Specifications Manual for Joint Commission National Quality Measures (v2018A1)
Home » Arrival Date

Release Notes:
Data Element
Version 2018A1

Data Element Name: Arrival Date
Collected For: ASR-IP-1, ASR-IP-2, CSTK-01, CSTK-03, CSTK-05, CSTK-06, CSTK-07, CSTK-09, CSTK-11, STK-4, STK-5
Definition:The earliest documented month, day, and year the patient arrived at the hospital.
Suggested Data Collection Question:What was the earliest documented date the patient arrived at the hospital?
Format:
Length:10 — MM-DD-YYYY (includes dashes) or UTD
Type:Date
Occurs:1
Allowable Values:

Enter the earliest documented date

MM = Month (01-12)
DD = Day (01-31)
YYYY = Year (20xx)
UTD = Unable to Determine

Notes for Abstraction:
  • If the date of arrival is unable to be determined from medical record documentation, select “UTD".”
  • The medical record must be abstracted as documented (taken at “face value”). When the date documented is obviously in error (not a valid format/range or outside of the parameters of care [after the Discharge Date] and no other documentation is found that provides this information, the abstractor should select “UTD".” Examples:
    • Documentation indicates the Arrival Date was 03- 42 -20xx. No other documentation in the list of Only Acceptable Sources provides a valid date. Since the Arrival Date is outside of the range listed in the Allowable Values for “Day”, it is not a valid date and the abstractor should select “UTD".”
    • Patient expires on 02-12-20xx and all documentation within the Only Acceptable Sources indicates the Arrival Date was 03-12-20xx. Other documentation in the medical record supports the date of death as being accurate. Since the Arrival Date is after the Discharge Date (death), it is outside of the parameter of care and the abstractor should select “UTD".”
Note: Transmission of a case with an invalid date as described above will be rejected from the CMS Clinical Warehouse and the Joint Commission's Data Warehouse. Use of “UTD” for Arrival Date allows the case to be accepted into the warehouse.
  • Review the Only Acceptable Sources to determine the earliest date the patient arrived at the ED, nursing floor, or observation, or as a direct admit to the cath lab. The intent is to utilize any documentation which reflects processes that occurred after arrival at the ED or after arrival to the nursing floor/observation/cath lab for a direct admit.
  • Documentation outside of the Only Acceptable Sources list should NOT be referenced (e.g., ambulance record, physician office record, H&P). Examples:
    • ED Triage Date/Time 03-22-20xx 2355. ED rhythm strip dated/timed 03-23-20xx 0030. EMS report indicates patient was receiving EMS care from 0005 through 0025 on 03-23-20xx. The EMS report is disregarded. Enter 03-22-20xx for Arrival Date.
    • ED noted arrival time of 0100 on 04-14-20xx. Lab report shows blood culture collected at 2345 on 04-13-20xx. It is not clear that the blood culture was collected in the ED because the lab report does not specify it was collected in the ED (unable to confirm lab report as an Only Acceptable Source). Enter 04-14-20xx for Arrival Date.
    • ED Triage Date/Time 06-18-20xx 0025. EMS report indicates patient arrived by ambulance on 06-17-20xx 2355. Patient routed directly to CT. The EMS report is disregarded. Enter 06-18-20xx for Arrival Date.
  • Arrival date should NOT be abstracted simply as the earliest date in one of the Only Acceptable Sources, without regard to other substantiating documentation. When looking at the Only Acceptable Sources, if the earliest date documented appears to be an obvious error, this date should not be abstracted. Examples:
    • ED arrival time noted as 0030 on 10-29-20xx. ED MAR shows an antibiotic administration time of 0100 on 10-28-20xx. Surrounding documentation on the ED MAR makes clear that the 10-28-20xx date is an obvious error - Date was not changed to 10-29-20xx. The antibiotic administration date/time would be converted to 0100 on 10-29-20xx. Enter 10-29-20xx for Arrival Date.
    • ED MAR shows an antibiotic administration time of 1430 on 11-03-20xx. All other dates in the ED record note 12-03-20xx. The antibiotic administration date of 11-03-20xx would not be used for Arrival Date because it is an obvious error.
    • ED ECG dated/timed as 05-07-20xx 2142. ED Greet Date/Time 05-08-20xx 0125. ED Triage Date/Time 05-08-20xx 0130. There is no documentation in the Only Acceptable Sources which suggests the 05-07-20xx is an obvious error. Enter 05-07-20xx for Arrival Date.
    • ED RN documents on a nursing triage note dated 04-24-20xx, “Blood culture collected at 2230.” ED arrival time is documented as 0130 on 04-25-20xx. There is no documentation in the Only Acceptable Sources which suggests the 04-24-20xx is an obvious error. Enter 04-24-20xx for Arrival Date.
  • The source “Emergency Department record”" includes any documentation from the time period that the patient was an ED patient — (e.g., ED face sheet, ED consent/Authorization for treatment forms, ED/Outpatient Registration/sign-in forms, ED vital sign record, ED triage record, ED physician orders, ED ECG reports, ED telemetry/rhythm strips, ED laboratory reports, ED x-ray reports, ED head CT scan, CTA, MRI, MRA reports).
  • The source “Procedure notes” refers to procedures such as cardiac caths, endoscopies, and surgical procedures. Procedure notes do not include ECG and x-ray reports.
  • The arrival date may differ from the admission date.
  • If the patient is in either an outpatient setting of the hospital other than observation status (e.g., dialysis, chemotherapy, cardiac cath) or a SNF unit of the hospital, and is subsequently admitted to acute inpatient, use the date the patient arrived at the ED or on the floor for acute inpatient care as the arrival date.
  • Observation status:
    • If the patient was admitted to observation from an outpatient setting of the hospital, use the date the patient arrived at the ED or on the floor for observation care as the arrival date.
    • If the patient was admitted to observation from the ED of the hospital, use the date the patient arrived at the ED as the arrival date.
  • Direct Admits:
    • If the patient is a “Direct Admit" to the cath lab, use the earliest date the patient arrived at the cath lab (or cath lab staging/holding area) as the arrival date.
    • For “Direct Admits” to acute inpatient or observation, use the earliest date the patient arrived at the nursing floor or in observation (as documented in the Only Acceptable Sources) as the arrival date.
  • If the patient was transferred from your hospital's satellite/free-standing ED or from another hospital within your hospital's system (as an inpatient or ED patient), and there is one medical record for the care provided at both facilities, use the arrival date at the first facility.
    CSTK, STK, AND ASR MEASURES ONLY
    EXCEPTION: Use the arrival date at the comprehensive stroke center/primary stroke center.
Suggested Data Sources:

ONLY ACCEPTABLE SOURCES:
  • Emergency department record
  • Nursing admission assessment/admitting note
  • Observation record
  • Procedure notes
  • Vital signs graphic record
Additional Notes:
Guidelines for Abstraction:
Inclusion Exclusion
None Addressographs/Stamps

Arrival Date
Specifications Manual for Joint Commission National Quality Measures (v2018A1)
Discharges 07-01-18 (3Q18) through 12-31-18 (4Q18)
^