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Quality Improvement Worksheets
The following series of worksheets will help your staff
become familiar with the process of quality improvement.
Interdisciplinary teams should use these worksheets whenever
improving a process (clinical or non-clinical) within their
facility. Each team should keep all of its worksheets together
for each project to record and track progress.
Quality Improvement Worksheets on MedQIC (link opens a new
window)
Getting Started Worksheets
The following worksheets are located on the MedQIC
website, and they provide a structured framework in which to
narrow down, collect data, select and organize a team for
the problem area chosen. Several sub-worksheets will help
start the process of identifying an area for improvement and
forming a team to address that improvement.
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Worksheet A: Identifying Areas for Improvement
Assists in identifying one component of care to improve.
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Worksheet B: Forming a Team
Guides the formation of the quality improvement team.
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Worksheet C: Team Meeting Notes
Provides a sample form to document team meetings, tasks, and
the next steps for team members as assigned.
Quality Implementation Worksheets
The following worksheets are located on the MedQIC
website, and they provide a guide through the steps of the
quality improvement process. There are several
sub-worksheets provided to frame and help document your
goals and progress throughout the quality improvement
process.
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Worksheet D: Goal Setting
Guides the team in determining the goal for improvement
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Worksheet E: Current Process Analysis
Guides the team in determining the goal for improvement.
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Worksheet F: Root-Cause Analysis
Guides the team in identifying the ‘root’ of the problem in
your current process; where and why the problem exists.
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Worksheet G: Fishbone Diagram
Provides a working tool to identify possible ‘root’ causes.
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Worksheet H: Process Improvement Plan
Guides the team in identifying a small improvement that can
be made in your process that addresses the root-cause of the
problem.
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Worksheet I: Implementation Strategy
Guides the team in planning an implementation of the
pilot-test of the small change (improvement) in process.
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Worksheet J: Pilot Testing
Guides the team in identifying staff roles in a pilot-test
in a small area of the facility.
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Worksheet K: Pilot-Test Evaluation
Guides the process to analyze the results of the pilot-test.
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Worksheet L: Ongoing Monitoring
Guides the team in developing ways to monitor the new
(improved) process.
Other Resources
The Colorado Foundation for Medical Care (CFMC), the Medicare quality improvement organization for Colorado, prepared this material under
contract with the Centers for Medicare & Medicaid Services (CMS), an
agency of the U.S. Department of Health and Human Services. The contents
do not necessarily reflect CMS Policy.
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