LOS Medicine per hospital admission
LENGTH OF STAY in all medicine wards per HOSPITAL ADMISSION
Indicators | |
Indicator: | LOS Medicine per hospital admission |
Created/Raw: | Created |
Program: | Medicine |
Start Date: | |
End Date: | |
Reports: | Directors Quarterly and Annual Report (Medicine) |
Usually used in aggregate form as "per location" and/or "per timeframe", e.g. month/quarter/year x Ward/Unit x Hospital.
Significance
Length of stay (LOS) is influenced by many factors, but safe and effective care should result in shorter length of stay.
Start Dates
- Oct 2003 to Sept 2020 - each record is per ward stay. A hospital stay may have one or more individual ward stay or records.
- Starting Oct 2020- each record is a continuous stay in any locations under Medicine service (or one Medicine episode) - see Definition of a Medicine Laptop Admission. If the patient is transferred to another service and comes back to Medicine service, this is a new record. A hospital stay may have one or more Medicine episodes.
Sampling Plan / Procedure
Inclusion Criteria
All Medicine admissions - see Definition of a Medicine Laptop Admission
Exclusion Criteria
None
Frequency
- Reported when patient had been discharged out of Medicine.
- Monthly, quarterly, year based on discharged date of Dispo DtTm
Definition and Derivation
- Calculate the LOS - see LOS Per Record
- Per patient, identify the records having the same Visit Admit DtTm. This implies same hospital stay or hospitalization.
- Per patient per hospitalization, sum up all the LOS Per Record
- It is possible that the same patient may have one or more hospitalization within the same time frame.
Data Source
- For dates refer to LOS Per Record
- For hospitalization date - use Visit Admit DtTm
- For patient identifier - either Person ID, Chart, PHIN
Reported
- Reported: 1) by ward of each hospital, 2) by CTUs/NTUs/MUs of each hospital, and 3) by hospital in the region.
Report Users
p:Dr. Dan Roberts You had this as "PRESCRIBED BY: "; which is not how you set it in Template:Reporting Indicators. Also, Dan is likely no longer the user of this, so it should probably be updated. If we use a title rather than a name it will be self updating. |
TARGET
"None yet." What does that mean in the context of "Target"? And how does "Target" fit in with the structure you described in Template:Reporting Indicators? |
Comment
The Medicine MedTMS and Critical TMSX Databases were combined to determine if a Medicine patient was admitted from ICU and/or have been transferred to ICU during a hospital stay. Patient’s stay to different services within the hospital were linked and cumulative LOS only in the medicine wards was calculated.
Two approaches to link patient's admissions within a hospital stay when a patient appeared more than once in the database, 1) link the admissions if the patient is transferred to or came from an ICU/another ward/went to OR within the hospital, and do not link if otherwise. 2) do not link the patient if the next admission is a new admission, and do link if otherwise. Both will produce the same results .
The second approach has been used and the criteria to determine a new admission are the following:
- Patient who has first and only admission
- Patient who left the hospital against medical advice (AMA) ( Med Var 6), from previous admission
- When patient is transferred to a different hospital, the admission for that hospital ends and the patient becomes a new admission to the second hospital (except if the reason is further lab test and the stay in the second hospital < 1 day because the bed is usually put on hold on the first hospital)
- Patient with previous encounter and now admitted from ER, home/long term care facility, outside city or province
- Patient with previous encounter who was discharged home/long term care facility, outside city or province and now admitted from a service/unit within the hospital
- Patient who was previously discharged to OR/RR and now admitted from OR/RR for more than 7 days from previous discharge date
- Patient who was previously discharged to a ward (not a Medicine ward) and now admitted from OR/RR for more than 30 days from previous discharge date
- Patient previously discharged to a ward and now admitted from a ward but the ward locations are now the same
- None of the above but the gap in time between the two admissions is >90 days.
Elements used in linking admissions
- PHIN, Last Name, First Name
- Hospital/Site
- Ward/ICU location
- ‘Admit From’ location
- ‘Discharge To’ location
- Admit date and time
- Discharge date and time
- Med Var 1, Med Var 2, Med Var 6
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