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Tally sheet (Check Sheet)

The Tally sheet (also called a Check Sheet) is a very simple way to accumulate data about the frequency of occurrenc
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
ut the frequency of occurrence of events.
real time at the location where it is generated.
eet 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:
# daily exercise number of exercise
Sat Sun daily goals met
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%

Bootcamp with
Gym with P/Trainer 9 9 100%
P/Trainer

Bootcamp with
Gym with P/Trainer 8 9 89%
P/Trainer

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