Measure 1: 1. Measure selected for Reason: improvement; reason for selection Baseline Start Date: Baseline End Date: 2./3. Baseline performance measurement; numeric goal Baseline Performance Measurement (% or #): for improvement (QI 03) Numeric Goal (% or #): 4. Actions taken to improve Action: and work toward goal; dates Date Action Initiated: of initiation (QI 10) Additional Actions: (Only 1 action required) 5. Remeasure performance Start Date: End Date: Note: Continuing QI is encouraged, (% or #): Performance Remeasurement but is not required for QI 10. 6. Assess actions; describe improvement. Note: Continuing QI is encouraged, but is not required for QI 10. Use FIVE Measures Identified in QI 08, QI 09 and QI 11 Measure 1: 1. Measure selected for Reason: improvement; reason for selection Baseline Start Date: Baseline End Date: 2./3. Baseline performance measurement; numeric Baseline Performance Measurement (% or #):
Measure 1: 1. Measure selected for improvement; reason for selection Reason: 2./3. Baseline performance measurement; numeric goal for improvement (QI 03) Baseline Start Date: Baseline End Date: Baseline Performance Measurement (% or #): Numeric Goal (% or #): 4. Actions taken to improve and work toward goal; dates of initiation (QI 10) (Only 1 action required) Action: Date Action Initiated: Additional Actions: 5. Remeasure performance Note: Continuing QI is encouraged, but is not required for QI 10. Start Date: End Date: Performance Remeasurement (% or #): 6. Assess actions; describe improvement. Note: Continuing QI is encouraged, but is not required for QI 10. Use FIVE Measures Identified in QI 08, QI 09 and QI 11 Measure 1: 1. Measure selected for improvement; reason for selection Reason: 2./3. Baseline performance measurement; numeric Baseline Start Date: Baseline End Date: Baseline Performance Measurement (% or #):
NCQA_PCMH_Quality_Measurement_and_Improvement_Worksheet_3.4.2017.docx