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Remove all [bracketed] and/or red text before publishing! And also the purple note panels!
[Bracketed] text should be replaced with actual content.
Red text is instructional.
Header Case
Title of page and response option headers should be sentence case (to match how they display in the online system).
Other headers in page that aren’t response options should be title case (Description, On-Screen Instructions, etc.).
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Labels
Use form_field and any relevant segment labels (asc, hospital, nursingfacility, pharmacy)
Use the relevant section label (e.g., surgical_event, event_information)
Note: event-specific fields should be tagged with the associated event type (e.g., surgical_event, fall_event) and NOT with overarching header “event_information”)
Use required if the field is required to submit for all reports.
For example, “it is required if it appears” should not be labeled “required.”
Use essential if the field is a top priority for transferring the data dictionary.
Note: if the field is required, it will already be considered “essential” and doesn’t need a second label.
All “essential” labels will need to be removed before the data dictionary goes live.
Description
[Brief description of what this field is collecting]
On-Screen Instructions
[Prompt text as it appears in the user interface.]
Prompt Text
If none or if field does not appear on-screen, put “n/a.” Use “include page” macro where possible (see examples below).
Description
Patient’s self-identified ethnicity.
On-Screen Instructions
| Include Page | ||||
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Field Type
[Type of field, but really type of interaction user will have: clicking a checkbox or radio button, choosing from a dropdown, filling in a date number, or text field, etc.]
Field Type
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| Include Page |
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Checkbox (multiselect)
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Number (minimum value: x; maximum value: x) [Delete min &/or max values if irrelevant]
Text (maximum length: x) [Delete maximum length if irrelevant]
Time (hh:mm)
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Responses
OPTION ONE: Answer options with content (definition and/or inclusions, exclusions)
Add an anchor in front of the H1 “Responses” heading and name the anchor “Top.”
Include a table of contents, which should be limited to the answer option headers and displayed as a list.
Add a dividing line macro below the table of contents.
| Table of Contents | ||||||
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Answer Option Anchors and Headings
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Definition
Copy/paste the “description” text from the data dictionary.
Includes
Excludes
Inclusions and Exclusions
Add a page layout of two equal columns below the definition. Inclusions go in the left column, exclusions in the right.
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Event-Type Specific Questions
| Filter by label (Content by label) | ||||||||
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Additional Support
| Filter by label (Content by label) | ||||||||
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Event-Type Specific Questions
If the answer option triggers additional question, add a content by label macro to display all pages that share the form_field label plus the relevant answer option label, possibly plus the relevant segment label, depending on the situation. The macro goes in a single cell table with a light gray fill. The title above the macro should just be table text, bold (no header level), that reads: Event-Type Specific Questions.
Additional Support
If the answer option is associated with an “faq” item, add a second row to the table and paste in a content by label macro to display all pages that share the faq label plus the relevant answer option label, possibly plus the relevant segment label, depending on the situation. Macro should have title “Additional Support” in the table cell, above it, as with the “Event specific questions” macro.
Return to Top Links
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Dividing Line
Add a dividing line after the “return to top” link and before the next answer option, or the next section (probably “Guide for Use”).
OPTION TWO: Answer options without content
Just list the available answer options without the answerID and answerCode.
[Answer option 1]
[Answer option 2]
[Answer option 3]
Guide for Use
[If there is a adequate information about each answer option, this section may not be necessary. But if there is guidance that isn’t about the specific responses, then this is where you would put it, including instructions for how to use this field. If there is no guidance, you can use the “No additional guidance” excerpt: ]
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In Option 2, this is where one would put an “Additional Support” or “Event-type Specific Questions” Content by Label macro in a single-cell table with light gray fill.
If the page should include “additional support” content that is is only relevant to this one question, move the content into the guide for use. If there are multiple pages for the question because of differences between segments, leave the content in a separate page and use the “include page” macro to include it (so we only have to edit in one place but it will still appear in multiple places).
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Additional Support
| Filter by label (Content by label) | ||||||||
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History
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Start Date
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Hispanic
Select “Hispanic” if the patient was of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture.
Not Hispanic
Select “Not Hispanic” if the patient was not of Cuban, Mexican, Puerto Rican, South or Central American, or other Spanish culture.
Unknown
Select “Unknown” if the patient's Hispanic or Latino ethnicity was unknown.
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Guide for Use
Note: If you are reporting an event that impacted multiple patients, please complete a separate form for each patient with their specific demographic data. Other sections of the form may be copied and pasted. If you have questions about this procedure, please contact a patient safety consultant.
History
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Start Date | 2006 |
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End Date | n/a |
Change History |
n/a [Month yyyy: brief description of change]
Spring 2012: PSRP implementation |
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