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Form for Adding  Projects to the Accelerating Care Transformation (ACT) Initiative Project Catalog
Use this form to add your Care Transformation / Clinical Quality Improvement / Learning Health System (LHS) activities to the catalog. This information will be used to cross-fertilize efforts. Information entered into this form is publically shared via this spreadsheet.
Work to produce and leverage this catalog is supported by the ACT.
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About  you and your organization
Name (Project liaison(s) to ACT) *
Title/Position
email *
Organization(s) *
Organization Type (select all that apply)
About your project 
Please complete a separate form for each target/project.
Project Name *
Target area(s) *
Required
Description (mention successes/learning and include link(s) to project-related summary as appropriate)
Indicate if your project depends on Electronic Health Record(s) (EHR[s]). Check all that apply
Project status
Clear selection
Project funding
Data standards used  (see slide 24-36 here for details)
Obstacles or Needs
What problems or barriers could other people or organizations help you solve, avoid or overcome (e.g., tools to address specific care transformation needs, strategies for obtaining leadership buy-in for transformation initiatives, funding)?
 *
Support you can offer
What problems or barriers could your organization help others solve, avoid or overcome (e.g., lessons learned, tools/methodological guidance, funding)
 *
How can we make the catalog usable, useful or relevant? (For example, how should we tag initiatives to facilitate search as the catalog grows?)
Thanks for sharing your work!
If you have questions or additional suggestions, please contact

Jerry Osheroff: josheroff@tmitconsulting.com
By submitting this form you are agreeing to participate in the Learning Health System.Care Transformation Initiative. You are also agreeing that information that you provide, including your name and  contact information, will be shared with others. 
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