Application Submission Guidelines

Submissions must be typed directly into this document and cannot exceed 10 pages, including charts and graphs. Additional pages will not be considered.

Whether you are applying for Idaho or Washington, submissions must be sent by February 2, 2018 to either:

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For questions on the Idaho application submission process, please contact Darcy Hall at or call (800) 488-1118, ext.5943.

For questions about the Washington application submission process, please contact Paula Parsons at or at (800) 949-7536, ext. 2470.

General Information for Reviewer Purposes:

Name of Organization:
Type of Healthcare Organization:

Project Title:

State: Idaho Washington


We welcome applications from healthcare organizations including single, large hospitals, single critical access hospitals, outpatient settings, health systems, post-acute provider settings, health plans, pharmacies and other healthcare environments.


Applicant Information:

Name of individual submitting application: Title:

Street address:

City:

State:

Zip:

Phone number: Fax:

Email:

Name of media contact for your organization:

Media contact email:

Please check this box if you are willing to present your project at the awards ceremony with a
poster if your organization receives an award.

By submitting this application, the applicant consents to release the project summary, facility contact information and images to Qualis Health to post on its website and potentially share with the media.

How did you hear about the Qualis Health Awards of Excellence in Healthcare Quality?

Direct Email Other Professional association

Qualis Health website Twitter

Information about Your Organization’s Quality Improvement Project

A.  Describe your organization. Provide a brief description of your organization in 150 words or less

B.  Describe your project. (55 Points)

1.  What problem are you trying to solve?

(10 points: 1 point = no clear need for improvement and limited evidence to support implementing the initiative; 10 points = well described prior gap in performance and randomized controlled trial level evidence supporting the intervention)

2.  What data metrics did you use to track and measure the progress of your project?
List the data metrics monitored during this project. Note: Actual results should be placed in section C. (10 points: 1 point = poorly defined metrics and/or subjective data use only; 10 points = clearly defined process, outcome measures and study design)

3.  What changes did you implement? (25 points: 1 point = data minimally used to identify or direct changes; 25 points = baseline data and information collected were systematically reviewed and prioritized, and robust, data-supported system or process changes were implemented)

4.  How does your project address equity and patient-centered care, such as directly engaging
patients and families, reducing disparities, and/or addressing social determinants of health?
(10 points)

C.  Results (30 Points)

What was the outcome of your project? Demonstrate your results. Show your data in graphs or charts.

D.  Triple Aim (15 points)

The awards program recognizes efforts that address the three-part aim of the National Quality Strategy: better care, healthy people/healthy communities, and lower cost of care. How did your project address each element of the Triple Aim?

E.  Summarize your project (Not scored)
Qualis Health uses this information to announce and promote award winners.

Provide a brief summary in 150 words or less of your project in simple language. Briefly state the following:
(1) what you aimed to improve, (2) why it’s important, (3) what changes you made and (4) your quantifiable result(s).

Provide a single chart or graph that illustrates the key results from your project and demonstrates
your success.