|Project Name||rev. MM/DD/YYYY|
|How good? For whom? By when? 1-2 sentences
|What is the problem? What happens, when, how often/how much, to whom does it happen? 2-3 sentences
|Why is this project important? How will the improvement benefit patients? What is the potential downside of this effort for patients? What background information (data/analysis/literature) supports the choice of this effort? What area or organizational goals does this project align with/support? 4-5 sentences
|Specific objectives and numerical targets. Anticipated products, tools and deliverables (e.g., checklist, clinical pathway, etc.).
|Brief measure descriptions summarized from more detailed measures table. Include outcome (1-2), process (2-5) and balancing (1-2) measures.
|What are the major challenges you anticipate? IT? Attitudes? Behaviors? Culture? Time?
|Who are the key stakeholders in the planned changes? How will you incorporate interprofessional and multidisciplinary input? How will you incorporate patients’ and families’ perspectives?
|In Scope:||Out of Scope:|
|Key dates (project kickoff, milestones, etc.) summarized from detailed project timeline.
|Team Member||Project Role (sponsor, lead, SME, coordinator, etc.)|