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
Friday, February 5, 2016, to either:
·
·
For questions on the Idaho application submission process, please contact
Hannah Sharp at or at (800) 488-1118, ext. 5945.
For questions about the Washington application submission process, please contact
Paula Parsons at or at (800) 949-7536, ext. 2470.
State: Idaho Washington
Category
The project described in this application is the work of a:
Single large hospital
Single critical access hospital
Post-acute provider (skilled nursing facility, assisted living facility, home health agency, etc.)
Outpatient setting (primary care, specialty care, ambulatory surgery center, community
organization, laboratory, etc.)
Health system (a multi-setting system of hospitals and other providers)
Other (health plan, pharmacy, etc.)
Project title:
Name of organization:
Name of individual submitting application: Title:
Name of media contact for your organization:
Media contact email:
Street address:
City:
State:
Zip:
Phone number: Fax:
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 Award of Excellence?
Direct email
Qualis Health website
Professional association
Other (Please specify)
Information about Your Organization’s Quality Improvement Project or Initiative
Please note:
Only those applications that receive an initial score of 80 or higher (on a scale of 0 to 100) will be further considered for an award. Each element of the application makes
a difference. Be sure to tell us about your project and spotlight your success in
each section.
A. Describe your organization. (e.g., hospital, clinic, location, number of beds, number of providers, specialty focus and anything else you’d like us to know, including any “hardship,” such as limitation of resources):
B. Tell us about your project.
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
RCT-level evidence supporting the intervention)
2. What data did you track to measure the progress of your project?
What metrics were monitored to define success? Please list.
(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? (15 points: 1 point = data minimally used to identify or direct changes; 15 points = baseline data and information collected were systematically reviewed and prioritized, and robust, data-supported system or process changes were implemented)
4. What were your results? Show examples and detailed quantitative evidence.
(45 points)
4a. Better healthcare for patients. (quality, safety, experience) (15 points)
4b. Better health for populations (15 points)
4c. Reduced costs (15 points)
5. How is your project unique? How does your project use an innovative idea, approach or method?
(10 points: 1 point = project is a repeat of a commonly known intervention or effort,
e.g., something required by regulation/core measures; 10 points = project uses an innovative idea, approach, method, etc.)
C. Summary
1. Provide a brief abstract or summary (150 words or less) of your project
in simple language that is understandable to people who don’t work in healthcare. Include why it is important and high-level quantitative
results and outcomes.
(5 points: 1 point = summary does not describe project clearly, need for project is not explained, high-level results are vague; 5 points = summary describes project and why it was needed, outcome is clear.)
2. Provide a single chart or graph that illustrates the key results from your project and demonstrates your success.
(5 points: 1 point = key graph/chart does not illustrate results; 5 points = key graph/chart clearly shows the progress that was made to improve the problem.)