SIP Study Application

The code block below illustrates how one might use # and // as comments in your logic and calculations.

This value you provided is not a number. Please try again.

This value you provided is not an integer. Please try again.

The value entered is not a valid Vanderbilt Medical Record Number (i.e. 4- to 9-digit number, excluding leading zeros). Please try again.

The value you provided must be within the suggested range

The value you provided is outside the suggested range

This value is admissible, but you may wish to double check it.

The value entered must be a time value in the following format HH:MM within the range 00:00-23:59 (e.g., 04:32 or 23:19).

This field must be a 5 or 9 digit U.S. ZIP Code (like 94043). Please re-enter it now.

This field must be a 10 digit U.S. phone number (like 415 555 1212). Please re-enter it now.

This field must be a valid email address (like joe@user.com). Please re-enter it now.

The value you provided could not be validated because it does not follow the expected format. Please try again.

Required format:

cKpydVGzvYQ5YPb5dXurZv7AbE7UWi9gViQcu59WLhRRQjQWiEhJV94a6vv7ruLsZdiGu5d7Bf7J65nIzMiLCtm

Thank you for applying to the SIP Study (Simultaneously Implementing Pathways for Improving Asthma, Pneumonia, and Bronchiolitis Care for Hospitalized Children)! For more details on the study, please visit our website.

Please note that this application requires you determine the number of children hospitalized with a primary diagnosis of asthma at your hospital in 2019. We encourage applicants to contact someone in your hospital's medical records department to determine this value. You can use ICD-9-CM codes 493.XX, or ICD-10-CM codes J4521, J4522, J4531, J4532, J4541, J4542, J4551, J4552, J45901, J45902, J45990 , J45991, J45998. You can include children admitted under inpatient or observation status. With that information in hand, this survey application should take less than 10 minutes.

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You have selected an option that triggers this survey to end right now.

To save your responses and end the survey, click the 'End Survey' button below. If you have selected the wrong option by accident and/or wish to return to the survey, click the 'Return and Edit Response' button.