Transfer Ready DtTm field

This field is currently being implemented, please check the instructions and put a discussion for anything that isn't clear. 

The Transfer Ready DtTm field contains the date and time that the intent to discharge a patient to a lower level in the #hierarchy of levels of care was documented. A "lower level of care" would be from an ICU to a ward, or from ward/ICU to hospital out of town, PCH, care facility or home.

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).

Collection Instruction

For each patient,

• if a date/time of intent to transfer to lower level in the #hierarchy of levels of care is documented, enter it into the Transfer Ready Date and Time Field
  • if a patient arrives transfer-ready 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, 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.

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
• WRHA IICU
• WRHA teaching ward
• WRHA nonteaching ward / EMIP
• ward outside WRHA
• PCH or home

Template:Discussion There have been a few questions about this. Please have a look if these instructions are clear now. If no questions in 2 weeks this comment can be deleted. Ttenbergen 15:16, 2016 June 20 (CDT)

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.

There used to be different instructions for Medicine and Critical Care but they are being unified with the move to the new fields as discussed with Dr. Garland, Dr. Roberts and Randy Martin.

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

• Function Dispo Chronological
• query check_dispo_lower_acuity_than_location and function Transfer_Ready_DtTm_vs_Location_vs_Dispo check for patients going to lower level of care but without Transfer Ready Date; Check will launch an error but allow no date, ie it's just a reminder, see #hierarchy of levels of care.
• query check_panelled_primary_but_adm_NE_tr: a record is an error if both
  • Primary Admit Diagnosis = 90601 or 90602
  • (Transfer Ready Date and Time) <> (Admit Date and Time)

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.