Qualtrics Survey | Qualtrics Experience Management

Thank you for your interest in becoming a QI Hub Faculty! You must be employed by BMC, a Boston HealthNet CHC, or a BACO site to be eligible.

Please see detail below on the time commitment required to be a QI Hub Faculty member. Tasks 1 and 2 are required for all faculty on a regular basis, however tasks 3-5 may not be required of every faculty member each year.

1. Monthly meetings - 1 hour per month (journal club volunteer needs to choose and lead discussion on an article)
2. MOCAM reviews - on-call mentor for 2 week period 1-2 times per year. Expected to review application within 1 week of receipt. Reviews may take 1-2 hours
3. Teaching courses - 2 times per year - 60-90 minute presentation and preparation for presentation
4. Course Mentor - about 5 hours per month over the course of the program
5. Ad Hoc Mentor - about 1-2 hours per month over the course of the relationship

Full Name

Degree(s)

Title

Have you had any formal training in quality improvement? Select all that apply

IHI Improvement Advisor
IHI Improvement Coach
Lean Six Sigma
Institutional QI Training (e.g. Improvement Leadership Academy or Leading Change Collaborative). Please describe and give institution.
Other, please explain

Have you used/do you have familiarity with the IHI Model for Improvement?

Yes
No

Please describe

FYI - we will ask that you complete the IHI Open School Modules if you are accepted as QI Hub Faculty

Do you have experience leading a QI project with some sustained improvement from baseline?

Yes
No

Please provide an example

Do you have an interest in teaching courses on quality improvement topics?

Yes
No

Do you have experience teaching a QI curriculum?

Yes
No

Do you have an interest in coaching/mentoring colleagues on their quality improvement projects?

Yes
No

Do you have experience coaching/mentoring on quality improvement projects?

Yes
No

Do you have support from your supervisor to be a QI Hub Faculty Member?

Yes
No

BMC is committed to providing equitable and inclusive care to all patients who come through our doors, particularly those who may need additional services and support.

I have a commitment to acting for equity in quality improvement work.

I agree
I do not agree