This page is part of the Healthcare Associated Infection Implementation Guide (v1.1.0: STU 2 Ballot 1) based on FHIR R3. The current version which supercedes this version is 2.0.0. For a full list of available versions, see the Directory of published versions 
JSON Format: Questionnaire-hai-questionnaire-opc-sdom-denom
Raw json
{
"resourceType" : "Questionnaire",
"id" : "hai-questionnaire-opc-sdom-denom",
"meta" : {
"versionId" : "7",
"lastUpdated" : "2019-03-11T03:27:25.000-04:00",
"profile" : [
"http://hl7.org/fhir/us/hai/StructureDefinition/hai-population-summary-questionnaire"
]
},
"language" : "en-US",
"text" : {
"status" : "generated",
"div" : "<div xmlns=\"http://www.w3.org/1999/xhtml\" lang=\"en-US\">\n <p>This Questionnaire instance defines the questions and possible answers in the Outpatient Procedure Component Denominator for Same Day Outcome Measures. It records the summary data for same outpatient procedures same day outcome measures.</p>\n <h2>Outpatient Procedure Component Denominator for Same Day Outcome Measures Report</h2>\n <table border=\"1\">\n <tbody>\n <tr>\n <td>url</td>\n <td>http://hl7.org/fhir/us/hai/Questionnaire/hai-questionnaire-opc-sdom-denom</td>\n </tr>\n <tr>\n <td>Version</td>\n <td>R1</td>\n </tr>\n <tr>\n <td>title</td>\n <td>Outpatient Procedure Component Denominator for Same Day Outcome Measures Report</td>\n </tr>\n <tr>\n <td>Publish date</td>\n <td>2019-04-01</td>\n </tr>\n <tr>\n <td>Realm</td>\n <td>US</td>\n </tr>\n <tr>\n <td>Code</td>\n <td>LOINC 51897-7: Healthcare Associated Infection report Document</td>\n </tr>\n <tr>\n <td>Code</td>\n <td>cdcNHSN 1657-6: Summary data reporting outpatient procedure component events at a facility</td>\n </tr>\n <tr>\n <td>Subject type</td>\n <td>Group</td>\n </tr>\n </tbody>\n </table>\n <h2>Questionnaire Items</h2>\n <table border=\"1\">\n <thead>\n <tr>\n <th>Group</th>\n <th>Item</th>\n <th>Type</th>\n <th>Required</th>\n <th>Repeats</th>\n </tr>\n </thead>\n <tbody>\n <tr>\n <td/>\n <td>Facility ID</td>\n <td>url</td>\n <td>true</td>\n <td>false</td>\n </tr>\n <tr>\n <td/>\n <td>First day of period reported</td>\n <td>date</td>\n <td>true</td>\n <td>false</td>\n </tr>\n <tr>\n <td/>\n <td>Last day of period reported</td>\n <td>date</td>\n <td>true</td>\n <td>false</td>\n </tr>\n <tr>\n <td/>\n <td>Facility Location Id</td>\n <td>url</td>\n <td>true</td>\n <td>false</td>\n </tr>\n <tr>\n <td/>\n <td>Facility Location Type</td>\n <td>choice</td>\n <td>true</td>\n <td>false</td>\n </tr>\n <tr>\n <td/>\n <td>Summary Data Group</td>\n <td>group</td>\n <td>true</td>\n <td>false</td>\n </tr>\n <tr>\n <td>Summary Data Group</td>\n <td>Number of Total Facility Encounters (for outpatient location)</td>\n <td>integer</td>\n <td>true</td>\n <td>false</td>\n </tr>\n <tr>\n <td/>\n <td>Report No Events Group</td>\n <td>group</td>\n <td>false</td>\n <td>false</td>\n </tr>\n <tr>\n <td>Report No Events Group</td>\n <td>No Same Day Outcome Measures (events) reported this month</td>\n <td>boolean</td>\n <td>false</td>\n <td>false</td>\n </tr>\n <tr>\n <td/>\n <td>Comments</td>\n <td>text</td>\n <td>false</td>\n <td>false</td>\n </tr>\n </tbody>\n </table>\n </div>"
},
"url" : "http://hl7.org/fhir/us/hai/Questionnaire/hai-questionnaire-opc-sdom-denom",
"identifier" : [
{
"value" : "hai-questionnaire-opc-sdom-denom-v1"
}
],
"version" : "2.0.0",
"name" : "hai-questionnaire-opc-sdom-denom",
"title" : "Outpatient Procedure Component Denominator for Same Day Outcome Measures Report",
"status" : "draft",
"experimental" : false,
"date" : "2018-04-01",
"publisher" : "HL7",
"description" : "This Questionnaire instance defines the questions and possible answers in the Outpatient Procedure Component Denominator for Same Day Outcome Measures. It records the summary data for same outpatient procedures same day outcome measures.",
"jurisdiction" : [
{
"coding" : [
{
"system" : "urn:iso:std:iso:3166",
"code" : "US"
}
]
}
],
"code" : [
{
"system" : "http://hl7.org/fhir/us/hai/CodeSystem/2.16.840.1.113883.6.277",
"code" : "1657-6",
"display" : "Summary data reporting outpatient procedure component evetns at a facility"
}
],
"subjectType" : [
"Group"
],
"item" : [
{
"linkId" : "facility-id",
"text" : "Facility ID",
"type" : "url",
"required" : true,
"repeats" : false
},
{
"linkId" : "report-period-start",
"text" : "First day of period reported",
"type" : "date",
"required" : true,
"repeats" : false
},
{
"linkId" : "report-period-end",
"text" : "Last day of period reported",
"type" : "date",
"required" : true,
"repeats" : false
},
{
"linkId" : "facility-location-id",
"text" : "Facility Location Id",
"type" : "url",
"required" : true,
"repeats" : false
},
{
"linkId" : "facility-location-type",
"text" : "Facility Location Type",
"type" : "choice",
"required" : true,
"repeats" : false,
"options" : {
"reference" : "http://hl7.org/fhir/us/hai/ValueSet/2.16.840.1.113883.13.19"
}
},
{
"linkId" : "summary-data-group",
"code" : [
{
"system" : "http://loinc.org",
"code" : "51900-9",
"display" : "Population Summary note"
}
],
"text" : "Summary Data",
"type" : "group",
"required" : true,
"repeats" : false,
"item" : [
{
"linkId" : "total-facility-encounters-outpatient",
"code" : [
{
"system" : "http://hl7.org/fhir/us/hai/CodeSystem/2.16.840.1.113883.6.277",
"code" : "1890-3",
"display" : "Number of Total Facility Encounters (for outpatient location)"
}
],
"text" : "Number of Total Facility Encounters (for outpatient location)",
"type" : "integer",
"required" : true,
"repeats" : false
}
]
},
{
"linkId" : "report-no-events-group",
"code" : [
{
"system" : "http://loinc.org",
"code" : "90252-8",
"display" : "Report no events"
}
],
"text" : "Report no events",
"type" : "group",
"required" : false,
"repeats" : false,
"item" : [
{
"linkId" : "no-same-day-outcome-measures",
"code" : [
{
"system" : "http://hl7.org/fhir/us/hai/CodeSystem/2.16.840.1.113883.6.277",
"code" : "1340-9",
"display" : "No Same Day Outcome Measures (events) reported this month"
}
],
"text" : "No Same Day Outcome Measures (events) reported this month",
"type" : "boolean",
"required" : false,
"repeats" : false
}
]
},
{
"linkId" : "nhsn-comment",
"code" : [
{
"system" : "http://www.loinc.org",
"code" : "86468-6",
"display" : "Report Comment Section"
}
],
"text" : "Comments",
"type" : "text",
"required" : false,
"repeats" : false,
"maxLength" : 2000
}
]
}
