The Canadian Institute for Health Information (CIHI) is pleased to provide its clients with the DAD Abstracting Manual, 2016–2017 Edition for the Discharge Abstract Database and the NACRS Abstracting Manual, 2016–2017 Edition for the National Ambulatory Care Reporting System.

Accessing the manuals

For Core Plan clients

  • Log in and click DAD/NACRS Abstracting Manuals. ​

Registered users who do not have the DAD/NACRS Abstracting Manual service will need to submit a request using the Request Access: New/Revoke tool found within their CIHI profile.

Non-registered users will first need to create a client services profile by selecting Create a profile and then submitting a request for access via the Request Access: New/Revoke tool.

Instructions to create a profile and/or request access can be found in our frequently asked questions about accessing our services. Please contact CIHI's Central Client Services team by email ( or by phone (613-241-5543) should you require any assistance with your profile or submitting an access request.

For all other clients

Clients who do not subscribe to the Core Plan can order the DAD Abstracting Manual or NACRS Abstracting Manual on our website. Simply add the manual to your cart and log in to order it.

Contact the Order Desk by email ( or by phone (613-241-5543) if you do not have an account or require assistance with ordering.

2016–2017 abstracting manual changes

The 2016–2017 DAD and NACRS abstracting manuals each include a table of changes. These tables provide an overview of content changes that apply to all provinces and territories, as well as jurisdiction-specific updates to the respective manuals.

Here are some highlights of additional changes to the 2016–2017 DAD and NACRS abstracting manuals:

  • Provincial/Territorial Variations: In both manuals, jurisdiction-specific collection instructions are indicated in the Field Status table in the row "P/T Variations" for each data element to ensure that data collectors can easily identify this information.
  • Unreserved Projects (includes project numbers 500 and greater): New and updated project details may be subject to change at any time throughout the year and can be found within the DAD/NACRS web application by clicking the Unreserved Projects link. Jurisdiction-specific interest groups may request an unreserved special project number any time throughout the fiscal year by contacting the Clinical Administrative Databases (CAD) team at

Section 2: Detailed Data Element Descriptions

Anaesthetic Technique: Analysis on the number of anaesthetic techniques captured for a single intervention episode found variations in capture across jurisdictions. To improve pan-Canadian comparability for this data, global enhancements have been applied to the DAD and NACRS abstracting manuals.

Section 3: Additional Abstracting Information (DAD)

  • Alternate Level of Care (ALC): To improve pan-Canadian comparability of acute care ALC data, CIHI has introduced standardized guidelines to support clinician designation of ALC in acute care. Global enhancements have been implemented in the 2016–2017 DAD manual to support consistent reporting of ALC data. By using the hyperlinks within the ALC section, you will be referred to the DAD page of CIHI's website for job aids for clinician designation of ALC and for selecting the correct Z-code for ALC reason.
  • Newborn Abstracting: Global enhancements to this section will support the pan-Canadian comparability of newborn abstracting.


Submit questions regarding the content of the DAD and NACRS abstracting manuals by selecting the Inpatient/Ambulatory abstracting and Education (DAD and NACRS) topic via CIHI's eQuery tool, available through the Applications link on CIHI's website.

Submit feedback on DAD and NACRS manual changes to the CAD team at with the subject "Manual Feedback."

Distribution: All participating DAD and NACRS facilities, DAD and NACRS software vendors, ministries/departments of health, Statistics Canada/Health Canada