WHAT EVIDENCE DO WE NEED TO DEMONSTRATE IMPLEMENTATION?

The Table of Evidence lists all documents, activities and observations that the Peer Team will use to evaluate your organisation's implementation of the standards.

All documents outlined in the Self-Study Documents column in the Table of Evidence should be included in your organisation's Self-Study.

The evidence listed in the On-Site Documents column should also be implemented during the Self-Study process, but will be reviewed during the site visit only if the Peer Team needs additional information to verify implementation of the standards.

The information listed in the On-Site Activities column should be used to prepare relevant staff for the interview process and to make the necessary arrangements for record reviews and facility observations prior to the site visit.

Examples of evidence include:

• licences and other legal documents
• contracts and/or written agreements
• board-approved policies
• procedures
• training materials
• meeting minutes
• quality improvement reports