Project Green Healthcare // Projet vert la santé Application Form
Thank you for your interest in Project Green Healthcare. Applications are due Thursday, October 1st, 2020 at 11:59 PM.
What is Project Green Healthcare?
Project Green Healthcare is an initiative administered by the Canadian Federation of Medical Students (CFMS) Health and Environment Adaptive Response Taskforce (HEART) that aims to build a national network of medical student teams to enter into local hospitals and perform needs assessments and green quality improvement projects to reduce the ecological footprint of the Canadian healthcare system. Selected teams will receive up to $2 000 in reimbursable funding and mentorship from physician and non-physician climate action leaders through the Canadian Association of Physicians for the Environment (CAPE) and the Canadian Coalition for Green Healthcare (CCGHC). Project Green Healthcare is sponsored by the CFMS through the Strategic Innovation Fund. If you have any questions, please email us at owen.luo@mail.mcgill.ca and jacob.carson@medportal.ca. We highly encourage any student team to email us to inform us of your interest in applying; we would be more than happy to provide feedback and support to your applications.
In what capacity would you like to join the Project Green Healthcare student network?
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As part of a team entitled to up to $2 000 in reimbursable funding and mentorship through the Canadian Association of Physicians for the Environment (CAPE) and the Canadian Coalition for Green Healthcare (CCGHC). You will also be automatically included in the Project Green Healthcare student network.
As part of the student network looking to learn more about greening healthcare and associated opportunities. Through this network, you may be connected with like-minded peers at your local medical school that can ultimately lead into the conception of a funded Project Green Healthcare student initiative in a subsequent funding cycle.
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Name
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First Name
Last Name
Email
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example@example.com
What Canadian medical school are you attending?
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What is your current medical school year?
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Class of 2021
Class of 2022
Class of 2023
Class of 2024
Other
We would love to hear your thoughts! What kind of green projects or change would you like to see happen in your local hospitals or healthcare system (optional)?
If you are currently conducting any sustainability projects inside or outside of healthcare, please share them with us here (optional):
Thank you for indicating your interest in joining the inaugural Project Green Healthcare student network!
You will be contacted at the email you have provided us after the selection of our inaugural Project Green Healthcare cohort teams on Monday, October 19th, 2020.
Do you have any comments or questions for us? (optional)
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Application Evaluation
Project proposals will be assessed on their feasibility, financial viability, impact, longevity, and alignment to the underlying strategy of CFMS HEART's Project Green Healthcare to build a more environmentally sustainable healthcare system.
Name of primary team contact. This is the person with whom the Project Green Healthcare Directors will be corresponding with.
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First Name
Last Name
Phone Number
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-
Area Code
Phone Number
E-mail
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example@example.com
Please provide the names of all of your team members (if applicable).
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First Name Last Name; First Name Last Name; etc.
What Canadian medical school (campus) is your team affiliated with?
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ie. McGill University (Montréal campus)
At what Canadian healthcare institution are you aiming to perform your green quality improvement project (N/A if not yet decided)?
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ie. Montréal General Hospital, Montréal, QC.
Please provide an executive summary of your proposed initiative.
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0/300
How does your proposed project integrate into the existing greening community at your target healthcare institution? Please indicate your partnership(s) with the hospital green team, administration, staff members and/or healthcare professionals?
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My team and I are already embedded into the hospital green team and/or administration.
My team and I are currently collaborating with healthcare professional(s) and/or other staff members working in the healthcare institution.
My team and I are in the process of seeking allies within the healthcare institution we are aiming to conduct our green quality improvement project.
Other
If applicable, please provide some additional details on your partnership(s) with the administration, staff members and/or healthcare professionals at your proposed healthcare institution. If known, please indicate whether a green team already exists at your target site (N/A if not applicable).
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0/300
At what stage is your project?
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Ideation Stage
Early Stage (1-2 years)
Established Stage (>2 years)
Please describe your team composition.
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Currently a one-person show
Already fully established (not looking to recruit additional members)
Looking to continue recruiting (we may be able to put you in touch with students at your medical school who have indicated interest in joining the Project Green Healthcare network).
Strategic Alignment
Your proposed student project will be evaluated on its alignment with the underlying strategy of CFMS HEART's Project Green Healthcare to build a more environmentally sustainable healthcare system.
Please elaborate on your project plan and explain its alignment with CFMS HEART Project Green Healthcare's goal of building a more environmentally-sustainable Canadian healthcare system. Please also include a specific timeline of your project delivery steps. Finally, please comment on the value that your project will bring to Canadian medical students.
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0/500
Feasibility
Your proposed student project will be evaluated on its likelihood to achieve its proposed goals within the proposed timeline.
Please discuss your team member qualifications/expertise, resources and partnerships that may facilitate the execution of your project plan outlined above, as well as the barriers you might encounter and strategies to overcome them.
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0/300
Financial
Your proposed student project will be evaluated on the appropriateness and cost-effectiveness of its utilization of the up to $2 000 of allocated funds provided through Project Green Healthcare.
Please attach a rough proposed budget of your project's first 1-2 year years of operation here. If you are seeking any other sources of revenue to complete your project, please also indicate them here. See below for a sample project budget.
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.xls, .xlsx, .xlsb, .xlsm, .doc, .docx, .pdf
Please use this space to elaborate on your budget and financial choices (optional).
0/300
Impact
Your proposed student project will be evaluated on how well it is demonstrated to address an unmet ‘green’ need in your local healthcare system.
Please outline your method and potential outcome metrics to evaluate your project's impacts. If applicable and known, please also describe the current state of greening efforts at your target healthcare institution and how your proposed project advances your target healthcare institution's greening goals.
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0/300
Longevity
Your proposed student project will be evaluated on how well it is demonstrated to elicit a sustained impact that lasts beyond the duration of your student project.
How will your team ensure that your proposed project will have a long-term, sustaining green impact on your target healthcare institution and/or healthcare system?
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0/300
Thank you for applying to the inaugural Project Green Healthcare cohort!
You will be contacted for a brief virtual interview that will be held between Monday, October 12th-Wednesday, October 14th, 2020.
Do you have questions or comments for us (optional)?
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