Gap Analysis and Data-Driven Planning Form
Clinical Practice Gap Topic:LIST GAPS ENCOUNTER
Column 1 | Column 2 | Column 3 | Column 4 | Column 5 |
Source
| Gap you found (Use actual data from your audits and surveys) | Best Practice Strategies (Action-oriented strategies you found in the literature to address the gap, with citation) |
(What barriers might you run into if you implemented this best practice strategy?) | Plan for Overcoming Barriers |
Care Audit: Complete at least 5 gaps with different best practice strategies to address the gap. | 1. | |||
2. | ||||
3. | ||||
4. | ||||
5. | ||||
Patient/client Survey and Patient experience Tracer At least 3 gaps with different best practice strategies to address the gap. | 1. | |||
2. | ||||
3. | ||||
Team Survey: At least 1 gap with different best practice strategies to address the team gap. | 1. | |||
Disparity: At least 1 gap that addresses disparity. | 1. |
REFERENCE LIST (in APA format with hyperlinks)




