Quality Improvement Plan Template Page 9
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16Measure of Service Quality (Complete this table for each indicator which is selected.
Note that only one indicator is required during the first year of the agreement.)
Name
Name. Usually a brief two or three word title.
Definition. With detail, explain the name by including the
Definition
data elements and the type of numerical value to be used
to express the indicator (percentage, rate, number of
occurrences etc.).
Describe how the data will be collected as well as the
Data Collection
method and frequency of collection, and who will collect
the data.
State how often the Quality Improvement Committee will
Assessment
assess information associated with the indicator.
Frequency
Assessment. Assessment is accomplished by comparing actual performance on an
indicator with:
Self over time.
Pre-established standards, goals or expected levels of performance.
Information concerning evidence based practices.
Other practices/clinics/organizations or similar service providers.
(List here the assessment strategies you will use. See APPENDIX A, attached, for examples of
performance improvement tools.)
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