Improvement Strategy Name: ___________________________________________________________
1. Goals and Strategies
|Project Team Members
|Barriers to Successful Implementation (actual or potential)
|Method of Study Improvement (check one or more)
|Plan, Do, Study, Act
|Activity (e.g., data collection, staff training,
development of new forms, purchases)
|Who is responsible?
|Who needs to know about the strategy?
|What information do they need?
|When do they need the information?
|Who will provide the information?
3. Estimated Time and Expenses
|Estimated Number of Hours for Implementation
|Number of hours per week
|Number of weeks
|Total number of hours
|Resources Needed for Implementation
|Estimated expenditure ($)
|Issue for Approval
4. Performance Measures
|Performance Measures (check all that apply)
|ED Arrival to ED Departure – Admitted Patients
|ED Arrival to ED Departure – Discharged Patients
|Admit Decision Time to ED Departure
|Left Without Being Seen
|ED Arrival to Bed
|ED Arrival to Physician