Selected Site-Directed Measures for Improvement in 2023
Deadline: December 9, 2022
Name of Site:
Name of person
submitting form:
Selected Measure:
Current Performance
(as reported on the QI
Dashboard):
Date:
Coordinating Center to complete:
Baseline Performance Score
(November 1, 2021 – October 31, 2022):
Date:
Outcome (inverse) measure: Yes No
Approves 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.
