Legacy info Transfer Ready date and time

items in this article have been pulled out of Transfer Ready date and time to here so they can be reviewed for toss out or rewording into Main article which is hard to follow!Trish Ostryzniuk 19:04, 2014 May 6 (CDT)

Section below need sorting and pruning

questions re, transfer date and dc tx

Pts who become ACP C and expire in hospital 3 days to one month after comfort care is ordered.

• I would like to know where this type of patients fits in. Example: a patient who has co- morbids and is admitted with pneumonia and does not improve or deteriorates. The decision is made to provide comfort care only (ACP C). This patient lives three days to one month in hospital and then dies. Does this patient need a transfer ready date?

• If a unit physician discontinues life-support treatment and a patient does not die immediately and is placed on a transfer/ready list, and then passes away PRIOR TO being transferred out of the ICU unit, then Transfer ready should not be recorded.

• If a patient arrests in the unit and CPR is unsuccessful, the date and time of stopping CPR should not be recorded for Transfer ready.

Instructions for medicine transfer ready dates and times

COPY OF: File:Transfer Ready ChartStamp Memo MEDICINE January 2012.pdf.

• It is important to understand that the transfer ready date and time indicates that the pt no longer needs a medicine bed in the hospital. Because of this definition, not all profiles will have a transfer ready date.
• If a pt moves from one ward to another and still requires hospital medical care, then that profile will not have a transfer ready date. Previously we saw this date as the date ready to leave that particular ward but this has changed based on Dr. Robert's definition.
• Dr Roberts will educate the medical staff about writing in the chart when the pt is medically stable enough for discharge. This is the date and time we will use.
• Another important change for medicine is that this date and time of transfer ready should not be changed even if the pt deteriorates and requires medical care again. Dr. Roberts wants the first day and time when the pt was deemed to be medically stable.
• If a pt already has a transfer ready date and time and is moved to another ward where a new profile is started, the transfer ready date and time will be the time of admission to that ward.

For example, a pt has been in acute care and is medically stable on Oct 15 at 1000. This is your transfer ready data and time. The pt is then transferred to a chronic ward on Oct 30, and a new profile is started. The admit date for the new profile is Oct 30 and you should fill in the transfer ready date as Oct 30 because the pt is still medically stable and continues to wait for discharge. Julie needs them done this way as she links the profiles.--LKolesar 08:59, 10 November 2011 (CST)

• We will re-start collecting transfer ready dates and times starting in November, 2011 even though Dr Roberts' indicators in the chart have not started yet. The data collectors will put in a transfer ready date and time if they have this available information from the current sources. --LKolesar 11:44, 9 November 2011 (CST)

Discussion

• Hi just want to clarify transfer ready times ie. pt was admitted Aug 1/11. Aug 15/11 service states medically stable transfered to S3 for panelling process Aug30/11. Pt discharged to nursing home Nov 10/11 When the pt is transferred to S3 I should be using Aug 15/11 as my admit time not the actual time pt arrived to the ward? Then how do we show the actual time pt arrives to the ward? Thanks
  • • Sorry if the above instructions are not clear enough, I will try to fix them. When a pt is transferred to a ward you still use the usual discharge and admit time. If this same pt already has a transfer ready date and time (when medically ready for discharge) which is Aug 15 in this example, this is already written as the transfer ready date and time in the first profile. If a new profile is started for the pt when transferred, the transfer ready time will be the same as the admit date because they are still waiting for discharge and have been transfer ready for a while already. Julie wants them done this way as she tracks the number of days waiting for discharge once transfer ready and will link this with the first profile. --LKolesar 08:59, 10 November 2011 (CST)
    • Sorry Laura, but I'm even more unclear about what we should be doing for patients transferred to another ward, who already have a transfer ready date and time from the first ward! You say above, "If a new profile is started for the pt when transferred, the transfer ready time will be the same as the admit date because they are still waiting for discharge and have been transfer ready for a while already." Does this mean that the admit date and time for the second move, or transfer is our usual date and time, and that the transfer ready date and time is the same as the admit date and time for the second profile? My understanding was that we use our usual dates and times for the admission to the second ward, but that the transfer ready date and time for the second profile would be the same as it was in the first profile. Am I mistaken about that?DPageNewton 13:01, 11 November 2011 (CST)
    • I know that it would make sense to use the same transfer ready date and time for the second profile but Julie does not want it done this way. She wants us to use the admit date and time of the second profile in this scenario as the transfer ready date and time because she links the two profiles. You can talk to her if you like. I already had this discussion with her. It has to do with the way she extracts data from the profiles.--LKolesar 07:04, 14 November 2011 (CST)
    • Based on the above information, I would suggest that when receiving a pt from another ward that the data collectors check the laptop of the sending ward to ensure they have knowledge of a transfer ready time from the sending ward. --LKolesar 14:36, 14 November 2011 (CST)
      • Is this something that would be useful to add to Transfer Tracker.mdb? Ttenbergen 18:04, 16 November 2011 (CST)
      • Yes, it would be a good item to include in the transfer tracker if this is possible. --LKolesar 16:02, 18 November 2011 (CST)
    • I just want to clarify transfer ready. The pt no longer has medical issues but may still be improving muscle strength and in self care (the pt still needs OT & PT). This pt is considered transfer ready because PT & OT are not considered medical issues. Correct? Judy 08/06/12.
  • The pt is not under-going medical treatment and can be discharged home. Quite often pts are discharged home and come in for occupational and physiotherapy but are not requiring medical intervention.--CMarks 12:01, 2012 June 11 (CDT)

Legacy Information

stamper implementation

• Spring 2012 - A "stamper" is suppose to be used by physicians on Medicine wards to document transfer ready.Trish Ostryzniuk 12:29, 2012 October 25 (EDT)
• January 2013 this data was moved to STB Electronic Patient Record. Chart stamping stopped because physicians were to record this in EPR.

Discussion Leading up to dropping "transfer ready" date collection for Medicine

This is legacy information only.

We did not collect transfer ready date and time for medicine patients from 2010-May-19 until November 2011 for the following reasons. We re-started collection because the data was seen as important enough to collect it even if it is not perfect.

As discussed in the Critical Care Review Group, the transfer ready date information is not very organized or consistent city wide so its value is questionable. Since the data is unreliable, we are are planning to propose to stop collecting this. Does anyone have any thoughts on this?

Dec 9.2008-Transfer Ready date/time

• Transfer ready date/time - will continue to be collected until further notice.

Betty Lou Rock will determine if this will be used or not. She plans to set up a working group to assess if a system could be developed within the Hospital system to make this data more reliable. Data collectors rely on Dr.’s orders, where this information frequently not recorded and they guess at time and sometimes date when a call to the bed desk for a patient who is transfer ready. ICU, because it is a smaller unit, collectors have a better chance of obtaining a fairly good estimate. Some ICU are very good at writing these orders, others are not. On Medicine there is a significant problem in obtaining accurate information because of lack of chart documentation. Currently there is no consistent process in place at each hospital that maintains a record of transfer ready dates/times where data collectors can draw or verify this information from. The next Steering Next Database Committee meeting is in February and Task team will follow up the status of transfer ready date. TOstryzniuk 17:44, 9 December 2008 (CST)

• At the HSC Transfer Ready is being called to admitting dept and recorded on forms. Perry Gray and Dr. Garland set these up. The forms are being faxed to us and entered by Data Processor into Transfer Ready Access database. The Steering Committee must review this information and decide it will still continue. The data coming in this route does not seem very reliable. Poor documentation and not legible.--TOstryzniuk 21:57, 6 November 2009 (CST)
  • For ICU the data collectors will continue to collect transfer/discharge ready.Betty Lou Rock invited Linda Hathout to a ICU QA meeting to explore other ways this information may be collected. Perry Gray has stopped the paper process from the Medical records department at the beginning of this month.--TOstryzniuk 20:11, 19 May 2010 (CDT)