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Our Residency Program wishes to be a member of the Collaborative and agrees to the following expectation as a requirement of participation:
  • Assign a QI team to the Collaborative and provide accurate contact information
  • Participate in the Fall 2022 and Spring 2023 learning sessions, bringing the QI team and participating as a team in PDSA activities
  • Submit the results of PDSA cycles to support our outcomes and process data results
  • Participate in all scheduled web conferences to review data and receive additional education that is critical to our continued improvement
  • Submit baseline and monthly data as set forth in the curriculum
  • Complete any evaluation activities such as surveys
  • Respond to the faculty and staff email inquiries in a reasonable amount of time

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* 1. Residency Program Name/Institution

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* 2. Residency Program Address

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* 3. Program Director 

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* 4. Program Director  Email

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* 5. Program Director Phone

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* 6. Residency Coordinator Contact Name

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* 7. Residency Coordinator Email

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* 8. Residency Coordinator  Phone

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