Project: Healthcare Quality Improvement Initiative and Evaluation Report

Name: Role/Title:

Department: Date:

Opportunities for Improvement

What are areas of concern or the opportunities for quality improvement initiatives to be implemented? What is the data or qualitative information that indicates there are problems?

Previously Addressed Concerns

Have these concerns been previously addressed in the past? What would indicate so? What is the impact of these previously addressed issues?

Quality Improvement Goals

What are the specific goals of a quality improvement plan that could address the opportunities for improvement?

Monitoring Progress

How will you monitor the progress of these goals? What is the follow-up schedule and benchmarks that would indicate improvements?

Additional Notes

What else should the quality team keep in mind if this improvement plan were to be put into action?