ICU Interfacility Transfer: Difference between revisions
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! sort !! ICD10 code !! CCI code !! From site STB to HSC ICU !! From site HSC to STB ICU !! From site GRA to HSC/STB ICU | ! sort !! ICD10 code !! CCI code !! From site STB to HSC ICU !! From site HSC to STB ICU !! From site GRA to HSC/STB ICU | ||
|- | |- | ||
| | | 1 || ||{{ CCIWithCode |Angioplasty, coronary (without stenting) }} || || YES || YES | ||
|- | |- | ||
| 3 ||{{ ICD10ByCode | N17.0 }} || || || YES | | 1 || ||{{ CCIWithCode |Angiogram, coronary (diagnostic cardiac catheterization) }} || || YES || YES | ||
|- | |||
| 1 || ||{{ CCIWithCode |Angioplasty, coronary (with stenting) }} || || YES || YES | |||
|- | |||
| 1 || ||{{ CCIWithCode |ECMO, VA }} || || YES || YES | |||
|- | |||
| 1 || ||{{ CCIWithCode |ECMO, VV}} || || YES || YES | |||
|- | |||
| 2 || ||{{ CCIWithCode | (T) Pericardium}} - {{ CCIWithCode |Excision Resection partial }} || || YES || YES | |||
|- | |||
| 2 || ||{{ CCIWithCode | (T) Pericardium}} - {{ CCIWithCode |Debridement}} || || YES || YES | |||
|- | |||
| 2 || ||{{ CCIWithCode | (T) Cardiac Conduction System}} - {{ CCIWithCode |Destruction}} || || YES || YES | |||
|- | |||
| 2 || ||{{ CCIWithCode | (T) Cardiac Conduction System}} - {{ CCIWithCode |Repair}} || || YES || YES | |||
|- | |||
| 2 || ||{{ CCIWithCode | (T) Cardiac Atrium}} - {{ CCIWithCode |Removal of Foreign Body}} || || YES || YES | |||
|- | |||
| 2 || ||{{ CCIWithCode | (T) Cardiac Atrium}} - {{ CCIWithCode |Repair }} || || YES || YES | |||
|- | |||
| 2 || ||{{ CCIWithCode | (T) Cardiac Atrium}} - {{ CCIWithCode |Excision Resection partial }} || || YES || YES | |||
|- | |||
| 2 || ||{{ CCIWithCode | (T) Cardiac Atrium}} - {{ CCIWithCode |Excision Resection total }} || || YES || YES | |||
|- | |||
| 2 || ||{{ CCIWithCode | (T) Cardiac Atrium}} - {{ CCIWithCode |Excision with Reconstruction Replacement }} || || YES || YES | |||
|- | |||
| 2 || ||{{ CCIWithCode | (T) Interatrial Septum}} - {{ CCIWithCode |Occlusion }} || || YES || YES | |||
|- | |||
| 2 || ||{{ CCIWithCode | (T) Interatrial Septum}} - {{ CCIWithCode |Release Decompression }} || || YES || YES | |||
|- | |||
| 2 || ||{{ CCIWithCode | (T) Interatrial Septum}} - {{ CCIWithCode |Repair }} || || YES || YES | |||
|- | |||
| 2 || ||{{ CCIWithCode | (T) Cardiac ventricle}} - {{ CCIWithCode |Implantation of Internal Device }} || || YES || YES | |||
|- | |||
| 2 || ||{{ CCIWithCode | (T) Cardiac ventricle}} - {{ CCIWithCode |Removal of Foreign Body }} || || YES || YES | |||
|- | |||
| 2 || ||{{ CCIWithCode | (T) Cardiac ventricle}} - {{ CCIWithCode |Repair }} || || YES || YES | |||
|- | |||
| 2 || ||{{ CCIWithCode | (T) Interventricular Septum}} - {{ CCIWithCode |Repair }} || || YES || YES | |||
|- | |||
| 2 || ||{{ CCIWithCode | (T) Tricuspid Valve Related Structures}} - {{ CCIWithCode |Ultrasound }} || || YES || YES | |||
|- | |||
| 2 || ||{{ CCIWithCode | (T) Tricuspid Valve Related Structures}} - {{ CCIWithCode |Implantation of Internal Device }} || || YES || YES | |||
|- | |||
| 2 || ||{{ CCIWithCode | (T) Tricuspid Valve Related Structures}} - {{ CCIWithCode |Repair}} || || YES || YES | |||
|- | |||
| 2 || ||{{ CCIWithCode | (T) Tricuspid Valve Related Structures - Excision with Reconstruction Replacement }} || || YES || YES | |||
|- | |||
| 2 || ||{{ CCIWithCode | (T) Pulmonic Valve Related Structures - Excision with Reconstruction Replacement }} || || YES || YES | |||
|- | |||
| 2 || ||{{ CCIWithCode | (T) Mitral Valve Related Structures - Ultrasound }} || || YES || YES | |||
|- | |||
| 2 || ||{{ CCIWithCode | (T) Mitral Valve Related Structures - Implantation of Internal Device }} || || YES || YES | |||
|- | |||
| 2 || ||{{ CCIWithCode | (T) Mitral Valve Related Structures - Repair }} || || YES || YES | |||
|- | |||
| 2 || ||{{ CCIWithCode | (T) Mitral Valve Related Structures - Construction Reconstruction }} || || YES || YES | |||
|- | |||
| 2 || ||{{ CCIWithCode |(T) Mitral Valve Related Structures - Excision with Reconstruction Replacement }} || || YES || YES | |||
|- | |||
| 2 || ||{{ CCIWithCode | (T) Aortic Valve Related Structures - Occlusion }} || || YES || YES | |||
|- | |||
| 2 || ||{{ CCIWithCode |(T) Aortic Valve Related Structures - Implantation of Internal Device }} || || YES || YES | |||
|- | |||
| 2 || ||{{ CCIWithCode |(T) Aortic Valve Related Structures - Repair }} || || YES || YES | |||
|- | |||
| 2 || ||{{ CCIWithCode | (T) Aortic Valve Related Structures - Construction Reconstruction }} || || YES || YES | |||
|- | |||
| 2 || ||{{ CCIWithCode | (T) Aortic Valve Related Structures - Excision with Reconstruction Replacement }} || || YES || YES | |||
|- | |||
| 2 || ||{{ CCIWithCode |(T) Heart NOS - Control of Bleeding }} || || YES || YES | |||
|- | |||
| 2 || ||{{ CCIWithCode | (T) Heart NOS - Installation of External Appliance }} || || YES || YES | |||
|- | |||
| 2 || ||{{ CCIWithCode |(T) Heart NOS - Drainage Evacuation }} || || YES || YES | |||
|- | |||
| 2 || ||{{ CCIWithCode |Pacemaker insertion permanent }} || || YES || YES | |||
|- | |||
| 2 || ||{{ CCIWithCode | (T) Heart NOS - Bypass }} || || YES || YES | |||
|- | |||
| 2 || ||{{ CCIWithCode | (T) Heart NOS - Repair }} || || YES || YES | |||
|- | |||
| 2 || ||{{ CCIWithCode | (T) Heart NOS - Excision Resection total }} || || YES || YES | |||
|- | |||
| 2 || ||{{ CCIWithCode | (T) Heart NOS - Excision with Reconstruction Replacement }} || || YES || YES | |||
|- | |||
| 2 || ||{{ CCIWithCode | (T) Thoracic Aorta - Control of Bleeding }} || || YES || YES | |||
|- | |||
| 2 || ||{{ CCIWithCode | (T) Thoracic Aorta - Implantation of Internal Device }} || || YES || YES | |||
|- | |||
| 2 || ||{{ CCIWithCode | IABP }} || || YES || YES | |||
|- | |||
| 2 || ||{{ CCIWithCode | (T) Thoracic Aorta - Bypass }} || || YES || YES | |||
|- | |||
| 2 || ||{{ CCIWithCode | (T) Thoracic Aorta - Repair }} || || YES || YES | |||
|- | |||
| 2 || ||{{ CCIWithCode | (T) Thoracic Aorta - Excision with Reconstruction Replacement }} || || YES || YES | |||
|- | |||
| 2 || ||{{ CCIWithCode | (T) Aorta NOS - Computerized Tomography (CT) }} || || YES || YES | |||
|- | |||
| 2 || ||{{ CCIWithCode | (T) Aorta NOS - Repair }} || || YES || YES | |||
|- | |||
| 2 || ||{{ CCIWithCode | (T) Aorta NOS - Excision with Reconstruction Replacement }} || || YES || YES | |||
|- | |||
| 2 || ||{{ CCIWithCode | (T) Coronary Arteries - MRI }} || || YES || YES | |||
|- | |||
| 2 || ||{{ CCIWithCode | (T) Coronary Arteries - Drainage Evacuation }} || || YES || YES | |||
|- | |||
| 2 || ||{{ CCIWithCode | (T) Coronary Arteries - Removal of Foreign Body }} || || YES || YES | |||
|- | |||
| 2 || ||{{ CCIWithCode | (T) Coronary Arteries - Extraction }} || || YES || YES | |||
|- | |||
| 2 || ||{{ CCIWithCode | (T) Coronary Arteries - Bypass }} || || YES || YES | |||
|- | |||
| 2 || ||{{ CCIWithCode | (T) Coronary Arteries- Debridement }} || || YES || YES | |||
|- | |||
| 2 || ||{{ CCIWithCode | (T) Coronary Vessels NOS - Repair }} || || YES || YES | |||
|- | |||
| 2 || ||{{ CCIWithCode | (T) Pulmonary Artery - Repair }} || || YES || YES | |||
|- | |||
| 2 || ||{{ CCIWithCode | (T) Pulmonary Artery - Excision with Reconstruction Replacement }} || || YES || YES | |||
|- | |||
| 2 || ||{{ CCIWithCode | (T) Vena Cava - Control of Bleeding }} || || YES || YES | |||
|- | |||
| 2 || ||{{ CCIWithCode | (T) Vena Cava - Repair }} || || YES || YES | |||
|- | |||
| 2 || ||{{ CCIWithCode | (T) Carotid Artery - Bypass - remove for transfer from HSC to STB 5Dec2023}} || || || YES | |||
|- | |||
| 2 || ||{{ CCIWithCode | (T) Carotid Artery - Excision with Reconstruction Replacement - remove for transfer from HSC to STB 5Dec2023}} || || || YES | |||
|- | |||
| 2 || ||{{ CCIWithCode | (T) Abdominal Aorta - Excision with Reconstruction Replacement - remove for transfer from HSC to STB 5Dec2023}} || || || YES | |||
|- | |||
| 2 || ||{{ CCIWithCode | (T) Abdominal Aorta - remove for transfer from HSC to STB 5Dec2023}} || || || YES | |||
|- | |||
| 3 ||{{ ICD10ByCode | N17.0 }} ||FALSE || || || YES | |||
|- | |||
| 3 ||{{ ICD10ByCode | N17.9 }} ||FALSE || || || YES | |||
|- | |||
| 3 ||{{ ICD10ByCode | N99.0 }} ||FALSE || || || YES | |||
|- | |||
| 4 ||{{ ICD10ByCode | I71.1}} ||FALSE || || || YES | |||
|- | |||
| 4 ||{{ ICD10ByCode | I71.2}} ||FALSE || || || YES | |||
|- | |||
| 4 ||{{ ICD10ByCode | I71.3}} ||FALSE || || add to STB || YES | |||
|- | |||
| 4 ||{{ ICD10ByCode | I71.4}} ||FALSE || || || YES | |||
|- | |||
| 4 ||{{ ICD10ByCode | I71.8}} ||FALSE || || || YES | |||
|- | |||
| 4 ||{{ ICD10ByCode | I71.9}} ||FALSE || || || YES | |||
|- | |||
| 4 ||{{ ICD10ByCode | I72}} ||FALSE || || || YES | |||
|- | |||
| || ||FALSE || || || | |||
|- | |||
| 5 ||{{ ICD10ByCode | G40}} ||FALSE || || || | |||
|- | |||
| 5 ||{{ ICD10ByCode | G41}} ||FALSE || || || | |||
|- | |||
| 5 ||{{ ICD10ByCode | R56.8}} ||FALSE || || || | |||
|- | |||
| 5 ||{{ ICD10ByCode | O15}} ||FALSE || YES || || YES | |||
|- | |||
| 5 ||{{ ICD10ByCode | G06.0}} ||FALSE || YES || || YES | |||
|- | |||
| 5 ||{{ ICD10ByCode | G08}} ||FALSE || YES || || YES | |||
|- | |||
| 5 ||{{ ICD10ByCode | I60}} ||FALSE || YES || || YES | |||
|- | |||
| 5 ||{{ ICD10ByCode | I61}} ||FALSE || YES || || YES | |||
|- | |||
| 5 ||{{ ICD10ByCode | I62}} ||FALSE || YES || || YES | |||
|- | |||
| 5 ||{{ ICD10ByCode | I63.4}} ||FALSE || YES || || YES | |||
|- | |||
| 5 ||{{ ICD10ByCode | I63.9}} ||FALSE || YES || || YES | |||
|- | |||
| 5 ||{{ ICD10ByCode | I64}} ||FALSE || YES || || YES | |||
|- | |||
| 5 ||{{ ICD10ByCode | I65}} ||FALSE || YES || || YES | |||
|- | |||
| 5 ||{{ ICD10ByCode | I67.1}} ||FALSE || YES || || YES | |||
|- | |||
| 5 ||{{ ICD10ByCode | I67.84}} ||FALSE || YES || || YES | |||
|- | |||
| 5 ||{{ ICD10ByCode | I67.9}} ||FALSE || YES || || YES | |||
|- | |||
| 5 ||{{ ICD10ByCode | G91.2}} ||FALSE || YES || || YES | |||
|- | |||
| 5 ||{{ ICD10ByCode | G91.9}} ||FALSE || YES || || YES | |||
|- | |||
| 5 ||{{ ICD10ByCode | G93.5}} ||FALSE || YES || || YES | |||
|- | |||
| 5 ||{{ ICD10ByCode | G93.6}} ||FALSE || YES || || YES | |||
|- | |||
| 5 ||{{ ICD10ByCode | Q28.2}} ||FALSE || YES || || YES | |||
|- | |||
| 5 ||{{ ICD10ByCode | G93.81}} ||FALSE || || || YES | |||
|- | |||
| 5 ||{{ ICD10ByCode | I67.4}} ||FALSE || || || | |||
|- | |||
| 5 ||{{ ICD10ByCode | I67.83}} ||FALSE || || || | |||
|- | |||
| 5 ||{{ ICD10ByCode | G92}} ||FALSE || || || | |||
|- | |||
| 5 ||{{ ICD10ByCode | G93.4}} ||FALSE || || || | |||
|- | |||
| 5 ||{{ ICD10ByCode | G93.80}} ||FALSE || || || | |||
|- | |||
| 5 ||{{ ICD10ByCode | G93.9}} ||FALSE || || || | |||
|- | |||
| 5 ||{{ ICD10ByCode | G45}} ||FALSE || || || | |||
|- | |||
| || ||FALSE || || || | |||
|- | |||
| || ||FALSE || || || | |||
|- | |||
| 6 ||{{ ICD10ByCode | S00 to S99}} ||FALSE || YES || || YES | |||
|- | |||
| 6 ||{{ ICD10ByCode | T07 to T14}} ||FALSE || YES || || YES | |||
|- | |||
| || ||FALSE || || || | |||
|- | |||
| 7 || ||{{ CCIWithCode |Monitoring Intracranial pressure }} || YES || || YES | |||
|- | |||
| || ||FALSE || || || | |||
|- | |||
| 8 || ||{{ CCIWithCode |Intraaortic balloon pump}} || || YES || YES | |||
|- | |||
| || ||FALSE || || || | |||
|- | |||
| 9 || ||{{ CCIWithCode |Peritoneal Dialysis}} || || YES || YES | |||
|- | |||
| || ||FALSE || || || | |||
|- | |||
| 10 || ||{{ CCIWithCode |Hemodialysis }} || || || YES | |||
|- | |||
| || ||FALSE || || || | |||
|- | |||
| 11 || ||{{ CCIWithCode |CRRT }} || || || YES | |||
|} | |} | ||
Revision as of 12:52, 2024 March 11
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 definition of interfacility 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 for Live ICU discharges
- Month, quarter or year based on ICU admission dates for the counts of transfers due to medical or bed access reasons
Definition and Derivation For Rate
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 or the Transfer OUT (see below definition)
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 report to specify the transfer "for medical reasons" vs. "for bed management" is added starting 2024. In order to determine the reason for transfer, the diagnoses on the transferring ICU will be evaluated depending on the facility the patient came from or the sending ICU and the admitting or receiving ICU. Also there are two perspective to consider in reporting transfer namely Transfer OUT and Transfer IN.
Medical Reason
- From STB facility to HSC ICUs - medical reasons include Neurological dxs, all types of trauma dxs and Monitoring Intracranial Pressure (MICP) procedure
- 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
We need links for these if we want to maintain the ability to quickly check on the wiki if a change to a collection component would affect reports. It also makes for more integrated documentation.
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- 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 HSC/STB facility to Grace ICU - no medical reason
Test
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 service.
- Example 1 - 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 service, include those from STB ER, STB Ward, Grace ER, Grace Ward. The reasons for transfer can either be medical or bed management reason.
- Example 2- patients admitted to Grace ICU can inpatients from STB/HSC ICU/Ward or non-inpatient from STB/HSC ER/OR/etc. All transfers can be attributed to Grace ICU and broken from ICU or Non-ICU service. However, the reason for transfer will only be due to bed management.
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
Related articles
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