Principal Applicant

PRIHS Proposal Title:

Principal Applicant:

Co-Principal Applicant(s) (if applicable):

Please complete the Gantt chart below for the3year period of the Project by listing the objectives and associated milestones.Highlight the timelines corresponding to each milestone by using the “Shading” function located under the “Table Tools” tab
(please append additional pages as required).

Year 1 / Year 2 / Year 3
January 1, 2014 – December 31, 2014 / January 1, 2015 – December 31, 2015 / January 1, 2016 – December 31, 2016
Milestone No. / Researcher / Milestone / Q1 / Q2 / Q3 / Q4 / Q1 / Q2 / Q3 / Q4 / Q1 / Q2 / Q3 / Q4
Objective 1: Description of Objective 1
1.1 / Milestone 1
1.2 / Milestone 2
1.3 / Milestone 3
1.4 / Milestone 4
Objective 2: Description of Objective 2
2.1 / Milestone 1
2.2 / Milestone 2
2.3 / Milestone 3
2.4 / Milestone 4
Objective 3: Description of Objective 3
3.1 / Milestone 1
3.2 / Milestone 2
3.3 / Milestone 3
3.4 / Milestone 4
Objective 4: Description of Objective 4
4.1 / Milestone 1
4.2 / Milestone 2
4.3 / Milestone 3
4.4 / Milestone 4
Objective 5: Description of Objective 5
5.1 / Milestone 1
5.2 / Milestone 2
5.3 / Milestone 3
5.4 / Milestone 4

PRIHS – Principal Applicant’s name–record #

In the table below please provide a detailed breakdownof total projected expenditures for each year of the Project.

Projected Expenditures / Year 1
(January 1, 2014- December 31, 2014) / Year 2
(January 1, 2015- December 31, 2015) / Year 3
(January 1, 2016- December 31, 2016) / Total Amount
Salaries
1) Direct investigator support
(release time payments)
2) Trainees
3) Research associates, technical
support staff, etc.
4)Management/administration
5) Other personnel (please list)
Research materials
6) Major equipment (>$10,000)
7) Major research initiatives/
projects (list separately)
8) General supplies and minor
equipment
9) Other (please list)
Knowledge translation
10) Knowledge dissemination
11) Communications /
networking
12) Other (please list)
Other expenditures
13) Expenditures (please list)
Total expenditures
Items 1-13

PRIHS – Principal Applicant’s name–record #

Based on the information provided in the Gantt chart, please provide projected expenses associated with each objective for
each year of the Projectin the table below.Please add rows to the table, renumber the objectives, and append additional pages
as required.

Summary of projected expenditures / Q1: January 1, 2014 – March 31, 2014 / Q2: April 1, 2014 – June 30, 2014 / Q3: July 1, 2014 – September 30, 2014 / Q4: October 1, 2014 –December 31, 2014 / Objective Total
Objective 1.
Objective 2
Objective 3
Objective 4
Objective 5
Year 1 Quarterly Total Expenditures
Summary of projected expenditures / Q1: January 1, 2015 – March 31, 2015 / Q2: April 1, 2015 – June 30, 2015 / Q3: July 1, 2015 – September 30, 2015 / Q4: October 1, 2015 –December 31, 2015 / Objective Total
Objective 1.
Objective 2
Objective 3
Objective 4
Objective 5
Year 2 Quarterly Total Expenditures
Summary of projected expenditures / Q1: January 1, 2016 – March 31, 2016 / Q2: April 1, 2016 – June 30, 2016 / Q3: July 1, 2016 – September 30, 2016 / Q4: October 1, 2016 –December 31, 2016 / Objective Total
Objective 1.
Objective 2
Objective 3
Objective 4
Objective 5
Year 3 Quarterly Total Expenditures

The total projected expenditures will inform the release the funds for the given period of research activities.

Please identify the risk factors associated with milestones that can potentially delay the Project, and outline the proposed mitigation strategies for the 3 year period of the award (please append additional pages as required).

Milestone No. / Milestone / Risk Factors – Potential Delay
of Project and/or Achieving Expected Outcome / Mitigation Strategy
Objective 1: Description of Objective 1
1.1 / Milestone 1
1.2 / Milestone 2
1.3 / Milestone 3
1.4 / Milestone 4
Objective 2: Description of Objective 2
2.1 / Milestone 1
2.2 / Milestone 2
2.3 / Milestone 3
2.4 / Milestone 4
Objective 3: Description of Objective 3
3.1 / Milestone 1
3.2 / Milestone 2
3.3 / Milestone 3
3.4 / Milestone 4
Objective 4: Description of Objective 4
4.1 / Milestone 1
4.2 / Milestone 2
4.3 / Milestone 3
4.4 / Milestone 4
Objective 5: Description of Objective 5
5.1 / Milestone 1
5.2 / Milestone 2
5.3 / Milestone 3
5.4 / Milestone 4

PRIHS – Principal Applicant’s name–record #

Please provide a description of the critical path required to achievethe objectives outlined in the Gantt chart.

Please provide a brief change management description outlining (i) a plan for system-wide implementation of research findings and (ii) a strategy to bring about the required change in clinician behavior for such implementation.

Please provide a description ofthe opportunities the Project will provide to build applied health research capacity in Alberta.

Please briefly describe what the expected outcomes related to value-for-money (e.g. cost-savings, cost-benefits, monetary gains) and quality improvements are within the three-year time frame of the award and the mechanism(s) to achieve them.

PRIHS – Principal Applicant’s name–record #