DAA for Clinical Excellence: Phase One

Two-Phased Application Process:

Phase one deadline: April 1, 2014
Phase two deadline: June 30, 2014

Phase One of the application process must be completed and returned by April 1, 2014. Phase One is essentially a high level outline of your project, while Phase Two is a more in depth reporting of metrics and results. Should you wish to change your proposed project, an amended application must be submitted or your application may be deemed ineligible for the competition.

Vital Statistics

Person Submitting Form


First Name*

Last Name*

Title*

Phone Number*

Email Address*

Organization Information  

Organization Name*

Address 1*

Address 2

City*

State*

Zip/Postal Code

Country

Web Site (URL)

Main Phone Number

CEO Information

First Name

Last Name

Title

Phone Number

Email Address

CMO Information

First Name

Last Name

Title

Phone Number

Email Address

CNO Information

First Name

Last Name

Title

Phone Number

Email Address

CIO Information

First Name

Last Name

Title

Phone Number

Email Address

CMIO Information

First Name

Last Name

Title

Phone Number

Email Address

Public Relations Contact Information

First Name

Last Name

Title

Phone Number

Email Address

 

Organization Profile

 

1.Provide a 50-75-word description of your organization, including number and types of facilities, bed size, number of inpatient and outpatient visits per year, and any specialties. Include any industry recognition or commendations your organization has received.

   

2. List the McKesson solutions used in the project.

   

3. Provide a brief project hypothesis.  (For example:  “Physician use of evidence-based protocols as deployed in Horizon Expert Orders will help reduce mortality rates related to sepsis.”)

 

4. What patient care area(s) and/or patient populations will be impacted by the project?  (For example, med-surg units, ED, all inpatient areas; diabetes patients, stroke patients, etc.).

   

5. What resources will be used for this project?  Include both people and technology.  (For example, specific leadership and/or staff roles, governance structure, data sources, reports).

   

6. Provide other relevant information or comments here.

   

Eligibility

 

Please review the eligibility requirements for the award prior to submission to ensure your organization meets them.

               


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