A
Form
Approved
OMB No. 0935-XXXX
Exp. Date XX/XX/20XX
The following general areas of discussion with the innovator are designed to supplement the information submitted by the innovator through the website.
The innovator submission requires: the name of the organization, the name and title of the submitter, the contact information, a brief description of the innovation, a brief description of the results, a description of the setting and population served, and funding sources. Therefore, the following areas of discussion are designed to augment the submitted information.
Problem: What problem does the innovation address?
Possible Probes:
What’s the process of care that is affected by this innovation (e.g., patient handoffs, hospital admissions)?
Quality aim: What’s the aspect of quality that this innovation addresses?
If the innovator cites data, request a source or at least note that we’ll need to find one.
Impetus: What was the impetus for the innovation?
Possible Probe: Was there a specific event or incident that served as the
impetus?
Goals: What specifically were you trying to achieve?
Possible Answers: improved outcomes, such as lower mortality rates, complication rates, etc.; reduced resource utilization, such as lower hospital admissions; better communication among providers; improved patient satisfaction
Public
reporting burden for this collection of information is estimated to
average 30
minutes per response, the estimated time required to complete
the survey. An agency may not conduct or sponsor, and a person
is not required to respond to, a collection of information unless it
displays a currently valid OMB control number. Form Approved: OMB
Number 0935-XXXX Exp. Date xx/xx/20xx. Send
comments regarding this burden estimate or any other aspect of
this collection of information, including suggestions for reducing
this burden, to: AHRQ Reports Clearance Officer Attention: PRA,
Paperwork Reduction Project (0935-XXXX) AHRQ, 540
Gaither Road, Room # 5036, Rockville, MD 20850.
Implementation: How did you implement the innovation?
Possible Probes:
Explore unique characteristics that affected implementation, if any
Describe what you did to plan for the activity and make it work?
Possible answers: supportive leadership, staff training, multidisciplinary teamwork, implementation tools
What does it take to sustain it over time?
Possible answers: manpower, financial resources, leadership
What other mechanisms do you use, are they available to share?
Possible answers: forms, communication tools
What training is required? (Who, what, when, how long?)
What challenges did you face and how did you overcome them?
Adoption: What does it take for others to adopt the innovation?
Possible Probes:
What advice do you have for others who may want to implement the innovation?
What worked based on your implementation experience, any surprises?
What guidance do you have for others for sustaining the innovation?
Are there other lessons from your experience?
What would you do differently?
What training, supplies, resources, equipment, organizational support are necessary?
File Type | application/msword |
File Title | Attachment C |
Author | wcarroll |
Last Modified By | wcarroll |
File Modified | 2008-08-12 |
File Created | 2008-08-12 |