Please feel free to use this template, your school’s template, or create one for your Chapter!

[Insert Chapter Leader(s) name(s), Faculty Advisor(s)] [Insert Chapter Name] [Insert Chapter Leader(s) name(s), Faculty Advisor(s)] 28th Annual IHI National Forum on Quality Improvement in Health Care

Chapter History Who started the Chapter? Why did you start the Chapter? What did you do to engage other students/faculty/health professionals/residents? What types of people are in your Chapter (nursing students, residents?)

Activities What does your Chapter do/what has it done to expand the knowledge of members and tackle improvements in health care? Example 1 Example 2 Has your Chapter participated in any local improvement activity? Has your Chapter been a catalyst for other types of activity on your campus/in your organization? What do you plan to do next?

Accomplishments How has your Chapter grown? Have you hosted any events? What did you do? (share pictures) Share 2-3 examples of early wins (recruiting methods, meetings, etc) Has teaching about quality improvement/patient safety begun or changed at your school or program since the start of your Chapter? What IHI Open School resources, if any, do faculty/staff include in their teaching? How does the inclusion of these resources change your experience as students?

Challenges What is/are your biggest challenge(s)? What are you doing to address them? Can people at the Forum help you overcome the challenge? (is there an “ask?”)

Contact Information [insert Chapter Leader Name(s) and email] Link to Chapter website or blog address Thank you!