Transfer Delay (Critical Care)
|Program:||Critical Care and Medicine|
|Reports:||Critical Care Program Quality Indicator Report, Directors Quarterly and Annual Report (Critical Care), HSC ICUs Data by Patient|
- "created" is not in the list (Created, Raw) of allowed values for the "IndicatorCreatedRaw" property.
- Default form:
There is a similar concept in medicine, Transfer Delay (Medicine).
- 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.
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
Calculation for reporting when transfer time missing
Before Oct 1,2020 -The following definitions are used by Julie in reporting from SAS, and by centralized_data_front_end.accdb to calculate the created_variables query.
- if discharge time < 1000 HR then dummy=0001 HR (12:01 am),
- else if discharge time >= 1000 HR dummy=1000HR (10:00 am)
This was based on Critical Care Vital Sign Monitor.
This is as per approval by Dr. Dan Roberts.
Starting Oct 1,2020, transfer ready time is always present.
Not tested yet, but the code to update this would be something like
- Update L_Log
- SET L_Log.Transfer_Ready_DtTm = [Transfer_Ready_DtTm]+IIf(TimeValue([Dispo_DtTm])<#12/30/1899 10:0:0#,#12/30/1899 12:1:0#,#12/30/1899 10:0:0#)
- WHERE (((TimeValue(Nz([Transfer_Ready_DtTm],#12/30/1899 0:1:0#)))=#12/30/1899#));
Admit DtTm or Dispo DtTm >= 2020-10-01 00:00
- 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
- Reported as count, Mean (average), Sum (Total), and Cumulative counts and percentage
- A - Determine the patients who left alive to a lower level of care in the Dispo field and
- A1 - Have transfer delays
- A2 - Have no transfer ready dttm - assign them as zero transfer delay
- Total True delays = Transfer delays from A1 + zeroes from A2 ; Total N = A1 + A2; Average True Delays=Total True Delays / Total N
- Total transfer delays > 2 hours - sum up those patients from A1 but excluding those with transfer delays <= 2 hours and compute the Average.
- Distribution of true transfer delays - counts, cumulative counts and percentage
- <= 4 hours
- >4h - 12h
- >12h - 1d
- >1d - 2d
- >2d - 3d
- >3d - 7d
- >10d - 14d
- B - Determine and report the number of patients with transfer delays who had left alive and went to same level of care in the Dispo field .
- C - Determine and report the number of patients with transfer delays who died in the Dispo field before going anywhere.
JALT one of the DC mentioned in the TASK meeting that GRA Med patient with transfer ready dttm and went to GRA ICU should be considered as bed wasted. In the current process, all with transfer ready dttm are included as bed wasted regardless where the patient went or died. but in this new way of reporting, this is not the case. can we discuss again which is the final way? --JMojica 13:28, 2022 June 24 (CDT)
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:
- to HSC IICU/H6, and
- 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.
- macro %CC_tready
- S:\MED\MED_CCMED\Julie\SAS_CFE\CFE_macros\prep_Tmp_BoardServiceTransfer.sas (macro %boardtransf)
Data Integrity Checks (automatic list)
|Query check long transfer delay||CCMDB.accdb||needs review|
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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.)