Quality Improvement Sharing Event

Quality Improvement Sharing Event Wednesday 14 October 2015 Registration Form

Surname of Applicant: Click here to enter text. First Name of Applicant: Click here to enter text. Job Title: Click here to enter text. Directorate: Choose an item. Email Address: Click here to enter text. Do you consider yourself to have a Choose an item. disability? If yes, do you have any specific requirements Click here to enter text. e.g. assistance on arrival, sign language, interpreter, materials in large print etc

Please identify below whether you wish to attend the Morning, Afternoon or Full Day

Morning ☐ Afternoon ☐ Full day ☐

If you plan to attend the Morning session, please select ONE of the options below:

Parallel Session 1 Parallel Session 2 (11.30am) (11.30am)

 Frailsafe: Improving the care of frail,  Sign of the times older people in the Medical Eilish Kilgallon, Community Access Assessment Unit Worker, Sensory Team Dr Pat McCaffrey, Dr Mark Roberts, Mary Burke, Medicine & Unscheduled Care  Anaesthetic critical incident trigger  “Verve”: Healthy Living Centre list: A tool to facilitate reporting Network, Dr Laure Martin ATTICS Lisa Follis Neighbourhood Renewal Health Coordinator  The Review of the Direct Current Cardioversion service (DCC) within  Enhancing disabled children’s SHSCT participation in the LAC Process Kay Carroll, Head of Service, Medicine Angela Cannaway Social Care Worker and Unscheduled Care

Panel Discussion Panel Discussion

I wish to attend Session 1: ☐ I wish to attend Session 2: ☐

We require you to rank your preferences for the Afternoon Session (ordered 1 to 5) so that we can allocate appropriately

If you plan to attend the Afternoon Session please rank your preferences below (with 1 being your most preferred option and 5 your least preferred):

 Communication, Communication, Communication Liam Creagh, Redbox Media  Making Quality Improvement happen John McClune, InvestNI  Gaining Support: Dragons Den Experiential Learning Workshop Roni McMillan, The Leadership Centre plus some of our own Staff as ‘Dragons’  Research in support of Quality Improvement Dr Patricia Gillen, SHSCT  Practical Hints and Tips on engaging Service Users and carers Carolyn Agnew, SHSCT

You are invited to make a donation to Marie Curie, our Trust Charity of the Year, and then collect your “Grab and Go” lunch

Collection buckets will be available on the day

I wish to avail of the “Grab and Go” Lunch ☐

If you are availing of the provided lunch and have any special dietery requirements please specify below Special Dietery Requirements………………………………………………… ……………………………………………………….…………………...…

Please return this form via email to:

[email protected]