PRACTICE INITIATIVE PROJECT: WORK PLAN ASSIGNMENT INSTRUCTIONS
OVERVIEW
The Work Plan
You will work with your group to complete the following:
Step One: Decide on a covenant of expectations for group behaviors, (e.g., who is doing
what, when are items due, editing, etc.). This document must be posted in the group
discussion board (but is not graded).
Step Two: Decide on the practice initiative to address, (i.e., target population and health
initiative).
Examples:
o A childhood asthma management program for underserved children
o A program to prevent and manage HIV/AIDS
o A program to address breast health screening and treatment of breast cancer for
underserved women
Link the program outcome to National Quality Forum indicators or other national
benchmarks. Utilize at least 3 – 5 peer-reviewed articles related to your practice initiative
for this assignment in addition to websites and other resources related to the development
of the practice initiative using the logic model.
Step Three: Select and discuss which organization the initiative will best fit based on
mission, vision, values, and strategic plan. These must be considered in designing the
practice initiative.
Step Four: Complete the project work plan template. Familiarize yourself with the logic
model for program development including how to write SMART objectives (all
objectives must be measurable). Review the resources listed above. Based on the logic
model, plan the practice initiative and complete the work plan template.
Note: the template has important samples and instructions for each section. Read these
additional instructions for important details regarding each section. All members of the
group must contribute to the assignment.
INSTRUCTIONS
Include the following information for the work plan submission: a title page written in
current APA format with the title of the practice initiative and all student names; work
plan document (may be landscape or portrait); and a reference page documenting web,
print, and electronic resources in written in current APA format.
This assignment must be 6 – 9 pages
Include 3 – 5 peer-reviewed resources written within the last 5 years (not including the
textbook).
This assignment must be written in current APA format.
The Work Plan
You will work with your group to complete the following:
Step One: Decide on a covenant of expectations for group behaviors, (e.g., who is doing
what, when are items due, editing, etc.). This document must be posted in the group
discussion board (but is not graded).
Step Two: Decide on the practice initiative to address, (i.e., target population and health
initiative).
Examples:
o A childhood asthma management program for underserved children
o A program to prevent and manage HIV/AIDS
o A program to address breast health screening and treatment of breast cancer for
underserved women
Link the program outcome to National Quality Forum indicators or other national
benchmarks. Utilize at least 3 – 5 peer-reviewed articles related to your practice initiative
for this assignment in addition to websites and other resources related to the development
of the practice initiative using the logic model.
Step Three: Select and discuss which organization the initiative will best fit based on
mission, vision, values, and strategic plan. These must be considered in designing the
practice initiative.
Step Four: Complete the project work plan template. Familiarize yourself with the logic
model for program development including how to write SMART objectives (all
objectives must be measurable). Review the resources listed above. Based on the logic
model, plan the practice initiative and complete the work plan template.
Note: the template has important samples and instructions for each section. Read these
additional instructions for important details regarding each section. All members of the
group must contribute to the assignment.
INSTRUCTIONS
Include the following information for the work plan submission: a title page written in
current APA format with the title of the practice initiative and all student names; work
plan document (may be landscape or portrait); and a reference page documenting web,
print, and electronic resources in written in current APA format.
This assignment must be 6 – 9 pages
Include 3 – 5 peer-reviewed resources written within the last 5 years (not including the
textbook).
This assignment must be written in current APA format.
Resources do not need to be included unless quoted. All students must submit the
assignment. All group members will receive the same group grade.
assignment. All group members will receive the same group grade.
PRACTICE INITIATIVE PROJECT: WORK PLAN TEMPLATE
Student Names:
Project Title:
Section A – Comprehensive Needs Assessment (SAMPLE)
Goal A1: Identifying major health issues for the populations to be served, unmet need, barriers to care, etc. (SAMPLE
HRSA)
Objective(s) Key Action Step(s) Expected
Outcome(s)
Data Evaluation
and
Measurement(s)
Person/Area
Responsible(s)
Comment(s)
(Maximum
500
characters)
A1.1 Develop protocol
and measures for
implementing needs
assessment within two
months of grant
award.
A.1.2 Establish a team
of knowledgeable
planning staff to
oversee undertaking of
needs assessment
within one month of
grant award.
A.1.3. Complete needs
assessment for
targeted service area
within four months of
award.
1. Identify appropriate
tools to use for the
need’s assessment.
2. Establish
Subcommittee of the
planning staff to
oversee needs
assessment.
3. Define roles of
planning staff and for
the project.
1. Participate in the
comprehensive
need’s assessment
elements meeting
with area
stakeholders.
2. Create tangible
targeted assessment
protocols and tools
for identified
populations in
collaboration with
other health
centers.
3. Conduct at least
one coordinating
meeting every
month.
4. Completed needs
assessment.
1. The number of
planning
meetings.
2. Determination
made regarding
approach.
3. The number of
meetings
attended.
4. Number of
persons at each
meeting.
5. Progress against
established
timeline for
completion of
assessment.
1. Planning
Grant
committee
2. CEO
3. Board of
Directors
4. Consultant
Student Names:
Project Title:
Section A – Comprehensive Needs Assessment (SAMPLE)
Goal A1: Identifying major health issues for the populations to be served, unmet need, barriers to care, etc. (SAMPLE
HRSA)
Objective(s) Key Action Step(s) Expected
Outcome(s)
Data Evaluation
and
Measurement(s)
Person/Area
Responsible(s)
Comment(s)
(Maximum
500
characters)
A1.1 Develop protocol
and measures for
implementing needs
assessment within two
months of grant
award.
A.1.2 Establish a team
of knowledgeable
planning staff to
oversee undertaking of
needs assessment
within one month of
grant award.
A.1.3. Complete needs
assessment for
targeted service area
within four months of
award.
1. Identify appropriate
tools to use for the
need’s assessment.
2. Establish
Subcommittee of the
planning staff to
oversee needs
assessment.
3. Define roles of
planning staff and for
the project.
1. Participate in the
comprehensive
need’s assessment
elements meeting
with area
stakeholders.
2. Create tangible
targeted assessment
protocols and tools
for identified
populations in
collaboration with
other health
centers.
3. Conduct at least
one coordinating
meeting every
month.
4. Completed needs
assessment.
1. The number of
planning
meetings.
2. Determination
made regarding
approach.
3. The number of
meetings
attended.
4. Number of
persons at each
meeting.
5. Progress against
established
timeline for
completion of
assessment.
1. Planning
Grant
committee
2. CEO
3. Board of
Directors
4. Consultant
Page 2 of 7
A2.3 Secure
consultant to assist
with needs assessment.
Goal A2:
Objective(s) Key Action Step(s) Expected
Outcome(s)
Data Evaluation
and
Measurement(s)
Person/Area
Responsible(s)
Comment(s)
(Maximum
500
characters)
Section B – Service Delivery
NURS 834
Page 3 of 7
Goal B1: Developing an appropriate service delivery model based on the comprehensive need’s assessment (list out at least 2
objectives for the service delivery. For example, screening and health care provision at school, health fair, community
centers, etc)
Include the key action steps to reach the target audience such as underserved women, children, men, ethnic groups, etc. List
expected outcomes, evaluation data, measurement (what defines success), and responsible person(s).
Objective(s) Key Action Step(s) Expected
Outcome(s)
Data Evaluation and
Measurement(s)
Person/Area
Responsible(s)
Comment(s)
(Maximum 500
characters)
Goal B2: If special populations (e.g., migrant/seasonal agricultural workers, residents of public housing, homeless persons,
low-income school children) are included in the target population, specifying activities related to the identification of the
unique access problems and health care needs of these populations. This section must be completed with at least 1 objective.
Objective(s) Key Action Step(s) Expected
Outcome(s)
Data Evaluation and
Measurement(s)
Person/Area
Responsible(s)
Comment(s)
(Maximum 500
characters)
Goal B3: Facility planning and location selection
Discuss in detail and complete each column. Are you considering a mobile van, rotating providers in community centers, or
one location? How and where will you reach your target population?
Objective(s) Key Action Step(s) Expected
Outcome(s)
Data Evaluation and
Measurement(s)
Person/Area
Responsible(s)
Comment(s)
(Maximum 500
characters)
B3.1 Identify
potential sites that
will meet the health
care needs of the
target population
by (DATE).
Page 3 of 7
Goal B1: Developing an appropriate service delivery model based on the comprehensive need’s assessment (list out at least 2
objectives for the service delivery. For example, screening and health care provision at school, health fair, community
centers, etc)
Include the key action steps to reach the target audience such as underserved women, children, men, ethnic groups, etc. List
expected outcomes, evaluation data, measurement (what defines success), and responsible person(s).
Objective(s) Key Action Step(s) Expected
Outcome(s)
Data Evaluation and
Measurement(s)
Person/Area
Responsible(s)
Comment(s)
(Maximum 500
characters)
Goal B2: If special populations (e.g., migrant/seasonal agricultural workers, residents of public housing, homeless persons,
low-income school children) are included in the target population, specifying activities related to the identification of the
unique access problems and health care needs of these populations. This section must be completed with at least 1 objective.
Objective(s) Key Action Step(s) Expected
Outcome(s)
Data Evaluation and
Measurement(s)
Person/Area
Responsible(s)
Comment(s)
(Maximum 500
characters)
Goal B3: Facility planning and location selection
Discuss in detail and complete each column. Are you considering a mobile van, rotating providers in community centers, or
one location? How and where will you reach your target population?
Objective(s) Key Action Step(s) Expected
Outcome(s)
Data Evaluation and
Measurement(s)
Person/Area
Responsible(s)
Comment(s)
(Maximum 500
characters)
B3.1 Identify
potential sites that
will meet the health
care needs of the
target population
by (DATE).
Section C – Securing Financial, Professional and Technical Assistance
Goal C1: Recruiting and retaining key management and other qualified staff.
Complete all columns and identify personnel needed (i.e. NP’s, Physicians, support staff, etc.). Do you plan to use existing
staff at the health care organization? Do you need an administrator for your program? Keep in mind these positions, and
resources must be reflected on your budget. Need at least 3 positions.
Objective(s) Key Action Step(s) Expected
Outcome(s)
Data Evaluation and
Measurement(s)
Person/Area
Responsible(s)
Comment(s)
(Maximum 500
characters)
C1.1 Identify
staffing needs for
future health center
by (DATE).
Goal C2: Providing technical assistance and acquiring consultant activities as appropriate (optional)
Objective(s) Key Action Step(s) Expected
Outcome(s)
Data Evaluation and
Measurement(s)
Person/Area
Responsible(s)
Comment(s)
(Maximum
500
characters)
Goal C3: Financial, management, and administrative considerations to the organization in relation to future operation of
the health program.
Add additional opportunities in this section. Complete this section and propose additional funding opportunities
Objective(s) Key Action Step(s) Expected
Outcome(s)
Data Evaluation and
Measurement(s)
Person/Area
Responsible(s)
Comment(s)
(Maximum
500
characters)
C3.1 Pursue funding
opportunities from
federal, state, local
resources to support
service delivery plan
by (DATE).
1. Identify available
state and local
funding resources for
future health center.
2. Apply for available
funding.
1. Identified potential
funding resources
for future health
center.
2. Funding for the
establishment and
long-term
operation of future
health center.
1. Number of
identified funding
opportunities
available for the
establishment and
operation of future
health center.
2. Number of funding
proposals
submitted.
1. CEO
2. Development
Director
Goal C4: Developing plans for attaining and maintaining long-term viability (i.e., future requirements for space, securing
other financial support)
List out patient growth and proposed payer mix for screening services. Answer the following in each column
Objective(s) Key Action Step(s) Expected
Outcome(s)
Data Evaluation and
Measurement(s)
Person/Area
Responsible(s)
Comment(s)
(Maximum
500
characters)
C4.1 Identify
projected patient
growth over next 3
years by (DATE).
C.4.2. Develop patient
payor mix calculations
based on needs
assessment.
1. Based on needs
assessment, calculate
projected patient
growth for targeted
service area.
1. Identify facility,
staff, and financial
resources needed
to provide health
services for the
target population
over next three
years.
1. Rate of projected
patient growth and
identified financial
needs for the first
four years of
operation.
Section D – Developing Community Involvement/Participation
Goal D1: Developing linkages/building partnerships with other providers in the community including any federally
qualified health centers, health departments, local hospitals, and rural health clinics
List out opportunities in the area for partnerships and steps taken to engage others in the community.
Objective(s) Key Action Step(s) Expected
Outcome(s)
Data Evaluation and
Measurement(s)
Person/Area
Responsible(s) Comment(s)
(Maximum
500
characters)
D1.1 Develop
linkages/building
partnerships with at
least 3 other providers
in the target area
based on the needs
assessment by
(DATE).
1. Identify local
providers in the
service area.
2. Schedule meetings
with local providers
to gain input on
planning activities for
the future health
center.
1. Establish local
provider support
for future health
center.
2. Establish linkages
with other area
providers.
1. Number of local
providers that are
in support of the
future health
center.
1. CEO
2. Board of
Directors
Goal D2: Developing a governing board that aligns
Discuss who will be recruited, key action steps, outcomes, etc.
Objective(s) Key Action Step(s) Expected
Outcome(s)
Data Evaluation and
Measurement(s)
Person/Area
Responsible(s)
Comment(s)
(Maximum
500
characters)
D2.1 Recruit
representatives who
live and work in
targeted service area
to serve on Governing
Board for future
health center by
(DATE).
1. Develop a strategy to
recruit for governing
board membership.
2. Identify potential
candidates (focus
groups, interviews,
interested parties).
3. Invite candidates to
join governance
board.
1. Established
governance board
for future health
center.
1. Number of
governance board
candidates that
have agreed to
serve on the board.
1. Planning
Committee
2. Community
Outreach
staff
Goal D3: Developing community support
Discuss objective and key action steps, outcomes, evaluation, and measure to expand community report and responsible
persons.
Objective(s) Key Action Step(s) Expected
Outcome(s)
Data Evaluation and
Measurement(s)
Person/Area
Responsible(s)
Comment(s)
500
characters)
D1.1 Develop
linkages/building
partnerships with at
least 3 other providers
in the target area
based on the needs
assessment by
(DATE).
1. Identify local
providers in the
service area.
2. Schedule meetings
with local providers
to gain input on
planning activities for
the future health
center.
1. Establish local
provider support
for future health
center.
2. Establish linkages
with other area
providers.
1. Number of local
providers that are
in support of the
future health
center.
1. CEO
2. Board of
Directors
Goal D2: Developing a governing board that aligns
Discuss who will be recruited, key action steps, outcomes, etc.
Objective(s) Key Action Step(s) Expected
Outcome(s)
Data Evaluation and
Measurement(s)
Person/Area
Responsible(s)
Comment(s)
(Maximum
500
characters)
D2.1 Recruit
representatives who
live and work in
targeted service area
to serve on Governing
Board for future
health center by
(DATE).
1. Develop a strategy to
recruit for governing
board membership.
2. Identify potential
candidates (focus
groups, interviews,
interested parties).
3. Invite candidates to
join governance
board.
1. Established
governance board
for future health
center.
1. Number of
governance board
candidates that
have agreed to
serve on the board.
1. Planning
Committee
2. Community
Outreach
staff
Goal D3: Developing community support
Discuss objective and key action steps, outcomes, evaluation, and measure to expand community report and responsible
persons.
Objective(s) Key Action Step(s) Expected
Outcome(s)
Data Evaluation and
Measurement(s)
Person/Area
Responsible(s)
Comment(s)
Page 7 of 7
(Maximum
500
characters)
D3.1 Attend at least 4
community events
and administer 100
surveys to assess
community support
for establishment of
future health center by
(DATE).
1. Identify community
events to attend.
2. Develop and test
survey instrument.
3. Identify survey
participation strategy.
4. Administer 100
surveys at 4 or more
community events.
1. Assessment of
community
support for
establishment of
future health
center.
1. The number of
events attended to
gain support.
2. Percent of survey
participants in
support of future
health center.
1. Planning
Committee
2. Community
Outreach
Staff
3. Board of
Directors
4. CEO
Section E – Establishing Collaborative Working Relationships with Other Area
Goal E1: Developing linkages/building partnerships with other providers in the community including any federally qualified
health centers, health departments, local hospitals, and rural health clinics
Objective(s) Key Action Step(s) Expected
Outcome(s)
Data Evaluation and
Measurement(s)
Person / Area
Responsible(s)
Comment(s)
(Maximum
500
characters)
E1.1 1. Obtain at least
5 letters of support
from health care
providers in the
service area for the
establishment of
future health center by
(DATE).
1. Identify local health
providers to target for
letters of support.
2. Meet with Executive
Officers to discuss
collaboration and
request letters of
support.
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