Performance Improvement

Hospital PI Form
Pre-Hospital PI Form
Scope of Performance Standards

Quality Care Issues may be submitted to the Quality/Performance Improvement Committee after all private efforts at resolution between the parties have failed. A submitting entity must show, by utilizing both pages of the Issue Referral form, the pathway undertaken to resolve the issue. Additional paperwork may be submitted but this completed form is mandatory in order for this committee to get involved in resolving the quality concern.

INSTRUCTIONS: Issue Referral Form