NW2 Support Gainful Employment (VR) QIA Kick-off
Webinar Post Assessment 2019

Please complete the following information.

This for is being used to assess understanding of purpose, facility role, and Network role in the 2019 Support Gainful Employment (VR) Quality Improvement Activity. Please review the Webinar Recording and/or webinar slides prior to competing this form.

Please complete by February 28, 2019.

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* 1. Please select your facility from the dropdown list below (CMS Certification Number (CCN) and Facility name listed)

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* 2. Contact:

Name

Email Address

Phone Number

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* 3. This webinar was over 1 hour long

Yes

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* 4. These QIAs include process review and QAPI reporting

Yes

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* 5. It is required for at least 1 staff member to attend quarterly National QIA LAN Calls

Yes

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* 6. The goal(s) of these QIA(s) is/are:

10% VR/EN Referral and 5% VR/EN Utilization

Facility staff being aware of VR/EN Resources

All Patients understating their VR/EN options

Standardizing the process of patient education on Vocational Rehabilitation

All of the above

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* 7. Do you feel your facility can meet the QIA(s) goals?

Yes

Comment

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* 1. Please select your facility from the dropdown list below (CMS Certification Number (CCN) and Facility name listed)

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* 2. Contact:

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* 3. This webinar was over 1 hour long

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* 4. These QIAs include process review and QAPI reporting

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* 5. It is required for at least 1 staff member to attend quarterly National QIA LAN Calls

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* 6. The goal(s) of these QIA(s) is/are:

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* 7. Do you feel your facility can meet the QIA(s) goals?

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* 8. Do you have any other comments, questions, or concerns?