1. Patient Safety/Quality Improvement Day 2014
1-Project Name
Project Name
Team Info
Time: Start Month, yr – current (month, yr)
Lead: who
Key Participants:
Name (dept)
This material is protected pursuant to the TN Patient Safety
and Quality Improvement Act of 2011.

2. Patient Safety/Quality Improvement Day 2014
2-Problem Statement
Background
Observations
Current Condition
Printer: On landscape, prints face-up, top-edge towards printer

3. Patient Safety/Quality Improvement Day 2014
3-Desired Condition
Vision
Metrics impacted
AIM Statement

4. Patient Safety/Quality Improvement Day 2014
4-Root Cause / Analysis

5. Patient Safety/Quality Improvement Day 2014
5-Data
Process Measure(s)
Outcome(s)
Countermeasure(s)

6. Patient Safety/Quality Improvement Day 2014
6-Key Strategies
Process Change
Implementation Plan
Lead
When
Impact
8-Financial Impact
Cumulative Savings
Remaining Opportunity

7. 7-Tests of Change (PDSA-Plan, Do, Study, Act--Cycles)
Patient Safety/Quality Improvement Day 2014
7-Tests of Change (PDSA-Plan, Do, Study, Act--Cycles)
PDSA/Test of Change
Rationale
When
Result

8. Patient Safety/Quality Improvement Day 2014
* See attached

9. 9-Followup / Barriers / Unresolved Issues
Patient Safety/Quality Improvement Day 2014
9-Followup / Barriers / Unresolved Issues