Transfer Ready DtTm field

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 Level of care hierarchy was documented.

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Legacy implementation right in the table

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See Level of care hierarchy for meaning of "lower level of care".

For Transfer Ready DtTms after 2020-10-15 this will be entered as a Transfer Ready DtTm tmp entry instead of using this field.

added: no added date action: no action date

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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. This is used as part of the concept Avoidable Days in ICU.

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

Entering a Transfer Ready DtTm

Follow the instructions in Transfer Ready DtTm tmp entry.

Before 2020-10-15

For each patient, enter the first date/time of intent to transfer to lower level in the Level of care hierarchy is documented into the Transfer Ready Date and Time Field; see #status changing back and forth if a patient arrives transfer-ready to a lower level of care than the current ward enter the same date into Transfer Ready DtTm field as in Arrive_DtTm field. if not available because the patient was clearly not transfer ready, leave the date/time empty and enter "not transfer ready" into the "TR info status field" if not available but the patient probably was transfer ready and it just wasn't documented, leave the date/time empty and enter "not available" into the "TR info status field" This entry is about the time of an intent, nothing to do with what actually happened to the patient after.

What is transfer ready?

I believe this contradicts the information on the Transfer Ready DtTm tmp entry page, not sure which is correct. I thought we were doing a transfer ready line for every physical location, not just lower levels of care? The distinction is between what means transfer ready (that is a matter of intent to discharge) and the things that actually happen (pt became worse and went to a higher level of care). The definition below is right for what defines when pt is transfer ready. The explanation in Transfer Ready DtTm tmp entry essentially just says when the clock re-sets, and that could either be because pt was successfully moved to a lower level of care, or because they died (still no longer taking up a bed) or because they became worse and went to a higher level of care (again no longer waiting for that initial lower level of care). Ttenbergen 14:19, 2020 October 19 (CDT)

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

• The goal here is to identify the intention of the team to send the patient to a lower level if there was an available bed there.
  • Obviously we don't always know the team's intentions, but if they do write them down, then USE THAT INFO.
• Regarding the statement that the patient is "medically stable"
  • This phrase could mean that the person is improved enough to go elsewhere, but it does NOT necessarily mean that. For example it could technically indicate that the condition is not changing lately, which may or may NOT mean that they're ready to go elsewhere.
  • Thus, by itself that phrase cannot be used alone to suggest the patient is transfer ready
  • e.g. Deconditioned patient may be medically stable but intention can be to leave them where they are for now to re-condition
  • e.g. Patient is medically stable but still needs a sitter --> another situation in which just being "medically stable" isn't sufficient to tell us if they're transfer ready
• In an ICU setting, you CAN take the following to indirectly indicate transfer ready to a lower level of care when nothing has been written:
  • care is stepped down to WARD FREQUENCY (q4hrs or less) of vitals, off ALL forms of life support except possibly intermittent dialysis
  • HSC_IICU consult is written
• In a ward setting, you can take the following to indirectly indicate transfer ready to a lower level of care when nothing has been written:
  • care is stepped down to change iv meds to po, remove monitoring
• In either ICU or ward setting being made ACP-C can be taken as indirect evidence of being transfer ready.

Hierarchy of levels of care

We require an entry in this field when the intent is to transfer from higher to lower level of care. See Level of care hierarchy for a list.

status changing back and forth

If a patient changes from being transfer ready back to not being transfer ready, collect the first time they are transfer ready on their current level of care. If they become no longer transfer ready, leave it alone, and if they become transfer ready again at the same level of care, retain only the original Transfer Ready DtTm for that level.

If the patient moves to a different (higher or lower) level of care, then enter an additional Transfer Ready DtTm tmp entry.

Data Use

Used to generate Transfer_Delay, see Transfer_Delay#data use.

Data Integrity Checks (automatic list)

	App	Status
Check Function Panelling admit transfer same	CCMDB.accdb	retired
Query check dispo lower acuity than location	CCMDB.accdb	retired
Link suspect transfer ready before arrive date	Centralized data front end.accdb	retired

Legacy

Legacy Content

This page contains Legacy Content.

• Explanation: legacy
• Successor: No successor was entered

Click Expand to show legacy content.

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