Term Description

The Patient Information Form (PIF) is used to collect demographic information as well as additional information about the impact of the event on a patient (e.g., level of harm, unplanned interventions). It supplements the Healthcare Event Reporting Form (HERF) in cases where an incident is being reported.

Panel Hierarchy

Details for each LOINC in Panel LHC-Forms

LOINCNameR/O/CCardinalityExample UCUM Units
74502-6Patient Safety Event Report - Hospital: Patient Information Form - Version 1.2
Indent74081-1Event ID:R1..1
Indent30947-6Initial Report Date (HERF Q1):R1..1{mm/dd/yyyy}
Indent74500-0At the time of the event what was the patient's age?R1..1
Indent74694-1Is the patient's ethnicity Hispanic or Latino?R1..1
Indent74693-3What is the patient's race?R1..1
Indent52797-8ICD-9-CM or ICD-10-CM principal diagnosis code at discharge (if available):O0..1
Indent74562-0Was any intervention attempted in order to "rescue" the patient (i.e., to prevent, to minimize, or to reverse harm)?R1..1
Indent74561-2Which of the following interventions (rescue) were documented?C1..1
Indent74560-4After any intervention to reduce harm, what was the degree of residual harm to the patient from the incident (and subsequent intervention)?R1..1
Indent74559-6What is the anticipated duration of the harm to the patient?R1..1
Indent74558-8Approximately when after discovery of the incident was harm assessed?R1..1
Indent74557-0Did, or will, the incident result in an increased length of stay?R1..1
Indent74556-2After the discovery of the incident, was the patient, patient's family, or guardian notified?R1..1

LOINC Names Get Info

Fully-Specified Name
Patient safety event report - hospital - patient information form - version 1.2:-:Pt:^Patient:-:AHRQ
Long Common Name
Patient safety event report - hospital - patient information form (PIF) - version 1.2 [AHRQ]

Part Model Get Info

  • Component
    Patient safety event report - hospital - patient information form - version 1.2
    LP182389-9
    • Analyte
      Patient safety event report - hospital - patient information form - version 1.2
      LP182389-9
      • Component Numerator
        Patient safety event report - hospital - patient information form - version 1.2
        LP182389-9
        • Component Numerator Core
          Patient safety event report - hospital - patient information form - version 1.2
          LP182389-9
        • Component Numerator Core Suffix
          NULL
           
      • Component Denominator
        NULL
         
        • Component Denominator Core
          NULL
           
        • Component Denominator Core Suffix
          NULL
           
    • Challenge
      NULL
       
    • Adjustment
      NULL
       
    • Count
      NULL
       
  • Property
    -
    LP6769-6
  • Time
    Pt
    LP6960-1
  • System
    ^Patient
    LP310005-6
    • System Core
      NULL
       
    • Super System
      Patient
      LP6985-8
  • Scale
    -
    LP7747-1
  • Method
    AHRQ
    LP173651-3

Basic Attributes

Class
PANEL.SURVEY.AHRQ
Type
Surveys
First Released
Version 2.48
Last Updated
Version 2.54 (MIN)
Panel Type
Panel

LOINC Terminology Service (API) using HL7® FHIR® Get Info

CodeSystem lookup
https://fhir.loinc.org/CodeSystem/$lookup?system=http://loinc.org&code=74502-6
Questionnaire definition
https://fhir.loinc.org/Questionnaire/?url=http://loinc.org/q/74502-6