Transfer Ready DtTm tmp entry: Difference between revisions

Line 13:

**In making this delineation, except as for the exceptions listed immediately below, only consider a clearly written intent that the team now desires the patient to be transferred to such a lower level of care.

***In particular, when a ward patient is transferred (e.g. home) without any notes stating the team’s intention to do so in advance or even an order to discharge, collectors ''should '''not''' attempt to make educated guesses'' from the notes of when the patient was ''probably'' clinically ready to leave.

*EXCEPTIONS:

'''EXCEPTIONS:'''

**In an ICU, take the following to indicate transfer ready to a lower level of care even if they have not written that explicitly:

***care is stepped down to '''ward frequency''' (q4hrs or less) of vitals AND off '''all''' forms of life support except possibly intermittent dialysis

'''In an ICU''', take the following to indicate transfer ready to a lower level of care even if they have not written that explicitly:

***[[HSC_IICU]] consult is written

*care is stepped down to '''ward frequency''' (q4hrs or less) of vitals AND off '''all''' forms of life support except possibly intermittent dialysis

***patient is made '''[[ACP C|ACP-C]]'''

*[[HSC_IICU]] consult is written

**In a ward, take the following to indicate transfer ready to a lower level of care even if they have not written that explicitly:

*patient is made '''[[ACP C|ACP-C]]'''

***order is written to change all iv meds to po AND remove monitoring

'''On a medicine ward''', take the following to indicate transfer ready to a lower level of care even if they have not written that explicitly:

***patient is made '''[[ACP C|ACP-C]]'''

*order is written to change all iv meds to po AND remove monitoring

***BUT in the absence of some clear indication (a discharge order, or a progress note, or one of the 2 items immediately above), do NOT try to guess at the transfer ready timing. For example, if there is no such order, and no note saying that the patient was ready to leave or ready for transfer to a lower level of care, but the patient was discharged or transferred, in this case assign the transfer ready timing as the actual [[Dispo DtTm]] or the date and time of the next [[Boarding Loc]]

*patient is made '''[[ACP C|ACP-C]]'''

*BUT in the absence of some clear indication (a discharge order, or a progress note, or one of the 2 items immediately above), do NOT try to guess at the transfer ready timing. For example, if there is no such order, and no note saying that the patient was ready to leave or ready for transfer to a lower level of care, but the patient was discharged or transferred, in this case assign the transfer ready timing as the actual [[Dispo DtTm]] or the date and time of the next [[Boarding Loc]]

** for '''lateral moves''' ie. acute medicine ward to another medicine ward, or ICU to ICU there would be no [[Transfer Ready DtTm]] so the checkbox would be checked

'''For purposes of transfer ready the following services are considered to be a lower level of care:'''

@@ Line 13: / Line 13: @@
 **In making this delineation, except as for the exceptions listed immediately below, only consider a clearly written intent that the team now desires the patient to be transferred to such a lower level of care.
 ***In particular, when a ward patient is transferred (e.g. home) without any notes stating the team’s intention to do so in advance or even an order to discharge, collectors ''should '''not''' attempt to make educated guesses'' from the notes of when the patient was ''probably'' clinically ready to leave.
-*EXCEPTIONS:
+'''EXCEPTIONS:'''
-**In an ICU, take the following to indicate transfer ready to a lower level of care even if they have not written that explicitly:
-***care is stepped down to '''ward frequency''' (q4hrs or less) of vitals AND off '''all''' forms of life support except possibly intermittent dialysis
+'''In an ICU''', take the following to indicate transfer ready to a lower level of care even if they have not written that explicitly:
-***[[HSC_IICU]] consult is written
+*care is stepped down to '''ward frequency''' (q4hrs or less) of vitals AND off '''all''' forms of life support except possibly intermittent dialysis
-***patient is made '''[[ACP C|ACP-C]]'''
+*[[HSC_IICU]] consult is written
-**In a ward, take the following to indicate transfer ready to a lower level of care even if they have not written that explicitly:
+*patient is made '''[[ACP C|ACP-C]]'''
-***order is written to change all iv meds to po AND remove monitoring
+'''On a medicine ward''', take the following to indicate transfer ready to a lower level of care even if they have not written that explicitly:
-***patient is made '''[[ACP C|ACP-C]]'''
+*order is written to change all iv meds to po AND remove monitoring
-***BUT in the absence of some clear indication (a discharge order, or a progress note, or one of the 2 items immediately above), do NOT try to guess at the transfer ready timing.  For example, if there is no such order, and no note saying that the patient was ready to leave or ready for transfer to a lower level of care, but the patient was discharged or transferred, in this case assign the transfer ready timing as the actual [[Dispo DtTm]] or the date and time of the next [[Boarding Loc]]
+*patient is made '''[[ACP C|ACP-C]]'''
+*BUT in the absence of some clear indication (a discharge order, or a progress note, or one of the 2 items immediately above), do NOT try to guess at the transfer ready timing.  For example, if there is no such order, and no note saying that the patient was ready to leave or ready for transfer to a lower level of care, but the patient was discharged or transferred, in this case assign the transfer ready timing as the actual [[Dispo DtTm]] or the date and time of the next [[Boarding Loc]]
 ** for '''lateral moves''' ie. acute medicine ward to another medicine ward, or ICU to ICU there would be no [[Transfer Ready DtTm]] so the checkbox would be checked
 '''For purposes of transfer ready the following services are considered to be a lower level of care:'''