Ambulation Date (v2019A1)

Specifications Manual for Joint Commission National Quality Measures (v2019A1)

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Release Notes:
Data Element
Version 2019A1

Name:

Ambulation Date

Collected For:

THKR-IP-2, THKR-OP-2

Definition:

The date the patient first ambulated following the surgical procedure.

Question:

On what date did the patient first ambulate following the surgical procedure?

Format:

Length:	10 – MM-DD-YYYY (includes dashes) or UTD
Type:	Date
Occurs:	1

Allowable Values:

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

Notes for Abstraction:

Select “UTD” if unable to determine the ambulation date.
Review the record to determine the earliest date the patient ambulated following the surgical procedure. There is no minimum distance requirement.
Ambulation with assistive devices (e.g., walker, cane) and/or physical assist (e.g., therapist, nurse) is acceptable.
Ambulation in the PACU is acceptable.
Documentation that the patient actually ambulated must be present. Do not assume the patient ambulated based solely on documentation that physical/occupational therapy saw the patient.
See the list of terms listed in the Inclusion/Exclusion Guidelines to determine if documentation supports ambulation.
Ambulation can be documented by any member of the healthcare team including but not limited to physician, advanced practice nurse, physician assistant, nurse, nurse assistant, clinical technician, physical therapist, occupational therapist, kinesiotherapist.
When the date documented is obviously invalid (not a valid format/range), e.g., a date after the Discharge Date or Outpatient Departure Date, or in an invalid format (12-39-20xx), and if no other documentation is found that provides the correct information, the abstractor should select “UTD.”
Example:
- Patient discharged on 02-12-20xx and documentation indicates the Ambulation Date was 03-12-20xx. Other documentation in the medical record supports the date of discharge as being accurate. Since the Ambulation Date is outside of the parmeter for care (after the Discharge Date), the abstractor should select “UTD.”
If the Ambulation Date is incorrect (in error) but it is a valid date and the correct date can be found and supported with other documentation in the medical record, use the correct date for Ambulation Date. If supporting documentation of the correct date cannot be found, the medical record must be abstracted as documented (at “face value.”)
Example:
- The patient underwent surgery on 12-10-2009. Nursing documentation indicates that the patient first ambulated on 12-10-2007 and the physical therapy documentation supports that the correct date was 12-10-2009; use the correct date (12-10-2009) as the Ambulation Date.

Suggested Data Sources:

Nursing notes
Progress notes
Flowsheets
PACU records
Rehabilitation records
Therapy notes (e.g., physical therapy, occupational therapy, kinesiotherapy)

Additional Notes:

Guidelines for Abstraction:

Inclusion

Exclusion

Ambulate
Step
Walk

Bedside commode usage
Dangle
Out of bed order
Sit in bed
Sit out of bed
Sit to Stand
Stand
Transfer from bed to chair
Up to chair

Specifications Manual for Joint Commission National Quality Measures (v2019A1)
Discharges 10-01-19 through 12-31-19 (4Q19)

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