Tally sheet (Check Sheet)
The Tally sheet (also called a Check Sheet) is a very simple way to accumulate data about the frequency of occurren
It is a simple, flexible, and effective data collection tool where data can be collected in real time at the location whe
The data it captures can be quantitative or qualitative. The information from a Tally Sheet can then be graphed in a
Examples of Tally sheets are shown in the next sheet (tab)
Template
Category How Many (count) Total
Total 0
out the frequency of occurrence of events.
n real time at the location where it is generated.
heet can then be graphed in a Pareto Chart or a Histogram.
Tally sheet examples
Example Tally Sheet: Causes of bed block
Event
(Causes of bed Tally Total
block)
No Cleaner to
clean bed in 3
ward
Delay in
5
investigation
No bed in 7
Ward
TOTAL
Incidents of 15
bed block
Example
Causes of Discharge Delay from Emergency Department
Cause Jan - Mar Apr - June Jul - Sept Oct - Dec TOTAL
X-Rays 39 30 28 29 126
Bed Shortage 13 16 21 13 63
Review by Team 5 4 7 4 20
Doctor busy 4 7 8 5 24
Patient 3 2 1 4 10
Other 3 2 1 3 9
TOTAL 67 61 66 58 252
EXAMPLE: Check sheet of where missing medical records were located
Category How Many Total
Doctors private
rooms II 2
Ward 1 East I 1
Ward 1 North IIIIIIII 8
Ward 1 South III 3
Ward 1 West II 2
Ward 2 East I 1
Ward 2 North II 2
Ward 2 South III 3
Ward 2 West II 2
Physiotherapy I 1
OT III 3
Research Unit II 2
Administration I 1
Admission
Office II 2
Out patient
Clinic II 2
TOTAL 35
Tally Sheet example of exercise goals
Mon Tue Wed Thur Fri
Week 1 Walk to work Walk to work Walk to work
(3 goals)
Week 2 Walk to work Walk to work Walk to work
(3 goals)
Week 3 Walk to work Walk to work Walk to work Walk to work Walk to work
(5 goals)
Week 4 Walk to work Walk to work Walk to work Walk to work Walk to work
(5 goals)
Week 5 Walk / jog to work Walk / jog to work Walk / jog to work Walk / jog to work Walk / jog to work
(5 goals)
Week 6 Walk / jog to work Walk / jog to work Walk / jog to work Walk / jog to work Walk / jog to work
(5 goals)
Week 7 Walk / jog to work
Ride bike to & from
Walk / jog to work
Ride bike to & from
Walk / jog to work
(7 goals) work work
Week 8 Walk / jog to work
Ride bike to & from
Walk / jog to work
Ride bike to & from
Walk / jog to work
(7 goals) work work
Week 9 Walk / jog to work Ride bike to & from Walk / jog to work Ride bike to & from Walk / jog to work
(7 goals) work work
Ride bike to & from
Week 10 Walk / jog to work
work
Walk / jog to work Ride bike to work Walk / jog to work
Ride bike to & from
Week 11 Walk / jog to work work Walk / jog to work Ride bike to work Walk / jog to work
Ride bike to & from
Week 12 Walk / jog to work work Walk / jog to work Ride bike to work Walk / jog to work
Week 13
Week 14
Week 15
Week 16
Week 17
Week 18
Week 19
Week 20
Achieved Did NOT
Legend: goal
achieve
goal
Denominat
or:
Total % daily
Numerator:
Sat Sun # daily exercise number of exercise
goals met daily goals met
exercise for week
goals for
week
2 3 67%
3 3 100%
4 5 80%
5 5 100%
3 5 60%
4 5 80%
5 7 71%
7 7 100%
Gym with P/Trainer 8 8 100%
Gym with P/Trainer 8 8 100%
Gym with P/Trainer Bootcamp with 9 9 100%
P/Trainer
Bootcamp with
Gym with P/Trainer P/Trainer 8 9 89%
