Questions marked with a * are required Exit Survey
 
 
Applications are encouraged from clinicians and/or researchers and/or trainees at all levels, in both academic and community settings. Nominees are not required to be ASH members or hematologists, however all submitted projects must address an area of overutilization relevant to hematology. Submissions from previous applicants are encouraged. All submissions are due by June 1, 2019.

Competitive submissions will:

  • Have data demonstrating a measurable impact (preliminary data is acceptable)
  • Highlight if a unique strategy was used (though successful applications may rely on existing strategies)
  • Describe if the project involved collaboration or interaction across multiple departments
  • Include details on any iterative changes that may have been necessary to achieve success, including how many iterations were needed and how adjustments were developed/implemented
  • Describe any barriers or challenges and how they were overcome

We are interested in projects from across the full spectrum of hematology, including adult and pediatric, malignant and non-malignant, transfusion and lab-based hematology.

Questions about the Choosing Wisely Champion’s application process can be forwarded to quality@hematology.org.
 
 
Contact Information
* First Name : 
* Last Name : 
* Email Address : 
 
 
* Institution/Practice
   
 
 
* Brief Bio (max one paragraph):
   
 
 
* Project Abstract (max 300 words):
   
 
 
* How did the project develop? Please include information about what prompted the need for action.
   
 
 
* What challenges did you encounter? How did you overcome them?
   
 
 
* Could this project be implemented at other centers? Has the project been emulated or exported to other centers?
   
 
 
* Is this project scalable for implementation at larger or smaller practices and institutions? Why or why not?
   
 
 
* Were patients involved in the genesis, design, or implementation of this project? If so, how?
   
 
 
* Have educational resources or an implementation toolkit been developed as part of the project? If yes, would you be interested in collaborating with ASH to share these tools with a wider audience? If no, would you be interested in developing these resources and collaborating with ASH to share with a wider audience?
   
 
 
 
Additional Data/Information (optional)

Please include any additional information you think would be helpful to provide context to your project.
   
 
 
 
Letters of Support (optional)

One or two supporting letters that contextualize or describe impact of the project may be forwarded to quality@hematology.org with the subject line “ASH Choosing Wisely Champion Nomination Letter of Support for [your name]”
 
 
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