This page is part of the PACIO Functional Status Implementation Guide (v0.1.0: STU 1 Ballot 1) based on FHIR R4. The current version which supercedes this version is 1.0.0. For a full list of available versions, see the Directory of published versions
<QuestionnaireResponse xmlns="http://hl7.org/fhir">
<id value="QResponse-Hospital-Discharge-Mobility-1"/>
<meta>
<profile
value="http://hl7.org/fhir/us/pacio-fs/StructureDefinition/pacio-functional-qr"/>
</meta>
<text>
<status value="generated"/>
<div xmlns="http://www.w3.org/1999/xhtml"><p><b>Generated Narrative</b></p><h3>Ids</h3><table class="grid"><tr><td>-</td></tr><tr><td>*</td></tr></table><h3>Meta</h3><table class="grid"><tr><td>-</td></tr><tr><td>*</td></tr></table><p><b>questionnaire</b>: <a href="https://api.logicahealth.org/PACIO/open/Questionnaire/MDS3.0-NC-1.17">https://api.logicahealth.org/PACIO/open/Questionnaire/MDS3.0-NC-1.17</a></p><p><b>status</b>: completed</p><p><b>subject</b>: <a href="Patient-patientBSJ1.html">Generated Summary: Betsy Smith-Johnson </a></p><p><b>authored</b>: Jul 10, 2020 7:34:00 PM</p><blockquote><p><b>item</b></p><h3>Ids</h3><table class="grid"><tr><td>-</td></tr><tr><td>*</td></tr></table><p><b>linkId</b>: Section-37</p><p><b>text</b>: Functional Abilities and Goals - Discharge</p><blockquote><p><b>item</b></p><h3>Ids</h3><table class="grid"><tr><td>-</td></tr><tr><td>*</td></tr></table><p><b>linkId</b>: Section-37/GG0170</p><p><b>text</b>: Mobility - Discharge Performance</p><h3>Items</h3><table class="grid"><tr><td>-</td></tr><tr><td>*</td></tr><tr><td>*</td></tr><tr><td>*</td></tr><tr><td>*</td></tr><tr><td>*</td></tr><tr><td>*</td></tr><tr><td>*</td></tr><tr><td>*</td></tr><tr><td>*</td></tr><tr><td>*</td></tr><tr><td>*</td></tr><tr><td>*</td></tr><tr><td>*</td></tr><tr><td>*</td></tr><tr><td>*</td></tr><tr><td>*</td></tr><tr><td>*</td></tr></table></blockquote></blockquote></div>
</text>
<questionnaire
value="https://api.logicahealth.org/PACIO/open/Questionnaire/MDS3.0-NC-1.17"/>
<status value="completed"/>
<subject>
<reference value="Patient/patientBSJ1"/>
</subject>
<authored value="2020-07-10T14:34:00-05:00"/>
<item id="88483-3">
<linkId value="Section-37"/>
<text value="Functional Abilities and Goals - Discharge"/>
<item id="88331-4">
<linkId value="Section-37/GG0170"/>
<text value="Mobility - Discharge Performance"/>
<item id="83218-8">
<linkId value="Section-37/GG0170A3"/>
<text
value="What was the patient's usual performance related to their ability to roll from lying on back to left and right side, and return to lying on back on the bed?"/>
</item>
<item id="83216-2">
<linkId value="Section-37/GG0170B3"/>
<text
value="What was the patient's usual performance related to their ability to move from sitting on side of bed to lying flat on the bed?"/>
</item>
<item id="83214-7">
<linkId value="Section-37/GG0170C3"/>
<text
value="What was the patient's usual performance related to their ability to move from lying on the back to sitting on the side of the bed with feet flat on the floor, and with no back support?"/>
</item>
<item id="83212-1">
<linkId value="Section-37/GG0170D3"/>
<text
value="What was the patient's usual performance related to their ability to come to a standing position from sitting in a chair, wheelchair, or on the side of the bed?"/>
</item>
<item id="83210-5">
<linkId value="Section-37/GG0170E3"/>
<text
value="What was the patient's usual performance related to their ability to transfer to and from a bed to a chair (or wheelchair)?"/>
</item>
<item id="83208-9">
<linkId value="Section-37/GG0170F3"/>
<text
value="What was the patient's usual performance related to their ability to get on and off a toilet or commode?"/>
</item>
<item id="83206-3">
<linkId value="Section-37/GG0170G3"/>
<text
value="What was the patient's usual performance related to their ability to transfer in and out of a car or van on the passenger side? Does not include the ability to open/close door or fasten seat belt."/>
</item>
<item id="83204-8">
<linkId value="Section-37/GG0170I3"/>
<text
value="What was the patient's usual performance related to their ability to once standing, walk at least 10 feet in a room, corridor, or similar space?"/>
</item>
<item id="83202-2">
<linkId value="Section-37/GG0170J3"/>
<text
value="What was the patient's usual performance related to their ability to once standing, walk at least 50 feet and make two turns?"/>
</item>
<item id="83200-6">
<linkId value="Section-37/GG0170K3"/>
<text
value="What was the patient's usual performance related to their ability once standing, to walk at least 150 feet in a corridor or similar space?"/>
</item>
<item id="83198-2">
<linkId value="Section-37/GG0170L3"/>
<text
value="What was the patient's usual performance related to their ability to walk 10 feet on uneven or sloping surfaces (indoor or outdoor), such as turf or gravel?"/>
</item>
<item id="83196-6">
<linkId value="Section-37/GG0170M3"/>
<text
value="What was the patient's usual performance related to their ability to go up and down a curb and/or up and down one step?"/>
</item>
<item id="83194-1">
<linkId value="Section-37/GG0170N3"/>
<text
value="What was the patient's usual performance related to their ability to go up and down four steps with or without a rail?"/>
</item>
<item id="83192-5">
<linkId value="Section-37/GG0170O3"/>
<text
value="What was the patient's usual performance related to their ability to go up and down 12 steps with or without a rail?"/>
</item>
<item id="83190-9">
<linkId value="Section-37/GG0170P3"/>
<text
value="What was the patients's usual performance related to their ability to bend/stoop from a standing position to pick up a small object, such as a spoon, from the floor?"/>
</item>
<item id="83188-3">
<linkId value="Section-37/GG0170R3"/>
<text
value="What was the patient's usual performance related to their ability to once seated in a wheelchair/scooter, wheel at least 50 feet and make two turns?"/>
</item>
<item id="83235-2">
<linkId value="Section-37/GG0170S3"/>
<text
value="What was the patient's usual performance related to their ability to once seated in a wheelchair/scooter, wheel at least 150 feet in a corridor or similar space?"/>
</item>
</item>
</item>
</QuestionnaireResponse>