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)

• Cargo

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

• Categories

• Default form:

See also Transfer Delay.

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 or end date and time of this level of care.

Definition

• Transfer delay is the difference in decimal days between End Dttm of a given level of care and #Time patient is ready for transfer .
• The End Dttm is either the Dispo DtTm, or the time the patient moves to a Boarding Loc with a lower level of care.

Example:

Scenario: arrive HOBS1 -> ready to transfer to reg ward -> regular ward -> ready to transfer out -> HOBS2 -> Home first transfer delay is (start of reg ward) - (ready to transfer to reg ward) second transfer delay is (dispo dttm) - (regular ward ready to transfer out) move to HOBS is up, so transfer ready is not re-set

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.

• 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.

Implementation in CFE

For now, a "Transfer Ready Med testing" button on the main form of CFE needs to be pressed to generate this data. Once we are comfortable with it this generating will be included in the "calc created variables" button.

This function is now ready to test. Ttenbergen 15:17, 2022 June 29 (CDT) emailed Tina some inconsistencies found aug 25,2022. --JMojica 13:09, 2022 August 29 (CDT)

• SMW

• Cargo

• Categories

Sub populate_created_transferDelay() loads created_TransferReady query (which generates transfer ready dates) and created_transferDelay_int query (which combines them with Boarding Loc or Dispo_DtTm as appropriate) and writes it to created_transferDelay table.

Which Transfer Ready DtTm To Use?

Admit DtTm or Dispo DtTm < 2020-10-01 00:00

• for each patient in ICU and Medicine ward, the transfer date and time is taken from the Transfer Ready DtTm field.

Admit DtTm or Dispo DtTm >= 2020-10-01 00:00

• 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, which may or may not be at a different level in the Level of care hierarchy, namely regular wards (CTU or NTU) and High-Obs Wards
• for the purpose of Transfer Delay (Medicine), we will have a transfer delay for each group of Boarding Locs at the same level of care, i.e. there may be more than one per CCMDB record. To accommodate more than one line per record, this is stored in its own table.
• the first Transfer Ready DtTm from a Boarding Loc with the same level of care will be used

Example:

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. Transfer delays for high obs and regular ward will be separately reported.

Why collect per ward in medicine when we only report separately for HOBS?

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.

Calculation when transfer time missing

Legacy Content

This page contains Legacy Content.

• Explanation: We have updated the data with an imputed time component for old transfer ready entries that only had a date.
• Successor: No successor was entered

Click Expand to show legacy content.

• Before Oct 1,2020 - 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.

• Starting Oct 1,2020, transfer time is always present.

Reporting of Transfer Delays

Refer to indicator Beds occupied by transferrable patients

SAS Program

• S:\MED\MED_CCMED\Julie\SAS_CFE\CFE_macros\logphi_TR.sas
  • %Med_tready
• S:\MED\MED_CCMED\Julie\SAS_CFE\CFE_macros\prep_Tmp_BoardServiceTransfer.sas (macro %boardtransf)

Data use

• Transfer Delay
• 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

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