Quality Improvement Self-Nomination Application
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1.
Title of Quality Improvement Project
(Required.)
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2.
Institution Name
(Required.)
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3.
Institution Type
(Required.)
Professional
Residency and Fellowship Program
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4.
Program contact person name
(Required.)
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5.
Would you be willing to integrate this quality improvement practice into future educational programming?
(Required.)
Yes
No
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6.
Describe your quality improvement project, including the purpose, goals, and scope of the quality improvement project? (e.g. one cohort, one clinical site, one class). [no more than 300 words]
(Required.)
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7.
Describe the implementation of the quality improvement project.[no more than 100 words]
(Required.)
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8.
In what ways has your quality improvement initiative led to measurable progress toward established program benchmarks, and how has this contributed to the program's long-term success? [no more than 200 words]
(Required.)
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9.
If applicable, describe the project's ability to be adapted or scaled to a different context or setting.
(Required.)
