Activity Impact Assessment

Purpose: To assess the impact of an activity funded through the Richmond Hospital Physician Society (RHPS)/Facility Engagement (FE) on engagement of medical staff. Your information along with others will be aggregated to understand how and where our funding has been used and whether it has made an impact on improving engagement between physicians and between physicians and the Health Authority. This in turn will reinforce RHPS' accountability to our funders, the Specialist Services Committee (SSC) and Facility Engagement (FE), to assure continued annual funding renewal.

Please note:

  • The information provided in this Activity Impact Assessment form will not be shared without your permission. For more information, please refer to RHPS' Privacy Policy.
  • The form cannot be saved mid-progress. Please ensure you are able to complete and submit the form once you have started.
  • For any questions or concerns, please contact Liana Gabriele, Facility Engagement Program Manager.

Activity Impact Assessment
1. Activity status: *

Project Lead

Project Info


8. For the key individuals involved in this activity, indicate their name, role (e.g. physician, nurse, operations director) and the level of their overall involvement (as it relates to the IAP2 Engagement Framework):

Informed - they were provided with information on an activity, project or policy
Consulted - they provided feedback on key decisions or activities
Collaborated - they provided advice, leadership and recommendations on the project, activity or policy
Empowered - they were a joint partner in decision-making

Click the "Add" button to add participants to your list.

Repeater

Level of overall involvement: *
plus1 Add minus1 Remove

Section3



9. Tell us about the success of the project in meeting its main objectives and how you measured success:

Section3.1a

Main Objective #1

Section3.1b

Was the objective met? *
Data source to validate success: *

Section3.2a

Main Objective #2

Section3.2b

Was the objective met?
Data source to validate success

Section3.3a

Main Objective #3

Section3.3b

Was the objective met?
Data source to validate success:

Section4



11. Indicate the overall impact of this activity based on the type of physician engagement work, on a scale of 1 to 10 (1 = negligible, 10 = extremely high):

Section


13. Indicate which of the following can be used to highlight your activity. Remember that the more we can highlight learning and successes at Richmond Hospital, the greater the potential for continued funding and sustainability. *
14. Upload photos of the project and/or contributing clinicians and/or administrators here:

Maximum file size: 33.55MB

15. Upload any additional supporting information or files here. This can include reports and/or data.

Maximum file size: 33.55MB

Submitted By

**Before submitting this form, please ensure you have answered all questions with as much information and detail as possible to provide a fulsome snapshot of your project. The information you provide will reinforce RHPS' accountability to our funders, the Specialist Services Committee (SCC) and Facility Engagement (FE), to assure continued annual funding renewal.