74502-6
Patient safety event report - hospital - patient information form (PIF) - version 1.2 [AHRQ]
Active
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
| LOINC | Name | R/O/C | Cardinality | Example UCUM Units |
|---|---|---|---|---|
| 74502-6 | Patient Safety Event Report - Hospital: Patient Information Form - Version 1.2 | |||
| Indent74081-1 | Event ID: | R | 1..1 | |
| Indent30947-6 | Initial Report Date (HERF Q1): | R | 1..1 | {mm/dd/yyyy} |
| Indent74500-0 | At the time of the event what was the patient's age? | R | 1..1 | |
| Indent74694-1 | Is the patient's ethnicity Hispanic or Latino? | R | 1..1 | |
| Indent74693-3 | What is the patient's race? | R | 1..1 | |
| Indent52797-8 | ICD-9-CM or ICD-10-CM principal diagnosis code at discharge (if available): | O | 0..1 | |
| Indent74562-0 | Was any intervention attempted in order to "rescue" the patient (i.e., to prevent, to minimize, or to reverse harm)? | R | 1..1 | |
| Indent74561-2 | Which of the following interventions (rescue) were documented? | C | 1..1 | |
| Indent74560-4 | After any intervention to reduce harm, what was the degree of residual harm to the patient from the incident (and subsequent intervention)? | R | 1..1 | |
| Indent74559-6 | What is the anticipated duration of the harm to the patient? | R | 1..1 | |
| Indent74558-8 | Approximately when after discovery of the incident was harm assessed? | R | 1..1 | |
| Indent74557-0 | Did, or will, the incident result in an increased length of stay? | R | 1..1 | |
| Indent74556-2 | After the discovery of the incident, was the patient, patient's family, or guardian notified? | R | 1..1 |
Fully-Specified Name
- Component
- Patient safety event report - hospital - patient information form - version 1.2
- Property
- -
- Time
- Pt
- System
- ^Patient
- Scale
- -
- Method
- AHRQ
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
Requests to this service require a free LOINC username and password. Below is a sample of the possible capabilities. See the LOINC Terminology Service documentation for more information.
- 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
LOINC Copyright
Copyright © 2025 Regenstrief Institute, Inc. All Rights Reserved. To the extent included herein, the LOINC table and LOINC codes are copyright © Regenstrief Institute, Inc. and the Logical Observation Identifiers Names and Codes (LOINC) Committee. See https://