Hospital Process Redesign Project Evaluation Form
Please provide your evaluation of the hospital process redesign project.
Project Name
*
Project Manager
*
First Name
Last Name
Evaluation Date
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Effectiveness of the Redesign
*
1
1
2
3
4
Best
5
1 is , 5 is Best
Impact on Patient Care
*
2
1
2
3
4
Best
5
1 is , 5 is Best
Impact on Staff Workflow
*
3
1
2
3
4
Best
5
1 is , 5 is Best
Overall Satisfaction with the Redesign
*
4
1
2
3
4
Best
5
1 is , 5 is Best
Strengths of the Redesign
*
Areas for Improvement
*
Additional Comments
*
Submit
Should be Empty: