To be completed by students and submitted during the HSA5923 Health Services Administration Master Degree Capstone class Week 1. The PICOT question must be approved by Dr. Gisela Llamas. Fill the form and send it to gllamas@fnu.edu to be reviewed, once the form is approved, the student must submit on Blackboard First Week assignment Folder using Turitin.

These forms are fillable.


Student information


Student Name:
FNU Email:




Student ID:






1. What is the practice issue (foreground?)


2. What is the practice area?


Administration: Yes ___ No___


Clinical: Yes ___ No___


Educational administration: Yes ___ No _____


Informatics: Yes ___ No ___


Policy: Yes ___ No ___


Organization philosophy or mission and vision statement of the institution:








3. How was the practice issue identified? (check all that apply)


Quality and safety/risk management: Yes ___ No ____


Significant financial concerns: Yes ____ No _____


Procedural or process issue: Yes ____ No ____


Unsatisfactory patient outcomes: Yes ____ No ______


Different between hospital and community practice: Yes _____ No _____


Other (define in space below): Yes ____ No _____


Wide variation in practice: Yes _____ No _____


Clinical practice issue: Yes ____ No _____





4. How will the project align (Support) with institution mission?

5. How will the project help improve the organization performance? Does your project align with the site business models?


6. What is the scope of the problem?




Family: Yes ___ No ___


Individual: Yes ___ No ___


Institution/system: Yes ___ No ___


Population: Yes ___ No ___


Other (define in space below):






7. What are the PICOT elements?


Quantitative/ Qualitative (PICOT)











Eight-week period ( One semester)



8. What evidence must be gathered? (check all that apply)


Integrative Literature review: Yes ____ No ___


Guidelines: Yes ___ No ___


Clinical Expertise: Yes ___ No ___


Systematic Literature review: Yes ____ No ____


Expert opinion: Yes ____ No ____


Financial analysis: Yes ___ No ___


Standards (regulatory, professional, community): Yes ___ No ___


Patient preferences: Yes ___ No ___


Other (define in space below): Yes ___ No ___



The topic description, definition and literature review:


9. State the PICOT question in narrow manageable terms.


Student’s Name:


PICOT Question Approved Yes _____ No _____


Dr. Gisela Llamas



At least 7 references for the past 5 years older only.