Transfer Ready date and time

see Transfer time rule for the unrelated rules around patients transferring between wards we collect data on

Transfer ready date and time is the time a patient is deemed to be ready to leave the ward/unit; there are very specific collection instructions for this, and they are different for ICU and Medicine.

ICU

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)
• See ICU special cases below

Not required for ICU when

• goes home ICU Var 6 - AMA Against Medical Advice
• when patient dies in the ICU
• transfer to one ICU from another ICU in same center or in in city
  • Template:Discussion intentionally excluding transfer to out of province ICU? Ttenbergen 19:37, 2014 October 23 (CDT)
• sent to operating room
• sent for procedure or test and doesn't return to unit

ICU Special Case - ACP-C

The time that a patient is made ACP-C in an ICU should be used as Transfer Date and Time. This is because the less acute care of a medicine ward is now sufficient for such a patient, so does not apply to medicine collection.

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 Against Medical Advice
• 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 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.

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.--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

Template: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.

Template:Discussion I don't think these run as written right now, and even if they do, they would be different than #NDC_Missing_TransferDate_w_pivot

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

Template: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

• LOS
• Multiple Encounter
• Transfer Delay
• bed occupancy

See Also

• Admit date and time
• Discharge date and time
• Transfer Ready date and time