Performance Improvement (PI) Plan and Template


Performance Improvement (PI) Plan and Template


This guide is a planning template for health care professionals working with long-term care patients to improve and sustain performance improvement strategies. The template can be customized through forms and analytical tools to apply in settings such as nursing and skilled nursing facilities, subacute care facilities, assisted living facilities and programs, residential care settings, and adult medical day health care services. The exhibits, forms, and tools include:

  • Design, Measure, Assess, Improve, and Control (DMAIC) Tool
  • Plan, Do, Check, Act (PDCA) Tool
  • Fishbone diagram
  • Root cause analysis (RCA)
  • Cause and effect map
  • Failure mode and effects analysis (FMEA)
  • Strategic, Measurable, Achievable, Relevant, Timely (SMART) Tool
  • Pareto analysis chart (PAC)


Health Care Association of New Jersey

Funding Sources:

Health Care Association of New Jersey


Release Date: 2009
Original Summary: June 2010
Last Updated: 12/18/13

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