Transfer Delay (Medicine): Difference between revisions
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** '''ends''' as a patient leaves that level of care in one of the following ways: | ** '''ends''' as a patient leaves that level of care in one of the following ways: | ||
*** to a [[Dispo]] location (ie [[Dispo DtTm]]) | *** to a [[Dispo]] location (ie [[Dispo DtTm]]) | ||
*** to a [[Boarding Loc]] with a different | *** to a [[Boarding Loc]] with a ''different''(higher or lower) [[Level of care]] (ie the start of that next [[Boarding Loc]]) | ||
{{ex | | {{ex | | ||
* Scenario: arrive HOBS1 -> ready to transfer to reg ward -> regular ward -> ready to transfer out -> HOBS2 -> Home | * 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) | ** first transfer delay is (start of reg ward) - (ready to transfer to reg ward) | ||
** second transfer delay is ( | ** second transfer delay is (start of hobs) - (ready to transfer out) | ||
** | ** three is no transfer ready between HOBS2 and home, so no additional delay | ||
}} | }} | ||
Revision as of 16:17, 2022 September 20
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) |
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
- Transfer Delay is the difference in decimal days between the time the pt is first transfer ready at a Level of care and the time that they leave that level
- starts at the Transfer Ready DtTm corresponding to the first Boarding Loc of a given Level of care
- ends as a patient leaves that level of care in one of the following ways:
- to a Dispo location (ie Dispo DtTm)
- to a Boarding Loc with a different(higher or lower) Level of care (ie the start of that next Boarding Loc)
Example: |
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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.
- Before Oct 1, 2020, it is calculated by Created_Variables_Common_maker query and stored in Created_Variables_Common table in CFE.
- 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?
Admit DtTm or Dispo DtTm < 2020-10-01 00:00
- for each patient in ICU and Medicine ward, the transfer date and time is taken from the Transfer Ready DtTm field.
Admit DtTm or Dispo DtTm >= 2020-10-01 00:00
- 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 corresponding to one or more boarding locations, which may or may not be at a different level in the Level of care hierarchy, namely regular wards (CTU or NTU) and High-Obs Wards
- for the purpose of Transfer Delay (Medicine), we will have a transfer delay for each group of Boarding Locs at the same level of care, i.e. there may be more than one per CCMDB record. To accommodate more than one line per record, this is stored in its own table.
- the first Transfer Ready DtTm from a Boarding Loc with the same level of care will be used
Example: |
|
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
- Include all cases with transfer ready dttm (who went to same/lower/higher level of care or died).
- Refer to indicator Beds occupied by transferrable patients
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)
App | Status | |
---|---|---|
Query check long transfer delay | CCMDB.accdb | needs review |