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Hospitalization Risk Assessment - CHAMP 2026
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- Click ‘Get Form’ to open the Hospitalization Risk Assessment - CHAMP in the editor.
- Begin by entering the Patient Name and Record Number at the top of the form. Ensure accuracy as this information is crucial for tracking.
- In the 'Prior pattern' section, check all applicable boxes indicating any hospitalizations or ER visits within the past year.
- Move to the 'Chronic conditions' section. Check all relevant conditions that apply to the patient, such as diabetes or COPD.
- Next, review the 'Risk Factors' section. Carefully check all factors that may contribute to hospitalization risk, ensuring a comprehensive assessment.
- Calculate and note the total number of checked boxes at the end of this section. This score can help identify patients at high risk.
- Proceed to document any patient-specific interventions required based on identified risks, including referrals and education needs.
- Finally, ensure that all necessary notifications are documented before signing and dating the form at the bottom.
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