Improvement Strategy Name: ___________________________________________________________
Date:_______________________________________________________________________________
1. Goals and Strategies
| Problem Statement |
| Goal Statement |
| Strategy Description |
2. Approach
| Project Team Members | |||
|---|---|---|---|
| Role | Name | Title | Department |
| Barriers to Successful Implementation (actual or potential) |
| Method of Study Improvement (check one or more) | |
|---|---|
| Plan, Do, Study, Act | |
| Lean | |
| Other | |
| Implementation Steps | ||
|---|---|---|
| Activity (e.g., data collection, staff training, development of new forms, purchases) |
Who is responsible? | Due Date |
| Communications Strategy | |||
|---|---|---|---|
| Who needs to know about the strategy? | What information do they need? | When do they need the information? | Who will provide the information? |
3. Estimated Time and Expenses
| Estimated Number of Hours for Implementation | ||||
|---|---|---|---|---|
| Role | Name | Number of hours per week | Number of weeks | Total number of hours |
| Resources Needed for Implementation | |
|---|---|
| Resource | Estimated expenditure ($) |
| Approvals Needed | |||
|---|---|---|---|
| Name | Issue for Approval | Date Approval Requested |
Date Approval Obtained |
4. Performance Measures
| Performance Measures (check all that apply) | |
|---|---|
| ED Arrival to ED Departure – Admitted Patients | |
| ED Arrival to ED Departure – Discharged Patients | |
| Admit Decision Time to ED Departure | |
| Left Without Being Seen | |
| ED Arrival to Bed | |
| ED Arrival to Physician | |
| Other Measure: | |
| Other Measure: | |
| Other Measure: | |
