Physician-Led Quality Improvement - Intake Form
Deadline : May 29th 2017, 4pm PT; For help contact :
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Community Of Care
1. What are you trying to accomplish and why?(250 WORDS)Please provide the problem or need to be addressed and a description of what you are trying to accomplish, by the project.
2. How does your idea align with your department/program/division/community of care goals and priorities?
3. What level of commitment are you able to provide? (select all that apply). Disclaimer : there is a monthly meeting/training as part of this process.
less than 8hrs/month
approx. ½ day/week, 20 hrs/month
4. What is you level of interest & involvement in Quality Improvement work?
I am really interested in Quality Improvement and I have been involved (took part/lead) in the past or currently
I am really interested in QI but I have not been involved in any/many actual QI projects.
I have just been introduced to QI training but may have done some QI work in the past.
I have just been introduced to QI training and would like to get involved and begin my first project
5. How did your hear about this initiative?
Send me a copy of my responses.
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