ED-GIM Dashboard Redesign - University Health Network
Indicator Summary
Last Updated:
May 17, 2007
Key ED-GIM Indicators Flow Process Indicator Flow Indicators LOS in ED General Waiting Area
Definition The average length of stay (in hours) for patients waiting in the Emergency Department General Waiting Area from the time of (Triage/Registration) to the receiving an ED bed.
Target Explanation Owner
Data Source Coded Data - May be possible to break this down by CTAS Level Uncoded Data - Not possible to break down by CTAS level Coded Data - May be possible to break this down by CTAS Level Uncoded Data - Not possible to break down by CTAS level Uncoded Data
Comments/Limitations
LOS in Fast Track Waiting Area
The average length of stay (in hours) for patients waiting in the Emergency Department Fast Track Waiting Area from the time of (Triage/Registration) to the receiving an ED bed.
LOS in ED Bed (Discharged Patients) The average length of stay (in hours) from the time a patient receives an ED Bed until the time the decision to discharge is made (verify this is available) LOS in ED Bed (Admitted Patients) The average length of stay (in hours) from the time a patient receives an ED Bed until the time the decision to admit to IP unit is made. Emergency Department Decision to Admit to IP Bed for - GIM Patients - All other IP Units The average wait time (in hours) for (I) GIM patients & (ii) All other IP units 4 Hours - UHN admitted via the ED from the time of decision to admit to receiving an accepted inpatient bed. Standard
This does not include patients admitted as an IP and discharged directly from the ED, left without being seen, or patients who died in the ED.
Uncoded Data
Uncoded Data
Decision to admit time may not always be the same time as documented on the patient's medical record. Rather, it may represent the time the visit was converted from 'emergency' to 'inpatient' in the UHN Clinical Desktop system. For this release, analysts ensured that attending physicians from the attending physician schedule were captured in the data extraction, as some physicians have a medical specialty other than GIM.
Admission and Volume Figures ED Visits (Walk-ins) ED Visits (via Ambulance) ED Admits: - GIM - Other IP Units - Total ED Admits discharged from ED : - GIM - Other IP Units - Total
The volume of patients who arriving by walking into the ED and are registered. The volume of patients who arrive by Ambulance into the ED and are registered. The volume of patients who are admitted as inpatients via the ED (Daily Avg) for (i) GIM, (ii) Other IP Units, (iii) Total
-
Uncoded Uncoded Uncoded Follow up with Performance Measurement regarding how patients arriving via Ambulance are identified
The daily avg. number of patients who were admitted as an IP and discharged via the ED for (i) GIM Patients (ii) Other IP Units (iii) Total
Uncoded
Flow Indicators - Patients Discharged Home The daily average length of stay (in days) for patients discharged home from 8A, 8B, 3B, 13ES, 14ES to an ALC facility and who fall into the 90th percentile GIM LOS (90th Percentile) The daily average number of weekday discharges from 8A, 8B, 3B, 13ES, 14ES Weekday Discharges The daily average number of weekend discharges from 8A, 8B, 3B, 13ES, 14ES Weekend Discharges The percentage of GIM inpatient discharges home recorded between % IP Discharges between 8am & 11am 8:00am -10:59am. The percentage of GIM inpatient discharges home recorded between % IP Discharges between 11am & 2pm 11:00am - 1:59pm. The percentage of GIM inpatient discharges home recorded between % IP Discharges between 2pm & 5pm 2:00pm - 4:59pm. Flow Indicators - Patients transferred to an ALC Facility The daily average length of stay (in days) from the time a patient receives a bed as an Inpatient until the time they are designated as ALC by a physician for patients transferred from 8A, 8B, 3B, 13ES, 14ES to an ALC facility and who fall into the 90th percentile GIM LOS (90th Percentile)
Uncoded
Uncoded Uncoded Uncoded Uncoded Uncoded
Uncoded
General File Name: Internal Medicine
2b23d427-7465-4fd5-bbb9-0687dda87581.xls Page 1 of 2 6/8/2009
ED-GIM Dashboard Redesign - University Health Network
Indicator Summary
Last Updated:
May 17, 2007
General Internal Medicine
The average alternate level of care (ALC) days per ALC patient discharged from 8A, 8B, 3B, 13ES, 14ES with a Most Responsible Physician credentialed in GIM. A patient is designated as ALC when a physician (or designated other) has indicated that the patient occupying an acute care hospital bed is well enough to be cared for elsewhere and is no longer in need of acute care. GIM ALC Days per ALC Patient The percentage of GIM inpatient transfers to an ALC facility recorded % IP Discharges between 8am & 11am between 8:00 - 10:59am. The percentage of GIM inpatient transfers to an ALC facility recorded % IP Discharges between 11am & 2pm between 11:00am - 1:59pm. The percentage of GIM inpatient transfers to an ALC facility recorded % IP Discharges between 2pm & 5pm between 2:00pm - 4:59pm. Admission and Volume Figures # of GIM Patients Admitted in ED The daily average number of patients admitted as a GIM IP and occupying an ED Bed @ 8:00am #of GIM Patients on GIM IP Units The daily average number of GIM patients admitted on a GIM IP unit (TGH 13ES, 14ES & TWH 3B, 8A, 8B) @ 8:00am # of GIM Patients Bed-Spaced The daily average number of patients admitted as a GIM IP and occupying a bed on another unit other then a GIM IP bed or ED bed @ 8:00am
# GIM Patients designated as ALC The daily average number of paitents who have been designated as ALC via the Whiteboard.
TGH - 8.0 TWH 13.8 (Reduce ALC Days by 5% BSC Target)
Coded
Since the data source is Coded, we may have to remove this.
Uncoded Uncoded Uncoded
Manual Collection Manual Collection Manual Collection
Manual collection from GIM Daily Census Does this include GI, Family Medicine? Manual collection from GIM Daily Census TWH 3B - Does this include GIM patients occupying a cardiology bed? Manual collection from GIM Daily Census TWH 3B - Does this include GIM patients occupying a cardiology bed?
Can be tracked using the Whiteboard
Manual Collection (Whiteboard)
Other Indicators GIM Patients in Hospital for >60 days
The total # of patients currently admitted on GIM with a length of stay greater then 30 days Total number of GIM IP transfers to an ALC Facility Total number of GIM IP transfers to Toronto CCAC Total number of GIM IP transfers to Bridgepoint Total number of GIM IP transfers to Castleview Wychwood Towers Total number of GIM IP transfers to Toronto Rehab Institute - Queen Eliz
Manual Collection
Manual Collection using the GIM Whiteboard
Post-Acute Care
IP Transfers - Total to Toronto CCAC to Bridgepoint to Castleview Wychwood Towers to Toronto Rehab Institute - Queen Eliz Emergency Department RIE- ED Acute Process: TGH
(I) Registration to RN Assessment Time (ii) ED Bed Turnaround time (Acute & Fast Track)
(I) 15 mins (as per RIE event)
Manual Collection
Updated every 30, 60, 90 Days
Rapid Improvement Events
General Internal Medicine Bed Turnaround Time TWH GIM Bullet Rounds Rapid Improvement Event
The daily average time between a GIM Patient discharge and the next patient admission to the same bed. Measure the number of tasks completed within the timelines specified at bullet rounds.
Manual Collection 80%
Updated every 30, 60, 90 Days
File Name: 2b23d427-7465-4fd5-bbb9-0687dda87581.xls Page 2 of 2 6/8/2009