PATIENT RESPONSE RECORD (continued) Data Field Element XML Element Attributes Description Valid Values Data Type Size Required Q31 None Has any dialysis center staff Yes 1 Alphanumeric 1 Yes getoff-machine ever told you how to get off No 2 character Each element must have a closing tag that the machine if there is an NOT APPLICABLE X is the same as the opening tag but with a emergency at the center? MISSING/DK M forward slash. This patient response data element should only occur once per patient. Example: Q32 None Using any number from 0 to Worst dialysis center Alphanumeric 2 Yes rate-staff 10, where 0 is the worst staff possible 0 character Each element must have a closing tag that dialysis center staff possible 1 1 is the same as the opening tag but with a and 10 is the best dialysis 2 2 forward slash. This patient response data center staff possible, what 3 3 element should only occur once per number would you use to rate 4 4 patient. your dialysis center staff? 5 5 Example: rate-staff2/rate-staff 6 6 7 7 8 8 9 9 Best dialysis center staff possible 10 NOT APPLICABLE X MISSING/DK M
PATIENT RESPONSE RECORD (continued) XML Element Attributes Description Valid Values Data Type Field Size Data Element Required Q31 getoff-machine Each element must have a closing tag that is the same as the opening tag but with a forward slash. This patient response data element should only occur once per patient. Example: None Has any dialysis center staff ever told you how to get off the machine if there is an emergency at the center? Yes 1 No 2 NOT APPLICABLE X MISSING/DK M Alphanumeric character 1 Yes Q32 rate-staff Each element must have a closing tag that is the same as the opening tag but with a forward slash. This patient response data element should only occur once per patient. Example: rate-staff2/rate-staff None Using any number from 0 to 10, where 0 is the worst dialysis center staff possible and 10 is the best dialysis center staff possible, what number would you use to rate your dialysis center staff? Worst dialysis center staff possible 0 1 1 2 2 3 3 4 4 5 5 6 6 7 7 8 8 9 9 Best dialysis center staff possible 10 NOT APPLICABLE X MISSING/DK M Alphanumeric character 2 Yes
ICH_SurveyAdminManual_Ver4_Feb2016.docx