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Certificate for Excellence in Quality Improvement

This certificate requires an application from the hospital, which will include a description of improvement efforts related to a nationally recognized quality measure. Positive trending is required to meet this portion of the award criteria, but all positive trends are welcome (no minimum improvement is required). Data shared must represent a minimum of two full quarters and must occur within the previous 12 months.
Please complete all three pages of this application to be considered for the HealthInsight Certificate for Excellence in Quality Improvement. The tab key may be used to navigate to the next field.

In order to save your application and continue completing it at a later time, you must first click this button:

From there, you can register your account, login and then click "Save for Later" at the bottom of the page. When you return to the form and login, you can then continue completing the application.

Please write the hospital's name as it should appear on the certificate in the event that the hospitals is a recipient.

Note: Please do not send protected health information (PHI) with your report. Please de-identify your reports of any patient identifiers.

Hospital Information

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Please double check spelling as this is the name that will appear on the award.

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Last Name, First Name

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Hospitals will select a quality measure from the following categories:

  1. Hospital-Acquired Conditions – for example, Hospital-Acquired-Stage 2+ Pressure Ulcer Prevalence (NQF 0201)
  2. CMS Inpatient Quality Measures – for example, Influenza immunization – IMM-2
  3. CMS Outpatient Quality Measures – for example, median time to transfer to another facility for acute coronary intervention – OP-3
  4. CDC- or HHS-endorsed Community Health Measures – for example, Adults with hypertension whose blood pressure is under control (a Healthy People 2020 leading health indicator)

In order for HealthInsight to fully understand the nature of your hospital’s quality improvement effort, please complete all of the fields below.

Please select a quality measure from the following categories:*

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See criteria above for examples.

How was the need for improvement identified?*
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Describe how the problem was identified.

How did your hospital organize around the effort?*
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Was a team formed?*
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Who were the team members?*
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What role did leadership play in the project?*
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How was performance measured?*
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How did your facility know that the interventions were appropriate?*
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How did your facility know if the interventions were working or not working?*
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What were the interventions?*
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What did you do and how did you do it?*
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What is different today as a result of this project that was not occurring before it began?*
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What were the results?*
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What percentage of improvement did you experience?*
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What was your rate before the initiative (baseline) and what were your results after the initiative (remeasurement)?*
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Did you partner with any local nursing homes or other community health care providers?*
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If so, please share your experience.*
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Please remember to attach appropriate documentation.

Note: Please do not send protected health information (PHI) with your report. Please de-identify your reports of any patient identifiers.

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Please compile all supporting documentation into a ZIP file (5MB max) and upload it here. Here are detailed instructions for making a ZIP file.

Explanations / Comments

If you have exceptions, explanations or comments regarding your data, please provide clarification here:

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Feedback

Feedback is welcome on the application process or suggestions for measures or technologies to incorporate in the future. Please provide them here:

Feedback
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Please remember to attach appropriate documentation.

Note: Please do not send protected health information (PHI) with your report. Please de-identify your reports of any patient identifiers.

If my hospital is selected as a recipient of the Certificate for Excellence in Quality Improvement:

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I authorize HealthInsight to release my organization’s name for publication via press releases, articles, and website announcements.

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I authorize HealthInsight to photograph our staff representatives with the award and display the photograph(s) in newsletters and on www.healthinsight.org.

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Please check the box to continue.

Providers who are under sanctions are not eligible for the HealthInsight Certificate for Excellence in Quality Improvement . I attest that no providers in my organization are under current sanctions. (This is subject to verification.)

Please type the text shown to continue*
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After you click "Submit Form," your form will be checked for errors and you will be returned to the pages that have information that needs to be fixed. After you fix these errors, please continue through to the end of the form to resubmit.

It can take several minutes for the form to submit, as any attachments will be uploaded. Please stay on this page as the form submits.