AHQA Feedback Tool

Please fill in the form below to submit your feedback.

Measurement Feedback Tool

Is this feedback on behalf of another person or organization?*
Is this feedback on behalf of another person or organization?
- Yes, another organization.
- Yes, another person.
- No, this is for me.
Organization Name
What is the organization name?
Submitting Organization's name:
Submitting Organization's name:
Type of Practice
What is this type of practice?
If you selected "other" please describe below:
If you selected "other" please describe below:
Please select all that apply to this practice:
Please select all that apply to this practice:
Specialty
Specialty
If you selected "other" please describe it below:
If you selected "other" please describe it below:
Size (number of Practitioners)
What is the size of the practice? (i.e. number of Practitioners)
- 1-5
- 6-10
- 11+
State
In which state is the practice located?
Rural/Urban
Is this practice rural or urban?
NQF Measure Name & Number
NQF Measure Name & Number
If the measure is not on the list above, please write it below:
If the measure is not on the list above, please write it below:
Use
How frequently is this measure used?
- Monthly
- Quarterly
- Annually
- Other
If you selected "other" please describe below:
If you selected "other" please describe below:
Type of Measure Use
The feedback your providing is related to what particular primary use?
- Federal programs
- Other accountability programs
- Quality Improvement
- Public reporting
- State programs
- Other
If you selected "other" please describe below:
If you selected "other" please describe below:
What challenges (if any) are you having with implementation?
What challenges (if any) are you having with implementation?
- Data Collection/Reporting Burden
- Challenges related to data reliability/viability (e.g. inconsistencies in charting or coding practices)
- Lack of alignment with local/organizational practices or priorities
- Lack of buy-in from clinicians or other providers
- Unexpected (positive or negative) findings or effects
- Variation in measure specification
- Other
If you selected "other" please describe below:
If you selected "other" please describe below:
What improvements would you suggest for this measure?
What improvements would you suggest for this measure?
What best practices do you have to share for this measure?
What best practices do you have to share for this measure?
Any other feedback?
Please provide any additional feedback you haven't already shared:
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