Perinatal Quality Improvement Report
Submit your perinatal care quality improvement report. Please provide clear, concise information to help drive improvements in care.
Date of Report
*
 -
Month
 -
Day
Year
2 digit month, 2 digit day, 4 digit year
Date
Facility or Unit Name
*
Project or Initiative Title
*
Brief Description of Quality Issue or Focus Area
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Actions or Interventions Implemented
*
Outcomes or Results Observed
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Rate the Impact of This Initiative
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No Impact
1
2
3
4
Significant Impact
5
1 is No Impact, 5 is Significant Impact
Barriers or Challenges Encountered
Lessons Learned
Recommendations for Future Improvement
Submit Report
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