Transfer Ready DtTm field: Difference between revisions

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* care is stepped down e.g. vital signs decreased, off monitor, IV meds changed to PO meds
* care is stepped down e.g. vital signs decreased, off monitor, IV meds changed to PO meds
* patient is made ACP-C in ICU, regardless of whether or not they are still intubated and ventilated
* patient is made ACP-C in ICU, regardless of whether or not they are still intubated and ventilated
{{discussion}} If patient died shortly in ICU after declaring ACP-C, say <2 hrs or within 2-4 hrs or within a day),is transfer ready needed? Or is there a cut-off time? --[[User:JMojica|JMojica]] 12:25, 2018 August 9 (CDT)
* date and time that the IICU consult is written for patient going to [[HSC_IICU]]
* date and time that the IICU consult is written for patient going to [[HSC_IICU]]
* A deconditioned patient may still be medically stable if they can re-condition elsewhere; use your judgement.
* A deconditioned patient may still be medically stable if they can re-condition elsewhere; use your judgement.

Revision as of 12:25, 2018 August 9

see Transfer time rule for the unrelated rules around patients transferring between wards we collect data on


Data Element (edit)
Field Name: Transfer_Ready_DtTm
CCMDB Label: Transfer Ready DtTm
CCMDB tab: Dispo
Table: L_Log table
Data type: date
Length: not stated
Program: Med and CC
Created/Raw: Raw
Start Date: 2016-07-01
End Date: 2300-01-01
Sort Index: 47

Date and time the intent to discharge a patient to a lower level in the #hierarchy of levels of care was documented.

  • SMW

Legacy implementation right in the table

  • Cargo


  • Categories
  • Forms


See #hierarchy of levels of care for meaning of "lower level of care".

Purpose

The purpose is to determine the avoidable days or bed wasted by patients who are deemed ready to leave the unit or ward and then either move to a lower level of care or leave the hospital. Bed wasted or avoidable days are being derived from Transfer Ready DtTm and Discharge Date_time (or Dispo Dt_Tm).

At the 11Sept2017 Steering Committee meeting, it was clarified that what is being sought here is the INTENT to send someone to a lower level of care only. Thus, it doesn’t matter what actually happened after this intent occurs (e.g. patient getting sicker and the transfer intent cancelled).

Collection Instruction

For each patient,

This entry is about the time of an intent, nothing to do with what actually happened to the patient after.

what is transfer ready?

Any of these criteria, for a patient going to a lower level of care, as per hierarchy below:

  • "medically stable" written anywhere in the chart
  • care is stepped down e.g. vital signs decreased, off monitor, IV meds changed to PO meds
  • patient is made ACP-C in ICU, regardless of whether or not they are still intubated and ventilated

Template:Discussion If patient died shortly in ICU after declaring ACP-C, say <2 hrs or within 2-4 hrs or within a day),is transfer ready needed? Or is there a cut-off time? --JMojica 12:25, 2018 August 9 (CDT)

  • date and time that the IICU consult is written for patient going to HSC_IICU
  • A deconditioned patient may still be medically stable if they can re-condition elsewhere; use your judgement.
  • if criteria are otherwise met but need a sitter or some other level of care the the ward can't provide is required then the patient is still considered transfer ready

Hierarchy of levels of care

We require an entry in this field when the transfer is from higher to lower level of care:

  • WRHA ICU (includes: CICU, ACCU, MICU, SICU, CCU)
  • Other MB RHA ICU or Other Province ICU
  • WRHA IICU
  • WRHA HOB ward
  • "ward" - the following are all considered the same level of care
  • ward outside WRHA
  • PCH or home

Template:Discussion would need to be reconciled as part of Eliminating distinction between different ward types

ACP C

A patient is transfer ready on Medicine or ICU once they become ACP-C

status changing back and forth

If a patient changes from being transfer ready back to not being transfer ready, collect the first transfer ready dttm.

pt becoming non-teaching is not a reason to consider transfer ready

  • @ HSC we no longer consider patients who are made non-teaching as "transfer ready". This is because residents routinely change patients from "teaching" to "non-teaching" when their quota of patients is filled. The patient moves to non-teaching status under the staff man but are routinely changed back to teaching once discharges occur.--CMarks 13:56, 2017 October 3 (CDT)
    • StB B5 NTU routinely admits Nephrology NT Service patients as well as lateral transfers such as HSC, as identified above, but does not transfer them back to a CTU. Instead the teaching unit Doctors follow the patient on the NT ward they are admitted to.ENagy 14:12, 2017 October 6 (CDT)E.Nagy
      • Template:Discussion Is this only for HSC? Probably not, right? if not the HSC part above should come out and the direction for this be made generic. Does this really point to a general lack of distinction between teaching and non-teaching? If so, do we need to adjust other processes about this? Ttenbergen 08:54, 2018 June 7 (CDT)

Template:Discussion would need to be reconciled as part of Eliminating distinction between different ward types

Data Use

Used to generate Transfer_Delay, which is used in Overstay and several reports, see also Transfer_Delay#data use.

Template:CCMDB Data Integrity Checks

Template:CCMDB Data Integrity Checks

Legacy

Similar to the old Transfer Ready date and time, but we eliminated special cases and differences between medicine and critical care. Going forward the entry will be collected even if pt dies or goes to ER etc. It's the intent that counts, not what ended up happening. Resp. field names L_Log.R_TRDate and L_Log.R_TRTime

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