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Next Level Improvement Science for EMS
Thank you for taking the time to complete this short application. Your answers will be used in the course selection process. If you have any questions please don't hesitate to contact us at
info@dmwaustin.com
.
You can see an overview of the course here.
Applications are due Friday April 18th. After this date, applications will be reviewed on a rolling basis as space allows. Invitations will be sent by May 1.
Please note: This program is designed for a small cohort to support engagement, adult learning, and community. Applications not accepted in this offering will be added to the waiting list for consideration in the next cohort.
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* Indicates required question
Email
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Your email
First Name
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Your answer
Last Name
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Your answer
Organization
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Your answer
Role/Title
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Your answer
Phone Number
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Your answer
Why do you want to participate in Next Level Improvement Science for EMS?
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Your answer
Describe how you use improvement science in your current work (e.g. the projects you currently work on, your role in those projects, the specific teams you coach etc.)
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Your answer
Previous formal training (Please check all that apply or specify under other):
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NAEMSP 2-Day Quality and Safety Course
NAEMSP Year-Long Quality Improvement and Safety Course
NFA EMS: Quality Management R0158
Other:
Required
Number of years coaching results-driven teams:
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Your answer
Rate your competency with Microsoft Excel:
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Choose
I don't use Microsoft Excel
Option 2
I understand the basic structure of Excel and can enter data
Option 4
I can perform simple data analysis using Excel
Option 6
I can create charts using the Excel toolbar and can manipulate the graphics once created (e.g., hange scale, name axis, update visual display)
Option 8
I can write functions to calculate and summarize the data (e.g., countif, average, median)
Option 10
I can write programs in Excel using VBA
The program is project-based and requires actively working on a project in your organization to improve the outcomes of a core operational or clinical process. What are key processes or services your organization has prioritized that could be a good project for the program?
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Your answer
Will you be able to attend all the scheduled in-person workshops in Austin, TX (September 8-11, 2025, and February 23-26, 2026) and virtual Zoom sessions (3rd Tuesday of the month 2-3:30 EST)? (specify any specific, unavoidable conflicts below)
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Your answer
Tuition Payment Preference (Tuition $5,000 per person)
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Cash/check
ACH bank transfer
Credit card (3% convenience fee)
Other:
What else do you need to know?
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Your answer
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