Attachment M - Sampling and Information Booklet

2009
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

(8-28-2008)

US

U.S.
D

BU

NHAMCS-124

ENT OF C
TM
O
AR

CE
ER
M
M

EP

U.S. CENSUS BUREAU

TABLE OF CONTENTS

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

Ambulatory Surgery Center Sampling Instruction . . . . . . . . . . . . . . . . . . . . . . . .

7

VII Ambulatory Surgery Census Table of Take Every Numbers . . . . . . . . . . . . . . .

8

VIII OPD Classification of Clinics – Alphabetic Listing

10

IX

OPD Classification of Clinics – By Specialty Group

16

X

OPD Listing of Ineligible Clinics

20

XI

Ambulatory Unit Director Meeting Checklist

21

XII Ambulatory Unit Staff Instruction Checklist

22

XIII Quality Control Visit Checklist

24

XIV Checklist for Conducting NHAMCS

25

XV Quick Reference, Categorizing NHAMCS Clinics . . . . . . . . . . . . . . . . . . . . . . .

28

XVI NHAMCS-101, Item 9c, Hospital Trauma Level Ratings and Descriptions . .

29

XVII NHAMCS-101, Item 14o, Flashcard . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

30

NHAMCS-124 (8-28-2008)

Page 1

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.
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 service area. 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 service area listed.
5. If an ESA 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 emergency service area listed, follow these steps:
1. You determined the service area’s TE number above in part I.A. Find the
service area’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 (8-28-2008)

TABLE OF TAKE EVERY NUMBERS

6000–11999

5400–5999

4800–5399

4200–4799

3600–4199

3000–3599

2400–2999

1800–2399

1200–1799

1100–1199

950–1099

850–949

700–849

600–699

500–599

350–499

250–349

120–249

1–119

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1
39

2

2

2

2

2

2

2

2

2

2

2

2

2

2

2

2

2

2

2

2

1

40
79

3

3

3

3

3

3

3

3

3

3

3

3

3

3

3

3

3

3

3

3

2

1

4

4

4

4

4

4

4

4

4

4

4

4

4

4

4

4

4

4

4

3

2

NA

5

5

5

5

5

5

5

5

5

5

5

5

5

5

5

5

5

5

4

3

2

NA

6

6

6

6

6

6

6

6

6

6

6

6

6

6

6

6

6

5

4

3

2

NA

7

7

7

7

7

7

7

7

7

7

7

7

7

7

7

7

6

5

4

3

2

NA

8

8

8

8

8

8

8

8

8

8

8

8

8

8

8

7

6

5

4

3

2

NA

9

9

9

9

9

9

9

9

9

9

9

9

9

9

8

7

6

5

4

3

NA

NA

10

10

10

10

10

10

10

10

10

10

10

10

10

9

8

7

6

5

4

3

NA

NA

15

15

15

15

15

15

15

15

15

15

15

15

10

9

8

7

6

5

4

NA

NA

NA

20

20

20

20

20

20

20

20

20

20

20

15

10

9

8

7

6

NA

NA

NA

NA

NA

25

25

25

25

25

25

25

25

25

25

20

15

10

9

8

NA

NA

NA

NA

NA

NA

NA

30

30

30

30

30

30

30

30

30

25

20

15

NA

NA

NA

NA

NA

NA

NA

NA

NA

NA

35

35

35

35

35

35

35

35

30

25

20

15

NA

NA

NA

NA

NA

NA

NA

NA

NA

NA

40

40

40

40

40

40

40

35

30

25

20

NA

NA

NA

NA

NA

NA

NA

NA

NA

NA

NA

45

45

45

45

45

45

40

35

30

25

20

NA

NA

NA

NA

NA

NA

NA

NA

NA

NA

NA

50

50

50

50

50

45

40

35

30

25

NA

NA

NA

NA

NA

NA

NA

NA

NA

NA

NA

NA

90

90

90

90

50

45

40

35

30

25

NA

NA

NA

NA

NA

NA

NA

NA

NA

NA

NA

NA

150

150

150

100

50

45

40

35

30

NA

NA

NA

NA

NA

NA

NA

NA

NA

NA

NA

NA

NA

200

200

150

100

50

45

40

35

NA

NA

NA

NA

NA

NA

NA

NA

NA

NA

NA

NA

NA

NA

250

200

150

100

NA

NA

NA

NA

NA

NA

NA

NA

NA

NA

NA

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

NA

NA

NA

NA

250

200

150

NA

NA

NA

NA

NA

NA

NA

NA

NA

NA

NA

NA

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

NA

NA

NA

NA

VISITS TO THE INDIVIDUAL EMERGENCY SERVICE AREAS

12000–17999

1

2

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

18000–23999

1

VISITS TO
THE ENTIRE
ED

24000–30000

NHAMCS-124 (8-28-2008)

Page 3

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 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 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 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 (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 (8-28-2008)

TABLE OF TAKE EVERY NUMBERS

60000–74999

40000–59999

20000–39999

15000–19999

13500–14999

12000–13499

10500–11999

9000–10499

7500–8999

5500–7499

3500–5499

2500–3499

1750–2499

1500–1749

1350–1499

1200–1349

1050–1199

900–1049

750–899

600–749

350–599

1–349

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1

1
39

2

2

2

2

2

2

2

2

2

2

2

2

2

2

2

2

2

2

2

2

2

2

2

2

40
79

3

3

3

3

3

3

3

3

3

3

3

3

3

3

3

3

3

3

3

3

3

3

3

3

2

4

4

4

4

4

4

4

4

4

4

4

4

4

4

4

4

4

4

4

4

4

4

4

3

2

5

5

5

5

5

5

5

5

5

5

5

5

5

5

5

5

5

5

5

5

5

5

4

3

2

6

6

6

6

6

6

6

6

6

6

6

6

6

6

6

6

6

6

6

6

6

5

4

3

2

7

7

7

7

7

7

7

7

7

7

7

7

7

7

7

7

7

7

7

7

6

5

4

3

2

8

8

8

8

8

8

8

8

8

8

8

8

8

8

8

8

8

8

8

7

6

5

4

3

2

9

9

9

9

9

9

9

9

9

9

9

9

9

9

9

9

9

9

8

7

6

5

4

3

2

10

10

10

10

10

10

10

10

10

10

10

10

10

10

10

10

10

9

8

7

6

5

4

3

2

15

15

15

15

15

15

15

15

15

15

15

15

15

15

15

15

10

9

8

7

6

5

4

3

NA

20

20

20

20

20

20

20

20

20

20

20

20

20

20

20

15

10

9

8

7

6

5

4

NA

NA

30

30

30

30

30

30

30

30

30

30

30

30

30

30

20

15

10

9

8

7

6

NA

NA

NA

NA

40

40

40

40

40

40

40

40

40

40

40

40

40

30

20

15

10

9

8

NA

NA

NA

NA

NA

NA

50

50

50

50

50

50

50

50

50

50

50

50

40

30

20

15

10

NA

NA

NA

NA

NA

NA

NA

NA

60

60

60

60

60

60

60

60

60

60

60

50

40

30

20

15

NA

NA

NA

NA

NA

NA

NA

NA

NA

70

70

70

70

70

70

70

70

70

70

60

50

40

30

20

15

NA

NA

NA

NA

NA

NA

NA

NA

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

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

VISITS TO THE INDIVIDUAL OUTPATIENT CLINICS

75000–89999
1
2

80 120 150 180 210 240 270 300 400 600 900 1200 1500 1800 2100 2400 2700 3000 4000 10000 12000 15000 18000
119 149 179 209 239 269 299 399 599 899 1199 1499 1799 2099 2399 2699 2999 3999 9999 11999 14999 17999 20999

90000–104999
1

VISITS TO
THE ENTIRE
OPD

105000–119999

NHAMCS-124 (8-28-2008)

Page 5

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 15 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 (c) 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 (8-28-2008)

NHAMCS-124 (8-28-2008)

Page 7

VI AMBULATORY SURGERY CENTER SAMPLING INSTRUCTIONS
A. Determining the Take Every (TE) Number
Use the table on page 9. 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.
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 ASC. 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
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 service area’s TE number above in part VI.A. Find the
service area’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 8

NHAMCS-124 (8-28-2008)

TABLE OF TAKE EVERY NUMBERS

6000–11999

5400–5999

4800–5399

4200–4799

3600–4199

3000–3599

2400–2999

1800–2399

1200–1799

1100–1199

950–1099

850–949

700–849

500–599

350–499

250–349

120–249

1–119

2

2

2

2

2

2

2

2

2

2

2

2

2

2

2

2

2

2

2

1

1
10

3

3

3

3

3

3

3

3

3

3

3

3

3

3

3

3

3

3

3

2

1

11
15

4

4

4

4

4

4

4

4

4

4

4

4

4

4

4

4

4

4

4

4

3

1

16
20

5

5

5

5

5

5

5

5

5

5

5

5

5

5

5

5

5

5

4

3

2

1

21
25

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

8

8

8

8

8

8

8

8

8

8

8

8

8

8

8

7

6

5

4

3

2

1

36
40

9

9

9

9

9

9

9

9

9

9

9

9

9

9

8

7

6

5

4

3

2

1

41
45

10

10

10

10

10

10

10

10

10

10

10

10

10

9

8

7

6

5

4

3

2

1

46
50

15

15

15

15

15

15

15

15

15

15

15

15

10

9

8

7

6

5

4

3

2

1

51
75

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

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

25

20

15

10

9

8

7

6

5

4

3

2

1

251
500

150

150

150

100

50

45

40

35

30

25

20

15

10

9

8

7

6

5

4

3

2

1

501
750

200

200

150

100

50

45

40

35

30

25

20

15

10

9

8

7

6

5

4

3

2

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

VISITS ON INDIVIDUAL AMBULATORY SURGERY CENTER LOG

12000–17999
2
3

VISITS TO
ALL ASCs

18000–23999
2

600–699

24000–29999

NHAMCS-124 (8-28-2008)

Page 9

VII AMBULATORY SURGERY CENTER

VIII 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 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

B
Back Care, SURG
Behavior & Development (Child), PED
Behavioral Medicine, OTH
Biofeedback, OT
Birth Control, OBG
Birth Defect, PED
Blood Bank, OS
Page 10

Bone Density Screening, OS
Bone Marrow Aspiration, SURG
Bone Marrow Transplant, SURG
Brain Tumor, GM
Breast, SURG
Breast Care, SURG
Breast Medical Oncology, GM
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

NHAMCS-124 (8-28-2008)

VIII 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
Cricital 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
NHAMCS-124 (8-28-2008)

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

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

Page 11

VIII OUTPATIENT DEPARTMENT
CLASSIFICATION OF CLINICS
Alphabetic Listing – Continued
H – Continued
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

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
Page 12

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 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

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

NHAMCS-124 (8-28-2008)

VIII 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, OT
Pain Management, OT
Pain Medicine, OT
Palliative Medicine, OT
Partial Hospitalization, OS
Partial Hospitalization Program (Psyc), OS

NHAMCS-124 (8-28-2008)

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

Page 13

VIII 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

Page 14

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 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
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
NHAMCS-124 (8-28-2008)

VIII 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
Substance Abuse, SA

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
Travel Medicine, GM
Tuberculosis, GM
Tumor (Brain & Other), GM

NHAMCS-124 (8-28-2008)

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

Page 15

IX 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

Page 16

Infectious Diseases (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
Tuberculosis
Travel Medicine
Tumor
Urgent Care
Vascular
Walk-in and/or Screening
Weight Management
Wellness
NHAMCS-124 (8-28-2008)

IX 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
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
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.

NHAMCS-124 (8-28-2008)

Page 17

IX 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
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 18

Hemophilia (Child)
High Risk Pediatrics
HIV Pediatrics
Hyperlipidemia (Pediatric)
Immunization
Immunology (Pediatric)
Infectious Diseases (Pediatric)
Internal Medicine (Pediatric)
Lead Poisoning (Pediatric)
Learning Disorder
Metabolic (Pediatric)
Neonatal
Neonatal Follow-up
Neonatology
Nephrology (Pediatric)
Newborn
Obesity (Pediatric)
Oncology (Pediatric)
Pediatrics
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)
Spina Bifida (Child)
Teen Health
Teen-Tot
Teenage
Urgent Care (Pediatric)
Well Child Care

NHAMCS-124 (8-28-2008)

IX 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 Health
Maternity
Obstetrics
Oncology (Gynecologic)
Perinatal (Obstetrics)
Postpartum (Obstetrics)
Pregnancy Verification
Prenatal
Prenatal (Obstetrics)
Preteen Gynecology
Reproductive
Reproductive Endocrinology
Well Woman
Women’s Care

NHAMCS-124 (8-28-2008)

SUBSTANCE ABUSE (SA)
Alcohol Abuse
Alcohol Detoxification
Alcohol Walk-in
Chemical Dependency
(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
Pain
Pain Medicine
Pain Management
Palliative Medicine
Preventive Medicine
Psychiatry (Adolescent)
Psychiatry (Adult)
Psychiatry (Child)
Psychiatry (Geriatric)
Psychiatry (Pediatric)
Psychopharmacology
Sleep Disorder
Sleep Medicine
Toxicology
Page 19

X

OUTPATIENT DEPARTMENT
CLASSIFICATION OF CLINICS
INELIGIBLE CLINICS (OS)

EXCLUDE the following clinics from the list of eligible clinics.
Abortion/Pregnancy Termination
Lithotripsy
Acupuncture
Mammography
Adult Day Care
Methadone Maintenance
Ambulatory Surgery Center
Nuclear Medicine
Amniocentesis
Nurse Clinic/Nurse Only
Anesthesia
Nutrition
Anesthesiology
Occupational Health
Arthroscopy
Occupational Safety & Health
Audiology
Occupational Therapy
Blood Bank
Optometry
Bone Density Screening
Oral Surgery
Bronchosopy
Orthotics
Cardiac Catheterization
Partial Hospitalization
CAT Scan & Imaging
Partial Hospitalization Program (Psyc)
Chemotherapy
Path Lab
Chiropractic
Pathology
Colonoscopy
Pharmacy
Colposcopy
Physiatry
Cystoscopy
Physical Medicine
Day Hospital
Physical Therapy
Dental
Physiotherapy
Dental Surgery
Podiatry
Diabetic Foot Clinic
Preadmission Testing
Diagnostic X-ray (imaging)/Radiology
Pregnancy Termination/Abortion
Dialysis
Psychology
Dietary
Pulmonary Function Lab
Drug Immunotherapy
Radiation Diagnosis
Echocardiology
Radiation Oncology
Electrocardiogram (ECG)
Radiation Therapy
Electroconvulsive Therapy (ECT)
Radiology/Diagnostic X-ray (imaging)
Electromyography
Reading & Language
Employee Health Service/Center
Reference Lab
Endoscopy
Reference X-Ray
Fetal Diagnostic Testing
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 1995 National Survey of Ambulatory Surgery show that the four most commonly
performed procedures were extraction of lens, endoscopy of large intestine, insertion of prosthetic lens,
and endoscopy of small intestine. Physicians who utilize ASC’s are usually staffed in other parts of the
hospital or are from private practices; they only use the ASC to perform the actual surgery.
Page 20

NHAMCS-124 (8-28-2008)

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 or 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.

NHAMCS-124 (8-28-2008)

Page 21

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 6 – Record the patient’s height, weight, temperature, and blood pressure in the box next to the
type of measurement.
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.

Page 22

NHAMCS-124 (8-28-2008)

Emergency Department Patient Record Form – NHAMCS-100(ED)
ITEM 1a – Indicate (1) the time of day the patient arrived, (2) time seen by physician, and (3) time of
discharge for this visit. Make sure to indicate if the time is AM, PM or military and to mark the box if the
patient was discharged more than 24 hours from the arrival time.
ITEM 1i – Check the primary expected source of payment for this visit.
ITEM 2 – Record the patient’s initial temperature, heart rate, respiratory rate, blood pressure, pulse
oximetry, and orientation.
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), and if it was intentional. 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 12 – Complete item 12 on the reverse side of the Patient Record form, if the patient was admitted
to the hospital.
(5) Instruct the hospital staff to refer to the item-by-item instructions in the Emergency Service Area or
Outpatient Department Clinic Instruction Booklet, the Emergency Service Area or Outpatient Department
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.

NHAMCS-124 (8-28-2008)

Page 23

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.

Page 24

NHAMCS-124 (8-28-2008)

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.

NHAMCS-124 (8-28-2008)

NHAMCS-101,
Questionnaire
with instructions from
the NHAMCS-124,
Sampling and
Information Booklet

Page 25

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
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
NHAMCS-176

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 call
backs 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.

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NHAMCS-124 (8-28-2008)

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 coodinator 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.

NHAMCS-124 (8-28-2008)

After the hospital’s reporting
period when all forms have
been edited and transmitted.

NHAMCS-181(L),
Thank-You Letter
(Generic Thank-You
Letter)

Page 27

Page 28

XV. QUICK REFERENCE
Categorizing NHAMCS Clinics
NATIONAL HOSPITAL AMBULATORY MEDICAL CARE SURVEY

Not all Pediatric clinics belong in the PED specialty
group. The following are some exceptions:
Adolescent Gynecology OBG
Adolescent Psychiatry OT
Child Psychiatry OT
Pediatric ENT SURG

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

Any clinic dealing with Obstetrics or Gynecology belongs in the OBG
specialty group, regardless of any other specialization in the clinic name.
GYNECOLOGY

OBSTETRICS

Adolescent Gynecology
Endocrinologic Gynecology
Oncologic Gynecology
Pediatric Gynecology
Preteen Gynecology

HIV Obstetrics
Perinatal Obstetrics
Prenatal Obstetrics

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.
ONCOLOGY
NHAMCS-124 (8-28-2008)

Breast Medical Oncology GM
Dental Oncology OS
Gynecologic Oncology OBG
Medical Oncology GM

Surgical Oncology SURG
Pediatric Oncology PED
Radiation Oncology OS
Surgical Oncology SURG

ENDOCRINOLOGY
Endocrinology GM
Gynecologic Endocrinology OBG
Pediatric Endocrinology PED
Reproductive Endocrinology OBG

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.

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.

NHAMCS-124 (8-28-2008)

Page 29

XVII. NHAMCS-101 Item 14o 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

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NHAMCS-124 (8-28-2008)