


===Frequency===
===Frequency===
* Once the transfer ready date has been written and the allowable 2.0 hours has elapsed, compute [[Transfer Delay (Critical Care)]] or the total time it takes for ICU patient to leave the unit. 
* Recorded [[Transfer Delay (Critical Care)|Transfer Delay]] per patient
**If no time is indicated with the transfer ready date_tm field a proxy time of 10:00 am for day shift and midnight for night shift will be used for calculation purposes. 
* Monthly, quarterly or yearly basis based on either ICU Admission Dates or ICU [[Dispo DtTm]].
* To be completed at time of discharge from ICU, compute the total days spent in ICU (refer as [[LOS]])
{{DJ |
* To be calculated and reported on a monthly, quarterly or yearly basis based on either ICU Admission Dates or ICU Discharge Dates.
* ''For the [[Directors Quarterly and Annual Report (Critical Care)]], the [[Dispo DtTm]] is used as the time of reference.
* For the Director reports, the discharge dates are used as the time of reference.
** The record's ICU [[Dispo DtTm]], or the linked ICU Hospitalization's [[Dispo DtTm]]?
}}


==Definition and Derivation==
==Definition and Derivation==
Avoidable days is defined as the total time from date/time of transfer ready to date/time transfer out of ICU (in hours) less 2.0 hours (and divided by 24 to give yield total avoidable days)
*Refer to the definition of [[Transfer Ready DtTm]] and [[Transfer Delay (Critical Care)]]
*Refer to the definition of [[Transfer Ready DtTm]] and [[Transfer Delay (Critical Care)]]


===Numerator===
===Numerator===
Num = Total [[Transfer Delay (Critical Care)]] in a given period
Num = Total [[Transfer Delay (Critical Care)]] in a given time frame


===Denominator===
===Denominator===
Denom =Total Patient Days on the same period as the numerator
Denom =number of calendar days in a given time
 
===Formula===
===Formula===
Avoidable Days (%) = Num / Denom * 100
Beds Occupied by transferable patient = Num / Denom  
 
===Example===
===Example===
*Time Reference: Discharge Dates from Jan 1, 2017 to March 31, 2017
*Time Reference: Discharge Dates from Jan 1, 2021 to March 31, 2021
*Total Avoidable Days of all patients with transfer ready date-time= 254.5
*Total Transfer Delays for patients who went to Ward/Home= 200 days
*Total LOS of all ICU discharges = 1175.3
*Beds Occupied by Transferable Patients  to Ward/Home = 200 / 90 = 2.22 beds
*Avoidable Days (%) = 254.5 / 1175.3 * 100= 21.7%
*Total Transfer Delays for patients who went to IICU or H6 = 50 days
*Beds Occupied by Transferable Patients to Ward/Home = 50 / 90 = 0.55 beds


==Data Sources==
==Data Sources==
* Per patient [[Transfer Delay (Critical Care)]]  
* Per patient [[Transfer Delay (Critical Care)]]  
**Before Oct 1, 2020 : derived from [[Transfer Ready DtTm field]] and [[Dispo DtTm field]].
**July 1988 to Sept 2020 : derived from [[Transfer Ready DtTm field]] and [[Dispo DtTm field]].
**Starting Oct 1, 2020: derived from the first transfer ready date and time in the [[Transfer Ready DtTm tmp entry]] and [[Dispo DtTm field]] .
**Starting Oct 1, 2020: derived from the first transfer ready date and time in the [[Transfer Ready DtTm tmp entry]] and [[Dispo DtTm field]] .
*Per patient [[LOS]] is derived from [[Accept DtTm field]] or [[Arrive DtTm field]] and [[Dispo DtTm field]]


==SAS Program==
==SAS Program==
X:\Julie\SAS_CFE\CFE_macros\logphiunit.sas
*S:\MED\MED_CCMED\Julie\SAS_CFE\CFE_macros\logphi.sas
*S:\MED\MED_CCMED\Julie\SAS_CFE\CFE_macros\prep_Tmp_BoardServiceTransfer_15Sept2021.sas


== Data Integrity Checks ==
== Data Integrity Checks ==
* [[Query check long transfer delay]]
* [[Query check long transfer delay]]
== Data use ==
see infobox
==Report Users==
==Report Users==
*Critical Care Directors and Site  Managers
*Critical Care Directors and Site  Managers
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== Change Log ==
== Change Log ==
July 1, 2018 - Definition changed  "Avoidable days is defined as the total time from date/time of transfer ready to date/time transfer out of ICU (in hours) less 2.0 hours (and divided by 24 to give yield total avoidable days)" from 4 hrs as per instruction by [[p:Jodi Walker Tweed]].
*Starting March 22, 2023,  transfer delays will be reported based on actual delay times with no more allowances of less than n hours as per agreed in JALT Meeting March 22, 2023.
*From July 1, 2018 to March 21, 2023 - Definition changed  "Avoidable days is defined as the total time from date/time of transfer ready to date/time transfer out of ICU (in hours) less 2.0 hours (and divided by 24 to give yield total avoidable days)" from 4 hrs as per instruction by [[p:Jodi Walker Tweed]].


== Related articles ==  
== Related articles ==  
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[[Category: Transfer Ready]]
[[Category:Transfer Ready]]
[[Category: Admit/Discharge]]
[[Category:Admit/Discharge]]
[[Category: Length of stay]]
[[Category:Length of stay]]
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