April 20, 1999 - MCG Health
6858014414500Application FormYour information (all client-identifying information will be blinded to the judges):Organization NameClick to enter nameEmailClick to enter emailName of person completing applicationClick to enter namePhone numberClick to enter phoneTitleClick to enter titleMCG Account ExecutiveClick to enter namePlease select the type that best describes your organization:Choose onePlease select the MCG solution(s) pertinent to this application:Software Solutions? Indicia? Cite CareWebQI? Cite AutoAuth? Cite Guideline Transparency? Guideline Modification Module? Interrater Reliability ModuleAnalytic Solutions? MCG/Milliman MedInsight Guideline Analytics? Benchmarks and Data Content Volumes? Ambulatory Care? Behavioral Health Care? Chronic Care? General Recovery Care? Home Care ? Inpatient & Surgical Care ? Medicare Compliance ? Multiple Condition Management ? Patient Information ? Recovery Facility Care ? Transitions of Care BRIEF DESCRIPTIONWord Count LimitPlease provide a brief description of your care initiative. Use additional pages if necessary. Please omit your organization name and other elements that might identify you, such as “presented at the XYZ conference in Detroit.”500 words (3,500 characters) or lessQUESTION 1Weight and Word Count LimitExplain how your initiative helps drive effective care.Weight: 20%250 words (1,700 characters) or less QUESTION 2Weight and Word Count LimitDescribe how this initiative has influenced other departments, divisions or regions within your organization.Weight: 10%250 words (1,700 characters) or lessQUESTION 3Weight and Word Count LimitDescribe the qualitative impact this initiative has had on your organization – comparing your status before you began with where you are now.Weight: 20%250 words (1,700 characters) or lessQUESTION 4Weight and Word Count LimitDescribe how your senior leadership supported the implementation of this initiative.Weight: 5%250 words (1,700 characters) or lessQUESTION 5Weight and Word Count LimitHow is this initiative innovative?Weight: 10%250 words (1,700 characters) or lessQUESTION 6Weight and Word Count LimitDescribe the quantitative impact this initiative has had within your organization on any of the following areas:Quality improvement or patient safetyPatient or member satisfactionStaff efficiency, productivity, or satisfactionProvider or payer satisfaction or communicationOther external agency satisfactionCost (utilization, fixed cost, patient throughput)(e.g. Staff productivity increased by X%, reduction of readmissions reduced costs by X dollars)Weight: 35%500 words (3,500 characters) or lessApplication GuidelinesPlease omit all identifying information from your application EXCEPT on the application’s first page. Each client organization may submit no more than two initiatives for consideration. Each initiative must be submitted as a separate application.We encourage you to include any charts or graphs that support your written responses in an appendix. These materials will not be subject to the word count limits, but we ask that you limit the appendix to ten pages total.How to Submit Your ApplicationPlease keep your application in Word format and submit via email with a digital signature.Email applications to: scarlet.leung@Subject Line: 2018 Doyle Award SubmissionDeadline to SubmitThe application deadline is Friday, August 10, 2018 for email receipt.AgreementBy submitting this application for the Doyle Award, the Organization agrees to attend MCG’s Client Forum 2019 and to present its initiative, if selected as a Doyle Award winner. In addition, Organization agrees to work with MCG to develop and distribute a mutually acceptable press release and case study, present its initiative via webinar, and to participate in a video profile/testimonial created by MCG. The Organization hereby agrees that MCG may record any presentation by Organization by audio or video recording and the Organization grants MCG the royalty-free worldwide right to use, reproduce, distribute, display, and perform the recording and video profile for its business anization NameClick here to enter textYour NameClick here to enter textTitleClick here to enter textDateClick here to enter text ................
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