Quality Improvement Project Submission Form

NICAP QI Project Application

This form must be completed when submitting a project in coordination the Neuormedicine Interdisciplinary Clinical and Academic Program (NICAP). Questions regarding this application should be sent to Dr. Jacqueline Baron-Lee, Director of Quality Improvement, at jbaronlee@ufl.edu.
  • What is the Problem? This is your problem statement.
  • What are we trying to accomplish? This is your AIM Statement. Your aim should be specific, measurable and time-bound. EX: We will reduce same-day surgery cancellations by 50% within 6 months.
  • How will we know that change is an improvement? This is a critical piece of the project There are several types of measures, including process (what was done) and outcome (what happened). Process measure example: percentage of staff washing hands before an encounter with a patient, use of an emergency manual during a critical incident in the operating room, percentage of ASA 4 patients seen in pre-op clinic at least 7 days before scheduled surgery. Outcome measure examples: Incidence of wound infections, outcomes of intraoperative critical incidents, same-day surgery cancellations. Process measures are often easier to measure for smaller projects and can often be obtained through online surveys.
  • What changes can we make that will result in an improvement? Be specific and realistic.
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    Inclusive list of members.
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    Who will be affected to make the change successful?
    Please indicate the UF Health Big Aim(s) relating to your project. To find out more about the UF Health Big Aims, please visit nicap.med.ufl.edu.
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    Please list between 3-5 keywords