Transfer Delay (Critical Care): Difference between revisions
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* The purpose is to determine the amount of time the patient is occupying a bed in an ICU setting when the patient no longer needs that [[Level of care hierarchy| level of care]] (also referred to as wasted bed) from the [[#Transfer Ready DtTm in use at different times]] until the [[Dispo DtTm]]. | * The purpose is to determine the amount of time the patient is occupying a bed in an ICU setting when the patient no longer needs that [[Level of care hierarchy| level of care]] (also referred to as wasted bed) from the [[#Transfer Ready DtTm in use at different times]] until the [[Dispo DtTm]]. | ||
== Calculation of Transfer Delay == | == Calculation of Transfer Delay == | ||
*As agreed in JALT meeting March 22, 2023, transfer delays will be reported based on actual delay times with no more allowances of less than n hours. | |||
*Initially, transfer delay calculation follows the national Vital Signs Monitoring program guideline which is substracting 2 hrs from all actual delay time. | *Initially, transfer delay calculation follows the national Vital Signs Monitoring program guideline which is substracting 2 hrs from all actual delay time. | ||
*In the meeting held Jan 11, 2023, it was decided as per approval from the Critical Care Director to define transfer delays as follows: (a) ignore such transfer delays <2 hrs, but (b) for all delays >=2 hrs to use the actual delay time. | *In the meeting held Jan 11, 2023, it was decided as per approval from the Critical Care Director to define transfer delays as follows: (a) ignore such transfer delays <2 hrs, but (b) for all delays >=2 hrs to use the actual delay time. | ||
Revision as of 11:49, 2023 March 23
Transfer Delay is the difference between Dispo_DtTm and #Transfer Ready DtTm in use at different times in decimal days.
| Indicators | |
| Indicator: | Transfer_Delay_CC |
| Created/Raw: | created |
| Program: | Critical Care and Medicine |
| Start Date: | 1999-01-15 |
| End Date: | |
| Reports: | Critical Care Program Quality Indicator Report, Directors Quarterly and Annual Report (Critical Care), HSC ICUs Data by Patient |
There is a similar concept in medicine, Transfer Delay (Medicine).
It is stored in the Transfer_Delay_CC field in Created_Variables_CC_2021 table.
Use
- The purpose is to determine the amount of time the patient is occupying a bed in an ICU setting when the patient no longer needs that level of care (also referred to as wasted bed) from the #Transfer Ready DtTm in use at different times until the Dispo DtTm.
Calculation of Transfer Delay
- As agreed in JALT meeting March 22, 2023, transfer delays will be reported based on actual delay times with no more allowances of less than n hours.
- Initially, transfer delay calculation follows the national Vital Signs Monitoring program guideline which is substracting 2 hrs from all actual delay time.
- In the meeting held Jan 11, 2023, it was decided as per approval from the Critical Care Director to define transfer delays as follows: (a) ignore such transfer delays <2 hrs, but (b) for all delays >=2 hrs to use the actual delay time.
Transfer Ready DtTm in use at different times
Admit DtTm or Dispo DtTm < 2020-10-01 00:00
- Use the DtTm in Transfer Ready DtTm field
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Query to run if we really want to do this for all records w zero times even if different dates.
UPDATE L_Log INNER JOIN created_Program ON L_Log.D_ID = created_Program.D_ID SET L_Log.Transfer_Ready_DtTm = [transfer_ready_dttm]+IIf(TimeValue([dispo_dttm])<#12/30/1899 10:0:0#,#12/30/1899 0:1:0#,#12/30/1899 10:0:0#) WHERE (((L_Log.Transfer_Ready_DtTm)>#1/1/1900#) AND ((created_Program.program)="cc") AND ((L_Log.Dispo_DtTm) Is Not Null) AND ((TimeValue(Nz([transfer_ready_dttm],#1/1/1900#))=#12/30/1899#)=True) AND ((DateValue(Nz([dispo_dttm],#1/2/1900#))=DateValue(Nz([transfer_ready_dttm],#1/1/1900#)))=True));
Admit DtTm or Dispo DtTm >= 2020-10-01 00:00
- Use the first Transfer Ready DtTm tmp entry, as derived by created_FirstTransferReady query
Background
- For each record, it is possible to have one or more entries of Transfer Ready DtTm tmp entry corresponding to one or more boarding locations.
- We only collect one level of care per CC record, so we only ever care about the first Transfer Ready DtTm tmp entry that has a DtTm
- Any additional Transfer Ready DtTm tmp entry will be ignored for this calculation
Why collect per boarding loc when we only report per admission?
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.
Reporting of Transfer Delays
- Include all cases with transfer ready dttm (who went to same/lower/higher level of care or died).
- Refer to the following indicators:
IICU and H6 Reporting
For the ICU annual and quarter reports, the transfer ready delay to the IICU and to HSC H6 (LTV) are reported separately from the transfer delay to the other Wards and home. Thus two derived delay variables, namely:
- to HSC IICU/H6, and
- to other wards/Home (including nursing home/long term care facility)
The Dispo location will be used to define the destination. As per Dr. Garland & Dr. Paunovic.
SAS Program
- S:\MED\MED_CCMED\Julie\SAS_CFE\CFE_macros\logphi_TR_Jan2023.sas
- macro %CC_tready
- S:\MED\MED_CCMED\Julie\SAS_CFE\CFE_macros\prep_Tmp_BoardServiceTransfer.sas (macro %boardtransf)
Data use
Data Integrity Checks (automatic list)
| App | Status | |
|---|---|---|
| Query check long transfer delay | CCMDB.accdb | needs review |
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Reporting change from 4 to 2 hrs
- Starting July 1, 2018 Transfer Delay Over 2 hours for Critical Care (i.e. subtract 2 hours instead of 4 hours from transfer delay as per instruction by Jodi Walker Tweed.)