“Project Title” – A Quality Improvement Initiative in Department/Hospital Name

• Observed issue: (Describe the current problem or deficiency.)
• Impact: (Who or what is affected? How often? How seriously?)
• Baseline data (if available): (e.g., infection rate, wait time, satisfaction score)

• Known evidence: (What is already known about this issue from literature or internal data?)
• Context: (Brief description of your department or hospital and its relevance to the problem.)

• Objective: (What do you want to improve? How much? By when?)
• Example: “Reduce ICU admission delays by 30% within 3 months.”

• Describe the approach (e.g., PDSA cycles, pre/post intervention, Lean).

• What was implemented? How? By whom?

• Process Measures: (e.g., compliance rate, number of checklists completed)
• Outcome Measures: (e.g., patient mortality, satisfaction scores)
• Balancing Measures: (e.g., unintended consequences)

• Before and after comparison: Include tables, figures or summary data.
• Successes: (What improved? How much?)
• Unexpected findings: (Positive or negative)

• Interpretation: (What do the results mean?)
• Barriers and enablers: (What helped or hindered implementation?)
• Limitations: (Design, data, generalizability)

• Summary of impact
• Sustainability plan
• Recommendations for replication or scale-up

• Charts, protocols, team roles, PDSA documentation, etc.

• Observed issue: There is a shared perception among staff that the neurosurgery team is demotivated, with decreased engagement, lower morale, and reduced participation in teaching, research, or quality initiatives.
• Impact: Potential risk to patient safety, loss of talent, decreased productivity, reduced innovation, and burnout among staff.
• Preliminary evidence: Informal interviews and anecdotal observations suggest withdrawal from voluntary activities, increased absenteeism, and reluctance to engage in improvement projects.

• Known evidence: Studies have shown that healthcare team motivation strongly correlates with leadership style, recognition, workload balance, and communication culture. (E.g., Shanafelt et al., 2017; West et al., 2016)
• Context: The neurosurgery department is a high-pressure environment with demanding clinical load, uneven distribution of academic responsibilities, and limited formal feedback mechanisms.

• Objective: To identify key factors contributing to team demotivation in the neurosurgery service and implement targeted interventions to improve morale and engagement by 30% within 6 months.

• Mixed-methods approach using pre/post intervention comparison.
• Three stages: baseline assessment, intervention design, outcome evaluation.

• Stage 1 (Assessment):
  1. Anonymous survey measuring motivation (Likert scale), workload perception, and satisfaction.
  2. Optional focus groups for qualitative input.
• Stage 2 (Implementation):
  1. Regular feedback meetings.
  2. Recognition of individual and team efforts.
  3. Redistribution of academic and clinical tasks based on interest.
  4. Monthly “open forum” with leadership.
• Stage 3 (Evaluation):
  1. Repeat survey after 6 months.
  2. Measure engagement in optional activities (teaching, research, QI).
  3. Track absenteeism and retention rates.

• Primary Outcome: Change in motivation score (quantitative survey).
• Secondary Outcomes: Participation rates, number of internal projects launched, feedback satisfaction.
• Balancing Measures: Risk of overburdening active staff, perception of favoritism, meeting fatigue.

• Before and after comparison: To be completed post-intervention.
• Include baseline statistics, visual representation of survey results.
• Qualitative themes from open comments.

• Interpretation: Did the intervention address the root causes? What improved?
• Barriers: Time constraints, skepticism, lack of protected time.
• Facilitators: Leadership support, visible change, peer motivation.
• Limitations: Single-department focus, short follow-up, subjective measures.

• Summary: Initial results suggest that structured communication, transparency, and shared ownership can improve motivation.
• Recommendation to expand initiative hospital-wide or to other departments.
• Plan for sustainability: quarterly check-ins, inclusion of motivational metrics in performance review.

• Survey instrument
• Focus group guide
• Sample feedback report template
• References: Shanafelt TD et al. Mayo Clin Proc. 2017; West CP et al. JAMA. 2016.

Please answer the following questions honestly. Responses are anonymous and will be used solely to improve our team's working environment.

• I feel motivated to come to work each day. (1–5)
• I feel recognized for the work I do. (1–5)
• I am proud to be part of this department. (1–5)
• I feel emotionally exhausted or burned out. (1–5)
• I feel encouraged to participate in academic or improvement initiatives. (1–5)

• My workload is fair and manageable. (1–5)
• I have the resources and support I need to do my job well. (1–5)
• I can speak openly with leadership about my concerns. (1–5)
• Leadership values the input of all team members. (1–5)

• What motivates you most in your work here?
• What discourages you or causes frustration?
• What could leadership do to improve the work climate?