Transfer Delay (Medicine)

Transfer Delay is the difference between Dispo_DtTm and #Time patient is ready for transfer in decimal days. Other terms use to call it are Beds Occupied by transferable patients, Wasted Beds, Avoidable Days.

Indicators
Indicator:	Transfer Delay (Medicine)
Created/Raw:	created
Program:	Medicine
Start Date:	2003-10-01
End Date:
Reports:	Directors Quarterly and Annual Report (Medicine)

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• SMW:
  • "created" is not in the list (Created, Raw) of allowed values for the "IndicatorCreatedRaw" property.

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• Default form:

See also Transfer Delay.

According to the discussion at Task on 2022-04-20 this will need to be updated once the reporting is updated. Something about 30 minutes grace time for all? Ttenbergen 20:59, 2022 April 20 (CDT) And there was a scenario HOBS -> ward -> HOBS2, what would we use as an end date for the ward in the middle? Julie was going to check how she has implemented this and then document here. I hope the start of HOBS2 is the end date 15:50, 2022 April 27 (CDT)

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Use

• The purpose is to determine the amount of time the patient is occupying a bed in a High Observation ward or a regular ward setting when the patient is no longer needing that level of care from the Transfer Ready DtTm until the Dispo DtTm.

Definition details

• Transfer Delay Over 4 hours for Medicine (i.e. subtract 4 hrs from transfer delay)

Implementation

Time patient is ready for transfer

The definition of this has changed between before and after PatientFollow Project.

Starting Oct 1, 2020, it will need to be calculated differently.

It is not reported by ward, it is reported only per episode / profile.

Julie sums up the multiple transfer delays that might be present.

Start time is first transfer ready per level of care; end is either last of this level of care, or dispo.

_dev_CFE Make that available in CFE.

added: 2021-08-03 action: 2021-08-17

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• Before Oct 1, 2020, it is calculated by Created_Variables_Common_maker query and stored in Created_Variables_Common table in CFE.

• Starting Oct 1, 2020, it will be added but haven't started.

_dev_CFE add the updated calculation based on the new process to Created Variables.

added: no added date action: no action date

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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.

Starting Oct 1, 2020

• for each record and each boarding location in 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.
• for each record, it is possible to have more than one Level of care hierarchy namely
  • WRHA HOB Medicine ward (examples: HSC_HOBS, STB_IMCU as of 2020-10)
  • WRHA regular Medicine ward (CTU or NTU)
• for each record if the patient moves to various locations, the first Transfer Ready DtTm from a Boarding Loc with the same level of care will be used
  • for example, a Med patient stays in high obs bed and then move to regular ward bed and then another regular ward bed. There are two levels of care - one for high obs and another which is lower, for the regular ward. At least two Transfer Ready DtTm intent are expected here - first intent for high obs ready to go to a regular ward and the second intent is from a regular ward to be discharged to another lower level of care or home or PCH. Assuming that there are transfer orders both at regular ward 1 and regular ward 2 and both are with same level of care, the first Transfer Ready DtTm time will be used in calculating the wasted bed for that lower level of care. There will be another wasted bed to be calculated for the high Obs level of care from the Transfer Ready DtTm to the time the patient left the high obs bed (ie the Dispo DtTm or the next Boarding Loc start DtTm. The sum of the two scenarios will be the total wasted bed for that patient.
  • if the Med patient stays in more than one regular wards (or boarding location), all locations are considered with the same level of care, the wasted bed is calculated from the first Transfer Ready DtTm until Dispo DtTm.

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 < 1200 HR then dummy=0001 HR (12:01 am) ,
• else if discharge time >= 1200 HR dummy=1200HR (12:00 noon)

This is as per approval by Dr. Dan Roberts.

SAS Program

• S:\MED\MED_CCMED\Julie\SAS_CFE\CFE_macros\logphi.sas
• S:\MED\MED_CCMED\Julie\SAS_CFE\CFE_macros\prep_Tmp_BoardServiceTransfer_15Sept2021.sas (macro %boardtransf)

Data use

Beds occupied by transferrable patients

Data Integrity Checks (automatic list)

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

related fields

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