Acute Care Access and Flow Dashboard - MCH - DRAFT 2013 2014 Sept Oct Nov Dec Jan Feb Mar Apr May Jun Jul Aug Total Admissions 1,481 1,527 1,469 1,391 1,429 1,330 1,565 1,506 1,555 1,478 1,334 1,473 Total Discharges 1,451 1,520 1,166 1,410 1,423 1,312 1,539 1,501 1,539 1,474 1,339 1,479 Direct Admits 147 136 94 121
Acute Care Access and Flow Dashboard - MCH - DRAFT
Acute Care Access and Flow Dashboard - MCH - DRAFT EMS Wait Time Data
Acute Care Access and Flow Dashboard - MCH - Surgery Program - DRAFT
Acute Care Access and Flow Dashboard - MCH - Surgery Program - DRAFT
Acute Care Access and Flow Dashboard - MCH - Medicine Program - DRAFT
Acute Care Access and Flow Dashboard - MCH - Medicine Program - DRAFT
Acute Care Access and Flow Dashboard - MCH - Mental Health Program - DRAFT
Acute Care Access and Flow Dashboard - MCH - Mental Health Program - DRAFT
MCH Site Summary Acute Care Access and Flow Dashboard - MCH Sep-13 Oct-13 Nov-13 Dec-13 Jan-14 Feb-14 Mar-14 Apr-14 May-14 Jun-14 Jul-14 Baseline (FY 12/13) ED Totals ED Visits - Admitted 384 419 440 434 458 409 464 446 517 450 435 467 ED Visits - Non-Admitted 4,043 4,202 3,746 3,973 3,883 3,460 3,829 3,772 4,049 3,935 4,083 3,761 Median ED LOS (Admitted) 15.2 10.9 12.6 13.2 13.2 11.6 14.6 13.3 14.5 14.3 15.7 12.0 Median ED LOS (Non-Admitted) 2.9 3.2 3.3 3.2 3.1 3.0 3.2 3.4 3.2 3.1 2.9 3.3 ED Length of Avg Time to Bed Assignment 9.5 6.5 5.9 6.4 6.2 8.8 9.1 8.2 8.2 6.8 8.4 5.4 Stay Blue to Bed (EDIS) 33 32 35 36 34 31 33 36 34 33 30 Median ED Wait to see a Physician(hr) 1.3 1.4 1.4 1.4 1.4 1.3 1.5 1.6 1.6 1.4 1.3 Total Admissions 1,481 1,527 1,469 1,391 1,429 1,330 1,565 1,506 1,555 1,478 1,334 1,450 IP Flow Total Discharges 1,451 1,520 1,166 1,410 1,423 1,312 1,539 1,501 1,539 1,474 1,339 1,451 % IP Discharged before 11 a.m. 30 26 24 21 21 24 24 24 25 23 21 26 Acute LOS/ELOS Ratio 0.91 0.99 0.96 0.95 0.99 0.98 0.95 0.98 0.98 0.95 0.99 1.04 ALOS/ELOS Avg Acute LOS (excludes ALC) 4.5 5.3 4.8 5.2 5.0 5.0 5.0 5.1 5.1 5.2 6.1 5.8 % ALC Days 8.0 12.1 6.3 5.9 6.4 12.7 9.4 7.7 6.2 7.6 10.9 7.7 Readmission 7 Day Readmission Rate (%) 3.0 2.7 3.1 2.7 3.1 2.4 2.7 3.1 3.6 2.6 30 Day Readmission Rate (%) 6.2 6.1 5.9 5.7 7.0 6.1 6.4 6.5 7.3 6.5 Occupancy MCH site level occupancy 96% 94% 93% 93% 94% 97% 96% 96% 96% 96% 94% 94% Data is for entire site, all programs and services Baseline for ED Visits - Admitted and Non-Admitted, Total Admissions and Total Discharges is the monthly average for FY 2012-13 data Non-Admitted ED visits include deceased, LAMA, LWBS Avg Time to Bed Assignment - average time decision to admit to inpatient bed assigned (Tableau). Blue to Bed - median bed ready to discharge (EDIS). Acute LOS/ELOS Ratio is the Acute LOS/ELOS for typical cases Atypical Cases are excluded from ELOS comparison; Atypical Cases are deaths, sign-out (left AMA), transfers to and/or from another acute care site. Avg. Acute LOS is Total Hospital LOS minus ALC days divided by number of discharges % ALC Days is ALC Days divided by Total Hospital LOS Readmission info is based on the admit date recorded on the discharged inpatient record and is therefore reported 2 months behind DAD availability. (avail to April 2014). This 2 month lag is to allow for the 30 day readmit window in addition to time required to discharge, code the chart and receive the file. Total Qualifying Readmit Discharges is the denominator for the readmission rate calculation; this excludes deaths, transfers to acute care, sign-out, and residents from outside of AB. MCH Surgery Surgery Program Summary Sep-13 Oct-13 Nov-13 Dec-13 Jan-14 Feb-14 Mar-14 Apr-14 May-14 Jun-14 Jul-14 Flow Admissions from ED 131 168 157 155 153 154 142 127 148 138 115 146 Total Discharges 532 576 540 499 502 510 571 549 569 538 387 521 Baseline (FY 12/13)
Flow Acute LOS/ELOS and ALC Readmission % IP Discharged before 11 a.m. 46 42 38 33 36 41 38 42 43 42 41 43 Acute LOS/ELOS Ratio 0.80 0.88 0.87 0.82 0.84 0.81 0.84 0.87 0.90 0.87 0.86 0.90 Avg Acute LOS (excludes ALC) 4.0 4.0 3.5 3.8 3.7 3.6 3.7 4.1 4.0 3.8 4.2 4.0 % ALC Days 4.8 3.3 0.8 3.2 9.5 0.3 5.4 1.5 1.3 0.8 7.7 2.6 7 Day Readmission Rate (%) 2.8 2.5 1.8 2.4 3.0 1.9 1.8 3.0 4.0 2.1 30 Day Readmission Rate (%) 6.4 6.3 5.0 4.8 6.7 6.0 5.0 6.7 6.8 5.7 Admissions: Patients admitted from the Emergency Department with Physician Service of Surgery Baseline for Admissions from ED and Total Discharges is the monthly average for FY 2012-13 data Total Discharges includes all dispositions (home, death, transfer, AMA) % Discharged before 11am source data: Tableau Inpatient Self Serve Tool - Program Surgery Acute LOS/ELOS Ratio is the Acute LOS divided by the ELOS for typical cases Atypical Cases are excluded from ELOS comparison; Atypical Cases are deaths, sign-out (left AMA), transfers to and/or from another acute care site. Average Acute LOS is the Total Hospital Los minus ALC days divided by the number of discharges % ALC Days is ALC Days divided by Total Hospital LOS MCH Medicine Program Summary Sep-13 Oct-13 Nov-13 Dec-13 Jan-14 Feb-14 Mar-14 Apr-14 May-14 Jun-14 Jul-14 Baseline (FY12/13) FLOW ALOS/ELOS and ALC Readmission Admissions from ED 283 278 307 321 326 273 319 323 341 298 303 284 Total Discharges 279 319 309 340 350 264 325 348 336 316 323 298 % IP Discharged before 11 a.m. 23 20 20 16 15 21 16 17 20 14 20 18 Acute LOS/ELOS Ratio 1.10 1.19 1.10 1.12 1.20 1.24 1.15 1.14 1.14 1.07 1.15 1.15 Avg Acute LOS (excludes ALC) 10.3 13.1 9.7 11.8 10.6 12.3 12.1 10.4 10.4 10.7 13.1 13.3 % ALC Days 13.8 19.7 10.7 9.1 7.2 22.6 14.6 13.8 11.8 13.4 14.5 13.6 7 Day Readmission Rate (%) 4.6 5.2 5.3 5.3 4.5 2.8 4.0 4.5 6.8 4.8 30 Day Readmission Rate (%) 12.4 14.2 13.4 13.7 14.9 10.1 14.7 13.1 17.3 15.0 * Totals do not include data from RAH unit 42 Includes Critical Care Admissions: Patients admitted from the Emergency Department with Physician Service of Internist, Family Practitioner, Neurologist Baseline for Admissions from ED and Total Discharges is the monthly average for FY 2012-13 data Total Discharges includes all dispositions (home, death, transfer, AMA) Discharges, Hospital LOS, ALC days - source data: Meta Health PowerAbstract database and excludes cases with entire stay in critical care % Discharged before 11am source data: Tableau Inpatient Self Serve Tool - Program Medicine, All Most Responsible Physician Services except Critical Care *Acute LOS/ELOS Ratio and Readmission Info is reported from the AHS Database. Cases with entire stay in critical care can NOT be excluded Acute LOS/ELOS Ratio is the Acute LOS divided by the ELOS for typical cases Atypical Cases are excluded from ELOS comparison; Atypical Cases are deaths, sign-out (left AMA), transfers to and/or from another acute care site. Average Acute LOS is the Total Hospital Los minus ALC days divided by the number of discharges % ALC Days is ALC Days divided by Total Hospital LOS MCH Flow Mental Health Program Summary Apr-14 May-14 Jun-14 Jul-14 Baselin e (FY 12/13) Admissions from ED 13 7 9 10 17 Total Admissions 22 20 24 30 32
Flow Acute LOS/ELOS and ALC Readmission Total Discharges 18 20 25 31 32 % IP Discharged before 11 a.m. 38 29 38 5 36 Acute LOS/ELOS Ratio 0.79 0.84 0.84 1.04 1.60 Avg Acute LOS (excludes ALC) 18.2 22.7 25.0 24.9 26.8 % ALC Days 8.7 2.4 12.1 16.0 2.6 7 Day Readmission Rate (%) 0.0 0.0 2.2 30 Day Readmission Rate (%) 0.0 11.1 6.1 * MCH Mental Health patients transferred back from RAH March 2014. 30 Day readmission does not include RAH cases. Admissions: Patients admitted from the Emergency Department with Physician Service of Mental Health Baseline for Admissions from ED, Total Admissions and Total Discharges is the monthly average for FY data Total Discharges includes all dispositions (home, death, transfer, AMA) % Discharged before 11am source data: Tableau Inpatient Self Serve Tool - Program Mental Health Acute LOS/ELOS Ratio is the Acute LOS divided by the ELOS for typical cases Atypical Cases are excluded from ELOS comparison; Atypical Cases are deaths, sign-out (left AMA), transfers to and/or from another acute care site. Average Acute LOS is the Total Hospital Los minus ALC days divided by the number of discharges % ALC Days is ALC Days divided by Total Hospital LOS The Acute Inpatient Readmits represents the proportion of occurrences of an unplanned admission to hospital within 30 days of a patient being discharged from a hospital stay. Only initial visits where the patient is discharged are included (transfers, sign-outs and deaths are excluded). Any cause of the readmission is included. Numerator: Cases within the denominator with an unplanned readmission within 30-days of discharge for any cause. Denominator: Total number of discharges, excluding transfers, sign-outs and deaths.
Source contact ED Visits - Admitted ED Visits - Non-Admitted Tableau http://tableauahs.albertahealthservices.ca/views/emergencydepartmentdata-selfservetool/measures May Kharaghani Median ED LOS - Admitted Median ED LOS - Non-Admitted Tableau http://tableau.albertahealthservices.ca/views/emergencydepartmenttrendsandperformancemeasures/datatable Jason Scarlett Avg Time to Bed Assignment Tableau http://tableauahs.albertahealthservices.ca/views/zip8hrtrends/overalladmittingtrendsfromtheed#1 Jason Scarlett Blue to Bed (EDIS)(minutes) EDIS L:\Reporting\Multi Site\Routines\ER Dashboards\_ED GNCH (or MCH) Dashbd yyyy_yy.xls - use Blue to Bed Christine Musselman Total Admissions Crystal Report (PowerAbstract) Site Data Total Admissions Total Discharges Crystal Report (PowerAbstract) Site Data LOS Age Gender for DC - use grand total discharges % IP Discharged before 11 a.m. Tableau http://tableauahs.albertahealthservices.ca/views/inpatientdata-selfservetool/inpatientdata-selfservetool#2 Christian Schmid Typical Cases [hide line] Acute LOS (typical cases only)[hide] ELOS [hide line] Acute LOS/ELOS Ratio Crystal Report Calculated (AHSDRRX) Site Data ALOS-ELOS - use Typ only Hospital LOS (days) [hide line] Crystal Report (PowerAbstract) Site Data LOS Age Gender for DC - use grand total LOS ALC Days [hide line] Crystal Report (PowerAbstract) Site Data ALC Avg Acute LOS Calculated % ALC Days Calculated Total Qualifying Readmit Discharges Crystal Report [hide line] (AHSDRRX) Readmit Denominator - use month total 7-DAY Total Readmissions [hide line] Crystal Report (AHSDRRX) Readmit Numerator - 7 Day - use month total 7 Day Readmission Rate (%) Calculated 30-DAY Total Readmissions [hide] Crystal Report (AHSDRRX) Readmit Numerator - 30 Day - use month total 30 Day Readmission Rate (%) Calculated GNCH site level occupancy Tableau http://tableauahs.albertahealthservices.ca/workbooks/acutecareoccupancy Jason Scarlett
Source ED Visits - Admitted Tableau Admissions from ED to own facility - see below for list of EDIS dispositions ED Visits - Non-Admitted Tableau All discharge dispositions except admitted (includes deaths, LWBS, LAMA) Median ED LOS - Admitted Tableau Triage to Discharge = ED LOS Median ED LOS - Non-Admitted Tableau Triage to Discharge = ED LOS; excludes LWBS, LAMA, deaths) - see below for list of EDIS dispositions Avg Time to Bed Assignment Tableau Average LOS Decision to Admit to IP Bed Assigned Blue to Bed (EDIS)(minutes) EDIS Median LOS Bed Ready to Disch (min) Total Admissions Crystal Report Total Discharges Crystal Report Flow ratio (total visits) % IP Discharged before 11 a.m. Tableau Inpatient Data - Self Serve Tool Typical Cases [hide line] Crystal Report Atypical Cases are excluded from ELOS comparison; Atypical Cases are deaths, sign-out (left AMA), transfers to and/or from another acute care site. Acute LOS (typical cases only)[hide] Crystal Report Total Hospital LOS minus ALC days for typical cases only ELOS [hide line] Crystal Report The ELOS for a record is basically the Canadian average of the length of stay of a case in that CMG, age group and Resource Intensity Level. Acute LOS/ELOS Ratio Calculated Acute LOS/ELOS Ratio is the Acute LOS/ELOS for typical cases Hospital LOS (days) [hide line] Crystal Report CIHI definition: the difference, in days, between the Admission Date and Discharge Date.If Admission Date equals Discharge Date (the difference is 0), the Calculated LOS is 1 ALC Days [hide line] Crystal Report Alternate Level of Care Days CIHI definition: When a patient is occupying a bed in a facility and does not require the intensity of resources/services provided in that care setting (Acute, Complex Continuing Care [Chronic], Mental Health or Rehabilitation), the patient must be designated Alternate Level of Care (ALC) at that time by a physician or her/his delegate. The authorized designate may be a long term care assessor, patient care manager, discharge planner or care team member. Avg Acute LOS Calculated Total Hospital LOS minus ALC days divided by number of discharges % ALC Days Calculated ALC Days divided by Total Hospital LOS Total Qualifying Readmit Discharges [hide line] Crystal Report Total Qualifying Readmit Discharges is the denominator for the readmission rate calculation; all discharges from the reporting facility excluding deaths, transfers to acute care, sign-out, and residents from outside of AB. 7-DAY Total Readmissions [hide line] Crystal Report Cases where READMIT 30D_FG field = 1 and DAYS_BTW_VISITS is less than or equal to 7 7 Day Readmission Rate (%) Calculated Readmission info is based on the admit date recorded on the discharged inpatient record and is therefore reported 2 months behind DAD availability. This 2 month lag is to allow for the 30 day readmit window in addition to time required to discharge, code the chart and receive the file. 30-DAY Total Readmissions [hide] Crystal Report Cases where READMIT 30D_FG field = 1 30 Day Readmission Rate (%) Calculated GNCH site level occupancy Tableau Tableau EDIS discharge disposition decoder. Received from Jason Scarlett August 19, 2014 The DISP_PERF_RPT column is used most of the time Tableau report disp_group disp_perf_rpt EDIS Dispositions: Admitted Admitted ADMITTED Admitted Admitted **DISCHARGED TO TX AREA WITHIN HOSPITAL Admitted Admitted FCP-ADMITTED Died Died **DECEASED Died Died DEAD ON ARRIVAL Died Died **MORGUE Died Died DIED IN EMERGENCY Discharged Discharged DISCHARGED WITH APPROVAL Discharged Discharged **DISCHARGED TO OTHER FACILITY Discharged Discharged **DISCHARGED WITH HOME CARE Discharged Discharged **DISCHARGED TRANSFERED OUT Discharged Discharged TRANSFER WITH APPROVAL Discharged Discharged DISCHARGE DISASTER PATIENT Discharged Discharged **FAST TRACK
Discharged Discharged **FAST TRACK Admitted Exclude **STILL IN HOSPITAL Exclude Exclude DOUBLE TRIAGED Exclude Exclude **INCORRECT HRN Referred Exclude **SHOULD BE SEEN IN CLINIC NOT EMERG Admitted Exclude ALREADY IN PATIENT Exclude Exclude EXPECTED ELSEWHERE NOT ER Exclude Exclude WRONG INFORMATION ENTERED LAMA LAMA **LEFT AGAINST MEDICAL ADVICE LAMA LAMA LEFT AGAINST MEDICAL ADVICE LAMA LAMA LEFT PRIOR TO COMPLETION OF TX LWBS LWBS LEFT WITHOUT BEING SEEN LWBS LWBS **LEFT W/OUT TX LWBS LWBS **DISCHARGED PRIOR TO BEING SEEN LWBS LWBS **LEFT W/O BEING REGISTERED LWBS LWBS LEFT WITHOUT BEING REGISTERED