Transfer Delay (Critical Care)

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

• Cargo

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

• Categories

• Default form:

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

• Transfer Delay is the difference between Dispo DtTm and first Transfer Ready DtTm.

see previous definitions

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. previously, transfer delay calculation followed the national Vital Signs Monitoring program guideline which subtracted 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

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:

1. Avoidable Days
2. Beds occupied by transferrable patients

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:

1. to HSC IICU/H6, and
2. 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

• Avoidable Days (Critical Care)
• 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

Legacy

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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.)