{
  "description": "This Questionnaire instance defines the questions and possible answers in the Outpatient Procedure Component Same Day Outcome Measures Event Report. It records data on each patient who experienced one or more of the same day outcome measures events.",
  "_filename": "Questionnaire-hai-questionnaire-opc-sdom-event.json",
  "package_name": "hl7.fhir.us.hai",
  "subjectType": [ "Patient" ],
  "date": "2019-04-01",
  "meta": {
    "profile": [ "http://hl7.org/fhir/us/hai/StructureDefinition/hai-single-person-report-questionnaire" ],
    "versionId": "2",
    "lastUpdated": "2019-03-11T00:49:08.000-04:00"
  },
  "publisher": "HL7",
  "jurisdiction": [ {
    "coding": [ {
      "code": "US",
      "system": "urn:iso:std:iso:3166"
    } ]
  } ],
  "name": "hai-questionnaire-opc-sdom-event",
  "item": [ {
    "text": "Facility ID",
    "type": "url",
    "linkId": "facility-id",
    "repeats": false,
    "required": true
  }, {
    "text": "Date of Encounter (Admission)",
    "type": "date",
    "linkId": "date-of-encounter",
    "repeats": false,
    "required": true
  }, {
    "code": [ {
      "code": "51899-3",
      "system": "http://loinc.org",
      "display": "Details Document"
    } ],
    "item": [ {
      "code": [ {
        "code": "125666000",
        "system": "http://snomed.info/sct",
        "display": "Burn"
      } ],
      "text": "Same Day Outcome Measure: Patient Burn",
      "type": "boolean",
      "linkId": "same-day-outcome-measure-patient-burn",
      "repeats": false,
      "required": true
    }, {
      "code": [ {
        "code": "217082002",
        "system": "http://snomed.info/sct",
        "display": "Accidental fall"
      } ],
      "text": "Same Day Outcome Measure: Patient fall",
      "type": "boolean",
      "linkId": "same-day-outcome-measure-patient-fall",
      "repeats": false,
      "required": true
    }, {
      "code": [ {
        "code": "1645-1",
        "system": "http://hl7.org/fhir/us/hai/CodeSystem/2.16.840.1.113883.6.277",
        "display": "Hospital transer/admission"
      } ],
      "text": "Same Day Outcome Measure: Hospital transfer/admission",
      "type": "boolean",
      "linkId": "same-day-outcome-transfer-admission",
      "repeats": false,
      "required": true
    }, {
      "code": [ {
        "code": "1646-9",
        "system": "http://hl7.org/fhir/us/hai/CodeSystem/2.16.840.1.113883.6.277",
        "display": "Wrong site"
      } ],
      "text": "Same Day Outcome Measure: Wrong site",
      "type": "boolean",
      "linkId": "same-day-outcome-measure-wrong-site",
      "repeats": false,
      "required": true
    }, {
      "code": [ {
        "code": "1647-7",
        "system": "http://hl7.org/fhir/us/hai/CodeSystem/2.16.840.1.113883.6.277",
        "display": "Wrong side"
      } ],
      "text": "Same Day Outcome Measure: Wrong side",
      "type": "boolean",
      "linkId": "same-day-outcome-measure-wrong-side",
      "repeats": false,
      "required": true
    }, {
      "code": [ {
        "code": "1648-5",
        "system": "http://hl7.org/fhir/us/hai/CodeSystem/2.16.840.1.113883.6.277",
        "display": "Wrong patient"
      } ],
      "text": "Same Day Outcome Measure: Wrong patient",
      "type": "boolean",
      "linkId": "same-day-outcome-measure-wrong-patient",
      "repeats": false,
      "required": true
    }, {
      "code": [ {
        "code": "370898007",
        "system": "http://snomed.info/sct",
        "display": "Wrong surgical procedure performed on a patient"
      } ],
      "text": "Same Day Outcome Measure: Wrong procedure",
      "type": "boolean",
      "linkId": "same-day-outcome-measure-wrong-procedure",
      "repeats": false,
      "required": true
    }, {
      "code": [ {
        "code": "1649-3",
        "system": "http://hl7.org/fhir/us/hai/CodeSystem/2.16.840.1.113883.6.277",
        "display": "Wrong implant"
      } ],
      "text": "Same Day Outcome Measure: Wrong implant",
      "type": "boolean",
      "linkId": "same-day-outcome-measure-wrong-implant",
      "repeats": false,
      "required": true
    } ],
    "text": "Same Day Outcome Measures Event Details: Contains details about same-day outcome measures events",
    "type": "group",
    "linkId": "same-day-outcome-measures-event-details",
    "repeats": false
  }, {
    "code": [ {
      "code": "86468-6",
      "system": "http://www.loinc.org",
      "display": "Report Comment Section"
    } ],
    "text": "Comments",
    "type": "text",
    "linkId": "nhsn-comment",
    "repeats": false,
    "required": false,
    "maxLength": 2000
  } ],
  "type": null,
  "experimental": "false",
  "resourceType": "Questionnaire",
  "title": "Outpatient Procedure Component Same Day Outcome Measures Event Report",
  "package_version": "1.1.0",
  "status": "draft",
  "language": "en-US",
  "id": "81513e6f-1349-4188-b2b0-16ba92d473c1",
  "kind": null,
  "url": "http://hl7.org/fhir/us/hai/Questionnaire/hai-questionnaire-opc-sdom-event",
  "code": [ {
    "code": "51897-7",
    "system": "http://loinc.org",
    "display": "Healthcare Associated Infection report Document"
  } ],
  "identifier": [ {
    "value": "hai-questionnaire-opc-sdom-event-v1"
  } ],
  "version": "R1"
}