The National PACE Association is seeking speakers willing to present at the 5th Annual Summer Quality Symposium to be held in Kansas City, MO on Friday, June 5, 2015.

Please complete this survey by April 3rd.

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* 1. Contact Information:

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* 2. Please provide a biographical summary which highlights your relevant experience (150 word maximum).

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* 3. On which topics are you interested in presenting (Rank top three)?

  1st choice 2nd choice 3rd choice
Infection control/Injection safety
Use of DataPACE 2 data to improve quality, efficiency, and/or cost (e.g. program design, trends, lesson learned)
Quality initiatives to address participant/caregiver/family satisfaction/involvement in decision-making
Level II reporting & root cause analysis activity
Effective strategies to document and log service requests
ICD-9/ICD-10 coding & documentation requirements
HPMS data entry, checklists, call structure/preparation/frequency
Role and structure of QI departments
Best practices in care management with applicability to PACE model
National quality models and applicability to PACE
Structure and processes to support culture of safety and how participants and their family are involved
Use of technology and its impact on health care outcomes and/or service delivery (e.g., telemedicine)
Changes to 2015 CMS PACE Regulation & its impact on PACE organizations (if released in Spring 2015)
Impact of CMS Emergency Preparedness policy on PACE
Effective strategies to prepare for first CMS PACE audit
Effective strategies and tools to develop an annual quality plan
Compliance
Meaningful use
Patient Centered Medical Home

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* 4. Please provide a "working" presentation title and three (3) learning objectives for your 1st choice topic.

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* 5. Please provide a "working" presentation title and three (3) learning objectives for your 2nd choice topic.

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* 6. Please provide a "working" presentation title and three (3) learning objectives for your 3rd choice topic.

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* 7. Based on your response to Question #3, in what format would you like to present?

  Interactive workshop/case study Panel discussion Lecture presentation Keynote
1st choice
2nd choice
3rd choice

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* 8. Why are you the right person to speak on the selected topics?

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