Leading the Way to Zero | The Joint Commission
Patient NameUnique Patient IdentifierBirthdateAdmission DateDischarge DateICD-10 Principal DX CodeICD-10 Other DX CodeICD-10 Other DX CodeICD-10 Other DX CodeICD-10 Principal Procedure CodeICD-10 Principal Procedure DateICD-10 Other Procedure CodesICD-10 Other Procedure CodesICD-10 Other Procedure CodesAmbulation YES or NOAmbulation Date/TimeDischarge Disposition1 Home2 Hospice-Home3 Hospice-Health Care Facility4 Acute Care Facility5 Other Health Care Facility6 Expired7 Left AMA8 Not Documented or UTDPACU Discharge Date/TimePostop ICU Admit or TransferYES or NOPreop Assessments CompletedYES or NOPreop Assessments Completion DateReason for No Regional AnesthesiaYES or NOReason for Not Ambulating the Day of SurgeryYES or NOReason for Not Discharging Patient to HomeYES or NORegional AnesthesiaThere is documentation that the procedure was performed using regional anesthesia.There is documentation that regional anesthesia was attempted but unsuccessful.There is no documentation that the procedure was performed using regional, nor attempted or UTD.Resident of Other Health Care FacilityYES or NOIMPORTANT: REFER TO IMPLEMENTATION GUIDE FOR MEASURE INFORMATION FORMS, ALGORITHMS, DATA ELEMENT DEFINITIONS AND NOTES FOR ABSTRACTIONPLEASE NOTE: THIS IS A SAMPLE TOOL AND IS PROVIDED AS AN EXAMPLE OF HOW YOU MAY CHOOSE TO FORMAT YOUR DATA COLLECTION TOOL; A DATA COLLECTION TOOL IS NOT REQUIRED. ................
................
In order to avoid copyright disputes, this page is only a partial summary.
To fulfill the demand for quickly locating and searching documents.
It is intelligent file search solution for home and business.
Related searches
- the joint commission universal protocol
- the joint commission manual pdf
- the joint commission and medicare standards
- the joint commission approved abbreviations
- the joint commission accreditation manual
- the joint commission specifications manual
- the joint commission hospital compare
- the joint commission amp system
- the joint commission resources amp
- the joint commission accreditation standards
- the joint commission manual 2020
- the joint commission accredited hospitals