Quality Excellence Award Nominations 2021

Application Information

Organization Name**

*As you want it to appear to others

Address*

City*

State, Zip*

Contact Person*

Email*

Phone*

Project Summary*

The summary must not exceed 250 words. Summary should not refer to names, organization and/or location as this will deem the application ineligible. This will ensure unbiased judging takes place.

Application

Application Category*

Critical Access Hospital

Large Hospital (PPS)

Post-Acute

Triple Aim Alignment*

Improved Population Health - improvements address population cared for with at least one shared characteristic contributing to health behaviors or health outcomes.

Improved Experience of Care - improvements address experience of care.

Lower Cost, Increased Value, or Reduced waste - reduced costs/waste, penalties or increased value of care.

Aim Alignment*

Safe – Project improved safety of care

Timely – Project reduced waiting or delays in receiving care and services.

Effective – Project used science and evidence based care as the standard in the delivery of care.

Equitable – Project reduced or removed unequal treatment, provided equity of access to the care and treatment that improves disparity of population served.

Efficient – Project focused on removal of waste and impacted cost of care and service.

Person-Centered – Project impacted the system of care by respect personal preferences and put the person and/or family in control.

Problem Statement (supported by data)*

Any supporting documentation can be uploaded at the end of this form. Consider these questions: - Identify the issue. - Why was this an issue selected for improvement? - How does the problem work to improve the aims listed above? - What data supports that there is an issue? - How does the issue link to the organizations plan, goals and/or mission?

Project Goal*

Any supporting documentation can be uploaded at the end of this form. Consider these questions: Are you using a SMART goal(s)? • Specific-is it detailed to the issue you want to see improved • Measurable-can you see if there is improvement • Appropriate-does it make sense to what you are working • Realistic-are you able to achieve the goal set given the resources, time, and work needing to be done • Timed-Do you have an end date when this should occur that can realistically be achieved

Strategy to Improve*

Any supporting documentation can be uploaded at the end of this form. Consider these questions: • What are going to do to improve the issue? • Describe the strategy/plan for this improvement project. • Steps taken to implement these ideas. • Location(s) for this improvement project (one area, all areas, community, etc.) and why this location was selected.

Methodology Used for Improvement and Evaluation of Progress*

Any supporting documentation can be uploaded at the end of this form. Consider these questions: • Was there a methodology or framework used to implement the improvement project? Examples (there are many others): • PDSA (Plan, Do, Study, Act) • Lean • IHI Improvement cycle • Improvement tools used to implement the improvement project (Small tests of change, diagrams, surveys, etc.) • How do you plan to change behavior, motivate and support change? Ideas: • Educate for understanding • Reward for implementation • Celebrate successes • Involve those doing the work to develop the change • Make it as easy as possible to implement the change

Engagement of Leaders and External Stakeholders*

Any supporting documentawtion can be uploaded at the end of this form. Consider these questions: • How was leadership involved? • Were there others involved such as patients, families, staff (from different areas), community, local pharmacy, etc.

Results*

Please describe the following in the open text field provided. Please note: one, five-page supplemental document in Word, Excel or PDF format may be submitted with the application to support this section; tables and graphics are encouraged. Any supporting documentation can be uploaded at the end of this form.

Sustainability of Resources and Results*

Any supporting documentation can be uploaded at the end of this form. Consider these questions: • Do you have a plan for reviewing results and making further improves and/or expansion of project? • Is there a plan to continue to support work and to sustain improvement made?

Lessons Learned*

Any supporting documentation can be uploaded at the end of this form. Consider these questions: • Was the project successful? • What did you learn? • Were there challenges? • What would you have done differently • Are you able to build on this work? • How did you address issues if there were challenges? • What would you suggest others do if they implement a similar project?

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