Transfer Ready DtTm tmp entry: Difference between revisions
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* Care is stepped down to '''ward frequency''' (q4hrs or less) of vitals AND off '''all''' forms of life support except possibly intermittent dialysis | * Care is stepped down to '''ward frequency''' (q4hrs or less) of vitals AND off '''all''' forms of life support except possibly intermittent dialysis | ||
* [[HSC_IICU]] consult is written | * [[HSC_IICU]] consult is written | ||
* patient is made '''[[ACP C|ACP-C]]''' | * patient is made '''[[ACP-C|ACP-C]]''' | ||
* for organ donors, see [[Guideline for coding organ donation after death]] | * for organ donors, see [[Guideline for coding organ donation after death]] | ||
* if the patient is a '''potential organ donor and then deemed not to be''', the Transfer Ready tmp DtTm will be when that determination is made | * if the patient is a '''potential organ donor and then deemed not to be''', the Transfer Ready tmp DtTm will be when that determination is made | ||
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====Specifically for Medicine ==== | ====Specifically for Medicine ==== | ||
'''On a medicine ward''', take the following to indicate transfer ready to a lower level of care even if they have not written that explicitly: | '''On a medicine ward''', take the following to indicate transfer ready to a lower level of care even if they have not written that explicitly: | ||
*For SBGH If there is no discharge order, then the DC summary date/time that the attending signs off can be used, however if the date and time is after the DC time then it may be documented in a nursing or allied health IPN. | *For SBGH If there is no discharge order, then the DC summary date/time that the attending signs off can be used, however if the date and time is after the DC time then it may be documented in a nursing or allied health IPN. Also, for SBGH often bed utilization will document when they are waiting on a transfer to an LAU or other facility, or rehab services will document when they are on the central wait list, or long term care (LTC) will document when they are approved for a PCH bed. | ||
*For HSC if there is no discharge order, then check the IPN notes (nursing, allied health etc), often bed utilization will document when they are waiting on a transfer to an LAU or other facility, or rehab services will document when they are on the central wait list, or long term care (LTC) will document when they are approved for a PCH bed. | *For HSC if there is no discharge order, then check the IPN notes (nursing, allied health etc), often bed utilization will document when they are waiting on a transfer to an LAU or other facility, or rehab services will document when they are on the central wait list, or long term care (LTC) will document when they are approved for a PCH bed. | ||
* | * Order is written to change all iv meds to po AND monitor discontinued/vital sign frequency is reduced | ||
* | * Patient is made '''[[ACP-C|ACP-C]]''' | ||
* When [[Dispo]] is PCH, use the date and time of the pre-panel checklist initiation as the [[Transfer Ready DtTm]], this will usually be documented in the notes by one of the allied health workers or LTC | |||
* If a discharge order is written during the preceding day(s) prior to discharge: | * If a discharge order is written during the preceding day(s) prior to discharge: | ||
** and a specific date and time for discharge is documented in that order, the transfer ready date and time would be the date and time specified in the order. | ** and a specific date and time for discharge is documented in that order, the transfer ready date and time would be the date and time specified in the order. | ||
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** and there is no specific date and time documented for discharge or another order for discharge is written, then check the checkbox or use that new discharge order date and time | ** and there is no specific date and time documented for discharge or another order for discharge is written, then check the checkbox or use that new discharge order date and time | ||
* | * The discharge medication reconciliation form should NOT be used as transfer ready date and time. | ||
* '''PT/OT Assessment''': Before going home, some ward patients get a home safety evaluation from PT and OT, and if deemed safe for home get a homecare evaluation before going home. The transfer ready date/time in such a situation should be only after the PT/OT evaluation has deemed them safe to go home, i.e. before homecare has seen them. The rationale is that homecare evaluation can occur after discharge, but a hospitalized patient who “fails” their home safety evaluation will end up going to LTC, not home. | * '''PT/OT Assessment''': Before going home, some ward patients get a home safety evaluation from PT and OT, and if deemed safe for home get a homecare evaluation before going home. The transfer ready date/time in such a situation should be only after the PT/OT evaluation has deemed them safe to go home, i.e. before homecare has seen them. The rationale is that homecare evaluation can occur after discharge, but a hospitalized patient who “fails” their home safety evaluation will end up going to LTC, not home. | ||
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== Start DtTm/Legacy == | == Start DtTm/Legacy == | ||
We used the old [[Transfer Ready DtTm]] | We used the old [[Transfer Ready DtTm field]] '''for transfer ready dttms''' before 2020-10-15, and use this new entry for dttms after. | ||
The data during the transition period for [[PatientFollow Project]] is inconsistent, so we use all the new and the old in [[Created TransferReady query]]. | The data during the transition period for [[PatientFollow Project]] is inconsistent, so we use all the new and the old in [[Created TransferReady query]]. | ||
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Used via [[Created_TransferReady query]] and [[Created_transferDelay table]] to generate [[Transfer Delay]] and [[Avoidable Days (Critical Care)]]. | Used via [[Created_TransferReady query]] and [[Created_transferDelay table]] to generate [[Transfer Delay]] and [[Avoidable Days (Critical Care)]]. | ||
{{DJ | | |||
* Grace Hospital not filled this out according to instructions documented here, but some old version instead. That makes data between GRA and other sites problematic to compare. Lisa and Gail have more info. We should document which version they have been using so it can be accounted for when using this data. }} | |||
== Background == | == Background == | ||