Project Documentation Form 2017


Purdue Healthcare Advisors’ (PHA) 2017 Annual Event on August 17, 2017, will highlight project information from 14 Indiana-based Critical Access Hospitals and Rural Hospitals participating in a three-year Lean Healthcare Transformation initiative facilitated by PHA and funded by the Indiana State Office of Rural Health. The answers you provide will document the work your team completed this past year.

Before you start filling out this form...

Make sure that you have printed out the instructions, and have your answers ready. Be prepared to copy-and-paste the answers into the related fields. This form cannot be saved.

Provide the name of the team's primary contact (first and last names), including credentials

An email sent to this address will confirm your submission.

List the names of all the team members. Include their credentials; hospital-related title; and whether they are pursuing an Advanced Lean Practitioner or Lean Practitioner Certification.


Quantify the impact of the current situation. This may include financial, lead time, patient outcome, etc. (200 words max)

Describe the findings and areas to address. (300 words max)

List the identified RIEs. (100 words max)

List the measures and goals the organization wants to accomplish through this work. (100 words max)


Describe the RIE’s and their targets. (100 words max)

Describe the focus areas and problems found during the RIE’s. (200 words max)


Include your aha moments, new tools that were helpful... (200 words max)

Describe the measurable results of the lean work. (200 words max)

(200 words max)

Describe what the hospital has coming up by way of improvement initiatives. (200 words max)


This can be provided in a word doc you can upload here.

Resolution of 300 d.p.i. preferred. Examples include photos of your Lean team at work; areas under transformation. NO PATIENT PHOTOS PLEASE.

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