ASPIRE Meeting/Deliverable Forms
Saved in L:\MPOG-ASPIRE-ACQR Last updated: 07/10/2024
Selected Site-Directed Measure for Improvement in 2025
Deadline: December 6, 2024
Site to Complete:
Name of site:
Name of person
submitting report:
Selected Measure:
Current Performance (as
reported in Galileo):
Date:
Coordinating Center to complete:
Outcome (inverse) Measure: Yes No
Approved as Measure: Yes No
Site QI Champion Signature:
Date:
ASPIRE Signature:
Date:
Submit the completed form to Tory Lacca (lacca@med.umich.edu) at the ASPIRE Coordinating Center.
Baseline Performance Score
(November 1, 2023 – October 31, 2024):
Date:
M
M
M
M
