Readmission Rate to ICU
Number of ICU readmission within 72 hours per 100 discharges to ward.
| Indicators | |
| Indicator: | Readmission Rate to ICU |
| Created/Raw: | Created |
| Program: | Critical Care |
| Start Date: | |
| End Date: | |
| Reports: | Critical Care Program Quality Indicator Report, HSC ICUs Data by Patient |
QI domain
- Safe
Reported as
Percent of total discharges to ward
Significance
Unplanned readmissions are associated with worse patient outcomes. Most factors associated with an increased risk of readmission are patient and admission-specific. System related risk factors include discharge at night and ICU occupancy at the time of discharge. Readmission may reflect premature transfer out of ICU due to errors in clinical judgment or system constraints.
Sampling Plan / Procedure
Inclusion Criteria
100% of all ICU patients discharged to ward
Exclusion Criteria
Frequency
- Once the transfer ready has been written and the allowable 4.0 hours has elapsed, compute Transfer Delay or the total time it takes for ICU patient to leave the unit.
- If no time is indicated with the transfer ready date a proxy time of 10:00 am for day shift and midnight for night shift will be used for calculation purposes.
- If more than one transfer ready has been written, use the transfer ready date & time closest to actual ICU transfer
- To be completed at time of discharge from ICU, compute the total days spent in ICU (refer as LOS)
- To be calculated and reported on a monthly, quarterly or yearly basis based on either ICU Admission Dates or ICU Discharge Dates.
- For the Director reports, the discharge dates are used as the time of reference.
Definition and Derivation
Avoidable days is defined as the total time from date/time of transfer ready (e.g. stable enough to transfer) to date/time transfer out of ICU (in hours) less 4.0 hours (and divided by 24 to give yield total avoidable days)
Numerator
Num = Total Transfer Delay in a given period
Denominator
Denom =Total Patient Days on the same period as the numerator
Formula
Avoidable Days (%) = Num / Denom * 100
Example
- Time Reference: Discharge Dates from Jan 1, 2017 to March 31, 2017
- Total Avoidable Days of all patients with transfer ready = 254.5
- Total LOS of all ICU discharges = 1175.3
- Avoidable Days (%) = 254.5 / 1175.3 * 100= 21.7%
Data Sources
- Per patient Transfer Delay is derived from Transfer Ready DtTm field and Dispo DtTm field of the Centralized_data.mdb.
- Per patient LOS is derived from Accept DtTm field or Arrive DtTm field and Dispo DtTm field of the Centralized_data.mdb.
SAS Program
X:\Julie\SAS_CFE\CFE_macros\datetimes.sas
Report Users
- Critical Care Directors and Site Managers
- Critical Care Quality Improvement Team (QIT)