SHARK TANK APPLICATION FORM

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MELBOURNE NURSING & MIDWIFERY SYMPOSIUM 26 OCTOBER 2018 www.cha.org.au @chaaustralia #NMS18 #NursesKnow SHARK TANK APPLICATION FORM

WIN $2,000 TO BUILD YOUR IDEA Innovation in health care is key to maintaining the exceptional reputation of Catholic health and aged care providers across the country. Our expert panellists will hear pitches from our excellent nurses from across the country in the search for cutting-edge ideas for innovation in health service provision. Following on from the success of last year, we are again holding a Shark Tank session to round off the Nursing & Midwifery Symposium. The session will run from 3:00-4:30pm on Friday, 26 October at Aerial South Wharf Melbourne. We are looking for creative forward thinkers who can pitch their idea to our team of three panellists. The panel will be made up of experts from health, academic and corporate backgrounds. Each entry can be either an individual or a team of two maximum. All chosen candidates will have their registration fees for the Symposium waived. The pitch will last for three minutes and will need to include an introduction of the team, followed by the concept, why it s relevant, and the project outcomes. This information needs to be succinctly described in the application form below, however the pitch on the day need only be based upon this information. The pitchers will then be asked questions by each of the panellists, with question time lasting for two minutes maximum. Each pitch and questions will last for five minutes total. The audience and the panellists will then be asked to vote on the idea, with each representing 50% of the vote. The three winners each to be presented with $2,000 prize money will then be announced at the end of the session. Completed applications should include a short PowerPoint presentation to accompany the pitch and be submitted to by COB Tuesday, SHARK TANK CATEGORIES WHAT WE RE LOOKING FOR There are three main categories which you will need to nominate in your application: 1. Patient Quality and Safety 2. Technological Innovation 3. Best Communication Strategies If you feel that your entry crosses over these categories please nominate both and the reviewers will allocate your entry to the appropriate category. Each winner will receive a prize of $2,000 to use to further develop the innovation and advice from our panellists. The member organisation s Director of Nursing representative on our committee will have overall approval of how these funds are spent.

PART ONE NAME(S) OF CANDIDATE(S) ORGANISATION DIRECT SUPERVISOR CANDIDATE EMAIL CANDIDATE MOBILE NAME OF INNOVATION OR PROJECT Who is in the team? NAME OF TEAM MEMBER ONE BIO OF TEAM MEMBER ONE (50 WORDS) NAME OF TEAM MEMBER ONE BIO OF TEAM MEMBER ONE (50 WORDS) Tell us about your idea, project or innovation. BRIEF DESCRIPTION OF THE INNOVATION (100 WORDS) NURSING & MIDWIFERY SYMPOSIUM SHARK TANK APPLICATION FORM 2

PART TWO What are the aims/ objectives of the innovation? BRIEFLY EXPLAIN THE PURPOSE OF THE PROJECT (100 WORDS) How does it work? BRIEFLY EXPLAIN HOW YOU INTEND TO DEVELOP AND IMPLEMENT THE PROJECT (100 WORDS) 3 NURSING & MIDWIFERY SYMPOSIUM SHARK TANK APPLICATION FORM

PART THREE What are the Outcomes? BRIEFLY DESCRIBE THE OUTCOMES ACHIEVED TO DATE AND EXPECTED FUTURE OUTCOMES WITH FURTHER IMPLEMENTATION (100 WORDS) In the context of your chosen innovation category Please answer the following question. BRIEFLY EXPLAIN HOW THE INNOVATION FITS INTO THE CHOSEN CATEGORY (200 WORDS) NURSING & MIDWIFERY SYMPOSIUM SHARK TANK APPLICATION FORM 4