Ventilated patient flow

Ventilated Patient Flow is the number of mechanically ventilated patients at any time during the ICU stay per bed per period of time.

Indicators
Indicator:	Ventilated Patient Flow
Created/Raw:	Created
Program:	Critical Care
Start Date:	Jan 1 2013
End Date:
Reports:	Critical Care Program Quality Indicator Report
Data Dependencies(Reports/Indicators/Data Elements):

• Cargo

• Helper template:

• Cargo

• Categories

none

• Default form: none, this is populated by Template:Report and Template:Reporting Indicators and their respective forms.

• SMW:

• Categories

• Default form:

QI domain

• Efficient

Reported as

Count of patients on mechanical ventilation per bed per period of time

Significance

Experience with mechanical ventilation is associated with improved patient outcomes. Factors affecting ventilated patient flow include ICU patient type and acuity, Structural and process-related aspects of care, and factors affecting patient flow following ICU care.

Sampling Plan / Procedure

Inclusion Criteria

100% sampling of patients on mechanical ventilation as indicated by the presence of one of the following TISS items:

• T18 - Invasive Mechanical Ventilation (TISS Item)
• T21 - Non-invasive CPAP or BIPAP (TISS Item)

Exclusion Criteria

Patients who are not on mechanical ventilation

Frequency

• Daily recording of dates of patient being on mechanical ventilation
• Total number of ICU discharges being on mechanical ventilation at least one day during the ICU stay are calculated and reported on a monthly, quarterly or yearly basis based on the daily data.
• Time Reference for month, quarter or year is based on ICU discharge dates.
• Number of physical ICU beds available. The number of available bed rarely change except for pandemic or seasonal closures.
  • If the number of daily available bed changes over the period of time, use the number of bed which is the most numbered. Example, in a monthly period, 20 out of 30 days have opened bed = 15 while 10 days have 14 beds, use the number of bed=15.

Definition and Derivation

Numerator

Num = Total number of discharges who were ventilated at any time during the ICU stay

Denominator

Denom = Number of ICU beds

Formula

Ventilated Patient Flow = Num / Denom

Example

• Time Reference: Discharge Dates from Jan 1, 2017 to March 31, 2017
• Number of patients who have discharge dates from Jan 1, 2017 to March 31, 2017 and who were on mechanical ventilation at HSC MICU = 158
• Opened Bed = 15
• Ventilated Patient Flow = 158 / 15 = 10.5

Data Sources

Daily data for Invasive and non invasive mechanical ventilation are taken on TISS28 elements T18 - Invasive Mechanical Ventilation (TISS Item) and T21 - Non-invasive CPAP or BIPAP (TISS Item) respectively. The TISS form is being marked daily by ICU bed side nurses and quality checked by the Database Data Collectors. The daily bed available or opened per unit is taken from the Bed Census Database.

SAS Program

Part of X:\Julie\SAS_CFE\CC_reports\ChartReport\prepCCChart.sas

Report Users

• Critical Care Directors and Site Managers
• Critical Care Quality Improvement Team (QIT)