Transfer Delay (Critical Care)

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Revision as of 13:39, 2022 April 21 by Ttenbergen (talk | contribs)
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Transfer Delay is the difference between Dispo_DtTm and #Time patient is ready for transfer in decimal days.

Indicators
Indicator: Transfer Delay
Created/Raw: created
Program: Critical Care and Medicine
Start Date: 1999-01-15
End Date:
Reports: Critical Care Program Quality Indicator Report, Directors Quarterly and Annual Report (Critical Care), HSC ICUs Data by Patient


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  • SMW:
    • "created" is not in the list (Created, Raw) of allowed values for the "IndicatorCreatedRaw" property.
  • Categories
  • Default form:
  • According to the discussion at Task on 2022-04-20 this will need to be updated once the reporting is updated. Something about 30 minutes grace time for all? Ttenbergen 20:59, 2022 April 20 (CDT)
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Use

  • The purpose is to determine the amount of time the patient is occupying a bed in an ICU setting when the patient is no longer needing that level of care (also referred to as wasted bed) from the Transfer Ready DtTm until the Dispo DtTm.

Definition Details

Transfer Delay Over 2 hours for Critical Care (i.e. subtract 2 hrs from the time between ready for transfer (#Which Transfer Ready DtTm To Use? and Dispo DtTm.

Which Transfer Ready DtTm To Use?

Before Oct 1, 2020

Starting Oct 1, 2020

  • For each record and each boarding location in ICU , the transfer date and time is taken from the Transfer Ready DtTm tmp entry.
  • 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.
  • if the patient moves to various locations, the first Transfer Ready DtTm from a Boarding Loc will be used
    • As described in Transfer Ready DtTm tmp entry, collectors make a notation about transfer ready in each separate boarding loc, looking solely at whether or not the patient was recorded as transfer ready from that location (i.e. collectors should not "carry over" knowledge about transfer readiness at prior boarding locs).
    • BUT, when calculating "wasted days", Julie will only use the FIRST transfer ready date/time:
      • example 1: Mr. Jones spent 7 days in Location1 and then directly transferred to Location2 where he stayed another 7 days. On Location1 day 3 a progress note said he was ready to go to ward, but he didn't. At no time during his Location2 stay did any notes indicate transfer readiness. Julie will calculate this as 4 wasted Location1 days, and 7 wasted Location2 days.
      • example 2: Mr. Jones spent 7 days in Location1 and then directly transferred to Location2 where he stayed another 7 days. On Location1 day 3 a progress note said he was ready to go to ward, but he didn't. On Location2 day 1 a progress note indicates transfer readiness. Julie will calculate this as 4 wasted Location1 days, and 7 wasted Location2 days.
      • example 3: Mr. Jones spent 7 days in Location1 and then directly transferred to Location2 where he stayed another 7 days. On Location1 day 3 a progress note said he was ready to go to ward, but he didn't. On Location2 day 5 a progress note indicates transfer readiness. Julie will calculate this as 4 wasted Location1 days, and 7 wasted Location2 days.
      • ALL 3 of these examples have the same # of wasted days.

Why collect per ward in medicine 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.

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:

  1. to HSC IICU/H6, and
  2. 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.

Calculation when transfer time missing

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.

SAS Program

X:\Julie\SAS_CFE\CFE_macros\logphi.sas

Data use

Data Integrity Checks (automatic list)

 AppStatus
Query check long transfer delayCCMDB.accdbneeds review

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