Transfer Delay (Medicine)

From CCMDB Wiki

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.

Use

  • The purpose is to determine the amount of time the patient is occupying a bed in a High Observation ward or a regular ward setting when the patient is no longer needing that level of care from the Transfer Ready DtTm until the Dispo DtTm or end date and time of this level of care.

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 (dispo dttm) - (regular ward ready to transfer out)
      • move to HOBS is up, so transfer ready is not re-set

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.

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.


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  • This function is now ready to test. Ttenbergen 15:17, 2022 June 29 (CDT)
  • SMW


  • Cargo


  • Categories

Sub populate_created_transferDelay() loads created_TransferReady query (which generates transfer ready dates) and created_transferDelay_int query (which combines them with Boarding Loc or Dispo_DtTm as appropriate) and writes it to created_transferDelay table.

Which Transfer Ready DtTm To Use?

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.

Why collect per ward in medicine when we only report separately for HOBS?

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.

Calculation when transfer time missing

Legacy Content

This page contains Legacy Content.
  • Explanation: We have updated the data with an imputed time component for old transfer ready entries that only had a date.
  • Successor: No successor was entered

Click Expand to show legacy content.

  • 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

  • Reported as count, Mean (average), Sum (Total), and Cumulative counts and percentage separately for High Obs and regular ward
  • 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 > 4 hours - sum up those patients from A1 but excluding those with transfer delays <= 4 hours and compute the Average.
    • Distribution of true transfer delays - counts, cumulative counts and percentage
      • zero
      • <= 4 hours
      • >4h - 12h
      • >12h - 1d
      • >1d - 2d
      • >2d - 3d
      • >3d - 7d
      • >10d - 14d
      • >10d
  • B - Determine and report the number of patients with transfer delays who had left alive and went to a higher or 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

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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