Transfer Delay (Medicine)

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Transfer Delay is the difference between Dispo_DtTm and #Time patient is ready for transfer in decimal days. Other terms use to call it are Beds Occupied by transferable patients, Wasted Beds, Avoidable Days.

Indicators
Indicator: Transfer Delay (Medicine)
Created/Raw: created
Program: Medicine
Start Date: 2003-10-01
End Date:
Reports: Directors Quarterly and Annual Report (Medicine)


  • Cargo


  • SMW:
    • "created" is not in the list (Created, Raw) of allowed values for the "IndicatorCreatedRaw" property.
  • Categories
  • Default form:

See also Transfer Delay (Critical Care).

Use

  • The purpose is to determine the amount of time a patient is occupying a bed in at a given Level of care (High Observation ward or a regular ward) when the patient is no longer needing that Level of care.
  • This is relevant because:
    • If patients are at a higher level of care than they need this can indicate that beds at a lower level are not available and more might be needed.
    • It might also indicate that beds at a higher (and more expensive) level of care might be reduced if patients could consistently move to the appropriate level of care.
    • A patient who doesn't need to be in a hospital runs the risk of nosocomial complications if they remain in hospital.

Definition

Example:   
  • Scenario: arrive HOBS1 -> ready to transfer to reg ward -> regular ward -> ready to transfer out -> HOBS2 -> Home
    • first transfer delay is (start of reg ward) - (ready to transfer to reg ward)
    • second transfer delay is (start of hobs) - (ready to transfer out)
    • three is no transfer ready between HOBS2 and home, so no additional delay

Implementation

Time patient is ready for transfer

The definition of this has changed between before and after PatientFollow Project.

Starting Oct 1, 2020, it will need to be calculated differently.

It is not reported by ward, it is reported only per episode / profile.

Julie sums up the multiple transfer delays that might be present and reports them all aggregated to their Dispo DtTm. It is done this way because only once we have a complete record with a Dispo DtTm we have reliable Transfer Ready data, so it's the only way we can report on this without becoming inconsistent with data reported earlier.

Start time is first transfer ready per level of care; end is either last of this level of care, or dispo.

  • Starting Oct 1, 2020, it will be added but haven't started.

Implementation in CFE

For now, a "Transfer Ready Med testing" button on the main form of CFE needs to be pressed to generate this data. Once we are comfortable with it this generating will be included in the "calc created variables" button.

Sub populate_created_transferDelay() loads created_TransferReady query (which generates transfer ready dates) and created_BoardingLoc_plus_historical query and writes delays to created_transferDelay table.

Which Transfer Ready DtTm To Use?

Swiss Army Knife.svg
  • SMW


  • Cargo


  • Categories

Admit DtTm or Dispo DtTm < 2020-10-01 00:00

Admit DtTm or Dispo DtTm >= 2020-10-01 00:00

Example:   
  • for example, a Med patient stays in high obs bed and then move to regular ward bed and then another regular ward bed. There are two levels of care - one for high obs and another which is lower, for the regular ward. At least two Transfer Ready DtTm intent are expected here - first intent for high obs ready to go to a regular ward and the second intent is from a regular ward to be discharged to another lower level of care or home or PCH. Assuming that there are transfer orders both at regular ward 1 and regular ward 2 and both are with same level of care, the first Transfer Ready DtTm time will be used in calculating the wasted bed for that lower level of care. There will be another wasted bed to be calculated for the high Obs level of care from the Transfer Ready DtTm to the time the patient left the high obs bed (ie the Dispo DtTm or the next Boarding Loc start DtTm. Transfer delays for high obs and regular ward will be separately reported.

Calculation when transfer time missing

legacy info, expand to see details - we have updated the data with an imputed time component for old transfer ready entries that only had a date.   
  • 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 < 1200 HR then dummy=0001 HR (12:01 am) ,
    • else if discharge time >= 1200 HR dummy=1200HR (12:00 noon)

This is as per approval by Dr. Dan Roberts.

  • Starting Oct 1,2020, transfer time is always present.

Reporting of Transfer Delays

SAS Program

  • S:\MED\MED_CCMED\Julie\SAS_CFE\CFE_macros\logphi_TR.sas
    • %Med_tready
  • S:\MED\MED_CCMED\Julie\SAS_CFE\CFE_macros\prep_Tmp_BoardServiceTransfer.sas (macro %boardtransf)

Data use

Data Integrity Checks (automatic list)

 AppStatus
Query check long transfer delayCCMDB.accdbneeds review

related fields

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