QAPI Program Utilization_Manual

Project : _______________________________________________ QAPI PROJECT Problem: _________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ Data Source: ______________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ Baseline Data Results: ______________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ Goal: ____________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ Possible Interventions: _____________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ Barriers:__________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ Possible Rapid Cycle Testing (e.g., PDSA): ______________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ Plans on Spreading: ________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ Monitoring Plan: __________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ _________________________________________________________________________________ Staff/title preparing the project: ___________________________________ Date: ___________ Signature: __________________________ Plan-Do-Study-Act 117