1. Please feel free to use this template, your school’s template, or create one for your Chapter!

2. [Insert Chapter Leader(s) name(s), Faculty Advisor(s)]
[Insert Chapter Name]
[Insert Chapter Leader(s) name(s), Faculty Advisor(s)]
23rd Annual IHI National Forum on Quality Improvement in Health Care

3. Getting Started… Who started the Chapter?
Why did you start the Chapter?
What did you do to engage other students/faculty/health professionals/residents?
What types of people are in your Chapter (nursing students, residents?)

4. Activity
What does your Chapter do/what has it done to expand the knowledge of members and tackle improvements in health care?
Example 1
Example 2
Example 3
Has your Chapter participated in any local improvement activity?
Has your Chapter been a catalyst for other types of activity on your campus/in your organization?
What do you plan to do next?

5. Content
Has teaching about quality improvement/patient safety begun or changed at your school or program since the start of your Chapter?
What IHI Open School resources, if any, do faculty/staff include in their teaching? How does the inclusion of these resources change your experience as students?

6. Community Integration
Does your Chapter have a relationship with a local health care organization?
Who is it?
How were you connected?
What are you doing with the organization?
How do you collaborate?
How has your Chapter worked with other parts of the IHI network (mentor hospitals, Improvement Advisors, Fellows, etc)?
What advice do you have for health care organizations about working with students in the improvement community? (if applicable)
What do you plan to do next with the organization?

7. Successes How has your Chapter grown?
Have you hosted any events? What did you do? (share pictures)
Share 2-3 examples of early wins (recruiting methods, meetings, etc)

8. Challenges What is/are your biggest challenge(s)?
What are you doing to address them?
Can people at the Forum help you overcome the challenge? (is there an “ask?”)

9. Help! What are your goals?
Identify three ways local health professionals could support your Chapter (if applicable)

10. Contact Information
[insert Chapter Leader Name(s) and ]
Chapter website or blog address
Thank you!