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SMART Goal Setting Worksheet Guide

The Goal Setting Worksheet is designed to assist QAPI teams in establishing clear and measurable goals for performance improvement projects using the SMART criteria. It guides users through defining the business problem, setting specific, measurable, attainable, relevant, and time-bound goals, and emphasizes the importance of communication and visibility of the goals. The document includes disclaimers stating that its use is not mandated by CMS for regulatory compliance.

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75 views2 pages

SMART Goal Setting Worksheet Guide

The Goal Setting Worksheet is designed to assist QAPI teams in establishing clear and measurable goals for performance improvement projects using the SMART criteria. It guides users through defining the business problem, setting specific, measurable, attainable, relevant, and time-bound goals, and emphasizes the importance of communication and visibility of the goals. The document includes disclaimers stating that its use is not mandated by CMS for regulatory compliance.

Uploaded by

ryanbati
Copyright
© © All Rights Reserved
We take content rights seriously. If you suspect this is your content, claim it here.
Available Formats
Download as PDF, TXT or read online on Scribd

Goal Setting Worksheet

Directions: Goal setting is important for any measurement related to performance improvement. This
worksheet is intended to help QAPI teams establish appropriate goals for individual measures and also for
performance improvement projects. Goals should be clearly stated and describe what the organization
or team intends to accomplish. Use this worksheet to establish a goal by following the SMART formula
outlined below. Note that setting a goal does not involve describing what steps will be taken to achieve
the goal.

Describe the business problem to be solved:

Use the SMART formula to develop a goal:

SPECIFIC
Describe the goal in terms of 3 ‘W’ questions:

What do we want to accomplish?

Who will be involved/affected?

Where will it take place?

MEASURABLE
Describe how you will know if the goal is reached:

What is the measure you will use?

What is the current data figure (i.e., count, percent, rate) for that measure?

What do you want to increase/decrease that number to?

Disclaimer: Use of this tool is not mandated by CMS for regulatory compliance nor
does its completion ensure regulatory compliance.
ATTAINABLE
Defend the rationale for setting the goal measure above:

Did you base the measure or figure you want to attain on a particular best practice/average score/
benchmark?

Is the goal measure set too low that it is not challenging enough?

Does the goal measure require a stretch without being too unreasonable?

RELEVANT
Briefly describe how the goal will address the business problem stated above.

TIME-BOUND
Define the timeline for achieving the goal:

Goal Setting Worksheet


What is the target date for achieving this goal?

Write a goal statement, based on the SMART elements above. The goal should be descriptive, yet concise
enough that it can be easily communicated and remembered.
[Example: Increase the number of long-term residents with a vaccination against both influenza and
pneumococcal disease documented in their medical record from 61 percent to 90 percent by
December 31, 2011.]
Tip: It’s a good idea to post the written goal somewhere visible and regularly communicate the goal during
meetings in order to stay focused and remind caregivers that everyone is working toward the same aim.

Disclaimer: Use of this tool is not mandated by CMS for regulatory compliance nor
does its completion ensure regulatory compliance.

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