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Contributing factor(s) for event


Data Element ID: DE105
Name: Contributing factor(s) for event
Version: Hospital Version 1.1, Hospital Version 1.2
Data Element ISO Name: Event-Contributing factor(s),CD
Definition: Determination if any contributing factor(s) to the event are known.
Question: What factor(s) contributed to the event?
Multiple Choice: Yes
Form Name: Summary of Initial Report (SIR)
Setting: Hospitals, including outpatient pharmacies and outpatient departments located within the hospital
Comments: None defined at this time
Description of Change: Removed A408 (i) "Equipment/device: Function", A411 (j) "Equipment/device: Design", A414 (k) "Equipment/device: Availability", and A417 (l) "Equipment/device: Maintenance" from the answer value set;
Changed Maximum Length of characters for free text from "500" to "2000"
Go-To Logic: Refer to Common Formats Flow Charts
Guide For Use: Answer this question only if you are reporting an incident or near miss.
Format: N/A
HL7 Data Type: Concept Descriptor (CD)
Data Type: Character
Maximum Length: 4 (2000 for free text associated with 'Other: Please specify' response.)
Answer Code Answer ID Answer Value Code System Code System Name
A384 a Environment: Culture of safety, management 2.16.840.1.113883.3.263.1.12 AHRQ Common Formats
A387 b Environment: Physical surroundings (e.g., lighting, noise) 2.16.840.1.113883.3.263.1.12 AHRQ Common Formats
A390 c Staff qualifications: Competence (e.g., qualifications, experience) 2.16.840.1.113883.3.263.1.12 AHRQ Common Formats
A393 d Staff qualifications: Training 2.16.840.1.113883.3.263.1.12 AHRQ Common Formats
A396 e Supervision/support: Clinical supervision 2.16.840.1.113883.3.263.1.12 AHRQ Common Formats
A399 f Supervision/support: Managerial supervision 2.16.840.1.113883.3.263.1.12 AHRQ Common Formats
A402 g Policies and procedures, includes clinical protocols: Presence of policies 2.16.840.1.113883.3.263.1.12 AHRQ Common Formats
A405 h Policies and procedures, includes clinical protocols: Clarity of policies 2.16.840.1.113883.3.263.1.12 AHRQ Common Formats
A420 i Data: Availability 2.16.840.1.113883.3.263.1.12 AHRQ Common Formats
A423 j Data: Accuracy 2.16.840.1.113883.3.263.1.12 AHRQ Common Formats
A424 k Data: Legibility 2.16.840.1.113883.3.263.1.12 AHRQ Common Formats
A426 l Communication: Supervisor to staff 2.16.840.1.113883.3.263.1.12 AHRQ Common Formats
A429 m Communication: Among staff or team members 2.16.840.1.113883.3.263.1.12 AHRQ Common Formats
A432 n Communication: Staff to patient (or family) 2.16.840.1.113883.3.263.1.12 AHRQ Common Formats
A435 o Human Factors: Fatigue 2.16.840.1.113883.3.263.1.12 AHRQ Common Formats
A438 p Human Factors: Stress 2.16.840.1.113883.3.263.1.12 AHRQ Common Formats
A441 q Human Factors: Inattention 2.16.840.1.113883.3.263.1.12 AHRQ Common Formats
A444 r Human Factors: Cognitive factors 2.16.840.1.113883.3.263.1.12 AHRQ Common Formats
A447 s Human Factors: Health issues 2.16.840.1.113883.3.263.1.12 AHRQ Common Formats
A66 t Other: Please specify 2.16.840.1.113883.3.263.1.12 AHRQ Common Formats
Effective Date: 03/31/2010
Until Date: - -
Update Date: 04/03/2012
Source: Agency for Healthcare Research and Quality
Submitting Organization: Agency for Healthcare Research and Quality (AHRQ)
Date of Submission: - -
Responsible Organization: Agency for Healthcare Research and Quality (AHRQ)
Creator: Amy Helwig, MD, MS
Data Steward: Agency for Healthcare Research and Quality (AHRQ)
References: No specific reference at this time
Rationale for Change: Answer Value clarification;
Increased narrative field size to accommodate more information
Administrative Status: Final
Administrative Status Date: 04/03/2012
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