74501-8
Patient Safety Event Report - Hospital: Summary of Initial Report - Version 1.2
Active
74081-1 Event ID:
Observation ID in Form
DE2
Observation Required in Panel
Required
Fully-Specified Name
- Component
- Patient safety event
- Property
- ID
- Time
- Pt
- System
- ^Event
- Scale
- Nom
- Method
- AHRQ
Basic Attributes
- Class
- SURVEY.AHRQ
- Type
- Surveys
- First Released
- Version 2.46
- Last Updated
- Version 2.66
- Order vs. Observation
- Observation
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 74725-3 | Patient safety event report - hospital - device or medical AndOr surgical supply, including health information technology (HIT) - version 1.2 [AHRQ] |
| 74495-3 | Patient safety event report - hospital - healthcare event reporting form (HERF) - version 1.2 [AHRQ] |
| 74080-3 | Patient safety event report - hospital - medication or other substance - version 1.2 [AHRQ] |
| 74502-6 | Patient safety event report - hospital - patient information form (PIF) - version 1.2 [AHRQ] |
| 74501-8 | Patient safety event report - hospital - summary of initial report (SIR) - version 1.2 [AHRQ] |
30947-6 Initial Report Date (HERF Q1):
Observation ID in Form
DE30
Observation Required in Panel
Required
Fully-Specified Name
- Component
- Date form completed
- Property
- Date
- Time
- Pt
- System
- Form
- Scale
- Qn
- Method
Additional Names
- Short Name
- Date form completed
Basic Attributes
- Class
- ADMIN
- Type
- Clinical
- First Released
- Version 2.04
- Last Updated
- Version 2.61
- Order vs. Observation
- Observation
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 97887-4 | Core Outcome Measures Index for the Back [COMI] |
| 97327-1 | Core Outcome Measures Index for the Neck [COMI] |
| 69412-5 | Deprecated Continuity Assessment Record and Evaluation (CARE) tool - Long term care hospital (LTCH) - version 1.0 |
| 85645-0 | Deprecated Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Admission - version 3.00 [CMS Assessment] |
| 85671-6 | Deprecated Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Expired - version 3.00 [CMS Assessment] |
| 85662-5 | Deprecated Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Planned Discharge - version 3.00 [CMS Assessment] |
| 85668-2 | Deprecated Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Unplanned Discharge - version 3.00 [CMS Assessment] |
| 100203-9 | Knee Society Score post-op panel [Knee Society Score] |
| 100159-3 | Knee Society Score pre-op panel [Knee Society Score] |
| 103949-4 | Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Admission - version 5.1 during assessment period [CMS Assessment] |
| 103948-6 | Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Expired - version 5.1 during assessment period [CMS Assessment] |
| 103946-0 | Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Planned Discharge - version 5.1 during assessment period [CMS Assessment] |
| 103947-8 | Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Unplanned Discharge - version 5.1 during assessment period [CMS Assessment] |
| 101111-3 | MDS v3.0 - RAI v1.18.11 - Interim Payment Assessment (IPA) item set during assessment period [CMS Assessment] |
| 101105-5 | MDS v3.0 - RAI v1.18.11 - Nursing home comprehensive (NC) item set during assessment period [CMS Assessment] |
| 101107-1 | MDS v3.0 - RAI v1.18.11 - Nursing home discharge (ND) item set during assessment period [CMS Assessment] |
| 101109-7 | MDS v3.0 - RAI v1.18.11 - Nursing home part A PPS discharge (NPE) item set during assessment period [CMS Assessment] |
| 101110-5 | MDS v3.0 - RAI v1.18.11 - Nursing home PPS (NP) item set during assessment period [CMS Assessment] |
| 101106-3 | MDS v3.0 - RAI v1.18.11 - Nursing home quarterly (NQ) item set during assessment period [CMS Assessment] |
| 101113-9 | MDS v3.0 - RAI v1.18.11 - Swing bed discharge (SD) item set during assessment period [CMS Assessment] |
| 101112-1 | MDS v3.0 - RAI v1.18.11 - Swing bed PPS (SP) item set during assessment period [CMS Assessment] |
| 104608-5 | MDS v3.0 - RAI v1.19.1 - Interim Payment Assessment (IPA) item set during assessment period [CMS Assessment] |
| 103564-1 | MDS v3.0 - RAI v1.19.1 - Nursing home comprehensive (NC) item set during assessment period [CMS Assessment] |
| 104606-9 | MDS v3.0 - RAI v1.19.1 - Nursing home discharge (ND) item set during assessment period [CMS Assessment] |
| 105201-8 | MDS v3.0 - RAI v1.19.1 - Nursing home part A PPS discharge (NPE) item set during assessment period [CMS Assessment] |
| 104552-5 | MDS v3.0 - RAI v1.19.1 - Nursing home PPS (NP) item set during assessment period [CMS Assessment] |
| 104554-1 | MDS v3.0 - RAI v1.19.1 - Nursing home quarterly (NQ) item set during assessment period [CMS Assessment] |
| 104607-7 | MDS v3.0 - RAI v1.19.1 - Swing Bed discharge (SD) item set during assessment period [CMS Assessment] |
| 104609-3 | MDS v3.0 - RAI v1.19.1 - Swing bed PPS (SP) item set during assessment period [CMS Assessment] |
| 46611-0 | Mental residual functional capacity (RFC) assessment form |
| 74725-3 | Patient safety event report - hospital - device or medical AndOr surgical supply, including health information technology (HIT) - version 1.2 [AHRQ] |
| 74495-3 | Patient safety event report - hospital - healthcare event reporting form (HERF) - version 1.2 [AHRQ] |
| 74080-3 | Patient safety event report - hospital - medication or other substance - version 1.2 [AHRQ] |
| 74502-6 | Patient safety event report - hospital - patient information form (PIF) - version 1.2 [AHRQ] |
| 74501-8 | Patient safety event report - hospital - summary of initial report (SIR) - version 1.2 [AHRQ] |
| 105485-7 | PhenX - healthcare communications protocol 281101 |
| 60687-1 | Test of Infant Motor Performance Version 5.1 |
| 55140-8 | Vaccine Adverse Event Reporting System (VAERS) panel |
Language Variants Get Info
| Tag | Language | Translation |
|---|---|---|
| es-AR | Spanish (Argentina) | fecha de formulario completo: |
| es-MX | Spanish (Mexico) | Formulario de fecha completado: |
| it-IT | Italian (Italy) | Data completamento form: Synonyms: Amministrativo Punto nel tempo (episodio) |
| pt-BR | Portuguese (Brazil) | Data formulário preenchido: Synonyms: Time stamp; |
| ru-RU | Russian (Russian Federation) | Дата форма заполнение: Synonyms: Дата заполнения формы Количественный Точка во времени; |
| zh-CN | Chinese (China) | 表单完成日期: Synonyms: 可用数量表示的; |
Example Units
| Unit | Source |
|---|---|
| {mm/dd/yyyy} | Example UCUM Units |
30947-6 What is the date of the summary of the initial report?
Observation ID in Form
DE75
Observation Required in Panel
Required
Fully-Specified Name
- Component
- Date form completed
- Property
- Date
- Time
- Pt
- System
- Form
- Scale
- Qn
- Method
Additional Names
- Short Name
- Date form completed
Basic Attributes
- Class
- ADMIN
- Type
- Clinical
- First Released
- Version 2.04
- Last Updated
- Version 2.61
- Order vs. Observation
- Observation
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 97887-4 | Core Outcome Measures Index for the Back [COMI] |
| 97327-1 | Core Outcome Measures Index for the Neck [COMI] |
| 69412-5 | Deprecated Continuity Assessment Record and Evaluation (CARE) tool - Long term care hospital (LTCH) - version 1.0 |
| 85645-0 | Deprecated Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Admission - version 3.00 [CMS Assessment] |
| 85671-6 | Deprecated Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Expired - version 3.00 [CMS Assessment] |
| 85662-5 | Deprecated Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Planned Discharge - version 3.00 [CMS Assessment] |
| 85668-2 | Deprecated Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Unplanned Discharge - version 3.00 [CMS Assessment] |
| 100203-9 | Knee Society Score post-op panel [Knee Society Score] |
| 100159-3 | Knee Society Score pre-op panel [Knee Society Score] |
| 103949-4 | Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Admission - version 5.1 during assessment period [CMS Assessment] |
| 103948-6 | Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Expired - version 5.1 during assessment period [CMS Assessment] |
| 103946-0 | Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Planned Discharge - version 5.1 during assessment period [CMS Assessment] |
| 103947-8 | Long-Term Care Hospital (LTCH) Continuity Assessment Record and Evaluation (CARE) Data Set (LCDS) - Unplanned Discharge - version 5.1 during assessment period [CMS Assessment] |
| 101111-3 | MDS v3.0 - RAI v1.18.11 - Interim Payment Assessment (IPA) item set during assessment period [CMS Assessment] |
| 101105-5 | MDS v3.0 - RAI v1.18.11 - Nursing home comprehensive (NC) item set during assessment period [CMS Assessment] |
| 101107-1 | MDS v3.0 - RAI v1.18.11 - Nursing home discharge (ND) item set during assessment period [CMS Assessment] |
| 101109-7 | MDS v3.0 - RAI v1.18.11 - Nursing home part A PPS discharge (NPE) item set during assessment period [CMS Assessment] |
| 101110-5 | MDS v3.0 - RAI v1.18.11 - Nursing home PPS (NP) item set during assessment period [CMS Assessment] |
| 101106-3 | MDS v3.0 - RAI v1.18.11 - Nursing home quarterly (NQ) item set during assessment period [CMS Assessment] |
| 101113-9 | MDS v3.0 - RAI v1.18.11 - Swing bed discharge (SD) item set during assessment period [CMS Assessment] |
| 101112-1 | MDS v3.0 - RAI v1.18.11 - Swing bed PPS (SP) item set during assessment period [CMS Assessment] |
| 104608-5 | MDS v3.0 - RAI v1.19.1 - Interim Payment Assessment (IPA) item set during assessment period [CMS Assessment] |
| 103564-1 | MDS v3.0 - RAI v1.19.1 - Nursing home comprehensive (NC) item set during assessment period [CMS Assessment] |
| 104606-9 | MDS v3.0 - RAI v1.19.1 - Nursing home discharge (ND) item set during assessment period [CMS Assessment] |
| 105201-8 | MDS v3.0 - RAI v1.19.1 - Nursing home part A PPS discharge (NPE) item set during assessment period [CMS Assessment] |
| 104552-5 | MDS v3.0 - RAI v1.19.1 - Nursing home PPS (NP) item set during assessment period [CMS Assessment] |
| 104554-1 | MDS v3.0 - RAI v1.19.1 - Nursing home quarterly (NQ) item set during assessment period [CMS Assessment] |
| 104607-7 | MDS v3.0 - RAI v1.19.1 - Swing Bed discharge (SD) item set during assessment period [CMS Assessment] |
| 104609-3 | MDS v3.0 - RAI v1.19.1 - Swing bed PPS (SP) item set during assessment period [CMS Assessment] |
| 46611-0 | Mental residual functional capacity (RFC) assessment form |
| 74725-3 | Patient safety event report - hospital - device or medical AndOr surgical supply, including health information technology (HIT) - version 1.2 [AHRQ] |
| 74495-3 | Patient safety event report - hospital - healthcare event reporting form (HERF) - version 1.2 [AHRQ] |
| 74080-3 | Patient safety event report - hospital - medication or other substance - version 1.2 [AHRQ] |
| 74502-6 | Patient safety event report - hospital - patient information form (PIF) - version 1.2 [AHRQ] |
| 74501-8 | Patient safety event report - hospital - summary of initial report (SIR) - version 1.2 [AHRQ] |
| 105485-7 | PhenX - healthcare communications protocol 281101 |
| 60687-1 | Test of Infant Motor Performance Version 5.1 |
| 55140-8 | Vaccine Adverse Event Reporting System (VAERS) panel |
Language Variants Get Info
| Tag | Language | Translation |
|---|---|---|
| es-AR | Spanish (Argentina) | fecha de formulario completo: |
| es-MX | Spanish (Mexico) | Formulario de fecha completado: |
| it-IT | Italian (Italy) | Data completamento form: Synonyms: Amministrativo Punto nel tempo (episodio) |
| pt-BR | Portuguese (Brazil) | Data formulário preenchido: Synonyms: Time stamp; |
| ru-RU | Russian (Russian Federation) | Дата форма заполнение: Synonyms: Дата заполнения формы Количественный Точка во времени; |
| zh-CN | Chinese (China) | 表单完成日期: Synonyms: 可用数量表示的; |
Example Units
| Unit | Source |
|---|---|
| {mm/dd/yyyy} | Example UCUM Units |
74573-7 Where did the event occur, or, if an unsafe condition, where does it exist?
Term Description
Determination of where the event occurred, or if an unsafe condition, where it existed.
Source: Regenstrief LOINC
Observation ID in Form
DE78
Observation Required in Panel
Required
Form Coding Instructions
Check one:
Source: Agency for Healthcare Research and QualityFully-Specified Name
- Component
- Location of patient safety event or unsafe condition
- Property
- Type
- Time
- Pt
- System
- ^Event
- Scale
- Nom
- Method
- AHRQ
Basic Attributes
- Class
- SURVEY.AHRQ
- Type
- Surveys
- First Released
- Version 2.48
- Last Updated
- Version 2.48
- Order vs. Observation
- Observation
Survey Question
- Text
- Where did the event occur, or, if an unsafe condition, where does it exist?
- Source
- SIR.Q2
Normative Answer List LL2829-1
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| Inpatient general care area (e.g., medical/surgical unit) | a | LA20784-7 | |
| Special care area (e.g., ICU, CCU, NICU) | b | LA20785-4 | |
| Labor and delivery | c | LA20786-2 | |
| Operating room or procedure area (e.g., cardiac catheter lab, endoscopy area), including PACU or recovery area | d | LA20787-0 | |
| Radiology/imaging department, including onsite mobile units | e | LA20788-8 | |
| Pharmacy | f | LA7223-6 | |
| Laboratory, including pathology department and blood bank | g | LA20789-6 | |
| Emergency Department | h | LA10268-3 | |
| Other area within the facility | i | LA20790-4 | |
| Outpatient care area | j | LA20791-2 | |
| Outside area (i.e., grounds of this facility) | k | LA20792-0 | |
| Unknown Copyright http://snomed.info/sct ID:261665006 Unknown (qualifier value) | l | LA4489-6 | |
| Other: PLEASE SPECIFY | m | LA20318-4 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 74501-8 | Patient safety event report - hospital - summary of initial report (SIR) - version 1.2 [AHRQ] |
Third Party Copyright
This material includes SNOMED Clinical Terms® (SNOMED CT®) which is used by permission of the International Health Terminology Standards Development Organisation (IHTSDO) under license. All rights reserved. SNOMED CT® was originally created by The College of American Pathologists. "SNOMED" and "SNOMED CT" are registered trademarks of the IHTSDO.
This material includes content from the US Edition to SNOMED CT, which is developed and maintained by the U.S. National Library of Medicine and is available to authorized UMLS Metathesaurus Licensees from the UTS Downloads site at https://uts.nlm.nih.gov.
Use of SNOMED CT content is subject to the terms and conditions set forth in the SNOMED CT Affiliate License Agreement. It is the responsibility of those implementing this product to ensure they are appropriately licensed and for more information on the license, including how to register as an Affiliate Licensee, please refer to http://www.snomed.org/snomed-ct/get-snomed-ct or info@snomed.org<mailto:info@snomed.org>. This may incur a fee in SNOMED International non-Member countries.
74572-9 Who reported the event or unsafe condition?
Term Description
Determination of who reported the event or unsafe condition.
Source: Regenstrief LOINC
Observation ID in Form
DE81
Observation Required in Panel
Required
Form Coding Instructions
(Please refer to HERF Question 20) Check one:
Source: Agency for Healthcare Research and QualityFully-Specified Name
- Component
- Reporter of adverse event or unsafe condition
- Property
- Type
- Time
- Pt
- System
- ^Event
- Scale
- Nom
- Method
- AHRQ
Basic Attributes
- Class
- SURVEY.AHRQ
- Type
- Surveys
- First Released
- Version 2.48
- Last Updated
- Version 2.48
- Order vs. Observation
- Observation
Survey Question
- Text
- Who reported the event or unsafe condition?
- Source
- SIR.Q3
Normative Answer List LL2830-9
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| Healthcare professional | a | LA20793-8 | |
| Healthcare worker | b | LA20794-6 | |
| Emergency service personnel | c | LA20795-3 | |
| Patient, family member, volunteer, caregiver, or home assistant | d | LA20796-1 | |
| Unknown Copyright http://snomed.info/sct ID:261665006 Unknown (qualifier value) | e | LA4489-6 | |
| Other: PLEASE SPECIFY | f | LA20318-4 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 74501-8 | Patient safety event report - hospital - summary of initial report (SIR) - version 1.2 [AHRQ] |
Third Party Copyright
This material includes SNOMED Clinical Terms® (SNOMED CT®) which is used by permission of the International Health Terminology Standards Development Organisation (IHTSDO) under license. All rights reserved. SNOMED CT® was originally created by The College of American Pathologists. "SNOMED" and "SNOMED CT" are registered trademarks of the IHTSDO.
This material includes content from the US Edition to SNOMED CT, which is developed and maintained by the U.S. National Library of Medicine and is available to authorized UMLS Metathesaurus Licensees from the UTS Downloads site at https://uts.nlm.nih.gov.
Use of SNOMED CT content is subject to the terms and conditions set forth in the SNOMED CT Affiliate License Agreement. It is the responsibility of those implementing this product to ensure they are appropriately licensed and for more information on the license, including how to register as an Affiliate Licensee, please refer to http://www.snomed.org/snomed-ct/get-snomed-ct or info@snomed.org<mailto:info@snomed.org>. This may incur a fee in SNOMED International non-Member countries.
74571-1 What is the type of healthcare professional?
Term Description
Determination of the type of healthcare professional that reported the event or unsafe condition.
Source: Regenstrief LOINC
Observation ID in Form
DE84
Observation Required in Panel
Conditional
Form Coding Instructions
Check one:
Source: Agency for Healthcare Research and QualityFully-Specified Name
- Component
- Healthcare professional
- Property
- Type
- Time
- Pt
- System
- ^Event
- Scale
- Nom
- Method
- AHRQ
Basic Attributes
- Class
- SURVEY.AHRQ
- Type
- Surveys
- First Released
- Version 2.48
- Last Updated
- Version 2.48
- Order vs. Observation
- Observation
Survey Question
- Text
- What is the type of healthcare professional?
- Source
- SIR.Q4
Normative Answer List LL2831-7
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| Doctor, dentist (including student) | a | LA20797-9 | |
| Nurse, nurse practitioner, physician assistant (including student or trainee) | b | LA20798-7 | |
| Pharmacist, pharmacy technician (including student) | c | LA20799-5 | |
| Allied health professional (including paramedic, speech, physical and occupational therapist, dietician) | d | LA20800-1 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 74501-8 | Patient safety event report - hospital - summary of initial report (SIR) - version 1.2 [AHRQ] |
74570-3 Additional details of event or unsafe condition [AHRQ]
Term Description
Description of any additional details about the event or unsafe condition discovered after completion of the Healthcare Event Reporting Form (HERF) form.
Source: Regenstrief LOINC
Observation ID in Form
DE87
Observation Required in Panel
Optional
Fully-Specified Name
- Component
- Additional details of event or unsafe condition
- Property
- Find
- Time
- Pt
- System
- ^Event
- Scale
- Nar
- Method
- AHRQ
Basic Attributes
- Class
- SURVEY.AHRQ
- Type
- Surveys
- First Released
- Version 2.48
- Last Updated
- Version 2.48
- Order vs. Observation
- Observation
Survey Question
- Source
- SIR.Q5
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 74501-8 | Patient safety event report - hospital - summary of initial report (SIR) - version 1.2 [AHRQ] |
74569-5 What prevented the near miss (close call) from reaching the patient?
Term Description
Determination of what process prevented the near miss from reaching the patient.
Source: Regenstrief LOINC
Observation ID in Form
DE93
Observation Required in Panel
Conditional
Form Coding Instructions
Check one:
Source: Agency for Healthcare Research and QualityFully-Specified Name
- Component
- Action that prevented the near miss incident from reaching the patient
- Property
- Find
- Time
- Pt
- System
- ^Patient
- Scale
- Nom
- Method
- AHRQ
Basic Attributes
- Class
- SURVEY.AHRQ
- Type
- Surveys
- First Released
- Version 2.48
- Last Updated
- Version 2.48
- Order vs. Observation
- Observation
Survey Question
- Text
- What prevented the near miss (close call) from reaching the patient?
- Source
- SIR.Q6
Normative Answer List LL2833-3
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| Fail-safe designed into the process and/or a safeguard worked effectively | a | LA20801-9 | |
| Practitioner or staff who made the error noticed and recovered from this error (avoiding any possibility of it reaching the patient) | b | LA20802-7 | |
| Spontaneous action by a practitioner or staff member prevented the event from reaching the patient | c | LA20803-5 | |
| Action by the patient's family member prevented the event from reaching the patient | d | LA20804-3 | |
| Other: PLEASE SPECIFY | e | LA20318-4 | |
| Unknown Copyright http://snomed.info/sct ID:261665006 Unknown (qualifier value) | f | LA4489-6 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 74501-8 | Patient safety event report - hospital - summary of initial report (SIR) - version 1.2 [AHRQ] |
Third Party Copyright
This material includes SNOMED Clinical Terms® (SNOMED CT®) which is used by permission of the International Health Terminology Standards Development Organisation (IHTSDO) under license. All rights reserved. SNOMED CT® was originally created by The College of American Pathologists. "SNOMED" and "SNOMED CT" are registered trademarks of the IHTSDO.
This material includes content from the US Edition to SNOMED CT, which is developed and maintained by the U.S. National Library of Medicine and is available to authorized UMLS Metathesaurus Licensees from the UTS Downloads site at https://uts.nlm.nih.gov.
Use of SNOMED CT content is subject to the terms and conditions set forth in the SNOMED CT Affiliate License Agreement. It is the responsibility of those implementing this product to ensure they are appropriately licensed and for more information on the license, including how to register as an Affiliate Licensee, please refer to http://www.snomed.org/snomed-ct/get-snomed-ct or info@snomed.org<mailto:info@snomed.org>. This may incur a fee in SNOMED International non-Member countries.
74568-7 Was the event associated with a handover/handoff?
Term Description
Determination if the event was associated with a handover/handoff.
Source: Regenstrief LOINC
Observation ID in Form
DE96
Observation Required in Panel
Conditional
Form Coding Instructions
Check one:
Source: Agency for Healthcare Research and QualityFully-Specified Name
- Component
- Event was associated with a handover
- Property
- Find
- Time
- Pt
- System
- ^Event
- Scale
- Ord
- Method
- AHRQ
Basic Attributes
- Class
- SURVEY.AHRQ
- Type
- Surveys
- First Released
- Version 2.48
- Last Updated
- Version 2.48
- Order vs. Observation
- Observation
Survey Question
- Text
- Was the event associated with a handover/handoff?
- Source
- SIR.Q7
Normative Answer List LL2817-6
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value) | a | LA33-6 | |
| No Copyright http://snomed.info/sct ID:373067005 No (qualifier value) | b | LA32-8 | |
| Unknown Copyright http://snomed.info/sct ID:261665006 Unknown (qualifier value) | c | LA4489-6 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 74501-8 | Patient safety event report - hospital - summary of initial report (SIR) - version 1.2 [AHRQ] |
Third Party Copyright
This material includes SNOMED Clinical Terms® (SNOMED CT®) which is used by permission of the International Health Terminology Standards Development Organisation (IHTSDO) under license. All rights reserved. SNOMED CT® was originally created by The College of American Pathologists. "SNOMED" and "SNOMED CT" are registered trademarks of the IHTSDO.
This material includes content from the US Edition to SNOMED CT, which is developed and maintained by the U.S. National Library of Medicine and is available to authorized UMLS Metathesaurus Licensees from the UTS Downloads site at https://uts.nlm.nih.gov.
Use of SNOMED CT content is subject to the terms and conditions set forth in the SNOMED CT Affiliate License Agreement. It is the responsibility of those implementing this product to ensure they are appropriately licensed and for more information on the license, including how to register as an Affiliate Licensee, please refer to http://www.snomed.org/snomed-ct/get-snomed-ct or info@snomed.org<mailto:info@snomed.org>. This may incur a fee in SNOMED International non-Member countries.
74567-9 Are any contributing factors to the event known?
Term Description
Determination if the factors that contributed to the event are known.
Source: Regenstrief LOINC
Observation ID in Form
DE102
Observation Required in Panel
Conditional
Form Coding Instructions
Check one:
Source: Agency for Healthcare Research and QualityFully-Specified Name
- Component
- Contributing factors for event were known
- Property
- Find
- Time
- Pt
- System
- ^Event
- Scale
- Ord
- Method
- AHRQ
Basic Attributes
- Class
- SURVEY.AHRQ
- Type
- Surveys
- First Released
- Version 2.48
- Last Updated
- Version 2.52
- Order vs. Observation
- Observation
Survey Question
- Text
- Are any contributing factors to the event known?
- Source
- SIR.Q8
Normative Answer List LL2817-6
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value) | a | LA33-6 | |
| No Copyright http://snomed.info/sct ID:373067005 No (qualifier value) | b | LA32-8 | |
| Unknown Copyright http://snomed.info/sct ID:261665006 Unknown (qualifier value) | c | LA4489-6 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 74501-8 | Patient safety event report - hospital - summary of initial report (SIR) - version 1.2 [AHRQ] |
Third Party Copyright
This material includes SNOMED Clinical Terms® (SNOMED CT®) which is used by permission of the International Health Terminology Standards Development Organisation (IHTSDO) under license. All rights reserved. SNOMED CT® was originally created by The College of American Pathologists. "SNOMED" and "SNOMED CT" are registered trademarks of the IHTSDO.
This material includes content from the US Edition to SNOMED CT, which is developed and maintained by the U.S. National Library of Medicine and is available to authorized UMLS Metathesaurus Licensees from the UTS Downloads site at https://uts.nlm.nih.gov.
Use of SNOMED CT content is subject to the terms and conditions set forth in the SNOMED CT Affiliate License Agreement. It is the responsibility of those implementing this product to ensure they are appropriately licensed and for more information on the license, including how to register as an Affiliate Licensee, please refer to http://www.snomed.org/snomed-ct/get-snomed-ct or info@snomed.org<mailto:info@snomed.org>. This may incur a fee in SNOMED International non-Member countries.
74566-1 What factor(s) contributed to the event?
Term Description
Determination of any factors that contributed to an event.
Source: Regenstrief LOINC
Observation ID in Form
DE105
Observation Required in Panel
Conditional
Form Coding Instructions
Check all that apply:
Source: Agency for Healthcare Research and QualityFully-Specified Name
- Component
- Contributing factors for event
- Property
- Find
- Time
- Pt
- System
- ^Event
- Scale
- Nom
- Method
- AHRQ
Basic Attributes
- Class
- SURVEY.AHRQ
- Type
- Surveys
- First Released
- Version 2.48
- Last Updated
- Version 2.48
- Order vs. Observation
- Observation
Survey Question
- Text
- What factor(s) contributed to the event?
- Source
- SIR.Q9
Normative Answer List LL2834-1
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| Environment: Culture of safety, management | a | LA20806-8 | |
| Environment: Physical surroundings (e.g., lighting, noise) | b | LA20807-6 | |
| Staff qualifications: Competence (e.g., qualifications, experience) | c | LA20809-2 | |
| Staff qualifications: Training | d | LA20810-0 | |
| Supervision/support: Clinical supervision | e | LA20812-6 | |
| Supervision/support: Managerial supervision | f | LA20813-4 | |
| Policies and procedures, includes clinical protocols: Presence of policies | g | LA20815-9 | |
| Policies and procedures, includes clinical protocols: Clarity of policies | h | LA20816-7 | |
| Data: Availability | i | LA20818-3 | |
| Data: Accuracy | j | LA20819-1 | |
| Data: Legibility | k | LA20820-9 | |
| Communication: Supervisor to staff | l | LA20822-5 | |
| Communication: Among staff or team members | m | LA20823-3 | |
| Communication: Staff to patient (or family) | n | LA20824-1 | |
| Human factors: Fatigue | o | LA20825-8 | |
| Human factors: Stress | p | LA20821-7 | |
| Human factors: Inattention | q | LA20817-5 | |
| Human factors: Cognitive factors | r | LA20826-6 | |
| Human factors: Health issues | s | LA20827-4 | |
| Other: PLEASE SPECIFY | t | LA20318-4 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 74501-8 | Patient safety event report - hospital - summary of initial report (SIR) - version 1.2 [AHRQ] |
74565-3 Was the event a National Quality Forum (NQF) Serious Reportable Event?
Observation ID in Form
DE109
Observation Required in Panel
Conditional
Form Coding Instructions
Check one:
Source: Agency for Healthcare Research and QualityFully-Specified Name
- Component
- Event was a National Quality Forum (NQF) serious reportable event
- Property
- Find
- Time
- Pt
- System
- ^Event
- Scale
- Ord
- Method
- AHRQ
Basic Attributes
- Class
- SURVEY.AHRQ
- Type
- Surveys
- First Released
- Version 2.48
- Last Updated
- Version 2.48
- Order vs. Observation
- Observation
Survey Question
- Text
- Was the event a National Quality Forum (NQF) Serious Reportable Event?
- Source
- SIR.Q10
Normative Answer List LL2817-6
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| Yes Copyright http://snomed.info/sct ID:373066001 Yes (qualifier value) | a | LA33-6 | |
| No Copyright http://snomed.info/sct ID:373067005 No (qualifier value) | b | LA32-8 | |
| Unknown Copyright http://snomed.info/sct ID:261665006 Unknown (qualifier value) | c | LA4489-6 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 74501-8 | Patient safety event report - hospital - summary of initial report (SIR) - version 1.2 [AHRQ] |
Third Party Copyright
This material includes SNOMED Clinical Terms® (SNOMED CT®) which is used by permission of the International Health Terminology Standards Development Organisation (IHTSDO) under license. All rights reserved. SNOMED CT® was originally created by The College of American Pathologists. "SNOMED" and "SNOMED CT" are registered trademarks of the IHTSDO.
This material includes content from the US Edition to SNOMED CT, which is developed and maintained by the U.S. National Library of Medicine and is available to authorized UMLS Metathesaurus Licensees from the UTS Downloads site at https://uts.nlm.nih.gov.
Use of SNOMED CT content is subject to the terms and conditions set forth in the SNOMED CT Affiliate License Agreement. It is the responsibility of those implementing this product to ensure they are appropriately licensed and for more information on the license, including how to register as an Affiliate Licensee, please refer to http://www.snomed.org/snomed-ct/get-snomed-ct or info@snomed.org<mailto:info@snomed.org>. This may incur a fee in SNOMED International non-Member countries.
74564-6 What was the applicable Serious Reportable Event?
Observation ID in Form
DE110
Observation Required in Panel
Conditional
Form Coding Instructions
Check one:
Source: Agency for Healthcare Research and QualityFully-Specified Name
- Component
- National Quality Forum (NQF) serious reportable event
- Property
- Type
- Time
- Pt
- System
- ^Event
- Scale
- Nom
- Method
- AHRQ
Basic Attributes
- Class
- SURVEY.AHRQ
- Type
- Surveys
- First Released
- Version 2.48
- Last Updated
- Version 2.48
- Order vs. Observation
- Observation
Survey Question
- Text
- What was the applicable Serious Reportable Event?
- Source
- SIR.Q11
Normative Answer List LL2835-8
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| Surgery or other invasive procedure performed on the wrong site | a | LA20829-0 | |
| Surgery or other invasive procedure performed on the wrong patient | b | LA20830-8 | |
| Wrong surgical or other invasive procedure performed on a patient | c | LA20831-6 | |
| Unintended retention of a foreign object in a patient after surgery or other invasive procedure | d | LA20832-4 | |
| Intraoperative or immediately postoperative/postprocedure death in an ASA Class 1 patient | e | LA20833-2 | |
| Patient death or serious injury associated with the use of contaminated drugs, devices, or biologics provided by the healthcare setting | f | LA20835-7 | |
| Patient death or serious injury associated with the use or function of a device in patient care, in which the device is used or functions other than as intended | g | LA20836-5 | |
| Patient death or serious injury associated with intravascular air embolism that occurs while being cared for in healthcare setting | h | LA20837-3 | |
| Discharge or release of a patient/resident of any age, who is unable to make decisions, to other than an authorized person | i | LA20839-9 | |
| Patient death or serious injury associated with patient elopement (disappearance) | j | LA20840-7 | |
| Patient suicide, attempted suicide, or self-harm that results in serious injury, while being cared for in a healthcare setting | k | LA20841-5 | |
| Patient death or serious injury associated with a medication error (e.g., errors involving the wrong drug, wrong dose, wrong patient, wrong time, wrong rate, wrong preparation, or wrong route of administration) | l | LA20843-1 | |
| Patient death or serious injury associated with unsafe administration of blood products | m | LA20844-9 | |
| Maternal death or serious injury associated with labor or delivery in a low-risk pregnancy while being cared for in a healthcare setting | n | LA20845-6 | |
| Death or serious injury of a neonate associated with labor or delivery in a low-risk pregnancy | o | LA20846-4 | |
| Patient death or serious injury associated with a fall while being cared for in a healthcare setting | p | LA20847-2 | |
| Any Stage 3, Stage 4, and unstageable pressure ulcers acquired after admission/presentation to a healthcare setting | q | LA20848-0 | |
| Artificial insemination with the wrong donor sperm or wrong egg | r | LA20849-8 | |
| Patient death or serious injury resulting from the irretrievable loss of an irreplaceable biological specimen | s | LA20850-6 | |
| Patient death or serious injury resulting from failure to follow up or communicate laboratory, pathology, or radiology test results | t | LA20851-4 | |
| Patient or staff death or serious injury associated with an electric shock in the course of a patient care process in a healthcare setting | u | LA20853-0 | |
| Any incident in which systems designated for oxygen or other gas to be delivered to a patient contains no gas, the wrong gas, or is contaminated by toxic substances | v | LA20854-8 | |
| Patient or staff death or serious injury associated with a burn incurred from any source in the course of a patient care process in a healthcare setting | w | LA20855-5 | |
| Patient death or serious injury associated with the use of physical restraints or bedrails while being cared for in a healthcare setting | x | LA20856-3 | |
| Death or serious injury of a patient or staff associated with the introduction of a metallic object into the MRI area | y | LA20858-9 | |
| Any instance of care ordered by or provided by someone impersonating a physician, nurse, pharmacist, or other licensed healthcare provider | z | LA20860-5 | |
| Abduction of a patient/resident of any age | aa | LA20861-3 | |
| Sexual abuse/assault on a patient or staff member within or on the grounds of a healthcare setting | bb | LA20862-1 | |
| Death or serious injury of a patient or staff member resulting from a physical assault (i.e., battery) that occurs within or on the grounds of a healthcare setting | cc | LA20863-9 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 74501-8 | Patient safety event report - hospital - summary of initial report (SIR) - version 1.2 [AHRQ] |
74563-8 How preventable was the incident?
Term Description
Determination of how preventable the incident was.
Source: Regenstrief LOINC
Observation ID in Form
DE99
Observation Required in Panel
Conditional
Form Coding Instructions
Check one:
Source: Agency for Healthcare Research and QualityFully-Specified Name
- Component
- Incident preventability
- Property
- Find
- Time
- Pt
- System
- ^Event
- Scale
- Nom
- Method
- AHRQ
Basic Attributes
- Class
- SURVEY.AHRQ
- Type
- Surveys
- First Released
- Version 2.48
- Last Updated
- Version 2.48
- Order vs. Observation
- Observation
Survey Question
- Text
- How preventable was the incident?
- Source
- SIR.Q12
Normative Answer List LL2837-4
| Answer | Code | Score | Answer ID |
|---|---|---|---|
| Almost certainly could have been prevented | a | LA20864-7 | |
| Likely could have been prevented | b | LA20865-4 | |
| Likely could not have been prevented | c | LA20866-2 | |
| Almost certainly could not have been prevented | d | LA20867-0 | |
| Provider does not make this determination by policy | e | LA20868-8 | |
| Unknown Copyright http://snomed.info/sct ID:261665006 Unknown (qualifier value) | f | LA4489-6 |
Member of these Panels
| LOINC | Long Common Name |
|---|---|
| 74501-8 | Patient safety event report - hospital - summary of initial report (SIR) - version 1.2 [AHRQ] |
Third Party Copyright
This material includes SNOMED Clinical Terms® (SNOMED CT®) which is used by permission of the International Health Terminology Standards Development Organisation (IHTSDO) under license. All rights reserved. SNOMED CT® was originally created by The College of American Pathologists. "SNOMED" and "SNOMED CT" are registered trademarks of the IHTSDO.
This material includes content from the US Edition to SNOMED CT, which is developed and maintained by the U.S. National Library of Medicine and is available to authorized UMLS Metathesaurus Licensees from the UTS Downloads site at https://uts.nlm.nih.gov.
Use of SNOMED CT content is subject to the terms and conditions set forth in the SNOMED CT Affiliate License Agreement. It is the responsibility of those implementing this product to ensure they are appropriately licensed and for more information on the license, including how to register as an Affiliate Licensee, please refer to http://www.snomed.org/snomed-ct/get-snomed-ct or info@snomed.org<mailto:info@snomed.org>. This may incur a fee in SNOMED International non-Member countries.