The Joint Commission seeks to support organizations adopting ecqms by enabling the sharing of ecqm and health-it driven quality improvement practices.

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1 Introduction The Joint Commission seeks to support organizations adopting ecqms by enabling the sharing of ecqm and health-it driven quality improvement practices. You are invited to submit your pioneering 2018 Proven Practices. Proven Practices are solutions, processes, or practices that demonstrate the use of ecqms and health IT for quality improvement. Topics of interest include, but are not limited to: - Using ecqms as part of organizational quality improvement efforts - Harmonizing clinical decision support and quality measurement - Optimizing clinical workflow and ecqm collection to support quality care - Improving or ensuring ecqm data quality and accuracy - Role of governance and structure in improving ecqm performance - Educating clinicians on quality improvement and electronic data collection Selected organizations will be recognized as a Pioneers in Quality Solution Contributor in The Joint Commission 2018 annual report, and their success stories shared in the Proven Practices Collection. The Proven Practices Collection is a new resource available to Joint Commission accredited organizations. In addition, organizations selected as Expert Contributors will be invited to present their Proven Practices as part of The Joint Commission s Pioneers in Quality webinar series. Eligibility: Organizations must be accredited by The Joint Commission to be eligible for selection Must be in the process of preparing for 2018 submission (CY 2017 ecqm data) or have previously submitted ecqm data to either The Joint Commission or CMS If selected, must be willing to present and/or share your Proven Practice in The Joint Commission s 2018 Proven Practices Collection Completing the Submission: The submission period opens March 5, 2018 and closes April 13, 2018 at 11:59 pm Central Daylight Time A PDF sample of the submission is available on The Joint Commission Pioneers in Quality web page. It is recommended you review the PDF sample submission prior to beginning the application

2 Evaluation criteria will assess the practice s contribution to health IT-enabled quality improvement, the level of the project s impact, and its replicability and sustainability Organizations selected for recognition will be notified in July 2018 Application-specific feedback will not be provided Using the Submission Platform: Please be sure to use the directional button prompts in the application and not your browser buttons (e.g., use of the Back button and Next buttons) Please note the character limit in certain question types. If you are copying and pasting from another document the response will be truncated to the designated character limit The software is designed to allow for your responses to be saved (for two weeks), if you need to complete the application at a later time.you will need to reopen the application from the same computer to access the saved information, as it is linked to your IP address Prior to submission you will have the opportunity to review your responses and download a PDF version to save to your computer. Please be sure that you have completed the application before it is submitted. If the application is inadvertently submitted prior to completion, please contact the Pioneers in Quality Team at PioneersInQuality@jointcommission.org to reopen the application Once submitted, all status updates are communicated via . Both the submitter and presenters should add jointcommission.org to their accepted sender lists. If you are the submitter of an abstract but not the presenter, please follow up with your presenter colleagues regarding any subsequent notices received from The Joint Commission For additional questions or support for completing the submission, please contact the Pioneers in Quality Team at PioneersInQuality@jointcommission.org Submission Demographics Are you submitting this application on behalf of a healthcare system? Yes No Please provide your contact information and an executive contact should your application be selected for the Proven Practices Collection. Individual Submitting: Organization: Healthcare System: Address:

3 City: State: Zip: Telephone: Executive Name: Executive Address: Executive City: Executive State Executive Executive Phone: Is your organization accredited by the Joint Commission? No Yes, provide your HCO ID# in the text box below Please indicate the primary inpatient Electronic Health Record (EHR) system for your organization. If this is a submission for a healthcare system, select all that apply. Allscripts Cerner/Siemens Epic McKesson Meditech Other, please specify in the box below Is your organization submitting ecqm data to the Joint Commission and/or CMS? Yes No How is your organization submitting your ecqm data?

4 Direct data submission Vendor Provide the name of the vendor and vendor ID utilized for Joint Commission data submission. Vendor Vendor ID# How many licensed beds are at your facility? 0-99 beds beds beds beds Which of the following best describes your type of organization? Teaching Non-teaching What service type most accurately best describes your organization? (select all that apply) Academic/University Community Health System Other What designation best describes your organization? Government, Federal Government, Non-Federal Non-Government (not for profit) Investor-Owned (for-profit) Physician-Owned (for-profit)

5 Application Title of Initiative/Proven Practice Proven Practices may include either technology solutions or clinical and business processes, or may encompass both technology and practice. Please select the topic(s) your Proven Practice demonstrates (please select all that apply): Using ecqms as part of organizational quality improvement efforts Harmonizing clinical decision support and quality measurement Optimizing clinical workflow and ecqm collection to support quality care Improving or ensuring ecqm data quality and accuracy Role of governance and structure in improving ecqm performance Educating clinicians on quality improvement and electronic data collection Other (please describe) Provide a brief summary description including the issue, challenge and/or approach including improved clinical care. if accepted that would be used in publications. (1500 characters max, including spaces) In the questions below you will be asked to provide detail in regards to your initiative. Please note: there is a 1,500 character maximum including spaces for each response. Please link the topics selected-${q://qid10/choicegroup/selectedchoices} to the following questions and describe:

6 I. Solution/process/practice and how it was identified. II. Approaches used to implement the solution/process/practice. III. Challenges or barriers you encountered, and how they were addressed. IV. Outcome or product.

7 V. Provide data to support how the technology/process/practice has improved clinical quality (e.g., improved quality measure performance, improvements in efficiency, safety). VI. Describe how the technology/process/practice has been or could be replicated across organizations. Include key considerations, including staff or roles required, time required, and any key lessons learned you would impart to those organizations seeking to replicate your success. Please provide data to support how the Proven Practice has reached the described achievement (e.g., graph models, graphical representation over time, etc.) If you have more than one model, please combine into one document. This is kept to a minimum of one combined file in a PDF and is limited to five pages. Any information exceeding the fifth page will not be considered. Please provide any additional information, demonstration of replication of the work in other organizations or care settings, press clippings, awards, etc. This is kept to a minimum of one combined file in a PDF and is limited to five pages. Any information exceeding the fifth page will not be considered.

8 End of Survey You have reached the end of the application. Please select the 'SUBMIT' button below to complete your submission. Once you submit your application you will be have the option to view and download a PDF of your application. Powered by Qualtrics

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