PHFPQ Sustainability Questionnaire

NW logo

Sustainability is about ensuring that the improvements you have made will last. In order for these enhancements to be lasting, we must establish a plan for sustainability. We all want these changes and improvements to become part of the culture in your facility.
 
To successfully complete this questionnaire, please take a moment to consider the most recent Quality Improvement Activity your facility participated in.
 
  • What can be done to ensure that this intervention will become part of the culture in your facility?
  • How will you ensure that these steps will continuously support your current processes?
  • Will this require that you modify training in your facility?
  • How will you track these interventions to ensure improvements in performance measures are sustained?
  • If you have a corporate partner, what is their role in supporting this sustainability plan?
 
 

Question Title

* 1. What is the name of your facility?

Question Title

* 2. What is the 6 digit CMS provider number of your facility? (Begins with a 45- or 67-)

Question Title

* 3. Please enter your first and last name.

Question Title

* 4. Please enter your email address.

Question Title

* 5. What is your title? (i.e. Facility Administrator, Clinic Manager, etc.)

Question Title

* 6. UTILIZATION: How will you utilize frontline staff and corporate leadership to implement these changes?

(For example: How could your corporate leadership be instrumental in assisting you at the clinic level to maintain gains and positive outcomes from the quality improvement activities that you have participated in?)

Question Title

* 7. SHARE: How will these new changes, or changes to existing processes, be communicated with existing staff, new staff, PRN staff, patients, and family members? How will feedback be obtained and addressed from each group?

(For example: Do you have a communication plan?)

T