Readmission Rate to ICU: Difference between revisions

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{{Reporting Indicators
{{Reporting Indicators
| description = Number of ICU readmission within 72 hours per 100 discharges to ward.
|description=Number of ICU readmission within 72 hours per 100 discharges to 1) ward only and 2) ward, home or elsewhere.
| indicator_name = Readmission Rate to ICU
|created_raw=Created
| created_raw = Created 
|Program=Critical Care
| program = Critical Care
|DataDependencies=Palliative care; Palliative Service; Palliative patient; Comfort Care; AMA; Admit Type for APACHE II; Dispo; Dispo DtTm; Admit date and time; Person ID field
| indicator_start_date =  
|indicator_name=Readmission Rate to ICU
| indicator_end_date =  
|program=Critical Care
}}
}}
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==
* Safe
* [[QualityDomain::Safe]]


==Reported as==
==Reported as==
Percent of total discharges to ward
* Definition1 : Percent of total discharges to ward
* Definition2 : Percent of total discharges to ward, home and elsewhere
 
==Significance==
==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.
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==
==Sampling Plan / Procedure==
===Inclusion Criteria===
===Inclusion Criteria===
100% of all ICU patients discharged to ward  
We report these in two ways:
* Definition1: 100% of all ICU patients [[Dispo|discharged to]] ward
* Definition2: 100% of all ICU patients [[Dispo|discharged to]] ward, home or elsewhere
 
===Exclusion Criteria===
===Exclusion Criteria===
Excluding patients with planned and scheduled surgery (e.g. [[Admit Type for APACHE II]] is not 'Elect.Surg' ) in the count of readmission.
* Definition1 & 2 : Excluding patients with planned and scheduled surgery in the count of readmission.
* Definition2 : Excluding patients who left [[AMA]] or [[palliative patient]]s in the count of readmission.
 
* Elective surgery
** [[Admit Type for APACHE II]] is 'Elect.Surg'
{{palliative patient}}
* AMA - see [[AMA]]


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


==Definition and Derivation==
==Definition and Derivation==
Number of ICU readmission within 72 hours per 100 discharges to ward
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===
===Numerator===
Num = 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 patients discharged to any ward, home or elsewhere and readmitted to any ICU within 72 hours coming from elsewhere
===Denominator===
===Denominator===
Denom =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 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 %


==Data Sources==
==Data Sources==
The following fields from L_Log table  are being used - [[Accept_DtTm field]] or [[Arrive DtTm field]], [[Dispo DtTm field]], [[Dispo field]] and [[Admit Type for APACHE II]].
See infobox in top left
 
== Duplication? ==
{{discussion}} Is this the same as [[Re-admission]]? Ttenbergen 12:03, 2017 July 5 (CDT)
*similar but specific with ICU.  I will do a separate one for Med and  delete the [[Re-admission]] after.


==SAS Program==
==SAS Program==
X:\Julie\SAS_CFE\CFE_macros\readmfronward.sas
S:\MED\MED_CCMED\Julie\SAS_CFE\CFE_macros\ccreadm_starting1Oct2020.sas


==Report Users==
==Report Users==
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*Critical Care Quality Improvement Team (QIT)
*Critical Care Quality Improvement Team (QIT)


[[Category: Data Use]]
== Related articles ==
[[Category: Reporting]]
{{Related Articles}}
[[Category: Statistical Analysis]]
 
[[Category:Multiple Encounter linking]]
[[Category:Multiple Encounter linking]]