Impact Assessment Worksheet

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Use this worksheet to assess the potential impact your chosen candidate will have on Twin Pines Medical Center (TPMC). You will use this information to help you define the structure of the affiliation agreement (assignment 4) and ultimately help you devise strategic recommendations for the assessment, the Affiliation Recommendation. The table below is based on Figure 2 in the “Impact Assessment Framework” resource located in the course. For each dimension (A-H), determine which outcomes (A1-H2) will have an impact on TPMC and what that impact will be.

Use the Impact Assessment Worsksheet ( assignment 3) with the TPMC article (which is attached)

Part 2:
Use this worksheet to identify potential partners and use their resources to begin to prepare a culturally sensitive strategic plan for collaboration.
1. Involve community leaders. Development of the process innovation must involve at least five Chinle community stakeholders, key conveners, or community leaders. Describe these five individuals in the following chart. Use the Chinle Service Unit Profile to guide your answers.

Part 3:
In keeping with step 5 of McKenzie & Pinger’s six-step model described in An Introduction to Community & Public Health, you must select a focus for your process innovation based on the information gathered so far. This focus will provide the first criterion for narrowing process innovation options. Use this worksheet to decide which process innovation might be the most successful in Chinle.

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