Quality Improvement Study Template - Implementation Guide
Slide 1: Quality Improvement Study Template
<Project Title>
<name> Ambulatory Surgery Center
<insert date>
Slide 2: Problem Statement
- <insert problem statement here>
Slide 3: Improvement Team
- Project Leader(s)
– <insert name> - Team Members
– <insert name> - Administrator/Manager
– <insert name> - Anesthesiologist/Certified Registered Nurse Anesthetist
– <insert name> - Circulating Nurse
– <insert name> - Scrub Technician
– <insert name> - Surgeon
– <insert name> - Data collector
– <insert name> - Anesthesia Technician
– <insert name> - Pre-op/Post-Anesthesia Care Unit Nurse (PACU)
– <insert name> - Physician Assistant
– <insert name> - Infection Preventionist
Slide 4: Data Description
- What:
- Where:
- What you’re using to collect data:
- Who:
- Exclusions:
- Who will collect data:
- Collection period:
Slide 5: Data Collection
- Baseline data collection period:
- Number of cases observed:
- Data collected
– <insert how data were collected>
Slide 6: Baseline Data
Data collection period:
Exclusions:
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Slide 7: The Goal
<insert goal>
Slide 8: Data Comparison
Slide 9: Data Comparison
Goal:
Observed performance:
Current performance: Below Goal by X or Goal Achieved
Slide 10: Cause of the Problem
<insert observed causes of the problem>
Slide 11: Corrective Actions/Interventions
- Intervention:
- Target:
- Timeframe:
Slide 12: Materials Developed (optional)
Slide 13: Change Data
Pre-Intervention
Post-Intervention
Data collection period:
Exclusions:
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|---|---|---|---|
Slide 14: Data Comparison
Slide 15: Data Comparison
Goal:
Observed performance:
Current performance: Below Goal by X or Goal Achieved
Slide 16: Additional Corrective Actions or Remeasurements
- Intervention:
- Target:
- Timeframe:
Slide 17: Materials Developed (optional)
Slide 18: Remeasurement
Post-Intervention # 1
| Cases Observed | Debriefs Completed | Debrief Completion Rate |
|---|---|---|
Post-Intervention # 2
Data collection period:
Exclusions:
| Observation Date | Cases Observed |
Debriefs Completed |
Debrief Completion Rate |
|---|---|---|---|
Slide 19: Data Comparison
Slide 20: Data Comparison
Goal:
Observed performance:
Current performance: Below Goal by X or Goal Achieved
Slide 21: Conclusions
- <insert conclusions>
Slide 22: Communication/Reporting of Findings
- The results of this study were shared with the board on XX/XX/2015
- <insert excerpt from board meeting minutes>
Slide 23: Sustaining the Gains
Performance was reassessed X months after the goal was achieved
Data collection period:
Exclusions:
Slide 24: Sustaining the Gains
Slide 25: Future Work
- <insert future work>
