Dartmouth-Hitchcock
Population Health Innovation Project Proposal
OVERVIEW
The Population Health Innovation Fund was established in 2014 to support the advancement of
population health across Dartmouth-Hitchcock practices sites and the communities. The Fund supports
community grants and other activities that measurably improve health of the population.
Based on review of Community Health Needs Assessments in communities served by the DartmouthHitchcock system of providers, the Dartmouth-Hitchcock Population Health Management Council has
established four priorities for the Fund:
1) Reducing harm from substance misuse
2) Reducing harm from unaddressed mental health needs
3) Improving health and well-being for frail elders
4) Improving access to care through innovative and community-delivered approaches
The Council will review applications addressing any topic, but has a special interest in proposals that
address one or more of these priority health needs.
APPLICATION
GENERAL INFORMATION
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Date:
Project Title:
Submitted By:
Phone:
E-Mail:
Department/Organization:
Project Location:
Name of Dartmouth-Hitchcock Clinical Sponsor:
Community Partner or State, Governmental, Public Health Sponsor:
Is this project intended to be implemented:
☐Locally;
☐Locally with possibility to replicate;
☐Locally as a pilot of a planned system-wide initiative;
☐System-wide.
Please indicate the best description(s) of the people who will be served by the proposed project:
☐Patients of Dartmouth-Hitchcock when they receive services at a D-H site (including
affiliate practices and facilities).
☐Patients of Dartmouth-Hitchcock served though community-delivered strategies.
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☐Populations in a community or region served by Dartmouth-Hitchcock practices.
☐Broad populations of communities (state or regions) regardless of where they seek health
care.
SECTION 1: ALIGNMENT with POPULATION HEALTH PRIORITIES (1-9 Points).
A. Alignment with D-H Population Health Improvement Goals: Which Population Health
Improvement priority does your proposal address?
☐Reducing harm from substance misuse;
☐Reducing harm from unaddressed mental health needs;
☐Improving health and well-being for frail elders;
☐Improving access to care through innovative and community-delivered approaches.
☐Addresses a different need. If so, please describe how this proposal addresses one or
more issues identified through a community health/public health needs assessment at the
local, regional, state, or clinic level, and whether it aligns with Community Health/Public
Health Improvement Plans? (500 characters or less)
B. Equity/Disparity/Service Gap Populations: Please describe whether this project serve
populations that have inequitable or disparate health impacts due to income, race, ethnicity,
disability, gender, education, language, discrimination/bias/stigma, or due to gaps in existing
services (i.e., long waiting lists for service or long distance to needed services). (500 characters or
less )
SECTION 2: PROBLEM, SMART GOALS, PROJECT DESCRIPTION, EVALUATION (1-9 Points)
C. Problem Definition: Please provide a clear statement of the problem this project will address,
potential root causes of the problem, and data to demonstrate the magnitude of this problem.
(1,500 characters or less)
D. Project Goals and Anticipated Outcomes: Please describe the goal and outcomes of this project,
using a SMART goal framework (Specific, Measurable, Achievable, Realistic, Time-bound). (1,500
characters or less)
E. Proposed Project/Intervention: Describe the proposed project/intervention. How will the
project achieve the stated SMART goals? Provide a project timeline and/or bulleted milestones
at every three months of the project. (5,000 characters or less)
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F. Metrics/Project Evaluation: What measures will you use to monitor and evaluate project
progress and success? (1,000 characters or less)
G. Team/Partners: Who will be involved in the delivery of this project?
Person or Organization
Project Role
H. Innovation: Describe how the project uses a novel approach, methodology, or intervention; or
implements an existing evidenced-based or best practice in a novel way or in a new setting? (500
characters or less)
SECTION 3: REPLICATION/SUSTAINABILITY (1-9 points)
I.
Feasibility. What is the likelihood that the proposed intervention can be implemented? How
difficult will it be to effect the required changes? (1,000 characters or less)
J.
Replicability: If this project is successful, what opportunities exist for it to be replicated in other
communities served by Dartmouth-Hitchcock? (500 characters or less)
K. Sustainability: Please describe how this project will be sustainable after the project period?
What are the incentives and motivations to maintain the changes? (1000 characters or less)
SECTION 4: LEARNING OPPORTUNITIES (1-9 points)
L. Opportunities to Generate New Knowledge. Please describe whether this project creates
opportunities for academic research or scholarly contributions by extending or creating new
knowledge. (250 characters or less)
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M. Opportunities for Learners: Please describe whether this project will create learning
opportunities for students, trainees, health professionals and/or community members? (250
characters or less)
SECTION 5: FINANCES of this INVESTMENT (1-9 points)
N. Cost Reduction: Will the project result in a measurable reduction in health-related costs to
Dartmouth-Hitchcock and/or in other costs for communities we serve? (1,500 characters or less)
O. Budget: The Population Health Innovation Fund is not intended to support activities that are
normally covered in operational budgets. Short-term funding to support operations will be
considered for funding if there is a long-term plan for ongoing support.
Items unlikely to be
funded
Employee salaries
Large capital items,
especially if there is
long-term operating
cost
Copyrighted or
licensed product
Examples
Physician FTE, clinical staff salaries. Funding can be used to
pay for consultants, backfill for personnel temporarily
dedicated to project support, or a new position certain to
have ongoing support in the next fiscal year budget.
Ancillary information system requiring purchase of
hardware and software.
Licensed products will be considered for funding only if
there is a plan to fund ongoing fees after the current
project is completed.
P. Budget: Please provide an annual budget for the proposed project (attach separate budget
documents if needed).
Cost Type
Amount
Justification
Salaries
Benefits
Equipment
Supplies
Other (describe)
Other (describe)
Other (describe)
Other (describe)
Other (describe)
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Total Requested
Please direct application questions, completed proposals, and supporting materials to Greg Norman,
Director, Dartmouth-Hitchcock Community Health (greg.norman@hitchcock.org).
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