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NATIONAL HOSPITAL
AMBULATORY
MEDICAL CARE
SURVEY
SAMPLING AND
INFORMATION
BOOKLET
UNITED STATES DEPARTMENT OF COMMERCE
Economics and Statistics Administration
USCENSUSBUREAU
S
EA
EN
UO
F TH E C
R
(11-17-2008)
US
U.S.
D
BU
NHAMCS-124
ENT OF C
TM
O
AR
CE
ER
M
M
EP
U.S. CENSUS BUREAU
Page
I
Emergency Department Sampling Instructions
2
II
Emergency Department Table of Take Every Numbers
3
III
Outpatient Department Sampling Instructions
4
IV
Outpatient Department Table of Take Every Numbers
5
V
Special Instructions for OPD Sampling (Updating Clinic Lists)
6
VI
OPD Classification of Clinics – Alphabetic Listing
7
VII
OPD Classification of Clinics – By Specialty Group
13
VIII
OPD Listing of Ineligible Clinics
17
IX
Ambulatory Surgery Center Sampling Instructions
18
X
Ambulatory Surgery Center Table of Take Every Numbers
19
XI
Ambulatory Unit Director Meeting Checklist
20
XII
Ambulatory Unit Staff Instruction Checklist
21
XIII
Quality Control Visit Checklist
23
XIV
Checklist for Conducting NHAMCS
24
XV
Quick Reference, Categorizing NHAMCS Clinics
27
XVI
NHAMCS-101, Item 9c, Hospital Trauma Level Ratings and Descriptions
28
XVII NHAMCS-101, Item 14e, 14x, and 15g, Flashcard
29
XVIII NHAMCS-101, Item 14s, Flashcard
30
NHAMCS-124 (11-17-2008)
Page 1
TABLE OF CONTENTS
TABLE OF CONTENTS
I
EMERGENCY DEPARTMENT SAMPLING INSTRUCTIONS
A. Determining the Take Every (TE) Number
Use the table on page 3. Get counts of visits from page 10 of the
NHAMCS-101, Questionnaire.
1. Go across the top of the table and find the range that includes the number of
visits expected for the individual emergency service area (ESA).
2. Go down the column on the left of the table until you find the range containing
the total number of visits for the entire ED. If you can not find the number of
total visits in any of these ranges (i.e., this number exceeds all ranges), call
the regional office supervisor immediately.
3. Look across the row (line) containing the number of visits for the entire ED
and find where it intersects the column containing the number of visits for the
individual ESA. The number located in the box where this column and row
intersect is the Take Every number.
4. Enter this number in column (d) on page 10 of the NHAMCS-101,
Questionnaire and in Section B, item 1, on the cover of the NHAMCS-101(U),
Ambulatory Unit Record. Repeat the process for each ESA listed.
5. If an ESA has less than 40 expected visits, then the Take Every number
should be 1.
B. Determining the Random Start Number
Next, select the Random Start numbers. Refer to the label on the back of the
NHAMCS-101, Questionnaire. The label has a row or heading of TE numbers and
a column or left margin of ten numbered rows. Random Start numbers (between 1
and the TE number) are located in the table’s cells. The Random Start number
should NEVER be greater than the Take Every number. To determine the Random
Start number for the first emergency service area listed, follow these steps:
1. You determined the ESA’s TE number above in part I.A. Find the ESA’s TE
number in the table heading on the label on the back of the NHAMCS-101,
Questionnaire.
2. For the first listed service area, start with row 1, (or next available row if others
were previously used), then look across the row and find where it intersects
the column headed by the TE number. The number located in this cell is the
Random Start number.
3. Circle the number and enter it in column (e) on page 10 of the NHAMCS-101,
Questionnaire. Also enter this Random Start number in Section B, item 2, on
the cover of the NHAMCS-101(U), Ambulatory Unit Record.
4. If the Take Every number is 1, then the Random Start number should be 1.
Do the same for any additional emergency service areas, each time using the
appropriate TE determined for the area and the next available row.
Page 2
NHAMCS-124 (11-17-2008)
NHAMCS-124 (11-17-2008)
9
8
8
7
7
7
6
6
6
6
5
5
5
5
4
4
4
4
3
3
3
3
2
2
2
2
1
1
1
1
1
1
3600–4199
4200–4799
4800–5399
5400–5999
6000–11999
12000–17999
25
25
20
20
15
15
10
10
9
9
8
8
7
6
5
4
3
2
1
24000–30000
25
7
20
6
15
5
10
Page 3
90
50
45
40
35
30
150
150
150
100
50
45
40
35
30
NA
200
200
150
100
50
45
40
35
NA
NA
ED Sampling
90
90
50
50
45
45
40
40
90
50
45
40
35
30
35
35
50
50
45
40
35
30
25
250
200
150
100
NA
NA
NA
NA
NA
NA
250
200
150
NA
NA
NA
NA
NA
NA
NA
250
200
150
NA
NA
NA
NA
NA
NA
NA
250
200
150
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
25
NA
NA
NA
NA
NA
NA
NA
NA
30
30
45
40
35
30
25
20
15
10
9
8
7
9
45
40
35
30
25
20
15
10
9
8
7
8
45
40
35
30
25
20
15
10
9
8
7
40
40
35
30
25
20
15
10
9
4
6
35
35
35
30
25
20
15
10
3
5
30
30
30
30
25
20
15
2
4
25
25
25
25
25
20
1
3
6
20
20
20
20
NA
20
NA
15
8
15
6
18000–23999
2
5
10
9
8
7
6
5
4
3
2
1
3000–3599
4
15
10
9
8
7
6
5
4
3
2
1
2400–2999
3
20
15
10
9
8
7
6
5
4
3
2
1
1800–2399
2
15
15
15
10
9
8
7
6
5
4
3
2
1
1200–1799
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
10
10
10
10
9
8
7
6
5
4
3
2
1
1100–1199
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
9
9
9
9
9
8
7
6
5
4
3
2
1
950–1099
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
8
8
8
8
8
7
6
5
4
3
2
1
850–949
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
7
7
7
7
7
7
6
5
4
3
2
1
700–849
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
6
6
6
6
6
6
5
4
3
2
1
600–699
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
5
5
5
5
5
5
5
4
3
2
1
500–599
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
4
NA
NA
4
4
4
4
4
4
4
3
2
1
350–499
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
3
NA
NA
3
3
3
3
3
3
3
2
1
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
250–349
2
NA
2
2
2
2
2
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
2
NA
1
NA
120–249
NA
NA
NA
1
1
1
1–119
80 120 150 180 210 240 270 300 400 600 900 1200 1500 1800 2100 2400 2700 3000 4000 9000 12000 15000 18000
119 149 179 209 239 269 299 399 599 899 1199 1499 1799 2099 2399 2699 2999 3999 8999 11999 14999 17999 20999
40
79
VISITS TO THE INDIVIDUAL EMERGENCY SERVICE AREA (ESA)
1
39
VISITS TO
THE ENTIRE
ED
TABLE OF TAKE EVERY NUMBERS
II EMERGENCY DEPARTMENT
III OUTPATIENT DEPARTMENT SAMPLING INSTRUCTIONS
A. Determining the Take Every (TE) Number
Use the table on page 5. Get counts of visits from page 16 of the
NHAMCS-101, Questionnaire.
1. Go across the top of the table and find the range that includes the number of
visits expected for the individual outpatient clinic.
2. Go down the column on the left of the table until you find the range containing
the total number of visits for the entire OPD. If you can not find the number of
total visits in any of these ranges (i.e., this number exceeds all ranges), call
the regional office supervisor immediately.
3. Look across the row (line) containing the number of visits for the entire OPD
and find where it intersects the column containing the number of visits for the
individual clinic. The number located in the box where this column and row
intersect is the Take Every number.
4. Enter this number in column (e) on page 16 of the NHAMCS-101,
Questionnaire and in Section B, item 1, on the cover of the NHAMCS-101(U),
Ambulatory Unit Record. Repeat the process for each clinic listed.
5. If a sampling unit has less than 40 expected visits, then the Take Every
number should be 1.
B. Determining the Random Start Number
Next, select the Random Start numbers. Refer to the label on the back of the
NHAMCS-101, Questionnaire. The label has a row or heading of TE numbers and
a column or left margin of ten numbered rows. Random Start numbers (between 1
and the TE number) are located in the table’s cells. The Random Start number
should NEVER be greater than the Take Every number. To determine the Random
Start number for the first outpatient clinic listed, follow these steps:
1. You determined the clinic’s TE number above in part III.A. Find the clinic’s TE
number in the table heading on the label on the back of the NHAMCS-101,
Questionnaire.
2. For the first listed clinic, start with row 1 (or next available row if others were
previously used), then look across the row and find where it intersects the
column headed by the TE number. The number located in this cell is the
Random Start number.
3. Circle the number and enter it in column (f) on page 16 of the NHAMCS-101,
Questionnaire. Also enter this Random Start number in Section B, item 2, on
the cover of the NHAMCS-101(U), Ambulatory Unit Record.
4. If the Take Every number is 1, then the Random Start number should be 1.
Do the same for any additional outpatient clinics, each time using the appropriate
TE determined for the area and the next available row. Should you run out of
available rows, contact your regional office supervisor and provide him or her with
the TE numbers of all remaining units. Your supervisor will determine all remaining
Random Start numbers.
Page 4
NHAMCS-124 (11-17-2008)
NHAMCS-124 (11-17-2008)
6
6
5
5
5
5
5
5
4
4
4
4
4
4
4
4
3
3
3
3
3
3
3
3
3
3
3
3
3
3
3
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1
1500–1749
1750–2499
2500–3499
3500–5499
5500–7499
7500–8999
9000–10499
10500–11999
12000–13499
13500–14999
15000–19999
20000–39999
40000–59999
60000–74999
75000–89999
2
6
5
4
3
2
1
1350–1499
1
6
5
4
3
2
1
1200–1349
105000–119999
6
5
4
3
2
1
1050–1199
3
3
6
5
4
3
2
1
900–1049
2
6
5
4
3
2
1
750–899
1
6
5
4
3
2
1
600–749
90000–104999
5
4
3
3
2
1
6
7
7
9
8
15
10
9
8
6
5
4
5
20
15
10
9
8
7
6
5
4
4
20
15
10
9
8
7
6
5
4
10
10
20
15
10
9
8
7
6
5
4
9
20
15
10
9
8
7
6
5
4
8
20
15
10
9
8
7
6
5
4
6
20
15
10
9
8
7
6
5
4
5
20
15
10
9
8
7
6
5
4
30
20
15
10
9
8
7
6
7
30
20
15
10
9
8
7
20
20
15
15
20
20
15
10
9
8
7
6
20
15
10
9
8
7
6
20
15
10
9
8
7
15
15
10
9
8
7
10
10
10
30
30
30
30
30
30
30
30
30
30
30
30
20
15
10
9
9
8
7
8
7
6
NA
NA
NA
NA
Page 5
50
60
60
70
70
70
60
50
50
70
70
70
70
70
70
70
60
50
40
30
20
15
NA
60
60
60
60
60
60
60
60
50
40
30
20
15
NA
50
50
50
50
50
50
50
50
50
40
30
20
15
10
NA
80
80
80
80
80
80
80
80
80
70
60
50
40
30
20
15
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
OPD Sampling
40
40
40
40
40
40
40
40
40
40
40
40
40
30
20
15
10
NA
NA
8
9
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
90
90
90
90
90
90
90
90
80
70
60
50
40
30
20
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
100
100
100
100
100
100
100
90
80
70
60
50
40
30
20
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
200
200
200
200
200
200
100
90
80
70
60
50
40
30
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
300
300
300
300
300
200
100
90
80
70
60
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
400
400
400
400
300
200
100
90
80
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
500
500
500
400
300
200
100
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
600
600
500
400
300
200
100
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
NA
900 1200 1500 1800 2100 2400 2700 3000 4000 10000 12000 15000 18000
1199 1499 1799 2099 2399 2699 2999 3999 9999 11999 14999 17999 20999
9
7
6
5
4
NA
NA
600
899
9
9
7
6
5
4
3
NA
400
599
9
8
7
8
7
6
5
4
3
2
300
399
8
7
6
5
4
3
2
270
299
8
7
6
5
4
3
8
7
6
5
4
3
2
240
269
7
4
3
2
210
239
VISITS TO THE INDIVIDUAL OUTPATIENT CLINIC
8
3
2
350–599
2
2
2
180
209
2
150
179
1
120
149
1–349
80
119
40
79
1
39
VISITS TO
THE ENTIRE
OPD
TABLE OF TAKE EVERY NUMBERS
IV OUTPATIENT DEPARTMENT
V
SPECIAL INSTRUCTIONS FOR OUTPATIENT DEPARTMENT SAMPLING
(Updating lists for OPDs with more than 5 clinics)
For previously participating hospitals with more than 5 clinics, a printout is
attached to page 16 of the NHAMCS-101, Questionnaire. This printout lists
the name and classification of eligible clinics previously reported. Ineligible
clinics are not included. Update the list as follows:
If the hospital provides their own listing, compare the two listings. Make
sure each eligible clinic on the hospital’s list is recorded on the printout attached
on page 16 of the NHAMCS-101, Questionnaire. Update the attached list by:
(1) Crossing through any clinics on the list which no longer exist or are no longer
operational in that hospital.
(2) Adding the names of any new clinics which have been created or have
become operational in that hospital. For each new clinic added to the list, be
sure to obtain the proper specialty code. Remember, include only ELIGIBLE
clinics.
(3) Obtaining an estimate of visits for each clinic, covering the 4-week reporting
period. Enter the estimate in column (d) of the attached listing.
If the hospital does not provide a listing of their own, show the hospital
representative your listing and update it as instructed above.
After updating the listing (i.e., verifying, adding, deleting, etc.), FAX the updated list
(and any listing provided by the hospital) to the regional office. The regional office
will choose the clinics for sample and provide you with the sampling instructions.
Upon receiving the instructions, attach a copy of the completed clinic listing
showing sampled clinics, the Take Every and Random Start numbers, etc., to page
15 of the NHAMCS-101, Questionnaire.
Page 6
NHAMCS-124 (11-17-2008)
VI OUTPATIENT DEPARTMENT
CLASSIFICATION OF CLINICS
Alphabetic Listing
24 Hour Observation, GM
A
Abdominal Surgery, SURG
Abortion/Pregnancy Termination, OS
Abuse (Child)/Sexual Assault, PED
Acupuncture, OS
Adolescent Gynecology, OBG
Adolescent Medicine, PED
Adolescent/Young Adult, PED
Adult Day Care, OS
Adult HIV, GM
Adult – Screening, GM
After hours (Pediatric), PED
AIDS, GM
Airway (Pediatric), PED
Alcohol Abuse, SA
Alcohol Detoxification, SA
Alcohol Walk-in, SA
Allergy (Adult), GM
Allergy (Pediatric), PED
Ambulatory Care, GM
Ambulatory Surgery Center, OS
Amniocentesis, OS
Amputee, SURG
Andrology, GM
Anesthesia, OS
Anesthesiology, OS
Anorectal, SURG
Antepartum, OBG
Anticoagulation, GM
Anxiety, OT
Apnea (Adult), GM
Apnea (Infant), PED
Arthritis/Rheumatology (Adult), GM
Arthritis/Rheumatology (Pediatric), PED
Arthroscopy, OS
Asthma, GM
Asthma (Pediatric), PED
Attention Deficit Disorder, PED
Audiology, OS
Autism, PED
B
Back Care, SURG
Behavior & Development (Child), PED
Behavioral Medicine, OT
Biofeedback, OT
Birth Control, OBG
Birth Defect, PED
Blood Bank, OS
NHAMCS-124 (11-17-2008)
Bone Density Screening, OS
Bone Marrow Aspiration, SURG
Bone Marrow Transplant, SURG
Brain Tumor, GM
Breast, SURG
Breast Care, SURG
Breast Medical Oncology, GM
Bronchoscopy, OS
Burn, SURG
C
Cancer Center, GM
Cancer Screening, GM
Cardiac (Pediatric), PED
Cardiac Catheterization, OS
Cardiology (Adult), GM
Cardiology (Pediatric), PED
Cardiothoracic Surgery, SURG
Cardiovascular, GM
Cardiovascular Surgery, SURG
Cast/Brace, SURG
CAT Scan & Imaging, OS
CD4, GM
Cerebral Palsy (Adult), GM
Cerebral Palsy (Child), PED
Chemical Dependence
(excluding Methadone Maintenance), SA
Chemotherapy, OS
Chest, GM
Chest (Pediatric), PED
Chest TB, GM
Chief Resident (Follow-up Surgery), SURG
Child
Abuse/Sexual Assault, PED
Behavior & Development, PED
Cerebral Palsy, PED
Cystic Fibrosis, PED
Down’s Syndrome, PED
Hemophilia, PED
Psychiatry OT
Sickle Cell, PED
Spina Bifida, PED
Chiropractic, OS
Chorea/Huntington’s Disease, GM
Chronic Wound, SURG
Cleft Palate, SURG
Clotting (Pediatric), PED
Club Foot, SURG
Coagulant, GM
Cochlear, SURG
Colon & Rectal Surgery, SURG
Colonoscopy, OS
Page 7
VI OUTPATIENT DEPARTMENT
CLASSIFICATION OF CLINICS
Alphabetic Listing – Continued
C – Continued
Colposcopy, OS
Congenital Heart, PED
Congestive Heart Failure, GM
Connective Tissue, GM
Craniofacial, SURG
Craniomalformation, PED
Critical Care (Pediatric), PED
Cryosurgery, SURG
Cystic Fibrosis (Adult), GM
Cystic Fibrosis (Child), PED
Cystoscopy, OS
Cytomegalovirus (CMV), GM
D
Day Hospital, OS
Dental, OS
Dental Surgery, OS
Dermatology (Adult), GM
Dermatology (Pediatric), PED
Developmental Disability, PED
Developmental Evaluation, PED
Diabetes, GM
Diabetes (Pediatric), PED
Diabetic Foot Clinic, OS
Diagnostic (Pediatric), PED
Diagnostic X-ray (Imaging)/Radiology, OS
Dialysis, OS
Dietary, OS
Digestive Disease, GM
Down’s Syndrome (Adult), GM
Down’s Syndrome (Child), PED
Drug Abuse
(excluding Methadone Maintenance), SA
Drug Detoxification
(excluding Methadone Maintenance), SA
Drug Immunotherapy, OS
Dysplasia (Gynecologic), OBG
E
Eating Disorder, OT
Echocardiology, OS
Elective Surgery, SURG
Electrocardiogram (ECG), OS
Electroconvulsive Therapy (ECT), OS
Electromyography, OS
Employee Health Service, OS
Page 8
Endocrinology (Adult), GM
Endocrinology (Gynecologic), OBG
Endocrinology (Pediatric), PED
Endocrinology (Reproductive), OBG
Endoscopy, OS
ENT (Ear, Nose, & Throat) (Adult), SURG
ENT (Ear, Nose, & Throat) (Pediatric), SURG
Epilepsy, GM
Epilepsy (Pediatric), PED
Eye, SURG
Eye Retinopathy of Prematurity, SURG
F
Family Planning, OBG
Family Practice, GM
Feeding Disorder (Child), PED
Fertility, OBG
Fetal Diagnostic Testing, OS
Fine Needle Aspiration, SURG
Fracture, SURG
G
Gastroenterology (Adult), GM
Gastroenterology (Pediatric), PED
Gastrointestinal (Pediatric), PED
General Medicine, GM
General Medicine (Outreach Program), GM
General Pediatrics, PED
General Practice, GM
General Preventive Medicine, OT
General Surgery, SURG
Genetics (Adult), GM
Genetics (Pediatric), PED
Genitourinary, SURG
Genitourinary Surgery, SURG
Geriatric Medicine, GM
Geriatric Psychiatry, OT
GI (Pediatric), PED
Growth Hormone, PED
Gynecology (OBG)
Adolescent, OBG
Dysplasia, OBG
Endocrinologic, OBG
Oncologic, OBG
Pediatric OBG
Preteen, OBG
NHAMCS-124 (11-17-2008)
VI OUTPATIENT DEPARTMENT
CLASSIFICATION OF CLINICS
Alphabetic Listing – Continued
H
Hand Surgery, SURG
Head (non-Surgical), GM
Headache (Neurology), OT
Head & Neck (non-Surgical), GM
Head & Neck Surgical, SURG
Hearing & Speech, OS
Heart Transplant, SURG
Hematology (Adult), GM
Hematology (Pediatric), PED
Hemodialysis, OS
Hemoglobinopathy (Pediatric), PED
Hemophilia (Adult), GM
Hemophilia (Child), PED
Hepatology, GM
High Risk Obstetrics, OBG
High Risk Pediatrics, PED
HIV Adult, GM
HIV Obstetrics, OBG
HIV Pediatrics, PED
Holistic Medicine, GM
Home Intravenous Therapy, OS
Homeless, GM
Huntington’s Disease/Chorea, GM
Hyperbaric oxygen, OT
Hyperlipidemia (Adult), GM
Hyperlipidemia (Pediatric), PED
Hypertension, GM
L
Laser Surgery, OS
Lasik Surgery, OS
Lead Poisoning (Adult), GM
Lead Poisoning (Pediatric), PED
Learning Disorder, PED
Leukemia, GM
Lipid, GM
Lithotripsy, OS
Liver, GM
Lupus (Systemic Lupus Erythematosus/SLE), GM
M
Mammography, OS
Maternal Fetal Medicine, OBG
Maternal Health, OBG
Maternity, OBG
Medical Oncology, GM
Medical Screening, GM
Melanoma, GM
Mental Health, OT
Mental Hygiene, OT
Metabolic, GM
Metabolic (Pediatric), PED
Methadone Maintenance, OS
Movement & Memory Disorders, GM
Multiple Sclerosis (MS), GM
Muscular Dystrophy (MD), GM
Myasthenia Gravis, OT
Myelomeningocele, OT
I
Imaging & CAT Scan, OS
Immunization, PED
Immunology, GM
Immunology (Pediatric), PED
Immunosuppression, GM
In Vitro Fertilization, OBG
Infectious Disease (Adult), GM
Infectious Disease (Pediatric), PED
Infertility, OBG
Infusion, OS
Infusion Therapy, OS
Injury, SURG
Injury (Pediatric), SURG
Internal Medicine (Adult), GM
Internal Medicine (Pediatric), PED
IV Therapy, OS
K
Kidney (Renal) Dialysis, OS
Knee, SURG
NHAMCS-124 (11-17-2008)
N
Neonatal, PED
Neonatal Follow-up, PED
Neonatology, PED
Nephrology (Adult), GM
Nephrology (Pediatric), PED
Neurocutaneous, GM
Neurofibromatosis,OT
Neurology (Adult), OT
Neurology (Pediatric), OT
Neuromuscular, OT
Neurophysiology, OT
Neuropsychiatry, OT
Neurosensory, OT
Neurosurgery, SURG
Newborn, PED
Non-surgical Head, GM
Non-surgical Head & Neck, GM
Nuclear Medicine, OS
Nurse Clinic/Nurse Only, OS
Nutrition, OS
Page 9
VI OUTPATIENT DEPARTMENT
CLASSIFICATION OF CLINICS
Alphabetic Listing – Continued
O
Obesity (Adult), GM
Obesity (Pediatric), PED
Observation, 23/24 Hour, GM
Obstetrics (OBG)
High Risk, OBG
HIV, OBG
Perinatal, OBG
Post Partum, OBG
Prenatal, OBG
Occupational Health, OS
Occupational Medicine, GM
Occupational Safety & Health, OS
Occupational Therapy, OS
Oncology (GM)
Breast Medical, GM
Gynecologic, OBG
Medical, GM
Pediatric, PED
Radiation, OS
Surgical, SURG
Ophthalmologic Surgery, SURG
Ophthalmology (Adult), SURG
Ophthalmology (Pediatric), SURG
Optometry, OS
Oral Surgery, OS
Orthopedic Surgery, SURG
Orthopedics (Adult), SURG
Orthopedics (Pediatric), SURG
Orthotics, OS
Ostomy, SURG
Otolaryngologic Surgery, SURG
Otolaryngology (Adult), SURG
Otolaryngology (Pediatric), SURG
Otology, SURG
Otorhinolaryngology, SURG
Outreach Program (General Medicine), GM
P
Pacemaker, GM
Pain, OS
Pain Block, OS
Pain Management, OS
Pain Medicine, OS
Palliative Medicine, OT
Partial Hospitalization, OS
Partial Hospitalization Program (Psyc), OS
Page 10
Path Lab, OS
Pathology, OS
Pediatric General, PED
Pediatric
Airway, PED
Allergy, PED
Arthritis/Rheumatology, PED
Cardiac, PED
Cardiology, PED
Chest, PED
Clotting, PED
Critical Care, PED
Dermatology, PED
Diabetes, PED
Diagnostic, PED
Endocrinology, PED
ENT (Ear, Nose, & Throat), SURG
Feeding Disorder, PED
Gastroenterology, PED
Gastrointestinal, PED
General, PED
Genetics, PED
GI, PED
Growth hormone, PED
Gynecology, OBG
Hematology, PED
Hemoglobinopathy, PED
High Risk, PED
HIV, PED
Hyperlipidemia, PED
Immunization, PED
Immunology, PED
Infectious Diseases, PED
Injury, PED
Internal Medicine, PED
Lead Poisoning, PED
Learning Disorder, PED
Nephrology, PED
Neurology, OT
Obesity, PED
Oncology, PED
Ophthalmology, SURG
Orthopedics, SURG
Otolaryngology, SURG
Plastic Surgery, SURG
Psychiatry, OT
Pulmonary, PED
Renal and Diabetes, PED
Rheumatology/Arthritis, PED
Scoliosis, SURG
NHAMCS-124 (11-17-2008)
VI OUTPATIENT DEPARTMENT
CLASSIFICATION OF CLINICS
Alphabetic Listing – Continued
P – Continued
Pediatric – Continued
Short Stay, PED
Spine, SURG
Surgery, SURG
Urology, SURG
Pentamidine, GM
Perinatal, PED
Perinatal (Obstetrics), OBG
Peripheral Vascular Disease, GM
Pharmacy, OS
Phenylketonuria, PED
Pheresis, GM
Physiatry, OS
Physical Medicine, OS
Physical Therapy, OS
Physiotherapy, OS
Pigmented Lesion, GM
Plasmapheresis, GM
Plastic Surgery (Adult), SURG
Plastic Surgery (Pediatric), SURG
Podiatry, OS
Postpartum (Obstetrics), OBG
Postoperative, SURG
Preoperative, SURG
Prader-Willi Syndrome, PED
Preadmission Testing, OS
Pregnancy Termination/Abortion, OS
Pregnancy Verification, OBG
Prenatal, OBG
Prenatal (Obstetrics), OBG
Preteen Gynecology, OBG
Preventive Medicine, OT
Primary Care, GM
Proctology, SURG
Psychiatry (Adolescent), OT
Psychiatry (Adult), OT
Psychiatry (Child), OT
Psychiatry (Geriatric), OT
Psychiatry (Pediatric), OT
Psychology, OS
Psychopharmacology, OT
Pulmonary (Adult), GM
Pulmonary (Pediatric), PED
Pulmonary Function Lab, OS
Pulmonary/Thoracic Surgery, SURG
NHAMCS-124 (11-17-2008)
R
Radiation Diagnosis, OS
Radiation Oncology, OS
Radiation Therapy, OS
Radiology/Diagnostic X-ray (imaging), OS
Reading & Language, OS
Rectal & Colon Surgery, SURG
Reference Lab, OS
Reference X-Ray, OS
Rehabilitation, OS
Renal, GM
Renal and Diabetes (Child), PED
Renal (Kidney) Dialysis, OS
Renal Surgery, SURG
Renal Transplant, SURG
Reproductive, OBG
Reproductive Endocrinology, OBG
Respiratory, GM
Rheumatic Heart Disease, PED
Rheumatology/Arthritis (Adult), GM
Rheumatology/Arthritis (Pediatric), PED
S
Same Day Surgery, OS
Sarcoidosis, GM
School Programs, OS
Scoliosis (Adult), SURG
Scoliosis (Pediatric), SURG
Screening (Adult), GM
Screening (Pediatric), PED
Screening-cancer, GM
Screening and/or Walk-in, GM
Seizure, GM
Senior Care, GM
Sexual Assault/Abuse (Child), PED
Sexually Transmitted Diseases (STD), GM
Short Stay (Child), PED
Sickle Cell (Adult), GM
Sickle Cell (Child), PED
Sigmoidoscopy, OS
Skeletal Dysplasia, PED
SLE/Systemic Lupus
Erythematosus (Lupus), GM
Sleep Disorder, OT
Sleep Medicine, OT
Social Work, OS
Speech & Hearing, OS
Spina Bifida (Adult), GM
Spina Bifida (Child), PED
Spinal Cord Injury, SURG
Spine (Adult), SURG
Spine (Pediatric), SURG
Page 11
VI OUTPATIENT DEPARTMENT
CLASSIFICATION OF CLINICS
Alphabetic Listing – Continued
S – Continued
Sports Medicine, SURG
STD/Sexually Transmitted Diseases, GM
Student Health Service/Center, OS
Substance Abuse
(excluding Methadone Maintenance), SA
Surg, SURG
Surgery (Adult), SURG
Surgery (Pediatric), SURG
Surgery cancer detection, SURG
Surgical Oncology, SURG
Suture, SURG
Systemic Lupus Erythematosus/SLE
(Lupus), GM
T
Teen Health, PED
Teen-Tot, PED
Teenage, PED
Tele-health, OS
Thoracic Surgery/Pulmonary, SURG
Thyroid, GM
Toxicology, OT
Transfusion, OS
Transplant Medicine, GM
Transplant Surgery, SURG
Trauma, SURG
Trauma, Traumatic Surgery, SURG
Traumatic Brain Injury, SURG
Travel Medicine, GM
Tuberculosis, GM
Tumor (Brain & Other), GM
Page 12
U
Ultrasound, OS
Urgent Care, GM
Urgent Care (Pediatric), PED
Urodynamics, SURG
Urologic Surgery, SURG
Urology (Adult), SURG
Urology (Pediatric), SURG
V
Vascular, GM
Vascular Surgery, SURG
Vertical Balance, OS
Visual Fields, SURG
W
Walk-in – Alcohol, SA
Walk-in and/or Screening, GM
Weight Management, GM
Well Child Care, PED
Well Woman, OBG
Wellness, GM
Women’s Alcohol Program, SA
Women’s Care, OBG
Wound Care, SURG
NHAMCS-124 (11-17-2008)
VII OUTPATIENT DEPARTMENT
CLASSIFICATION OF CLINICS
By Specialty Group
GENERAL MEDICINE (GM)
23/24 Hour Observation
Adult – Screening
Adult HIV
AIDS
Allergy (Adult)
Ambulatory Care
Andrology
Anticoagulation
Apnea (Adult)
Arthritis/Rheumatology (Adult)
Asthma
Brain Tumor
Breast Medical Oncology
Cancer Center
Cancer Screening
Cardiology (Adult)
Cardiovascular
CD4
Cerebral Palsy (Adult)
Chest
Chest TB
Chorea/Huntington’s Disease
Coagulant
Congestive Heart Failure
Connective Tissue
Cystic Fibrosis (Adult)
Cytomegalovirus (CMV)
Dermatology
Diabetes
Digestive Disease
Down’s Syndrome (Adult)
Endocrinology (Adult)
Epilepsy
Family Practice
Gastroenterology (Adult)
General Medicine
General Medicine (Outreach Program)
General Practice
Genetics (Adult)
Geriatric Medicine
Head (non-Surgical)
Head & Neck (non-Surgical)
Hematology (Adult)
Hemophilia (Adult)
Hepatology
HIV (Adult)
Holistic Medicine
Homeless
Huntington’s Disease/Chorea
Hyperlipidemia (Adult)
Hypertension
Immunology
Immunosuppression
NHAMCS-124 (11-17-2008)
Infectious Disease (Adult)
Internal Medicine (Adult)
Lead Poisoning (Adult)
Leukemia
Lipid
Liver
Lupus (Systemic Lupus Erythematosus/SLE)
Medical Oncology
Medical Screening
Melanoma
Metabolic
Movement & Memory Disorders
Multiple Sclerosis (MS)
Muscular Dystrophy (MD)
Nephrology (Adult)
Neurocutaneous
Non-Surgical Head
Non-Surgical Head & Neck
Obesity (Adult)
Occupational Medicine
Oncology
Outreach Program (General Medicine)
Pacemaker
Pentamidine
Peripheral Vascular Disease
Pheresis
Pigmented Lesion
Plasmapheresis
Primary Care
Pulmonary (Adult)
Renal
Respiratory
Rheumatology/Arthritis (Adult)
Sarcoidosis
Screening (Adult)
Screening – Cancer
Screening and/or Walk-in
Seizure
Senior Care
Sexually Transmitted Diseases (STD)
Sickle Cell (Adult)
SLE/Systemic Lupus Erythematosus (Lupus)
Spina Bifida (Adult)
STD/Sexually Transmitted Diseases
Systemic Lupus Erythematosus/SLE (Lupus)
Thyroid
Transplant Medicine
Travel Medicine
Tuberculosis
Tumor
Urgent Care
Vascular
Walk-in and/or Screening
Weight Management
Wellness
Page 13
VII OUTPATIENT DEPARTMENT
CLASSIFICATION OF CLINICS
By Specialty Group
SURGERY (SURG)
Abdominal Surgery
Amputee (Surgery & Rehab)
Anorectal
Back Care
Bone Marrow Aspiration
Bone Marrow Transplant
Breast
Breast Care
Burn
Cardiothoracic Surgery
Cardiovascular Surgery
Cast/Brace
Chief Resident (Follow-up Surgery)
Chronic Wound
Cleft Palate
Club Foot
Cochlear
Colon & Rectal Surgery
Craniofacial
Cryosurgery
Elective Surgery
ENT (Ear, Nose, & Throat) (Adult)
ENT (Ear, Nose, & Throat) (Pediatric)
Eye
Eye Retinopathy of Prematurity
Fine Needle Aspiration
Fracture
General Surgery
Genitourinary
Genitourinary Surgery
Hand Surgery
Head & Neck Surgery
Heart Transplant
Injury
Injury (Pediatric)
Knee
Neurosurgery
Oncologic Surgery
Ophthalmologic Surgery
Ophthalmology (Adult)
Ophthalmology (Pediatric)
Orthopedic Surgery
Orthopedics (Adult)
Orthopedics (Pediatric)
Ostomy
Otolaryngologic Surgery
Otolaryngology (Adult)
Otolaryngology (Pediatric)
Otology
Otorhinolaryngology
Plastic Surgery (Adult)
Plastic Surgery (Pediatric)
Postoperative
Preoperative
Proctology
Pulmonary/Thoracic Surgery
Rectal & Colon Surgery
Renal Surgery
Renal Transplant
Scoliosis (Adult)
Scoliosis (Pediatric)
Spinal Cord Injury
Spine (Adult)
Spine (Pediatric)
Sports Medicine
Surg
Surgery (Adult)
Surgery (Pediatric)
Surgery cancer detection
Surgical Oncology
Suture
Thoracic Surgery/Pulmonary
Transplant Surgery
Trauma
Traumatic Surgery
Traumatic Brain Injury
Urodynamics
Urologic Surgery
Urology (Adult)
Urology (Pediatric)
Vascular Surgery
Visual Fields
Wound Care
A Surgical clinic is similar to a surgeon’s office-based practice in terms of reasons for the patient’s visit,
diagnoses recorded, and procedures performed. Patients may be seen in Surgical clinics for the
following reasons: complaints which may eventually result in surgery (e.g., chronic abdominal pain);
preoperative and postoperative exams; second opinions regarding surgery; and minor surgical
procedures. A Surgical clinic may have a special room within the clinic where these procedures are
performed or, in some cases, they may be done in the examination room. The staff of a Surgical clinic
tends to remain fixed with the exception of rotating interns and residents in some hospitals.
Page 14
NHAMCS-124 (11-17-2008)
VII OUTPATIENT DEPARTMENT
CLASSIFICATION OF CLINICS
By Specialty Group
PEDIATRICS (PED)
Abuse (Child)/Sexual Assault
Adolescent Medicine
Adolescent/Young Adult
After hours (Pediatric)
Airway (Pediatric)
Allergy (Pediatric)
Apnea (Infant)
Arthritis/Rheumatology (Pediatric)
Asthma (Pediatric)
Attention Deficit Disorder
Autism
Behavior & Development (Child)
Birth Defect
Cardiac (Pediatric)
Cardiology (Pediatric)
Cerebral Palsy (Child)
Chest (Pediatric)
Clotting (Pediatric)
Congenital Heart
Craniomalformation
Critical Care (Pediatric)
Cystic Fibrosis (Child)
Dermatology (Pediatric)
Developmental Disability
Developmental Evaluation
Diabetes (Pediatric)
Diagnostic (Pediatric)
Down’s Syndrome (Child)
Endocrinology (Pediatric)
Epilepsy (Pediatric)
Feeding Disorder (Pediatric)
Gastroenterology (Pediatric)
Gastrointestinal (Pediatric)
General Pediatrics
Genetics (Pediatric)
GI (Pediatric)
Growth Hormone
Hematology (Pediatric)
Hemoglobinopathy (Pediatric)
Page 15
Hemophilia (Child)
High Risk Pediatrics
HIV Pediatrics
Hyperlipidemia (Pediatric)
Immunization
Immunology (Pediatric)
Infectious Disease (Pediatric)
Internal Medicine (Pediatric)
Lead Poisoning (Pediatric)
Learning Disorder
Metabolic (Pediatric)
Neonatal
Neonatal Follow-up
Neonatology
Nephrology (Pediatric)
Newborn
Obesity (Pediatric)
Oncology (Pediatric)
Pediatrics (General)
Perinatal
Phenylketonuria
Prader-Willi Syndrome
Pulmonary (Pediatric)
Renal and Diabetes (Pediatric)
Rheumatic Heart Disease
Rheumatology/Arthritis (Pediatric)
Screening (Pediatric)
Sexual Assault/Abuse (Child)
Short Stay (Pediatric)
Sickle Cell (Child)
Skeletal Dysplasia
Spina Bifida (Child)
Teen Health
Teen-Tot
Teenage
Urgent Care (Pediatric)
Well Child Care
NHAMCS-124 (11-17-2008)
VII OUTPATIENT DEPARTMENT
CLASSIFICATION OF CLINICS
By Specialty Group
OBSTETRICS/GYNECOLOGY (OBG)
Adolescent Gynecology
Antepartum
Birth Control
Dysplasia (Gynecologic)
Endocrinology (Gynecologic)
Endocrinology (Reproductive)
Family Planning
Fertility
Gynecology
Gynecology (Adolescent)
Gynecology (Dysplasia)
Gynecology (Endocrinologic)
Gynecology (Oncologic)
Gynecology (Pediatric)
Gynecology (Preteen)
High Risk Obstetrics
HIV Obstetrics
In Vitro Fertilization
Infertility
Maternal Fetal Medicine
Maternal Health
Maternity
Obstetrics
Oncology (Gynecologic)
Perinatal (Obstetrics)
Postpartum (Obstetrics)
Pregnancy Verification
Prenatal
Prenatal (Obstetrics)
Preteen Gynecology
Reproductive
Reproductive Endocrinology
Well Woman
Women’s Care
Page 16
SUBSTANCE ABUSE (SA)
Alcohol Abuse
Alcohol Detoxification
Alcohol Walk-in
Chemical Dependence
(excluding Methadone Maintenance)
Drug Abuse
(excluding Methadone Maintenance)
Drug Detoxification
(excluding Methadone Maintenance)
Substance Abuse
(excluding Methadone Maintenance)
Walk-in – Alcohol
Women’s Alcohol Program
OTHER (OT)
Anxiety
Behavioral Medicine
Biofeedback
Eating Disorder
General Preventive Medicine
Geriatric Psychiatry
Headache (Neurology)
Hyperbaric oxygen
Mental Health
Mental Hygiene
Myasthenia Gravis
Myelomeningocele
Neurofibromatosis
Neurology (Adult)
Neurology (Pediatric)
Neuromuscular
Neurophysiology
Neuropsychiatry
Neurosensory
Palliative Medicine
Preventive Medicine
Psychiatry (Adolescent)
Psychiatry (Adult)
Psychiatry (Child)
Psychiatry (Geriatric)
Psychiatry (Pediatric)
Psychopharmacology
Sleep Disorder
Sleep Medicine
Toxicology
NHAMCS-124 (11-17-2008)
VIII OUTPATIENT DEPARTMENT
CLASSIFICATION OF CLINICS
INELIGIBLE CLINICS (OS)
EXCLUDE the following clinics from the list of eligible clinics.
Abortion/Pregnancy Termination
Lithotripsy
Mammography
Acupuncture
Methadone Maintenance
Adult Day Care
Nuclear Medicine
Ambulatory Surgery Center
Nurse Clinic/Nurse Only
Amniocentesis
Nutrition
Anesthesia
Occupational Health
Anesthesiology
Occupational Safety & Health
Arthroscopy
Occupational Therapy
Audiology
Optometry
Blood Bank
Oral Surgery
Bone Density Screening
Orthotics
Bronchoscopy
Pain
Pain Block
Cardiac Catheterization
Pain Management
CAT Scan & Imaging
Pain Medicine
Chemotherapy
Partial Hospitalization
Chiropractic
Partial Hospitalization Program (Psyc)
Colonoscopy
Path Lab
Colposcopy
Pathology
Cystoscopy
Pharmacy
Day Hospital
Physiatry
Dental
Physical Medicine
Dental Surgery
Physical Therapy
Diabetic Foot Clinic
Physiotherapy
Podiatry
Diagnostic X-ray (imaging)/Radiology
Preadmission Testing
Dialysis
Pregnancy Termination/Abortion
Dietary
Psychology
Drug Immunotherapy
Pulmonary Function Lab
Echocardiology
Radiation Diagnosis
Electrocardiogram (ECG)
Radiation Oncology
Electroconvulsive Therapy (ECT)
Radiation Therapy
Electromyography
Radiology/Diagnostic X-ray (imaging)
Employee Health Service/Center
Reading & Language
Endoscopy
Reference Lab
Fetal Diagnostic Testing
Reference X-Ray
Rehabilitation
Hearing & Speech
Renal (Kidney) Dialysis
Hemodialysis
Same Day Surgery
Home Intravenous Therapy
School Programs
Imaging & CAT Scan
Sigmoidoscopy
Infusion
Social Work
Infusion Therapy
Speech & Hearing
IV Therapy
Student Health Service/Center
Kidney (Renal) Dialysis
Tele-Health
Laser Surgery
Transfusion
Lasik Surgery
Ultrasound
Vertical Balance
An Ambulatory Surgery Center (ASC) is similar in function to an operating room (OR). In some
hospitals, the ASC is located in the OR. The only purpose of an ASC is to serve as an area where
ambulatory surgery is performed. These areas may include specifically designed surgical suites,
operating suites that are also used for inpatient surgery, and procedure rooms within an outpatient
facility. Data from the 2006 National Survey of Ambulatory Surgery show that the four most commonly
performed procedures were endoscopy of large intestine and endoscopy of small intestine, extraction of
lens, injection of agent into spinal canal, and insertion of prosthetic lens. Physicians who utilize ASCs
are usually staffed in other parts of the hospital or are from private practices; they only use the ASC to
perform the actual surgery.
NHAMCS-124 (11-17-2008)
Page 17
IX AMBULATORY SURGERY CENTER SAMPLING INSTRUCTIONS
Locations within hospitals dedicated exclusively to dentistry,
podiatry, or small procedures (sometimes referred to as "lump
or bump" rooms) are out-of-scope.
A. Determining the Take Every (TE) Number
Use the table on page 19. Get counts of visits from page 19 of the
NHAMCS-101, Questionnaire.
1. Go across the top of the table and find the range that includes the number of visits
expected for the ASC patient visit log/list during the 4-week Reporting Period.
2. Go down the column on the left of the table until you find the range containing
the total number of visits to all ASCs. If you can not find the number of total
visits in any of these ranges (i.e., this number exceeds all ranges), call the
regional office supervisor immediately.
3. Look across the row (line) containing the number of visits to all ASCs and find
where it intersects the column containing the number of visits for the ASC
patient visit log/list. The number located in the box where this column and row
intersect is the Take Every number.
4. Enter this number in column (d) on page 19 of the NHAMCS-101,
Questionnaire and in Section B, item 1, on the cover of the NHAMCS-101(U),
Ambulatory Unit Record. Repeat the process for each ASC patient visit log/list.
5. If an ASC has less than 30 expected visits, then the Take Every number
should be 1.
B. Determining the Random Start Number
Next, select the Random Start numbers. Refer to the label on the back of the
NHAMCS-101, Questionnaire. The label has a row or heading of TE numbers and
a column or left margin of ten numbered rows. Random Start numbers (between 1
and the TE number) are located in the table’s cells. The Random Start number
should NEVER be greater than the Take Every number. To determine the Random
Start number for the first ASC patient visit log/list, follow these steps:
1. You determined the ASC’s TE number above in part VI.A. Find the ASC’s TE
number in the table heading on the label on the back of the NHAMCS-101,
Questionnaire.
2. For the first listed ASC patient visit log/list, start with row 1 (or next available
row if others were previously used), then look across the row and find where it
intersects the column headed by the TE number. The number located in this
cell is the Random Start number.
3. Circle the number and enter it in column (e) on page 19 of the NHAMCS-101,
Questionnaire. Also enter this Random Start number in Section B, item 2, on
the cover of the NHAMCS-101(U), Ambulatory Unit Record.
4. If the Take Every number is 1, then the Random Start number should be 1.
Do the same for any additional ASC patient visit logs/lists, each time using the
appropriate TE determined for the area and the next available row.
Page 18
NHAMCS-124 (11-17-2008)
NHAMCS-124 (11-17-2008)
3
3
3
3
2
2
2
2
2
2
2
2
2
1800–2399
2400–2999
3000–3599
3600–4199
4200–4799
4800–5399
5400–5999
6000–11999
12000–17999
2
3
2
1200–1799
24000–29999
3
2
1100–1199
2
3
2
950–1099
18000–23999
3
2
850–949
4
4
3
4
4
4
4
4
4
4
4
4
4
4
4
4
4
4
4
3
3
3
3
3
3
3
2
3
700–849
2
3
2
500–599
600–699
3
2
350–499
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
4
3
4
3
2
250–349
4
2
3
2
1
21
25
2
1
16
20
120–249
1
11
15
1
1
10
1–119
VISITS TO
ALL ASCs
6
6
6
6
6
6
6
6
6
6
6
6
6
6
6
6
6
5
4
3
2
1
26
30
7
7
7
7
7
7
7
7
7
7
7
7
7
7
7
7
6
5
4
3
2
1
31
35
Page 19
9
9
9
9
9
9
9
9
9
9
9
9
9
9
8
7
6
5
4
3
2
1
41
45
2
3
2
3
8
9
10
15
15
8
9
10
10
10
15
15
15
10
10
10
15
15
10
10
15
10
15
15
10
10
15
10
15
7
7
10
6
5
6
5
4
1
1
4
51
75
46
50
ASC Sampling
8
8
8
8
8
8
8
8
8
8
8
8
8
8
8
7
6
5
4
3
2
1
36
40
20
20
20
20
20
20
20
20
20
20
20
15
10
9
8
7
6
5
4
3
2
1
76
100
25
25
25
25
25
25
25
25
25
25
20
15
10
9
8
7
6
5
4
3
2
1
101
125
30
30
30
30
30
30
30
30
30
25
20
15
10
9
8
7
6
5
4
3
2
1
126
150
35
35
35
35
35
35
35
35
30
25
20
15
10
9
8
7
6
5
4
3
2
1
151
175
40
40
40
40
40
40
40
35
30
25
20
15
10
9
8
7
6
5
4
3
2
1
176
200
45
45
45
45
45
45
40
35
30
25
20
15
10
9
8
7
6
5
4
3
2
1
201
225
VISITS ON INDIVIDUAL AMBULATORY SURGERY CENTER (ASC) LOG
TABLE OF TAKE EVERY NUMBERS
50
50
50
50
50
45
40
35
30
25
20
15
10
9
8
7
6
5
4
3
2
1
226
250
100
100
100
100
50
45
40
35
30
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8
7
6
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251
500
150
150
150
100
50
45
40
35
30
25
20
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9
8
7
6
5
4
3
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1
501
750
200
200
150
100
50
45
40
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20
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9
8
7
6
5
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1
751
1000
250
200
150
100
50
45
40
35
30
25
20
15
10
9
8
7
6
5
4
3
2
1
1001
1250
X AMBULATORY SURGERY CENTER
XI AMBULATORY UNIT DIRECTOR MEETING CHECKLIST
(1) Briefly state the purpose of the NHAMCS.
(2) Explain the ambulatory unit staff members’ involvement with the study. They
will:
☞
List all eligible patient visits during the SPECIFIED 4-week period. Changes to
this reporting period are NOT permitted.
☞
Sample only certain visits using the Take Every and Random Start numbers.
☞
Complete a brief form for each of the sampled visits. Each form should take
about five minutes to complete and, at most, the unit should only have to
complete about 5 forms each day.
(3) Complete sections C through F of the Ambulatory Unit Record.
(4) Ask the director to designate staff to assist with the data collection activities.
Make sure all hours and shifts are covered.
Person completing forms should be knowledgeable about medical care and
services and should have access to the medical records of patient visits.
Person performing listing and sampling should have access to arrival log(s).
Assign one member of the staff as "data coordinator" to oversee patient visit
sampling and completion of Patient Record Forms.
(5) Arrange to meet with a designated staff member.
Page 20
NHAMCS-124 (11-10-2008)
XII AMBULATORY UNIT STAFF INSTRUCTION CHECKLIST
(1) Verify that the patient list kept by ambulatory unit staff is usable for sampling. That is, ALL patient visits
are listed and can be easily counted or numbered. (If not, provide a NHAMCS-103, Optional Patient
Log).
(2) Who to List/Who Not to List on Patient Log
• List every eligible ambulatory patient visit in this unit during the 4-week reporting period.
• Include patients the doctor does not see but who receive care from a physician assistant, nurse,
nurse practitioner, etc.
• Exclude persons who visit only for administrative reasons, such as to complete an insurance form or
pay a bill.
• Exclude patients who do not seek care or services, for example, they come to pick up a prescription
or leave a specimen.
• Exclude visits by persons currently admitted as inpatients to the sample hospital. (Nursing home
patients should be included, however.)
• Exclude telephone contacts with patients.
(3) Explain sampling method —
• Define the Random Start number and explain how it is used only once at the beginning of the reporting
period to start patient visit sampling.
• Discuss the Take Every number and demonstrate an example of its use. Emphasize the
importance of sampling continuously from the patient list – never start over at the
beginning of a new day or shift.
• Show staff the cover of the appropriate department instruction booklet. Take Every and Random Start
numbers are provided at the bottom.
(4) Go over Patient Record form items, paying careful attention to –
Outpatient Department Patient Record Form – NHAMCS-100(OPD)
ITEM 1g – Check the expected source(s) of payment for this visit.
ITEM 2 – Indicate whether the visit was related to an injury, poisoning, or adverse effect of
medical/surgical treatment.
ITEM 3 – When possible, record in patient’s own words using key words and phrases. If the patient is
unable to respond, record the reason as stated by the person accompanying the patient.
ITEM 5a – Diagnosis can be tentative or definitive. However, exclude "rule out" diagnoses. The
diagnoses should relate to the reason for visit recorded in item 3. Enter any other diagnoses
(2 and 3) which exist at time of visit, if they are of any direct concern to the visit.
ITEM 5b – Mark all other chronic diseases that the patient has that were NOT entered in 5a.
ITEM 7 – Mark all diagnostic and/or screening services ordered or provided at this visit. Specify
type for other scope procedure or other exam/test/service and site for biopsy.
ITEM 10 – List up to 8 drugs. Include prescription and over-the-counter medications, immunizations,
allergy shots, and dietary supplements that were ordered, supplied or administered or continued during
the visit. Indicate whether each is "New" or "Continued." Mark "NONE" if applicable.
NHAMCS-124 (11-17-2008)
Page 21
Checklists
ITEM 6 – Record the patient’s height, weight, temperature, and blood pressure in the box next to the
unit of measurement.
Emergency Department Patient Record Form – NHAMCS-100(ED)
ITEM 1a – Indicate the time of day and date (1) when the patient arrived, (2) was seen by provider,
and (3) discharged for this visit from ED. Make sure to indicate if the time is a.m., p.m., or Military.
ITEM 1i – Check the expected source(s) of payment for this visit.
ITEM 2 – Record the patient’s initial temperature, heart rate, respiratory rate, blood pressure, pulse
oximetry if the patient is on oxgen and Glasgow Coma Scale score.
ITEM 4 – When possible, record in patient’s own words using key words and phrases. If the patient is
unable to respond, record the reason as stated by the person accompanying the patient.
ITEM 5c – If the visit was related to an injury, poisoning, or adverse effect of medical/surgical treatment,
describe in detail the events that preceded the injury, poisoning, or adverse effect. For example, driver of
motor vehicle, lifting heavy machinery, bitten by spider, reaction to penicillin, etc. Also indicate where the
injury, poisoning or adverse effect occurred (e.g., home, work, school). Provide as much detail as
possible.
ITEM 6 – Diagnosis can be tentative or definitive. However, exclude "rule out" diagnoses. The
diagnoses should relate to the reason for visit recorded in item 4. Enter any other diagnoses
(2 and 3) which exist at time of visit, if they are of any direct concern to the visit.
ITEM 7 – Mark all diagnostic and/or screening services ordered or provided at this visit.
ITEM 9 – List up to 8 drugs given at this visit or prescribed at ED discharge. Include prescription and
over-the-counter medications, immunizations, and anesthetics. Indicate whether it was "Given in ED" or
"Rx at discharge." Mark "NONE" if applicable.
ITEM 13 – Complete item 13 on the reverse side of the Patient Record form, if the patient was admitted
to the observation unit.
ITEM 14 – Complete item 14 on the reverse side of the Patient Record form, if the patient was admitted
to the observation unit.
Ambulatory Surgery Center Patient Record Form – NHAMCS-100(ASC)
ITEM 1g – Check the expected source(s) of payment for this visit.
ITEM 1h – Indicate (1) the time in to operating room, (2) time surgery began, (3) time surgery ended,
(4) time out of operating room, (5) time in to postoperative care, and (6) time out of postoperative
care. Make sure to indicate if the time is a.m. or p.m. or Military. For example, enter 01:15 for 1:15 a.m.
or 1:15 p.m. Also, check the appropriate box (a.m., p.m., or Military) when recording the times.
Crosscheck the times in each item to ensure they appear sequentially.
ITEM 2 –Diagnoses may be tentative, provisional, or definitive. However, exclude “rule out” diagnoses.
Enter any other diagnoses which exist at the time if they are of any direct concern to the visit. Include
the ICD-9-CM code, if provided. Do not provide codes instead of narratives unless the narratives are not
included in the medical record.
ITEM 4 – List all procedures performed during this visit as they appear in the discharge summary
dictated by the surgeon. Include the ICD-9-CM/CPT-4 code, if provided. Do not provide codes instead of
narratives unless the narratives are not included in the medical record.
ITEM 5a – List up to 8 drugs given at this visit or prescribed at discharge. Include prescription,
over-the-counter medications, immunizations, anesthetics, and oxygen. Indicate whether it was
administered during the visit or at discharge.
ITEM 5b – Record all of the type(s) of anesthesia used during surgery.
ITEM 6 – Mark the specialty of all persons administering anesthesia.
ITEM 7 – Mark only one disposition.
(5) Instruct the hospital staff to refer to the item-by-item instructions in the Emergency Service Area,
Outpatient Department Clinic, or Ambulatory Surgery Center Instruction Booklet, the Emergency Service
Area, Outpatient Department, or Ambulatory Surgery Center Instruction Card, or the Job Aid Booklet for
PRFs if they are unsure of how to complete any items on the Patient Record form.
Remind the staff to tear off the top portion of the form containing the patient’s name and identification
number before they are collected.
Explain that the staff should never borrow Patient Record forms from another participating ambulatory
unit. Should they start running low, they should call you immediately.
(6) Explain that you will return at least once a week to collect completed forms, review the data collection
activities, and assist in any other way needed.
Page 22
NHAMCS-124 (11-17-2008)
XIII QUALITY CONTROL VISIT CHECKLIST
Make weekly quality control visits to:
(1) Verify patient visit log is complete, that is, all eligible patient visits are listed
and all blocks of time the ambulatory unit is open are accounted for on the
log.
(2) Ensure ambulatory unit staff are correctly sampling patient visits:
☞
☞
Are ineligible visits being excluded from the list or the count of visits?
☞
☞
☞
Is the correct Take Every number being used?
Is the correct Random Start number being used to begin the sample
selection? Is it being used only at the beginning of the reporting period?
Is the Take Every number being applied correctly?
Is the sample being selected continuously, i.e., from shift to shift and/or day to
day?
(3) Review completed Patient Record forms paying careful attention to ensure:
☞
Patient Record forms are completed for all patient visits selected from the
patient log
☞
☞
All items on the Patient Record forms have entries
All entries are legible
(4) Check supply of Patient Record forms to ensure there is an adequate supply
remaining to complete the reporting period.
(5) If applicable, examine pad of Patient Visit Logs to ensure the unit has an
adequate supply.
(6) Answer any questions or resolve any problems the staff might be
experiencing.
NHAMCS-124 (11-17-2008)
Page 23
XIV Checklist For Conducting NHAMCS
(Step-by-Step Guide)
Task
Time Schedule and
Sequence for
Completing Forms
Form Used
1. Telephone Screener.
Telephone hospital
administrators to verify
eligibility of hospital to
participate in the study. If
eligible, arrange
appointment for meeting.
Try to get an appointment
as soon as possible.
3 months before assigned
reporting period
NHAMCS-101,
Questionnaire
Section I
2. Induction Interview.
Visit hospital to induct
hospital administrator;
explain data collection
plan; solicit participation.
Attempt to schedule an
appointment within 2 weeks of
telephone screening.
NHAMCS-101,
Questionnaire
Section II
3. Complete Sections III,
IV,and V
(NHAMCS-101). Verify
and collect basic
information on the ED,
OPD and ASC from the
administrator.
During induction interview with
the administrator, if possible.
(You may have to schedule
additional appointments to
complete Sections III, IV, and
V, if the administrator
designates other respondents.)
NHAMCS-101,
Questionnaire
Section III (for ED),
and/or Section IV (for
OPD), and/or Section
V (for ASC)
4. Develop Sampling Plan. After completing Section IV of
the NHAMCS-101.
Sample clinics, if
necessary, and
complete sampling plan
for each ambulatory unit
selected.
Page 24
NHAMCS-101,
Questionnaire
with instructions from
the NHAMCS-124,
Sampling and
Information Booklet
NHAMCS-124 (11-17-2008)
XIV Checklist For Conducting NHAMCS – Continued
(Step-by-Step Guide)
Task
Time Schedule and
Sequence for
Completing Forms
Form Used
5. Complete the
NHAMCS-101(U) for
ambulatory units selected
for participation.
During the meeting with the
NHAMCS-101(U),
directors of each ED/OPD/ASC Ambulatory Unit
ambulatory unit.
Record Section B,
items 3 and 4
Sections C-F
6. Brief outpatient clinic/
emergency service
area/ASC staff on forms
(NHAMCS Patient
Record forms and Patient
Log Forms, if the unit
does not have an
appropriate logging
system) and procedures.
During and after each briefing
session.
NHAMCS-122,
Emergency Service
Area Instruction
Booklet,
NHAMCS-173,
NHAMCS-123,
Outpatient
Department Clinic
Instruction Booklet,
NHAMCS-174, and
NHAMCS-250, Job
Aid Booklet for PRFs
NHAMCS-126
Ambulatory Surgery
Center
Instruction Booklet
7. Perform quality control
visits to ensure data
collection procedures are
being followed accurately.
During regular weekly visits to
each ambulatory unit.
None
8. Collect all completed
forms and perform a
thorough edit. Make
callbacks to retrieve
missing information, if
necessary.
After the weekly QC visit to
each ED/OPD/ASC or after
hospital’s reporting period
when all forms have been
completed.
NHAMCS-131, Edit
Ambulatory Unit
Record
Check List
Complete the cover
items and Section I of
the NHAMCS-122, 123,
and 126 before the
briefing session.
NHAMCS-124 (11-17-2008)
Page 25
XIV Checklist For Conducting NHAMCS – Continued
(Step-by-Step Guide)
Task
9. Record ambulatory unit
patient visit and Patient
Record form totals.
Time Schedule and
Sequence for
Completing Forms
After the reporting period.
Record the final
disposition of each
ambulatory unit.
Form Used
NHAMCS-101(U),
Ambulatory Unit
Record
Section B, items 9
and 10, Section G
NHAMCS-101(U),
Ambulatory Unit
Record
Section H
10. Update appropriate
data coordinator and
hospital staff.
Anytime during the study when
there is a change of staff.
NHAMCS-101(U),
Ambulatory Unit
Record
Section F
11. Complete the disposition
and summary of the
hospital’s participation.
After the reporting period.
NHAMCS-101,
Questionnaire
Section VI
NHAMCS-102,
Transmittal Folder
Complete the
Transmittal Record.
Transmit completed
forms to the RO.
12. Send Thank-You
Letters to hospital
administrators and
other staff who
participated.
Page 26
After the hospital’s reporting
period when all forms have
been edited and transmitted.
NHAMCS-181(L),
Thank-You Letter
(Generic Thank-You
Letter)
NHAMCS-124 (11-17-2008)
NHAMCS-124 (11-17-2008)
Page 27
Job Aids
Pediatric
Pediatric
Pediatric
Pediatric
Gynecology OBG
Neurology OT
Ophthalmology SURG
Orthopedics SURG
Pediatric
Pediatric
Pediatric
Pediatric
Otolaryngology SURG
Plastic Surgery SURG
Psychiatry OT
Scoliosis SURG
Pediatric Spine SURG
Pediatric Surgery SURG
Pediatric Urology SURG
Preteen Gynecology OBG
HIV Obstetrics
Perinatal Obstetrics
Prenatal Obstetrics
Adolescent Gynecology
Endocrinologic Gynecology
Oncologic Gynecology
Pediatric Gynecology
Preteen Gynecology
Surgical Oncology SURG
Pediatric Oncology PED
Radiation Oncology OS
Surgical Oncology SURG
ENDOCRINOLOGY
Endocrinology GM
Gynecologic Endocrinology OBG
Pediatric Endocrinology PED
Reproductive Endocrinology OBG
Dental Surgery (exclusively)
Podiatric Surgery (exclusively)
Small procedure rooms ("Lump and bump" rooms)
Out-of-Scope ASC locations
REMEMBER: This is only a quick reference! Please use the full list starting on page 7 to
determine specialty groups for clinics not listed here.
Breast Medical Oncology GM
Dental Oncology OS
Gynecologic Oncology OBG
Medical Oncology GM
ONCOLOGY
Oncology and Endocrinology belong in the General Medicine specialty group.
HOWEVER, if it is a specialized type of oncologic or endocrinologic clinic, then
the specialized name in the title determines the categorization.
OBSTETRICS
GYNECOLOGY
Any clinic dealing with Obstetrics or Gynecology belongs in the OBG
specialty group, regardless of any other specialization in the clinic name.
Adolescent Gynecology OBG
Adolescent Psychiatry OT
Child Psychiatry OT
Pediatric ENT SURG
Not all Pediatric clinics belong in the PED specialty
group. The following are some exceptions:
NATIONAL HOSPITAL AMBULATORY MEDICAL CARE SURVEY
XV QUICK REFERENCE
Categorizing NHAMCS Clinics and ASCs
XVI HOSPITAL TRAUMA LEVEL RATINGS AND DESCRIPTIONS
National Hospital Ambulatory Medical Care Survey
NHAMCS-101, Item 9c (Page 4)
Level I – Provides comprehensive trauma care, serves as a regional resource, and
provides leadership in education, research, and system planning.
A level I center is required to have immediate availability of trauma surgeons,
anesthesiologists, physician specialists, nurses, and resuscitation equipment. American
College of Surgeons’ volume performance criteria further stipulate that level I centers
treat 1200 admissions a year, 240 major trauma patients per year, or an average of 35
major trauma patients per surgeon.
Level II – Provides comprehensive trauma care either as a supplement to a level I
trauma center in a large urban area or as the lead hospital in a less population-dense
area.
Level II centers must meet essentially the same criteria as level I, but volume
performance standards are not required and may depend on the geographic area
served. Centers are not expected to provide leadership in teaching and research.
Level III – Provides prompt assessment, resuscitation, emergency surgery, and
stabilization with transfer to a level I or II as indicated.
Level III facilities typically serve communities that do not have immediate access to a
level I or II trauma center.
Level IV & V – Provides advanced trauma life support prior to patient transfer in
remote areas in which no higher level of care is available.
The key role of the level IV center is to resuscitate and stabilize patients and arrange
for their transfer to the closest, most appropriate trauma center level facility.
Level V trauma centers are not formally recognized by the American College of
Surgeons, but they are used by some states to further categorize hospitals providing
life support prior to transfer.
Page 28
NHAMCS-124 (11-17-2008)
XVII NHAMCS-101, Item 14e, 14x, and 15g Flashcard
Are there any of the above features of your system that
your ED/OPD/ASC does NOT use or has turned off?
(1) Patient demographic information?
If ‘Yes’, ask- Does this include patient problem lists?
(2) Orders for prescriptions?
If ‘Yes’, ask- (a) Are there warnings of drug interactions
or contraindications provided?
(b) Are prescriptions sent electronically to
the pharmacy?
(3) Orders for tests?
If ‘Yes’, ask- Are orders sent electronically?
(4) Viewing of lab results?
If ‘Yes’, ask- Are out of range levels highlighted?
(5) Viewing of imaging results?
If ‘Yes’, ask- Can electronic images be viewed?
(6) Clinical notes?
If ‘Yes’, ask- Do they include medical history and
follow-up notes?
(7) Reminders for guideline-based interventions
and/or screening tests?
(8) Public health reporting?
If ‘Yes’, ask- Are notifiable diseases sent electronically?
NHAMCS-124 (11-17-2008)
Page 29
XVIII NHAMCS-101, Item 14s Flashcard
Which of the following procedures does
your ED use?
1. Bedside registration
2. Computer-assisted triage
3. Separate fast track for non-urgent care
4. Separate operating room dedicated
to ED patients
5. Electronic dashboard (i.e., displays updated
patient information and integrates multiple
data sources)
6. Radio frequency identification (RFID)
tracking (i.e., shows exact location of
patients, caregivers, and equipment)
7. Zone nursing (i.e., all of nurse’s patients
are located in one area)
8. "Pool" nurses (i.e., nurses that can be
pulled to the ED to respond to surges
in demand)
9. Full capacity protocol (i.e., allows some
admitted patients to move from the ED to
inpatient corridors while awaiting a bed)
10. None of the above
Page 30
NHAMCS-124 (11-17-2008)
| File Type | application/pdf |
| File Modified | 2008-11-18 |
| File Created | 2008-11-17 |