Transfer Delay

More Info

• Transfer Delay is reported as one of the following Indicators, see those pages for how specifically it is used there.
  • Transfer Delay (Critical Care)
  • Transfer Delay (Medicine)
• Transfer Delay is a concept involving:
  • The Level of care hierarchy
  • Transfer Ready DtTm = the date/time when a patient in a location with a given Level of Care is deemed ready by the care team to be transferred to a LOWER Level of Care
• Transfer Delay is specific to the current Level of Care
  • At a given Level of Care, it is the interval from the first designation as Transfer-Ready until the first of the following occur:
    • Death while at that same Level of Care
    • Transfer to a lower Level of Care
    • Transfer to a HIGHER Level of Care -- when this occurs, the "clock restarts" for possible Transfer Delay at that higher level
• So a single patient, during hospitalization who goes: {Ward --> ICU --> Ward --> ICU} could have Transfer Delays associated with EACH of the 4 locations.

Some Explanations/Rationale

• The main purpose of tracking Transfer Delays is for administrators to estimate bed needs:
  • e.g: Delays in transfers out of ICU generally are, in a sense "wasted ICU bed-days", and the cumulative number of ICU days patients spend waiting to leave ICU may indicate both inadequate ward beds AND a possible ability to reduce the number of ICU beds if it were possible to promptly send ICU patients out as soon as they are clinically ready
  • e.g: Delays in moving a patient -- who is physically in ED but has been admitted to the Medicine service -- to the ward may indicate problems a need for more ward beds, or more effective ED-to-ward transfer
• Regarding a patient deemed Transfer-Ready to a lower Level of Care but who before such transfer gets sicker and remains in their current location/level
  • It might seem like those days after the decision to "cancel" the transfer to a lower Level should not be counted as "wasted" -- however we never know what would have happened if the patient had indeed gone to the lower Level promptly, and it is possible that she/he would not have gotten sicker if that had occurred.