The Site-level Documentation Journal for QI teams is designed specifically to document in real time, the changes being implemented, and to aid teams in reviewing results in light of changes implemented. This tool is meant to be kept by QI teams for their own purposes and filled in with the level of detail needed by the team itself. The essential elements of the Documentation Journal are: the ongoing list of changes being implemented (including specific start and end dates, if appropriate), and the linking of those changes by annotating and analyzing time series charts based on results being tracked through regular monitoring of indicators.