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QIP Advisory Committee EOI

Quality Improvement Plan Advisory Committee - Expression of Interest Online Application

The Quality Improvement Plan Advisory Committee works in collaboration with partners from across the health care system to support the development and delivery of the provincial Quality Improvement Plan program. Please submit your online expression of interest application by March 1, 2018.

1. First Name *This question is required.

2. Last Name *This question is required.

3. Email Address *This question is required. This question requires a valid email address.

4. Phone Number This question requires a valid number format.

5. Administrative Assistant's Contact Information (if applicable)

6. Location (Ontario Geographical Region) *This question is required.

7. Please tell us why you are interested in participating as a volunteer member of the Quality Improvement Plan Advisory Committee.

8. Do you have experience leading the development of a Quality Improvement Plan?

9. Employer/Organization *This question is required.

10. Current Position/Title *This question is required.

11. Please check your areas of expertise and experience from the list below. Check all that apply.

Academia/research
Adminstration
Allied health
Implementation science
Change management
Equity

Health policy
Knowledge translation and exchange
Measurement and evaluation
Quality improvement
Other - Write In Please enter an 'other' value for this selection.

12. Are you currently involved in another committee at Health Quality Ontario?

No
Yes
If yes, please specify Please enter an 'other' value for this selection.

13. Please describe any additional experience and/or qualifications that you feel are relevant to this volunteer opportunity.

14. Please upload your CV.

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