|
Tag: Redirect target changed |
| (14 intermediate revisions by 3 users not shown) |
| Line 1: |
Line 1: |
| '' see [[Transfer time rule]] for the unrelated rules around patients transferring between wards we collect data on
| | #redirect:[[Transfer Ready DtTm tmp entry]] |
|
| |
|
| <onlyinclude>The [[Transfer Ready date and time]] for critical care is the time a patient is deemed stable enough to be transferred out of the ICU, the one for medicine is the ''first'' date during this ward stay that a patient was deemed medically stable and ready to be discharged. </onlyinclude>
| | '''''Legacy only. This data used to be collected as [[Transfer Ready DtTm field]]. Before that, this data was replaced as part of the [[2016 Time and Place changes]]. See [[Transfer Ready DtTm field]]. ''''' |
|
| |
|
| Transfer date/time resource too for data collectors, see: [[Transfer Tracker.mdb]]
| | Deleted original content of article for the old field so there is no confusion, people were editing it. If pre-dispo definition is required, see history for this article. |
|
| |
|
| == ICU ==
| | [[Category: L Log table Legacy]] |
| The transfer ready date and time is when the pt is deemed stable enough to be transferred out of the ICU.
| |
| | |
| ==='''Required''' for ICU when===
| |
| * a patient is sent to a '''ward''' from an ICU
| |
| * a patient is sent to '''IICU''' at HSC
| |
| * a patient is ready to go '''home (ZZ)'''
| |
| * a patient is ready to go to another hospital OUTSIDE the city
| |
| * See '''ICU special cases''' below
| |
| | |
| ==='''Not required''' for ICU when ===
| |
| * goes home [[ICU Var 6 - AMA]] '''A'''gainst '''M'''edical '''A'''dvice
| |
| * when patient '''dies''' in the ICU
| |
| * transfer to one ICU from another ICU in same center or in in city of Winnipeg
| |
| * sent to '''operating room'''
| |
| * sent for procedure or test and '''doesn't return''' to unit
| |
| | |
| === ICU Special Case - ACP-C ===
| |
| For patients who transfer out of the ICU and are ACP-C use the time that a patient is '''made ACP-C in the ICU''' as the transfer ready date and time. See above instructions for patients who die in the unit(transfer ready time isn't required).
| |
| | |
| === ICU Special Case - Condition Deteriorates ===
| |
| If a patient is on the transfer ready list in ICU and his '''condition deteriorates''' resulting in the need to remain in the unit, then this patients transfer ready is '''cancelled''' and the transfer ready date and time should be deleted. If the patient is put back on the transfer/discharge ready list, enter the '''new''' transfer ready date. '''Not applicable to Medicine ward patient.'''
| |
| | |
| This differs from the Medicine instructions.
| |
| | |
| == Medicine ==
| |
| The transfer ready date is the '''first''' date during this ward stay that a patient was deemed [[#medically stable]] and is ready to be discharged.
| |
| | |
| ==='''Required''' for Medicine when===
| |
| * a patient is sent '''Home''' (ZZ)
| |
| * a patient is sent to a long term care facility ('''NW, DW, RW'''...)
| |
| * a patient is sent '''from''' a '''Teaching''' medicine ward to a '''Non'''-teaching medicine ward or is changed to "non-teaching" '''status''' without changing wards
| |
| | |
| ==='''Not''' required for Medicine when ===
| |
| * patient is being transferred to an ICU
| |
| * a patient goes from one medical '''teaching''' unit to another in same facility or another facility in the city.
| |
| * goes home [[Med Var 6 - AMA]] '''A'''gainst '''M'''edical '''A'''dvice
| |
| * when patient dies on a medicine ward
| |
| * transfer to an ICU
| |
| * sent to operating room (OR)
| |
| * sent for procedure or test and doesn't come back to the ward
| |
| | |
| === Transfer ready DATE NOT available Medicine only===
| |
| Go to: [["No Transfer Date" in Medicine]]
| |
| | |
| === Medicine Special Case - Condition Deteriorates ===
| |
| If a patient develops a complication '''after''' they were deemed to be medically stable and transfer ready, you '''do not change''' their transfer ready date/time. This is unlike the ICU instructions.
| |
| | |
| Dr Roberts did indicate that he would like the transfer ready to be recorded and unchanged even if the pts condition changes. The original transfer ready date and time are still relevant to the [[:Category: OverstayProject | OverstayProject]]. As per discussions with Roberts for updated guidelines.
| |
| | |
| === Medicine Special Case - Patient arrives transfer-ready===
| |
| If a pt already has a transfer ready date and time and is moved to another ward, the transfer ready date and time will be the time of admission (1 minute later to keep [[#CCMDB Consistency Checks]] happy) to that ward. Needs to be done this way because of the way our [[statistician]] reports this data.
| |
| | |
| === Medicine Special Case - OM(osteomylitis)requiring the 4-6week IV ABx treatment ===
| |
| | |
| {{discussion}}If a patient has OM(osteomylitis)requiring the 4-6week IV ABx treatment: can they ever be considered medically stable while in hospital? At present a consult is made to Community IV Program and a PICC is inserted-arrangements made and D/C with community management OR
| |
| Patient is not suitable for CIVP d/t Hx of IV drug abuse/no home to go to/ antibiotic not stable enough to be given from alternate site if home due to its admixture etc so remains in hospital for their IV treatment and is often away on hospital day passes in between doses...
| |
| | |
| When discharged to home, the order to Discharge patient is their transfer date /transfer Ready time so we enter but they remain on AB IV...
| |
| | |
| I am unclear about this diagnostic code and Medically Stable determination...we get bad cellulitis/OM pts needing extensive IV AB Tx sent to D5 Non-teaching but not declared med stable D/T infection/s.
| |
| | |
| How do others feel re: this population?
| |
| --[[User:Llemoine|Llemoine]] 14:59, 2015 September 23 (CDT)
| |
| *I've wondered this as well. I would say they are not medically stable for discharge, and therefore in the case where the patient is transferred to a non-teaching ward, would have no transfer ready date. If they can be discharged home with the IV program, then I would assume the transfer ready date is the discharge to home order.[[User:Mlagadi|Mlagadi]] 07:49, 2015 September 24 (CDT)
| |
| *This has been my approach as well. [[User:Ppiche|Pamela Piche]] 08:16, 2015 September 24 (CDT)
| |
| *Does noncompliancy or a home care hold or all the reasons above change the fact that the pt is medically stable/ transfer ready would this be more of a discharge issue? (no place to go) The patient is ready to go home and for what ever reaons cant do CIVP Do we look at CIVP as a long term treatment like a foot ulcer? I guess I am saying is does the patient becomes Transfer ready once the acute phase of treatment is over and the pt is medically stable (no wbc elevation/ no temp/ vs stable ect )and treatment is no longer acute but chronic? ps just asking shirley
| |
| | |
| == Sources ==
| |
| In order of preference or ''which ever is source is most reliable at your site''
| |
| * Physician Diagnosis Form ([[green sheet]]) (available for ICU only)
| |
| * Transfer Ready stamp on physician orders or progress note (Medicine only)
| |
| * [[STB Electronic Patient Record]]
| |
| * Physicians’ Orders from patient chart
| |
| * ICU patient Log Book as recorded by unit clerk (from orders)
| |
| * Charge Nurse
| |
| * IPN - Often a physician will write "medically stable" in the IPN but not in the orders.--[[User:CMarks|CMarks]] 07:51, 2014 March 3 (CST)
| |
| | |
| == Data Use ==
| |
| Used to generate [[Transfer_Delay]], which is used in [[Overstay]] and several reports, see also [[Transfer_Delay#data use]].
| |
| | |
| == Date and time formats ==
| |
| see [[Date and Time Format]]
| |
| | |
| == {{CCMDB Data Integrity Checks}} ==
| |
| === CCMDB.mdb Transfer Date validation ===
| |
| If all of
| |
| * transfer ready date or even just time is blank
| |
| * survived,
| |
| * not [[Med Var 6 - AMA]] and not [[ICU Var 6 - AMA]]
| |
| * the discharge-to location ends in W, U, Z, X
| |
| then
| |
| * give an error requiring a comment in notes
| |
| * don't allow final-check if notes are blank
| |
| This is checked at registry-check or final check.
| |
| | |
| === NDC_Missing_TransferDate_w_pivot ===
| |
| This query in [[Centralized data front end.mdb]] flags patients discharged to "zz" or Like "?w" (ie home or ward) who have a discharge date "Between #2013/Oct/01# And #2013/Dec/31#" (?!) and a transfer date of #3000/Jan/01# (I think this would only catch those imported from Ed, not the newly sent ones).
| |
| | |
| for incomplete only
| |
| | |
| {{discussion}}
| |
| Should this be changed to be like [[#CCMDB.mdb Transfer Date validation]], once that is what we want it to be? Ttenbergen 14:43, 2014 June 23 (CDT)
| |
| | |
| == Date and time formats ==
| |
| see [[Date and Time Format]]
| |
| | |
| == Data use ==
| |
| Among other things, the times are used to generate statistics about
| |
| * [[:Category: Length of stay | LOS]]
| |
| * [[Multiple Encounter]]
| |
| * [[Transfer Delay]]
| |
| * [[bed occupancy]]
| |
| | |
| == See Also ==
| |
| *[[Admit date and time]]
| |
| *[[Discharge date and time]]
| |
| *[[Transfer Ready date and time]]
| |
| | |
| == Legacy ==
| |
| This article was spun out from [[Interrelation between Admit, Discharge and Transfer Ready date and time]], see that article for any history missing from here.
| |
| | |
| [[Category: Admit/Discharge]]
| |
| [[Category: Data Collection Guide]]
| |
| [[Category: Registry Data]]
| |
| [[Category: Transfer Ready|*]]
| |
| [[Category: L_Log table]]
| |
| [[Category: 1Main table]]
| |