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Quality Improvement Indicator Data Collection

Welcome to the Quality Improvement Indicator Data Collection (QIDC). It runs online or can be provided to your IT staff for internal only access. The QIDC allows clients to capture data associated with our Quality Improvement Indicators (QII) and Quality Improvement Programs (QIP). This includes:

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Sample Report - Hospitals

Quality Improvement Indicator Data Collection

This Quality Improvement Indicator Data Collection (QIDC) activity is to be assigned to a Ventilation Measurement and Assessment point of contact. This individual is responsible for this QIDC and its artifacts. Potential Ventilation Measurement and Assessment points of contacts are: Infectious Disease Nurse, Safety Officer, Facility Manager, Owner, or other designated person. It is expected that for large organazations there will be a data collection team that is assigned to various rooms. This team should be selected from the staff normally using the associated rooms. The team will collect the data.

Facility: example-hospital, Any Street, Phila, PA, 19123, www.cassbeth.com, sat@cassbeth.com,

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Room Observations Checklist (weekly or when there is a finding)
Facility Observations Checklist (monthly or when there is a finding)
Extensive Ventilation Systems Check (quarterly or when there is a finding)
ACH Level Measurement (quarterly)

Show Findings Summary


Room Observations Checklist (ROC)

The following data is collected weekly or when there is a negative finding detected. Enter the calender week number to view, enter, or update.

Week (1, 2, 3... 52):

Report: Week 1

see QIIs and QIRs

Previous Data: - New Data: 1 - Data Saved:

Open File .

ROC Facility Data Loaded: Yes

Insert
Row
Room Name Area Zone Room
#
RO2
y/n/f
RO3
y/n
RO4
y/n/na
RO5
y/n/na
RO6
y/n
RO7
y/n
RO8
y/n/f/na
RO9
y/n/f/na
RO10
y/n/f/na
RO11
y/n/f/na
# of
Finds
Date
dd/mm/yyyy
Name
0 - 17 1 - 16 2 - 15 3 - 14 4 - 13 5 - 12 6 - 11 7 - 10 8 - 9 9 - 8 10 - 7 11 - 6 12 - 5 13 - 4 14 - 3 15 - 2 16 - 1 17 - 0
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Findings: 4
Pass: 98%

ROC Save Data . Copy Data To Next Review (change the review number above and check both) .


Facility Observations Checklist (FOC)

The following data is collected monthly or when there is a negative finding detected.

Enter the calender month number to view, enter, or update.

Month (1, 2, 3... 12):

Report: Month 1

see QIIs and QIRs

Previous Data: - New Data: 1 - Data Saved:

Open File .

FOC Facility Data Loaded: Yes

Insert
Row
Area Name Area Zone O1
y/n/na
O2
y/n/na
O3
y/n/na
O4
y/n/na
O5
y/n/nt
O6
y/n
O7
y/n/na
O8
y/n/na
O9
y/n/f/na
M1
y/n
M2
y/n/nt
M3
y/n/nt
M4
y/n
M5
y/n
M6
y/n/na
M7
y/n/na
F1
y/n
F2
y/n
F3
y/n/na
A1
y/n/na
A2
y/n/na
A3
y/n/na
A4
y/n/na
A5
y/n/na
# of
Finds
Date
dd/mm/yyyy
Data Collector Name
0 - 30 1 - 29 2 - 28 3 - 27 4 - 26 5 - 25 6 - 24 7 - 23 8 - 22 9 - 21 10 - 20 11 - 19 12 - 18 13 - 17 14 - 16 15 - 15 16 - 14 17 - 13 18 - 12 19 - 11 20 - 10 21 - 9 22 - 8 23 - 7 24 - 6 25 - 5 26 - 4 27 - 3 28 - 2 29 - 1 30 - 0
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Findings: 3
Pass: 76%

FOC Save Data . Copy Data To Next Review (change the review number above and check both) .


Extensive Ventilation Systems Check

The following data is collected quarterly or when there is a negative finding detected.

Enter the calender quarter number to view, enter, or update.

Quarter (1, 2, 3, 4):

Report: 1

see QIIs and QIRs

Previous Data: - New Data: 1 - Data Saved:

Open File .

EVSC Facility Data Loaded: Yes

Insert
Row
Area Name Area Zone EVSC1
y/n/na
EVSC2
y/n/na
# of
Finds
Date
dd/mm/yyyy
Data Collector
Name
0 - 8 1 - 7 2 - 6 3 - 5 4 - 4 5 - 3 6 - 2 7 - 1 8 - 0
1.
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Findings:
Pass: 100%

EVSC Save Data . Copy Data To Next Review (change the review number above and check both) .


ACH Level Measurement

The following data is collected quarterly.

Enter the calender quarter number to view, enter, or update.

Quarter (1, 2, 3, 4):

Report: Quarter 1

see QIIs and QIRs

Previous Data: - New Data: 1 - Data Saved:

Open File .

ACH LM Facility Data Loaded: Yes

Insert
Row

Room Name
Area
Zone
Room
#

Length
Width
Height
Cubic
Feet

CFM
ACH
req'd

eACH
Total
ACH
req'd

Cert
(self / vendor)

ACH
Lvl
A

ACH
Lvl
1

ACH
Lvl
2

ACH
Lvl
3A

ACH
Lvl
3B

ACH
Lvl
4

ACH
Lvl
5

ACH
Lvl
6

# of
Finds

ACH Date
dd/mm/yyyy

ACH Data Collector Name
0 - 24 1 - 23 2 - 22 3 - 21 4 - 20 5 - 19 6 - 18 7 - 17 8 - 16 9 - 15 10 - 14 11 - 13 12 - 12 13 - 11 14 - 10 15 - 9 16 - 8 17 - 7 18 - 6 19 - 5 20 - 4 21 - 3 22 - 2 23 - 1 24 - 0
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283.
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285.
286.
287.
288.

Findings: 17
Pass: 94%

Select Acheivement Level:
A see QII or QIR
1 this is 5 ACH
2 this is 6 ACH
3A see QII or QIR
3B see QII or QIR
4 this is 12 ACH
5 this is 24 ACH
6 this is 50 ACH

ACH LM Save Data . Copy Data To Next Review (change the review number above and check both) .


Findings

Quality Summary Record # of
Findings
Completed
Room Observations Checklist 4 Week 1
ACH Level Measurement: 1 17 Quarter 1
Facility Ventilation Checklist 3 Month 1
Extensive Ventilation Systems Check Quarter 1
Total Findings 24


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