Published on in Vol 9, No 1 (2017):

Delay between Discharge and Admit Time Delay in  ADT-A03 messages via LEEDS

Delay between Discharge and Admit Time Delay in ADT-A03 messages via LEEDS

Delay between Discharge and Admit Time Delay in ADT-A03 messages via LEEDS

Authors of this article:

Jose Serrano1
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ObjectiveTo explore the difference between the reported date of admissionand discharge date using discharge messages (A03), from hospitalemergency departments participating in the Louisiana Early EventDetection System (LEEDS.IntroductionThe Infectious Disease Epidemiology Section (IDEpi) within theOffice of Public Health (LaOPH) conducts syndromic surveillanceof emergency departments by means of the Louisiana Early EventDetection System (LEEDS). LEEDS accepts ADT (admit-discharge-transfer) messages from participating hospitals, predominately A04(registration) and A03 (discharge), to obtain symptom or syndromeinformation on patients reporting to hospital emergency departments.Capturing the data using discharge messages (A03) only could resultin a delay in receipt of data by LaOPH, considering the variability inthe length of stay of a patient in the ED.MethodsEmergency department data from participating hospitals isimported daily to LEEDS and processed for syndrome classification.IDEpi syndromic surveillance messages received for the period ofCDC week 1632 and 1636 (8/8/16-9/8/16) using MS Access andExcel to calculate the difference (in days) between the reported admitdate and discharge date in A03 messages.Results88.1% of the A03 messages submitted in the 4 week analysisperiod exhibited no delay (delay=0 days) between the admit date andthe reported discharge date, compared to only 10.7% showing a delayof one day (delay = 1 day) and 1.06% showing a delay of 2 days ormore (delay≥2 days). Less than 0.2% of the messages had missinginformation regarding discharge date (Table 1).ConclusionsSyndromic surveillance systems operate under a constant need forimprovement and enhancement. The quality of the data, independentof the quality of the system, should always strive to be of the highestpedigree in order to inform disease-specific programs and detectpublic health aberrations. In order to identify these potential concerns,it is imperative that the data be submitted to public health agenciesin a timely manner. Based on this analysis, the lapse in time betweenadmit and discharge results in little to no patient syndromic data delayfor those hospital ED’s that exclusively send A03 messages. Thisstatement is supported by the finding that close to 99% of messagesdemonstrated a delay between admit date and discharge date of oneday or less.Table 1. Delay between reported Admit and Discharge date in A03 messagessubmitted to LEEDS