HealthcareAssociatedInfectionReports Implementation Guide CI Build

This page is part of the Healthcare Associated Infection Implementation Guide (v2.0.0: STU 2) based on FHIR R4. This is the current published version in it's permanent home (it will always be available at this URL). 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" : {
    "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         <h1 xmlns:xsl=\"http://www.w3.org/1999/XSL/Transform\">Outpatient Procedure Component Denominator for Same Day Outcome Measures Report</h1>\n         <p xmlns:xsl=\"http://www.w3.org/1999/XSL/Transform\">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         <p xmlns:xsl=\"http://www.w3.org/1999/XSL/Transform\">For further details on reporting healthcare-associated infections see the specific protocols and data collection forms on the NHSN website <a href=\"https://www.cdc.gov/nhsn/\">https://www.cdc.gov/nhsn/</a>.</p>\n         <h2 xmlns:xsl=\"http://www.w3.org/1999/XSL/Transform\">Questionnaire Details</h2>\n         <table xmlns:xsl=\"http://www.w3.org/1999/XSL/Transform\">\n            <tr>\n               <td>\n                  <b>Id:</b>\n               </td>\n               <td>hai-questionnaire-opc-sdom-denom</td>\n            </tr>\n            <tr>\n               <td>\n                  <b>Profile:</b>\n               </td>\n               <td>http://hl7.org/fhir/us/hai/StructureDefinition/hai-population-summary-questionnaire</td>\n            </tr>\n            <tr>\n               <td>\n                  <b>Language:</b>\n               </td>\n               <td>en-US</td>\n            </tr>\n            <tr>\n               <td>\n                  <b>Url:</b>\n               </td>\n               <td>http://hl7.org/fhir/us/hai/Questionnaire/hai-questionnaire-opc-sdom-denom</td>\n            </tr>\n            <tr>\n               <td>\n                  <b>Identifier:</b>\n               </td>\n               <td>\n                  <span>hai-questionnaire-opc-sdom-denom-v1</span>\n               </td>\n            </tr>\n            <tr>\n               <td>\n                  <b>Version:</b>\n               </td>\n               <td>Version: 2.0.0</td>\n            </tr>\n            <tr>\n               <td>\n                  <b>Name:</b>\n               </td>\n               <td>HAI_questionnaire_opc_sdom_denom</td>\n            </tr>\n            <tr>\n               <td>\n                  <b>Status:</b>\n               </td>\n               <td>draft</td>\n            </tr>\n            <tr>\n               <td>\n                  <b>Experimental:</b>\n               </td>\n               <td>false</td>\n            </tr>\n            <tr>\n               <td>\n                  <b>Subject Type:</b>\n               </td>\n               <td>Group (Source Group Resource)</td>\n            </tr>\n            <tr>\n               <td>\n                  <b>Date:</b>\n               </td>\n               <td>2019-04-01</td>\n            </tr>\n            <tr>\n               <td>\n                  <b>Publisher:</b>\n               </td>\n               <td>HL7 Structured Documents Work Group</td>\n            </tr>\n            <tr>\n               <td>\n                  <b>Jurisdiction:</b>\n               </td>\n               <td>\n                  <span title=\"Code system: urn:iso:std:iso:3166\">Code: US</span>\n               </td>\n            </tr>\n            <tr>\n               <td>\n                  <b>Code:</b>\n               </td>\n               <td>\n                  <ul style=\"list-style:none; padding-left:0; margin:0 0;\">\n                     <li>Healthcare Associated Infection report Document</li>\n                     <li>Code system: <a href=\"http://loinc.org\">http://loinc.org</a>\n                     </li>\n                     <li>Code: 51897-7</li>\n                  </ul>\n               </td>\n            </tr>\n            <tr>\n               <td>\n                  <b>Code:</b>\n               </td>\n               <td>\n                  <ul style=\"list-style:none; padding-left:0; margin:0 0;\">\n                     <li>Summary data reporting outpatient procedure component events at a facility</li>\n                     <li>Code system: <a href=\"http://hl7.org/fhir/us/hai/CodeSystem/2.16.840.1.113883.6.277\">http://hl7.org/fhir/us/hai/CodeSystem/2.16.840.1.113883.6.277</a>\n                     </li>\n                     <li>Code: 1657-6</li>\n                  </ul>\n               </td>\n            </tr>\n         </table>\n         <br xmlns:xsl=\"http://www.w3.org/1999/XSL/Transform\"/>\n         <br xmlns:xsl=\"http://www.w3.org/1999/XSL/Transform\"/>\n         <h2 xmlns:xsl=\"http://www.w3.org/1999/XSL/Transform\">Questionnaire Items (<span style=\"color:red\">*</span> required)</h2>\n         <ul xmlns:xsl=\"http://www.w3.org/1999/XSL/Transform\" style=\"list-style:none;\">\n            <li>\n               <span style=\"color:red\">* </span>\n               <span style=\"font-weight:bold\">Facility ID</span> [<span style=\"font-style:italic\">facility-id</span>] (url)\n    </li>\n            <li>\n               <span style=\"color:red\">* </span>\n               <span style=\"font-weight:bold\">First day of period reported</span> [<span style=\"font-style:italic\">report-period-start</span>] (date)\n    </li>\n            <li>\n               <span style=\"color:red\">* </span>\n               <span style=\"font-weight:bold\">Last day of period reported</span> [<span style=\"font-style:italic\">report-period-end</span>] (date)\n    </li>\n            <li>\n               <span style=\"color:red\">* </span>\n               <span style=\"font-weight:bold\">Facility Location Id</span> [<span style=\"font-style:italic\">facility-location-id</span>] (url)\n    </li>\n            <li>\n               <span style=\"color:red\">* </span>\n               <span style=\"font-weight:bold\">Facility Location Type</span> [<span style=\"font-style:italic\">facility-location-type</span>] (choice)\n    <ul>\n                  <li>answerValueSet: <a href=\"http://hl7.org/fhir/us/hai/ValueSet/2.16.840.1.113883.13.19\">http://hl7.org/fhir/us/hai/ValueSet/2.16.840.1.113883.13.19</a>\n                  </li>\n               </ul>\n            </li>\n            <li>\n               <span style=\"color:red\">* </span>\n               <span style=\"font-weight:bold\">Summary Data</span> [<span style=\"font-style:italic\">summary-data-group</span>] (group)\n    <ul style=\"list-style:none;\">\n                  <li>This group contains specific counts for the type of report. [<span style=\"font-style:italic\">summary-data-group-description</span>] (display)\n    </li>\n                  <li>\n                     <span style=\"color:red\">* </span>\n                     <span style=\"font-weight:bold\">Number of Total Facility Encounters (for outpatient location)</span> [<span style=\"font-style:italic\">total-facility-encounters-outpatient</span>] (integer)\n    </li>\n               </ul>\n            </li>\n            <li>\n               <span style=\"color:red\">* </span>\n               <span style=\"font-weight:bold\">Report no events</span> [<span style=\"font-style:italic\">report-no-events-group</span>] (group)\n    <ul style=\"list-style:none;\">\n                  <li>This group contains statements that there are no events to report for a particular type of event. [<span style=\"font-style:italic\">report-no-events-group-description</span>] (display)\n    </li>\n                  <li>\n                     <span style=\"font-weight:bold\">No Same Day Outcome Measures (events) reported this month</span> [<span style=\"font-style:italic\">no-same-day-outcome-measures</span>] (boolean)\n    </li>\n               </ul>\n            </li>\n            <li>\n               <span style=\"font-weight:bold\">Comments</span> [<span style=\"font-style:italic\">nhsn-comment</span>] (text)\n    </li>\n         </ul>\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,
  "subjectType" : [
    "Group"
  ],
  "date" : "2019-04-01",
  "publisher" : "HL7 Structured Documents Work Group",
  "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.\n\nFor further details on reporting healthcare-associated infections see the specific protocols and data collection forms on the NHSN website [https://www.cdc.gov/nhsn/](https://www.cdc.gov/nhsn/).\n",
  "jurisdiction" : [
    {
      "coding" : [
        {
          "system" : "urn:iso:std:iso:3166",
          "code" : "US"
        }
      ]
    }
  ],
  "code" : [
    {
      "system" : "http://loinc.org",
      "code" : "51897-7",
      "display" : "Healthcare Associated Infection report Document"
    },
    {
      "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 events at a facility"
    }
  ],
  "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,
      "answerValueSet" : "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" : "summary-data-group-description",
          "text" : "This group contains specific counts for the type of report.",
          "type" : "display"
        },
        {
          "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" : true,
      "repeats" : false,
      "item" : [
        {
          "linkId" : "report-no-events-group-description",
          "text" : "This group contains statements that there are no events to report for a particular type of event.",
          "type" : "display"
        },
        {
          "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
    }
  ]
}