NURSE PEER REVIEW FORM
APPROVED PROVIDER (AP) APPLICATION – 2015 CRITERIA
REVIEW OF SELF-STUDY NARRATIVE
(NEW “Form 23”)
REMINDER: Do not tell a Provider that you are recommending or not recommending approval. This is based on final NPRL Scoring with ANCC tool.
Directions: Click on a box to ‘check’ – click again to ‘un-check’. Type comments directly into table. Save completed form on your computer under a new name.This form is to be used by Nurse Peer Review Team Leader to document consensus decisions of the team, and is to be submitted with any application resubmissions to the NPRL.
Applicant Organization:Name of Provider Unit (if different):
This organization is
☐ Current Approved Provider / If yes, expiration date: / Current approval is through: ☐WNA or ☐ Other:☐ First time applicant / ‘Provider unit’ has been in operation six months: / ☐YES or ☐NO
If no, contact WNA office or WNA NPRL and do not review application.
Did applicant disclose previous denial/suspension/revocation of accreditation or approval of an IEA/Provider application by ANCC or an ANCC Accredited Approver?
☐ NO☐YES – Checkwith NPRL for instructions before reviewing application.
☐Not answered – Contact Applicant PNP to clarify before reviewing application.
Primary Nurse Planner signed/dated ‘Primary Nurse Planner Attestation’ on last page of application:
☐ YES or ☐ NO – Contact Applicant PNP before reviewing.REMINDER: Do not tell a Provider that you are recommending or not recommending approval. This is based on final NPRL Scoring with ANCC tool.
Reviewer Attestation: As a peer reviewer for this Approved Provider application, I attest that:
- I have no conflict of interest or personal or professional relationship with this applicant that would preclude me from reviewing this application in a fair and unbiased manner.
- I have conducted an independent review of this application.
Date of Initial Review:
☐ Final Review Date OR ☐Date sent to NPR for remediation:
Amount of time spent reviewing:
Review Team Leader - Name and Credentials: / Date:
☐Check this box if you designate the above as your electronic signature.
Review Team Member - Name and Credentials: / Date:
☐Check this box if you designate the above as your electronic signature.
Review Team Member - Name and Credentials: / Date:
☐ Check this box if you designate the above as your electronic signature.
Nurse Peer Review Leader - Name and Credentials: / Date:
☐Check this box if you designate the above as your electronic signature.
REMINDER: Do not tell a Provider that you are recommending or not recommending approval. This is based on final NPRL Scoring with ANCC tool.
Key to abbreviations:APU = Approved Provider Unit OO = Organization Overview SC = Structural Capacity EDP = Educational Design Process QO = Quality Outcomes PNP = Primary Nurse Planne
NP = Nurse Planner COI = Conflict of Interest CNE = Continuing Nursing Education CT-WNA-PA = “COMPLETING THE WNA PROVIDER APP REFERENCE TOOL”
PLEASE USE THE “COMPLETING THE WNA PROVIDER APPLICATION” REFERENCE TOOL WHEN YOU DO YOUR REVIEWS!
INITIAL QUALITATIVE REVIEW CONSENSUS / FINAL CONSENSUS DECISION
Self-study documentation of compliance with ANCC criterion / Complete / Incomplete / Not Submitted / Issues/Clarifications/Documents needed/Due date / Complete / Incomplete / Comments/Page number
ORGANIZATIONAL OVERVIEW:
STRUCTURAL CAPACITY / Com / Inc / Not / Com / Inc
OO1. Demographics
a. / Description of the APU features, including but not limited to scope of services, size, geographic range, target audience(s), content areas, and the types of educational activities offered.(SEE CT-WNA-PA REFERENCE TOOL PAGE 1 – 2)
Scope = Single or mutli-facility system? Number of locations served? Nursing target audience? Jointly provide?
Size = Number of: nurse planners, activities, learners served, or other aspects. If a Health or Ed system: number of sites you provide education to /are there nurse planners at those sites or if program is managed centrally
Geographic range = Where service is provided - Facility? Community? Other?
Target audience = types of nurses (RNs, APRNs, etc.) What practice areas? Inter-professional groups?
Content areas = (clinical, non-clinical; – give examples of broad categories (e.g. leadership, ed.curriculum, QI nursing, etc.)
Type = live? enduring material? blended learning? Other? / ☐ / ☐ / ☐ / ☐ / ☐
Self-study documentation of compliance with ANCC criterion / Complete / Incomplete / Not Submitted / Issues/Clarifications/Documents needed – Due date / Complete / Incomplete / Comments/Page number
b. / If APU is part of a multi-focused organization, description of the relationship of these scope dimensions to the total organization
(SEE REFERENCE TOOL PAGE 2)
Organization’s geographic range, population served, and size.
Describe how the activities of the APU fit into the organization’s goals, strategic plan and educational system. / ☐ / ☐ / ☐ / ☐NOT APPLICABLE / ☐ / ☐ / ☐NOT APPLICABLE
OO2. Lines of Authority and Administrative Support
a. / List of all names and credentials, positions, and titles of the PNP, other NPs) (if any), and all key personnel in the APU.
(SEE REFERENCE TOOL PAGE 2) / ☐ / ☐ / ☐ / ☐ / ☐
b. / Position descriptions for the PNP, other NP(s) (if any), and all key personnel in the APU.
(SEE REFERENCE TOOL PAGE 2)
Should reflect the responsibilities of each person related to his/her role in the provider unit. / ☐ / ☐ / ☐ / ☐ / ☐
c. / Chart depicting the structure of the APU, including the PNP, NP(s) if any, and all key personnel.
(SEE REFERENCE TOOL PAGE 2) / ☐ / ☐ / ☐ / ☐ / ☐
d. / If APU is part of a larger organization, an organizational chart, flow sheet, or similar image that depicts the organizational structure and the APU’s location within the organization.
(SEE REFERENCE TOOL PAGE 2) / ☐ / ☐ / ☐ / ☐NOT APPLICABLE / ☐ / ☐ / ☐NOT APPLICABLE
Self-study documentation of compliance with ANCC criterion / Complete / Incomplete / Not Submitted / Issues/Clarifications/Documents needed – Due date / Complete / Incomplete / Comments/Page number
ORGANIZATIONAL OVERVIEW:
EDUCATION DESIGN PROCESS / Com / Inc / Not / Com / Inc
OO3. Data Collection and Reporting
a. / Completed Approved Provider Continuing Education Summary of all CNE offerings provided in the past 12 months (or previous calendar year).
(SEE REFERENCE TOOL PAGE 2 - 3) / ☐ / ☐ / ☐ / ☐ / ☐
ORGANIZATIONAL OVERVIEW:
QUALITY OUTCOMES
Must have a target for each measure – see “Developing Outcomes for Your Approved Provider Unit” document for how outcomes should be written. / Com / Inc / Not / SEE “DEVELOPING OUTCOMES FOR YOUR APPROVED PROVIDER UNIT” DOCUMENT –
IF APPLICANT’S OUTCOMES ARE NOT DOCUMENTED SIMILAR TO THE EXAMPLES HIGHLIGHTED ON PAGE 3 OF THAT DOCUMENT, SEND THAT DOCUMENT TO THE PROVIDER TO HELP THEM REVISE THEIR APU OUTCOMES! / Com / Inc
OO4. Evidence
a. / List of the quality outcome measures the APU collects, monitors, and evaluates specific to the Approved Provider Unit STURCTURE AND PROCESS. (ALL Applicants: at least TWO one measurable outcomes)
(SEE REFERENCE TOOL PAGE 3 AND DEVELOPING OUTCOMES DOCUMENT) / ☐ / ☐ / ☐ / ☐ / ☐
b. / List of the quality outcome measures the APU collects, monitors, and evaluates specific to Nursing Professional Development.
(ALLApplicants: at least TWO measurable outcomes)
(SEE REFERENCE TOOL PAGE 4 AND DEVELOPING OUTCOMES DOCUMENT) / ☐ / ☐ / ☐ / ☐ / ☐
Response must include:
Narrative = describes how the APU complies with each criterion by explaining the APU’s process
Example = specific example demonstrates how the APU’s process was used/implemented to meet the criterion / Scoring scale:
4 = response exceeds criteria requirement
3 = response meets criteria requirement
2 = response partially meets criteria requirement
1 = response fails to meet criteria requirement / If provider scores all “1’s” on initial review, please contact WNA CEAP NPRL.
INITIAL QUALITATIVE REVIEW CONSENSUS / SECOND REVIEW CONSENSUS FINAL SCORE
Self-study documentation of compliance
with ANCC criterion / 4 - Exceeds / 3 - Meets / 2 – Partially meets / 1 – Fails to meet / Issues/Clarifications – Due date / Re-sub NARRATIVE / Re-sub EXAMPLE / 4 - Exceeds / 3 - Meets / 2 – Partially meets / 1 – Fails to meet / Resubmissions requested – Due date / 4 - Exceeds / 3 - Meets / 2 – Partially meets / 1 – Fails to meet
APPROVED PROVIDER CRITERION 1:
STRUCTURAL CAPACITY (SC) / 4 / 3 / 2 / 1 / Resubmit / Nar / Ex / 4 / 3 / 2 / 1 / 4 / 3 / 2 / 1
SC1. / Description and example demonstrate how the PNP is committed to learner needs, including how APU processes are revised based on data.
(SEE REFERENCE TOOL PAGE 4 – 5)
How does the Primary Nurse Planner (PNP) use feedback to change or improve provider unit processes or learning activities?
What feedback is used?
How are learner needs assessed?
How do you know what styles of learning fit your learners best or what learning modalities (live, webinars, independent study, etc.) they prefer?
What do you do with this information? / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐
SC2. / Description and example demonstrate how the Primary Nurse Planner ensures all Nurse Planners in the Approved Provider unit are appropriately oriented/trained to implement and adhere to the ANCC/WNA CEAP criteria.
(SEE REFERENCE TOOL PAGE 5)
How do you orient new nurse planners to your provider unit?
How do you keep them updated on changes?
How do you monitor to be sure they are doing the right things on a consistent basis? / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐
SC3. / Description and example demonstrate how the Primary Nurse Planner provides direction and guidance to individuals involved in planning, implementing, and evaluating CNE activities in compliance with ANCC/WNA CEAP criteria.
(SEE REFERENCE TOOL PAGE 5)
As PNP, how do you make your expectations clear to other nurse planners and others involved with CNE activities? (How do all involved know what to do?)
What process do you implement to support others who participate on planning committees or engage in the work of providing CNE?
How do you help nurse planners problem-solve when challenges or questions arise? / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐
# checked in column:
Multiply by: / 4 / 3 / 2 / 1
= column score:
Add all column scores:
MEAN SCORE for STRUCTURAL CAPACITY Divide by number of criteria(3):
Response must include:
Narrative = describes how the APU complies with each criterion by explaining the APU’s process
Example = specific example demonstrates how the APU’s process was used/implemented to meet the criterion / Scoring scale:
4 = response exceeds criteria requirement
3 = response meets criteria requirement
2 = response partially meets criteria requirement
1 = response fails to meet criteria requirement / If provider scores all “1’s” on initial review, please contact WNA CEAP NPRL.
INITIAL QUALITATIVE REVIEW CONSENSUS / SECOND REVIEW CONSENSUS FINAL SCORE
Self-study documentation of compliance
with ANCC criterion / 4 - Exceeds / 3 - Meets / 2 – Partially meets / 1 – Fails to meet / Issues/Clarifications – Due date / Re-sub NARRATIVE / Re-sub EXAMPLE / 4 - Exceeds / 3 - Meets / 2 – Partially meets / 1 – Fails to meet / Resubmissions requested – Due date / 4 - Exceeds / 3 - Meets / 2 – Partially meets / 1 – Fails to meet
APPROVED PROVIDER CRITERION 2:
EDUCATIONAL DESIGN PROCESS (EDP) / 4 / 3 / 2 / 1 / Resubmit / Nar / Ex / 4 / 3 / 2 / 1 / 4 / 3 / 2 / 1
EDP1. / Description and example demonstrate the process used to identify a problem in practice or an opportunity for improvement (professional practice gap).
(SEE REFERENCE TOOL PAGE 6 )
How do you define a professional practice gap?
How do you determine what the real issue is that needs attention?
What sources of data might alert you to the existence of a professional practice gap?
How do you know when a gap exists? / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐
Self-study documentation of compliance
with ANCC criterion / 4 - Exceeds / 3 - Meets / 2 – Partially meets / 1 – Fails to meet / Issues/Clarifications – Due date / Re-sub NARRATIVE / Re-sub EXAMPLE / 4 - Exceeds / 3 - Meets / 2 – Partially meets / 1 – Fails to meet / Resubmissions requested – Due date / 4 - Exceeds / 3 - Meets / 2 – Partially meets / 1 – Fails to meet
EDP2. / Description and example demonstrate how the Nurse Planner identifies the educational needs (knowledge, skills, and/or practice(s)) that contribute to the professional practice gap.
(SEE REFERENCE TOOL PAGE 6 )
How do you determine why a professional practice gap exists? (In Other Words: how do you figure out the problem causing the gap?)
How do you then do a more targeted assessment of the needs of the learners expected to participate in this activity to determine how to focus the content of the session to match the gap in knowledge, skills or practice?
What resources do you use to identify those underlying needs (example: new national standards; hospital quality data; nurse input)
How do you determine whether the gap is in knowledge, skills, or application in practice?
How do you determine if there is really an educational need vs. a need for systems change, a compliance issue, policy issue, etc? / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐
Self-study documentation of compliance
with ANCC criterion / 4 - Exceeds / 3 - Meets / 2 – Partially meets / 1 – Fails to meet / Issues/Clarifications – Due date / Re-sub NARRATIVE / Re-sub EXAMPLE / 4 - Exceeds / 3 - Meets / 2 – Partially meets / 1 – Fails to meet / Resubmissions requested – Due date / 4 - Exceeds / 3 - Meets / 2 – Partially meets / 1 – Fails to meet
EDP3. / Description and example demonstrate the process used to identify and resolve all conflicts of interest for all individuals in a position to control educational content.
(SEE REFERENCE TOOL PAGE 6 - 7)
How do you define “conflict of interest” (COI)?
Who has the ability to “control content” for an activity?
Of all involved in CNE, who needs to disclose relevant relationships?
What process and documents do you use to determine if anyone has a COI?
How do you determine whether there really is a conflict of interest for someone involved with the learning activity or if they just listed something on their disclosure form that isn’t really a relevant relationship?
What do you do if a person states that he/she has a conflict of interest?
What if the person states that he/she does not have a conflict of interest, but the nurse planner thinks there may be one?
What happens if someone declines to provide evidence related to conflict of interest for self or spouse?
Who reviews the nurse planner’s disclosure?
What happens if the nurse planner has a conflict of interest?
What options do you consider in resolving the conflict?
When would you choose one option over another? / How do you choose? / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐
Self-study documentation of compliance
with ANCC criterion / 4 - Exceeds / 3 - Meets / 2 – Partially meets / 1 – Fails to meet / Issues/Clarifications – Due date / Re-sub NARRATIVE / Re-sub EXAMPLE / 4 - Exceeds / 3 - Meets / 2 – Partially meets / 1 – Fails to meet / Resubmissions requested – Due date / 4 - Exceeds / 3 - Meets / 2 – Partially meets / 1 – Fails to meet
EDP4. / Description and example demonstrate how the content of the educational activity is developed based on best-available current evidence (e.g., clinical guidelines, peer-reviewed journals, experts in the field) to foster achievement of desired outcomes.
(SEE REFERENCE TOOL PAGE 7)
How does the content selected relate to the professional practice gap and evidence supporting the need for the activity (data from EDP 1 and 2)?
How do you define “best available current evidence”?
What are sources of evidence typically used to meet identified educational needs?
How does the planning committee work with the speaker/author to assure that content and references/resources relate to closing the identified practice gap?
How do you validate that the presenter/author is using best-available evidence to present the information?
Have you ever used content reviewers to evaluatecontent to be sure it is based on best available evidence? / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐
Self-study documentation of compliance
with ANCC criterion / 4 - Exceeds / 3 - Meets / 2 – Partially meets / 1 – Fails to meet / Issues/Clarifications – Due date / Re-sub NARRATIVE / Re-sub EXAMPLE / 4 - Exceeds / 3 - Meets / 2 – Partially meets / 1 – Fails to meet / Resubmissions requested – Due date / 4 - Exceeds / 3 - Meets / 2 – Partially meets / 1 – Fails to meet
EDP5. / Description and example demonstrate how strategies to promote learning and actively engage learners are incorporated into educational activities.
(SEE REFERENCE TOOL PAGE 8)
Why is it important that your learners be actively engaged?
What are common strategies you use to engage learners?
How do you select strategies to use for specific educational activities, depending on whether the gap is in knowledge, skills, or practice? (In Other Words - why do you choose the methods you choose?)
How do you evaluate the effectiveness of learner engagement strategies in your educational activities?
What do you do if learners don’t “engage”?
How are the selected teaching methods related to the identified professional practice gap and contribute to the learners’ ability to achieve the desired outcome of the activity? (Or why do you choose the methods you choose?) / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐
Self-study documentation of compliance
with ANCC criterion / 4 - Exceeds / 3 - Meets / 2 – Partially meets / 1 – Fails to meet / Issues/Clarifications – Due date / Re-sub NARRATIVE / Re-sub EXAMPLE / 4 - Exceeds / 3 - Meets / 2 – Partially meets / 1 – Fails to meet / Resubmissions requested – Due date / 4 - Exceeds / 3 - Meets / 2 – Partially meets / 1 – Fails to meet
EDP6. / Description and example demonstrate how summative evaluation data for an educational activity were used to guide future activities.
(SEE REFERENCE TOOL PAGE 8
How do you collect evaluation data? (NOTE: An evaluation FORM is not required; you are required to have an evaluation process.)
How you do select evaluation strategies based on whether the identified gap is in knowledge, skill, or application in practice?
What data can you collect to assess whether a practice gap is likely to be has been closed for an activity?
How do you summarize evaluation data?
Who is responsible for this process?
How is it shared, and with whom?
What is the purpose of sharing summative evaluation data?
How does sharing and reviewing this data help in planning future learning activities? / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐
Self-study documentation of compliance
with ANCC criterion / 4 - Exceeds / 3 - Meets / 2 – Partially meets / 1 – Fails to meet / Issues/Clarifications – Due date / Re-sub NARRATIVE / Re-sub EXAMPLE / 4 - Exceeds / 3 - Meets / 2 – Partially meets / 1 – Fails to meet / Resubmissions requested – Due date / 4 - Exceeds / 3 - Meets / 2 – Partially meets / 1 – Fails to meet
EDP7. / Description and example demonstrate how the Nurse Planner measures change in knowledge, skills, and/or practices of the target audience that are expected to occur as a result or participating in the educational activity.
(SEE REFERENCE TOOL PAGE 8 - 9)
What data do you look at to indicate your educational activity has contributed to nsg. professional development?
How and when do you measure change in learner knowledge, skill and/or practice? (Both short term and long-term strategies.)
What evaluation data or resources do you collect to indicate that the previously identified gap has been closed for a given learning activity?
What resources do you use to help you measure change?(e.g.; quality improvement data, surveys, or other existing sources of evidence within your system)
What evidence do you look at to show whether or not a learning activity changed nursing practice?
What data do you look at to indicate that your educational activity has contributed to nsg. professional development? / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐
# checked in column:
Multiply by: / 4 / 3 / 2 / 1
= column score:
Add all column scores:
MEAN SCORE for EDUCATIONAL DESIGN PROCESS Divide by number of criteria(7):
Response must include:
Narrative = describes how the APU complies with each criterion by explaining the APU’s process
Example = specific example demonstrates how the APU’s process was used/implemented to meet the criterion / Scoring scale:
4 = response exceeds criteria requirement
3 = response meets criteria requirement
2 = response partially meets criteria requirement
1 = response fails to meet criteria requirement / If provider scores all “1’s” on initial review, please contact WNA CEAP NPRL.
INITIAL QUALITATIVE REVIEW CONSENSUS / SECOND REVIEW CONSENSUS FINAL SCORE
Self-study documentation of compliance
with ANCC criterion / 4 - Exceeds / 3 - Meets / 2 – Partially meets / 1 – Fails to meet / Issues/Clarifications – Due date / Re-sub NARRATIVE / Re-sub EXAMPLE / 4 - Exceeds / 3 - Meets / 2 – Partially meets / 1 – Fails to meet / Resubmissions requested – Due date / 4 - Exceeds / 3 - Meets / 2 – Partially meets / 1 – Fails to meet
APPROVED PROVIDER CRITERION 3:
QUALITY OUTCOMES (QO) / 4 / 3 / 2 / 1 / Resubmit / Nar / Ex / 4 / 3 / 2 / 1 / 4 / 3 / 2 / 1
QO1. / Description and example demonstrate the process utilized for evaluating effectiveness of the APU in delivering quality CNE.
(SEE REFERENCE TOOL PAGE 9)
How do you evaluate the effectiveness of your provider unit?
How often does your provider unit evaluation process occur?
Who engages with you in the evaluation process?
What does “effectiveness” mean for your APU? How do you know you are effective?
What things, besides your individual activities, do you consider in your evaluation of the effectiveness of your provider unit? (e.g., strategic plan, mission, stake holder input, customer satisfaction, opportunities for improvement, and or human and financial resources?)
Why is it important that you conduct this type of evaluation? / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐
Self-study documentation of compliance
with ANCC criterion / 4 - Exceeds / 3 - Meets / 2 – Partially meets / 1 – Fails to meet / Issues/Clarifications – Due date / Re-sub NARRATIVE / Re-sub EXAMPLE / 4 - Exceeds / 3 - Meets / 2 – Partially meets / 1 – Fails to meet / Resubmissions requested – Due date / 4 - Exceeds / 3 - Meets / 2 – Partially meets / 1 – Fails to meet
QO2. / Description and example demonstrate how the evaluation process for the APU resulted in the development or improvement of an identified quality outcome measure.
(refer to identified quality outcomes list in OO4).
(SEE REFERENCE TOOL PAGE 9 -10)
What outcomes measures (identified in OO4a) are you using to evaluate your provider unit’s structure and processes?
When do you determine what your outcome measures will be?
What data have you collected to assess your progress on meeting these outcome measures?
From whom have you collected data about the effectiveness of your provider unit in meeting the quality outcome measures?
How do you analyze this data to determine your effectiveness?
Based on that data, what changes have you made to an existing outcome measure? Why?
What new outcome measures, if any, have you added? Why?
What outcome measures, if any, have you deleted from your priorities? Why? / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐
QO3. / Description and example demonstrate how, over the past 12 months, the Approved Provider Unit has enhanced nursing professional development(refer to identified quality outcomes list in OO4).
(SEE REFERENCE TOOL PAGE 10)
How are your learning activities designed to help nurses learn and grow?
What do you measure to determine that professional growth or change in practice occurred and that professional practice gaps were closed?
What evidence do you have that nurses are able to implement what they learned?
How does what nurses learn improve their professional development or the care they provided for their patients?
How do you know this?
How do you report and/or share your quality outcomes data with others in your organization?
Why does it matter? How do your outcomes benefit the organization as a whole? / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐ / ☐
# checked in column:
Multiply by: / 4 / 3 / 2 / 1
= column score:
Add all column scores:
MEAN SCORE for QUALITY OUTCOMES Divide by number of applicable criterion (3):
REMINDER: Do not tell a Provider that you are recommending or not recommending approval. This is based on final NPRL Scoring with ANCC tool.