Knowledge Exchange

Section One: Contact Information

First Name: *	Last Name: *
Position: *	Organization: *
Facility, Site, and/or Service: *
Setting:	If other, please specify:
City: *
Province or Territory:
Email: *

Section Two: Practice Information

Please be as detailed as possible with your descriptions within the allocated space. (Approximately 1000 characters per section)

1) What is the title of your practice? *

2) When was your practice implemented? *

3) Describe the issue that prompted the implementation of your practice: *

4) Describe your practice: *

5) Describe how your practice was implemented and the resources required (e.g. people, time, money): *

6) A) Explain the impact of your practice: *

B) How did it improve quality of worklife? *

C) How do you know? (e.g. surveys to staff, a formal evaluation process, specific outcomes, feedback) *

7) What lessons learned and issues to consider are you able to share with colleagues? *

8) Please attach key documents/tools/templates you are able to share with colleagues.

I give consent to the QWQHC to use this information in its future work (e.g. reports):

To submit your QWL Innovative Practice, please click the “Submit” button below.