AAAHC Institute for Quality Improvement
Bernard A. Kershner Innovations in Quality Improvement Award Program 2015
AAAHC accredited organizations are asked to submit descriptions of completed quality improvement studies and their resulting
interventions, which have led to positive outcomes. The Institute’s intent is to disseminate information on exemplary submissions.
By making a submission to this program, an organization agrees to allow the AAAHC Institute to indefinitely use all, or portions of,
the submission for educational and/or promotional purposes. Please send only the completed application as your entry; responses
are limited to 10 pages. The completed application must be sent by e-mail, in the computer-generated form, to
mchappell@aaahc.org,
The AAAHC Institute has appointed an Expert Panel to review all submissions. The criteria against which the Expert Panel will judge
submissions are listed in A and B below.
A. The Expert Panel will review all submissions for overall clarity and conciseness of the description of and/or rationale for:
1. The quality issue addressed
2. Appropriateness of the performance goal
3. Data collected (performance measure[s])
4. Data collection methodology
5. Data analyses and conclusions
6. Comparison of initial performance versus performance goal
7. The development and implementation of corrective action, and, if necessary, additional corrective action
8. Re-measurement, and, if necessary, additional re-measurement
9. New current performance versus performance goal
10. Methods of communication of the study findings throughout the organization
B. The Expert Panel will also review all submissions for evidence of: innovative thinking, working as a team, and setting an example
that can be used in other ambulatory health care settings/for other ambulatory health care issues.
In order to be in compliance with HIPAA, no patient identifiers are allowed on the application.
The representatives of the 1or 2 selected studies that most closely reflect the criteria used by the Expert Panel will receive:
1)
2)
3)
Complimentary registration (limit 1 per organization, 2 in total) to the AAAHC Achieving Accreditation program, to be
held December 4-5, 2015, at the Wynn Encore, in Las Vegas, Nevada;
Roundtrip economy airfare, within the continental United States, to Las Vegas, Nevada, and 3 nights stay (December 3,
4, 5, 2015) at the Wynn Encore, in Las Vegas, Nevada (limit 1 per organization, 2 in total);
An award from the AAAHC Institute on behalf of their organization, prior to making a poster presentation about their
activity at Achieving Accreditation.*
No other awards and/or compensation will be offered in lieu of those stated directly above. Meals and other expenses will be the sole
responsibility of the winning organization(s). The AAAHC Institute reserves the right to refuse to award items 1, 2, or 3as described
above, if the review panel finds that no submission sufficiently complies with the criteria established to evaluate entries.
Only submissions from organizations accredited by AAAHC, from February 26, 2015 up to and including the December 4, 2015 are
eligible for consideration. Organizations that employ an AAAHC/AAAHC Institute officer or director are not eligible for this award
program. ** Organizations may submit only one (1) application; multiple entries will not be considered. **
Due to an anticipated high volume of submissions, the AAAHC Institute will notify only those entrants who are finalists. Notification
of finalists will take place on/by July 17, 2015. Recommendations of the Expert Panel will be submitted to the AAAHC Institute
Board for review and approval. The decisions of the Board will be final.
Organizations submitting applications to the AAAHC Institute for this program agree to release from liability, indemnify, and hold
harmless AAAHC and the AAAHC Institute, and their employees, directors, officers, members and any other agents against all actual
and direct losses suffered, and all liability to third parties arising from or in connection with participating in the award program.
Program void where prohibited.
Accreditation Association for Ambulatory Health Care, Inc.
5250 Old Orchard Road, Suite 250, Skokie, Illinois 60077
Phone: (847) 853-6060 Fax: (847) 853-6118
Application
AAAHC Institute for Quality Improvement
Bernard A. Kershner Innovations in Quality Improvement Award Program 2015
Please send only the completed application as your entry submission; responses are limited to 10 pages. You must
email the computer generated completed application to mchappell@aaahc.org. The entry deadline is 12:00 pm
(noon) Central Time, June 12, 2015. Entries received after 12:00 pm (noon) Central Time, on June 12, 2015 will
not be accepted.
Please do not hesitate to contact Naomi Kuznets, PhD, AAAHC Institute Senior Director, (nkuznets@aaahc.org or 847853-6079) if you have any questions.
If you need additional space, please attach additional sheets of paper that include your contact information and the
question you are answering (see last page of form).
Name of Study:
Contact Name:
Title:
Organization Name:
AAAHC Organization ID Number:
Street Address:
City:
State:
ZIP:
Telephone:
Fax:
E-Mail:
Reminder: In compliance with HIPAA, no patient identifiers are allowed on the application.
To submit your application:
1. SAVE this completed form to your hard drive.
2. Send the electronic file (MS Word or Adobe pdf) via email to mchappell@aaahc.org.
3. Receipt will be confirmed by a return email.
4. If you do not receive a confirmation of receipt by return email, the document has not been received and
will not qualify for consideration.
Thank you for submitting your application to the 2015 “Innovations in Quality Improvement Award.”
1
Name of Study:
Contact Person:
Organization:
1. What was the quality issue you addressed? Please be as specific as possible.
Why is the issue you addressed in your quality improvement (QI) activity important to your organization and
others? (You are welcome, but not limited, to cite and provide significant information on important issues such
as threats to safety, high prevalence, high incidence, high cost, wide variations in practice, as well as literature
such as national clinical practice guidelines, national and local health statistics, and peer-reviewed research).
2. What was the performance goal against which you were comparing your current performance? What was your
rationale for this goal?
3. What data did you identify that you needed to collect, and from what data source, in order to determine: (1)
whether there was a problem, and if so, (2) how severe or frequent the problem was, and (3) the possible sources of
the problem?
2
Name of Study:
Contact Person:
Organization:
4. What was the time frame for your data collection? What information did you collect? How did you record these
data?
5. Please describe how you analyzed your data and what your initial findings were.
6. How did your initial performance compare with your identified goal?
3
Name of Study:
Contact Person:
Organization:
7. Describe the corrective action(s) you implemented, when re-measurement was scheduled, and the rationale for
these.
8. If any aspect (method, source, etc) of your re-measurement varied from the initial measurement, please describe
this and provide rationale for the change(s). What was the result of your re-measurement versus the performance
goal you identified?
4
Name of Study:
Contact Person:
Organization:
9. Was additional corrective action needed? If so, please describe the corrective action implemented/rationale, any
changes in measurement/rationale, and the results of your new re-measurement versus your performance goal.
10. How did you communicate your findings throughout your organization?
5
Name of Study:
Contact Person:
Organization:
On behalf of _________________________________ (Name of Organization), I agree to the terms of this program,
as described in the AAAHC Institute for Quality Improvement Innovations in Quality Improvement 2015 Award
Program document, and attest that the information included in this application is accurate and truthful to the best
of my knowledge. I agree to make available de-identified patient documentation of the activity described here, to
the AAAHC Institute, upon request.
______________________________________________
Authorized Organizational Representative
Sign and Print Name
________________________
Date
6
Name of Study:
Contact Person:
Organization:
The information on this additional page refers to question:
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Accreditation Association for Ambulatory Health Care, Inc.
5250 Old Orchard Road, Suite 250, Skokie, Illinois 60077
Phone: (847) 853-6060 Fax: (847) 853-6118