ACTION PLAN WORKSHEET – 90 DAY GOALS
INSTRUCTIONS:
1. Discuss with your team some changes you’d like to make specific to at least 3 of the Change Concepts listed in the table. Use the
information you’ve heard in the presentation, data from your site or organization, or observations you’ve made about how things
currently work in your site to guide your discussion.
2. List three changes that your team agrees are important to make in the table.
3. For each listed change write a 90-day goal. Remember to write your goals in a SMART (specific, measurable, actionable, realistic, and
time bound) format.
4. In the final box, list a few ‘testable ideas’ that will help you get to your goal. Use the Key Activities List to help you generate ideas.
EXAMPLE:
CHANGE
CONCEPT
CONTINUOUS,
TEAM-BASED
HEALING
RELATIONSHIPS
CHANGES WE WANT TO MAKE
We want to improve our
continuity measure by working
with the front desk staff on how
to best facilitate patients
getting their appointment
scheduled with their care
team.
90-DAY GOAL
MAKE IT SMART: SPECIFIC, MEASUREABLE,
ACTIONABLE, REALISTIC AND TIME-BOUND
By January 8th, we will have
improved our continuity rate for
at least two care teams to 75%.
TESTABLE IDEAS
 Provide scripts for the front desk
staff to use when patients call in to
make appt.
(We need to train the front desk staff
on the new focus and importance of
ensuring that patients see their own
care team. As we do that, we will
solicit their ideas for things to test.)
ACTION PLAN WORKSHEET – 90 DAY GOALS
SITE:
CHANGE
CONCEPT
ENGAGED
LEADERSHIP
QUALITY
IMPROVEMENT
STRATEGY
EMPANELMENT
CONTINUOUS,
TEAM-BASED
HEALING
RELATIONSHIPS
CHANGES WE WANT TO MAKE
90-DAY GOAL
MAKE IT SMART: SPECIFIC, MEASUREABLE,
ACTIONABLE, REALISTIC AND TIME-BOUND
TESTABLE IDEAS
CHANGE
CONCEPT
ORGANIZED,
EVIDENCE-BASED
CARE
PATIENTCENTERED
INTERACTIONS
ENHANCED
ACCESS
CARE
COORDINATION
CHANGES WE WANT TO MAKE
90-DAY GOAL
MAKE IT SMART: SPECIFIC, MEASUREABLE,
ACTIONABLE, REALISTIC AND TIME-BOUND
TESTABLE IDEAS