ICU Interfacility Transfer: Difference between revisions
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== Transfer for Medical Reason or Bed management == | == Transfer for Medical Reason or Bed management == | ||
A similar thing used to be reported for transfer "for medical reasons" vs. "for bed management". This is now added in the report starting 2024. In order to determine the reason for transfer, the diagnoses on the transferring ICU will be evaluated and | A similar thing used to be reported for transfer "for medical reasons" vs. "for bed management". This is now added in the report starting 2024. In order to determine the reason for transfer, the diagnoses on the transferring ICU will be evaluated and depends on the sending facility (where patient came from) and the admitting ICU. | ||
=== Medical Reason=== | === Medical Reason === | ||
* From STB facility to HSC ICUs - medical reasons include Neurological dxs, all types of trauma dxs and MICP procedures | * From STB facility to HSC ICUs - medical reasons include Neurological dxs, all types of trauma dxs and MICP procedures | ||
* From HSC facility to STB ICMS/ACCU/ICCS - medical reasons include Cath Lab procedures, Cardiovascular Post-op dxs, Aortic aneurysm, thoracic with rupture, IABP and Peritoneal Dialysis | * From HSC facility to STB ICMS/ACCU/ICCS - medical reasons include Cath Lab procedures, Cardiovascular Post-op dxs, Aortic aneurysm, thoracic with rupture, IABP and Peritoneal Dialysis | ||
* From Grace facility to HSC/STB ICUs - medical reasons include Cath Lab procedures, Cardiovascular Post-op dxs, Acute renal, vascular aneurysm, Neurological, all trauma, MICP, IABP, Peritoneal Dialysis, Hemodialysis, CRRT procedures. | * From Grace facility to HSC/STB ICUs - medical reasons include Cath Lab procedures, Cardiovascular Post-op dxs, Acute renal, vascular aneurysm, Neurological, all trauma, MICP, IABP, Peritoneal Dialysis, Hemodialysis, CRRT procedures. | ||
=== Bed Management Reason === | |||
* If none in the above Medical reason, then it is bed management reason. | |||
=== Transfer OUT === | === Transfer OUT === | ||
*Transfer OUT includes the transfers from a discharging or sending ICU to another site’s ICU for medical necessity or bed management reasons. | *Transfer OUT includes the transfers from a discharging or sending ICU to another site’s ICU for medical necessity or bed management reasons. | ||
Revision as of 13:53, 2024 January 30
Percent of live ICU discharges that are transferred to an ICU located at a different hospital.
| Indicators | |
| Indicator: | ICU Interfacility Transfer |
| Created/Raw: | Created |
| Program: | Critical Care |
| Start Date: | Oct 2016 |
| End Date: | |
| Reports: | Critical Care Program Quality Indicator Report |
Usually used in aggregate form as "per location" and/or "per timeframe", e.g. by day/month/quarter/year x Ward/Unit x Hospital.
See more details on the different scenario of transfer in ICU Interfacility Report .
QI domain
- Efficient
Significance
Reasons for transfer may be either to manage ICU beds or access to a required medical service. Bed management transfers can increase the efficiency of ICU bed numbers within a region. Patient transfers may increase the time to appropriate management and may place patients at risk.
Sampling Plan / Procedure
Inclusion Criteria
100% patients who survived and left ICU
Exclusion Criteria
- Patients transferred to a home hospital (i.e. not for medical or bed access reasons);
- patients not formally evaluated by the ICU team;
- patients admitted to a critical care unit within the same geographic site.
Frequency
Month, quarter or year based on ICU discharge dates.
Definition and Derivation
Percent of live ICU discharges that are transferred to an ICU located at a different hospital.
Numerator
Num = Number of live ICU discharges that are transferred to an ICU located at a different hospital
Denominator
Denom = Number of Live ICU discharges
Formula
Percent of live ICU discharges that are transferred to an ICU located at a different hospital = Num / Denom
Transfer for Medical Reason or Bed management
A similar thing used to be reported for transfer "for medical reasons" vs. "for bed management". This is now added in the report starting 2024. In order to determine the reason for transfer, the diagnoses on the transferring ICU will be evaluated and depends on the sending facility (where patient came from) and the admitting ICU.
Medical Reason
- From STB facility to HSC ICUs - medical reasons include Neurological dxs, all types of trauma dxs and MICP procedures
- From HSC facility to STB ICMS/ACCU/ICCS - medical reasons include Cath Lab procedures, Cardiovascular Post-op dxs, Aortic aneurysm, thoracic with rupture, IABP and Peritoneal Dialysis
- From Grace facility to HSC/STB ICUs - medical reasons include Cath Lab procedures, Cardiovascular Post-op dxs, Acute renal, vascular aneurysm, Neurological, all trauma, MICP, IABP, Peritoneal Dialysis, Hemodialysis, CRRT procedures.
Bed Management Reason
- If none in the above Medical reason, then it is bed management reason.
Transfer OUT
- Transfer OUT includes the transfers from a discharging or sending ICU to another site’s ICU for medical necessity or bed management reasons.
- The number of transfers is attributed to the discharging or sending or originating ICUs.
- To another site's ICU can be any ICU at different facility.
- For example, patients admitted at Grace ICU who are transferred to HSC MICU or STB ICMS are Transfer OUT.
- Patients who are admitted at Grace ICU, had a procedure in other facility and then admitted to an ICU service in that or another facility are Transfer OUT.
- Patients who are admitted at Grace ICU, had a procedure in other facility and then came back to Grace ICU are not Transfer OUT.
Transfer IN
- Transfer IN includes the transfers to a receiving or admitting ICU from another site for medical necessity or bed management reason.
- The number of transfers is attributed to the receiving or admitting ICUs.
- From another site can be another site’s ICU, ER, ICU, Ward, OR, RR, etc. Can be broken down from another site's ICU or Non-ICU location.
- For example, patients admitted to HSC MICU can be inpatients from STB ICMS or STB Ward or Grace ICU or Grace Ward or non-inpatients from STB ER or Grace ER. All these transfers are counted and attributed to HSC MICU. If need to separate from another site ICU, include only those from STB ICMS and Grace ICU. If from another site non-ICU location, include those from STB ER, STB Ward, Grace ER, Grace Ward.
Data Sources
SAS Program
- S:\MED\MED_CCMED\Julie\SAS_CFE\CFE_macros\InterfacilityReasonMed.sas - list the diagnosis (old coding and ICD10 codes) that defines a medical reason for transfer
- S:\MED\MED_CCMED\Julie\SAS_CFE\CFE_macros\InterfacilityInOut.sas
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