(Name of RHC here)

ANNUAL WORK PLAN
FY'2004

PROPOSED CONCEPT:

PERSON OR SITUATION BRINGING THIS CONCEPT FOR CONSIDERATION:

DATA THAT SUPPORTS THE PROPOSED CONCEPT:

PROPOSED OBJECTIVE, STATED IN MEASURABLE TERMS:

DESCRIBE THE PRIORITY OF ACHIEVING THE GOAL, NOTING WHETHER IT IS:
(CIRCLE OR HIGHLIGHT ALL THAT APPLY TO THE OBJECTIVE)

• HIGH-VOLUME
• HIGH-RISK SERVICE
• PRIMARY CARE FOR PREVENTION OR EARLY DETECTION
• CARE OF CHRONIC CONDITIONS
• AN OPERATIONAL ISSUE RELATED TO CLINICAL COMPETENCY, CLINICAL OPERATIONS, OR MEDICAL DOCUMENTATION
• RELATED TO PATIENT SAFETY
• RELATED TO COORDINATION OF CARE
• RELATED TO CONVENIENCE AND TIMELINES OF AVAILABLE SERVICES
• RELATED TO GRIEVANCES AND/OR COMPLAINTS

BASED ON THE ABOVE, DOES THE RHC RATE THIS OBJECTIVE AS "HIGH PRIORITY?"

DESCRIBE HOW ACHIEVING THE PROPOSED GOAL WILL IMPROVE PATIENT SAFETY, QUALITY OF CARE, AND/OR PATIENT SATISFACTION

.

DESCRIBE THE ORGANIZATIONAL PROCESSES, FUNCTIONS AND/OR SERVICES WHICH ARE INVOLVED:

DESCRIBE THE UTILIZATION OF CLINIC SERVICES IMPACTED BY THE OBJECTIVE, INCLUDING AT LEAST THE NUMBER OF PATIENTS SERVED BY THIS OBJECTIVE AND THE VOLUME OF SERVICES:

DESCRIBE THE PERFORMANCE MEASURES THAT REFLECT THE PROCESSES OF CARE AND RHC OPERATION SHOWN TO BE PREDICTIVE OF DESIRED PATIENT OUTCOMES OR BE THE OUTCOMES THEMSELVES (in other words, describe how the RHC can measure the effectiveness of the interventions in meeting the objective)

ANNUAL EVALUATION OF THE OBJECTIVE: USING THE MEASURE LISTED ABOVE, ANALYZE AND TRACK HOW WELL THE RHC IS MEETING THE OBJECTIVE

(To be completed by September 2004.)