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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Initial Build
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Staff Review
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Approval Status
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.” If automatically assigned, use excerpt text.
Field Type
Text (maximum length: x
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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Additional Support
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History
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Start Date
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Description
Cause or finding from event review and analysis.
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On-Screen Instructions
n/a
Field Type
Text
Guide for Use
Show a clear link between the cause and the action plan.
History
Start Date | 2006 |
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End Date | n/a |
Change History |
n/a [Month yyyy: brief description of change]
[Spring2012: PSRP implementation |
Field Name | cause_1, cause_2, cause_3, cause_4, cause_5 |
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