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Run: HCAHPS Action Plan Review

Quarterly HCAHPS Action Plan Review template for tracking domain performance, action plan progress, unit results, and next-quarter priorities. Use it to docu...

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HCAHPS Domain Performance

Goal Achievement and Action Plan Progress

HCAHPS Improvement Goals (required)

Document quarterly goals, measures, progress, and ratings for HCAHPS improvement work.

Action Plan Progress Summary (required)

Summarize completed actions, in-progress items, and any missed milestones with evidence.

Barriers and Escalations

Capture operational barriers, resource gaps, or escalations needed to keep the action plan on track.

Unit-Level Results and Root Cause Review

Unit-Level Results Summary (required)

Summarize the unit's HCAHPS results, trend direction, and notable changes from the prior quarter.

Root Cause Analysis (required)

Identify the most likely drivers of performance changes using observable evidence and operational data.

Stakeholder Feedback Reviewed

Select the feedback sources used to assess unit performance.

Next-Quarter Priorities and Development Plan

Next-Quarter Priorities (required)

List the top priorities for the next quarter with measurable outcomes and ownership.

Development Plan (required)

Capture development actions using a 70-20-10 approach, including on-the-job practice, coaching, and formal learning.

Overall Summary and Sign-Off

Overall Performance Summary (required)

Summarize overall quarterly performance using specific evidence from goals, HCAHPS results, and action plan execution.

Employee Reflection

Employee comments on results, barriers, and support needed for the next quarter.

Manager Signature (required)

Employee Signature (required)

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