ED QI Project Proposal Application

QI Project Proposal Application

Name of Person Completing this Form*

Project Name*

Proposed Team Members

Please outline the problem you are trying to solve*

Please list candidate measures

Timeline (start date)*

Timeline (end date)

Please state how this project aligns with the IOM domains (safe, effective, patient-centered, timely, efficient, equitable)*

ED Strategic Plan (select)*

(Outcomes: Provide equitable, inclusive care to achieve best health outcomes for patients we serve, Innovation: Be a national leader in innovation to to improve safety and quality, Experience: Deliver optimal care experience with respect, compassion, communication and collaboration, Safety: Eliminate harm to patients and staff by preventing conditions that lead to adverse events)

Outcomes

Innovation

Experience

Safety

Please state how this project aligns with the ED Strategic Plan for Safety and Quality*

QI Support Requested:

Data analytic support*

Yes

No

Project management support*

Yes

No

QI expertise*

Yes

No

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