Transfer Delay (Critical Care)

Data Element (edit)
Field Name:	Transfer Delay
CCMDB Label:	not stated
CCMDB tab:	not stated
Table:	Created_Variables_Common table
Data type:	number
Length:	single
Program:	Med and CC
Created/Raw:	Created
Start Date:	1999-01-15
End Date:	2300-01-01
Sort Index:	7

Transfer Delay is the difference between Dispo_DtTm and Transfer_Ready_DtTm in decimal days. Another term used to call it is Wasted beds.

• SMW

Legacy implementation right in the table

• Cargo

• Categories

• Forms

Transfer Delay

Indicators
Indicator:	Transfer Delay
Created/Raw:	Created
Program:	Critical Care and Medicine
Start Date:	1999-01-15
End Date:
Reports:	Critical Care Program Quality Indicator Report, Directors Quarterly and Annual Report (Critical Care), HSC ICUs Data by Patient

• Cargo

• SMW:

• Categories

• Default form:

Use

• The purpose is to determine the amount of time the patient is occupying a bed in an ICU or an IICU or a High Observation ward or a regular ward setting when the patient is no longer needing that level of care (also refer as wasted bed) from the Transfer Ready DtTm until the Dispo DtTm.

Definition Details

• Starting July 1, 2018 Transfer Delay Over 2 hours for Critical Care (i.e. subtract 2 hours instead of 4 hours from transfer delay as per instruction by p:Jodi Walker Tweed.)

Which Transfer Ready DtTm To Use?

Before Oct 1, 2020

• For each patient in ICU and Medicine ward, the transfer date and time is taken from the Transfer Ready DtTm field.
• It is calculated by Created_Variables_Common_maker query and stored in Created_Variables_Common table in CFE.

Starting Oct 1, 2020

• For each record and each boarding location in ICU and Medicine, the transfer date and time is taken from the Transfer Ready DtTm tmp entry.
• For each record, it is possible to have one or more entries of Transfer Ready DtTm corresponding to one or more boarding locations.
• if the patient moves to various locations, the first Transfer Ready DtTm from a Boarding Loc will be used
  • As described in Transfer Ready DtTm tmp entry, collectors make a notation about transfer ready in each separate boarding loc, looking solely at whether or not the patient was recorded as transfer ready from that location (i.e. collectors should not "carry over" knowledge about transfer readiness at prior boarding locs).
  • BUT, when calculating "wasted days", Julie will only use the FIRST transfer ready date/time:
    • example 1: Mr. Jones spent 7 days in Location1 and then directly transferred to Location2 where he stayed another 7 days. On Location1 day 3 a progress note said he was ready to go to ward, but he didn't. At no time during his Location2 stay did any notes indicate transfer readiness. Julie will calculate this as 4 wasted Location1 days, and 7 wasted Location2 days.
    • example 2: Mr. Jones spent 7 days in Location1 and then directly transferred to Location2 where he stayed another 7 days. On Location1 day 3 a progress note said he was ready to go to ward, but he didn't. On Location2 day 1 a progress note indicates transfer readiness. Julie will calculate this as 4 wasted Location1 days, and 7 wasted Location2 days.
    • example 3: Mr. Jones spent 7 days in Location1 and then directly transferred to Location2 where he stayed another 7 days. On Location1 day 3 a progress note said he was ready to go to ward, but he didn't. On Location2 day 5 a progress note indicates transfer readiness. Julie will calculate this as 4 wasted MICU days, and 7 wasted SICU days.
    • ALL 3 of these examples have the same # of wasted days.

• QUESTION: Why record a transfer ready date/time from each boarding loc if we are only actually going to use the first of them?
  • ANSWER: To make it easier for data collectors. This way, collectors don't have to try and go back and figure out if there was or was not a transfer ready in a prior location. They only need be concerned about the notes and orders from THIS boarding loc.

IICU and H6 Reporting

For the ICU annual and quarter reports, the transfer ready delay to the IICU and to HSC H6 (LTV) are reported separately from the transfer delay to the other Wards and home. Thus two derived delay variables, namely:

1. to HSC IICU/H6, and
2. to other wards/Home (including nursing home/long term care facility)

The Dispo location will be used to define the destination. As per Dr. Garland & Dr.Paunovic.

Calculation when transfer time missing

The following definitions are used by Julie in reporting from SAS, and by centralized_data_front_end.accdb to calculate the created_variables query.

• if discharge time < 1000 HR then dummy=0001 HR (12:01 am),
• else if discharge time >= 1000 HR dummy=1000HR (10:00 am)

This was based on Critical Care Vital Sign Monitor.

This is as per approval by Dr. Dan Roberts.

Data use

• Avoidable Days (Critical Care)
• Beds occupied by transferrable patients

Data Integrity Checks (automatic list)

	App	Status
Query check long transfer delay	CCMDB.accdb	needs review

related fields

• Arrive_DtTm
• Dispo_DtTm
• Transfer Ready DtTm tmp entry
• LOS
• Transfer Delay