Index of Web Site

RI004P - Access to the Case Review Subcommittee of the Bioethics Resource Committee by Patient, Patient Representative, Hospital Employee and/or Medical Staff

RI004F - Bioethics Case Review Summary Form

RI005P - Alternative Therapy Policy

RI006F - Consent for Blood Transfusion/Refusal of Consent for Transfusion

RI007O - Patient Responsibilities

RI008P/F - Advance Directive Policy and Form

RI009F - Advance Directives Worksheet

RI010F - Organ Donor Referral/Post Mortem Documentation Form

RI011F - Interim Care Directive

RI012P - OR Observers Policy

RI013P - Compliant Resolution Policy

Patient Assessment

PE001F - Assessment Form - Interdisciplinary

PE002O - Suicide/Homicide Precautions Protocol and Risk Flow Chart from Emergency Department

PE003P - Patient Acuity Policy

PE004P - Pain Management Policy #1

PE005P - Pain Management Policy #2

PE006P - Pain Management Policy #3

Care of Patients

TX001P - Restraint/Seclusion Log Policy

TX001Fa - Restraint Flowsheet
TX001Fb - Restraint Data Collection Sheet
TX001Fc - Data Aggregation Record

TX002F - Restraint Immobilization Record

TX003P - Anesthesia Drug Policy

TX004P/F - Fall Prevent and Risk Scoring Policy and Forms/Documents

TX005P - Latex Allergy Policy - Sample #1

TX006P - Latex Allergy Policy _ Sample #2

TX007F - Tools for Use of Sitters as an Alternative to Restraint Use

TX008P - Conscious Sedation Policy - Example 1

TX009P - Conscious Sedation Policy - Example 2

TX010Pa - Restraint and Seclusion Policy

TX010Pb - Restraint Protocol for Patients Interfering with Treatment

TX010Pc - Restraint Protocol for Patients at Risk for Fall

TX011F - Restraint Interventions/Alternatives Pathway

TX012P - Restraints and Seclusion Policy

TX013F - Outpatient Surgery Report

TX014P - Sample Patient Transportation Policy

TX0015F - Transfusion Consent Form

TX016O - Central Venous Line Manual

TX018P - Civil Involuntary Detention (96 Hour Hold) Protocol

TX019F - Fall Analysis and Medication Occurrence Analysis Form

Education

PF001F - Interdisciplinary Patient Teaching Record

PF002F - Interdisciplinary Patient/Family Education Policy

PF002Fa - Interdisciplinary Patient/Family Education Form - Learning Needs
PR002Fb - Interdisciplinary Patient/Family Education Form - Documentation

Improving Organization Performance

PI001O - Guidelines for Documenting Performance Improvement Activities

PI001Fa - Department/Team Mission Vision
PI001Fb - Department/Team Scope of Care
PI001Fc - Performance Improvement Plan and Findings
PI001Fd - Department/Team Annual Evaluation

PI002F - Forms for Review of Operative, Invasive and Noninvasive Procedure Measures (Previously Known as 'Surgical Case Review')

PI002Fa - Surgical Case Review Data Collection Sheet
PI002Fb - Anesthesia Case Review Data Collection Sheet
PI002Fc - Vascular Access Devices Surgical Case Review Data Collection Sheet

PI003F - Performance Improvement Sample Report (Report to the Governing Body)

PI004F - Patient Satisfaction Survey Example

PI004Fa - Patient Satisfaction Survey for Inpatients
PI004Fb - Patient Satisfaction Survey for Outpatients

PI005F - Performance Improvement Case Review Worksheet

PI006F - Performance Improvement Mortality Case Review Worksheet

PI007Oa - Sample PI Measures Sorted by Key Function

PI007Ob - Sample Board Report of Hospital-wide Required Functions

PI007Oc - Sample Board Report of Performance Improvement Measures (Teams/Departments)

PI008O - Important Processes or Outcomes Requiring Data Collection or Assessment

PI009O - Example Performance Improvement Plan

PI010O - Blood Trending Form and Sample Report

PI011F - Reappraisal of Quality Management Process Form

PI012P - Performance Improvement/Quality Assessment Plan Sentinel Events Policy

PI013O - Spreadsheet Template for Scoring Mock Surveys

PI014F - Mock Survey Tool

PI015F - Peer Review Form

PI016F - PI Report Sample

PD017P - Occurrence Reports Policy

PI018F - CPR Data Collection Form

PI019O - Peer Review Process

PI020F - Prioritization Tool

PI021F - Root Cause Analysis Form (JCAHO approved)

PI022F - Variance Report Survey

PI023F - Prioritization of PI Projects Tool

PI024F - Patient Safety Forms (Safety Concern/Suggestion Report Form and Informal Quality/Risk Concern Report Form

PI024F - Clinical Alarm List (National Patient Safety Goal #6)

Leadership

LD001P - Contracted Services Policy

LD002F - Hospital-wide Policy and Procedure Routing Form

LD003O - Sample Outline for Scope of Services

LD004F - Meeting Minutes/Tracking Format

LD005O - Plan for the Provision of Care

LD006O - HCFA (CMS) Mandated Medical & Surgical Supplies for Home Health

Environment of Care

EC001P - Safety Mission

EC002P - Administrative Support Statement

EC003P - Safety Management Plan

EC004P - Life Safety Management Plan

EC005P - Security Management Plan

EC006P - Emergency Preparedness Plan

EC007P - Medical Equipment Management Plan

EC008P - Utility Systems Management Plan

EC009P - Hazardous Materials and Wastes Management Plan

EC010P - Hazard Communication Program

EC011P - Abusive Patient or Visitor

EC012P - Aggressive and Violent Behavior

EC013P - Bomb Threat Plan

EC014P - Civil Disturbance or Riot

EC015P - Earthquake Plan

EC016F - Safety Performance Measures

EC017F - Safety Report

EC018O - Template for Annual Evaluation EOC/Risk Management Plan

EC019P - Elopement Policy

EC020P - Violence Management Policy

Management of Human Resources

HR001F - Age Specific Competency Assessment Form

HR002Fa - Sample Competency Check List

HR002Fb - Sample Department Orientation Check List

HR003O - Sample Competency Assessment Tools for Age Specific, Abuse, and Cultural

HR004O - Sample Medical Staff Coordinator Job Description

HR005O - Article: Organization Wide Education & Competency

HR006O - Multilple RN Job Descriptions

HR007O - Job Description - Director Quality and Accreditation

HR008O - Age Specific Guides - Reference for Units

HR009O - Volunteers Evaluation

HR010F - Quarterly Performance Review Report

HR011F - Medication Competencies

Management of Information

IM001F - Medical Record Review Summary Sheet and Review Forms

IM001Fa - Medical Record Review Summary Sheet
IM001Fb - Sample Collection Form 1 (Example)
IM001Fc - Sample Collection Form 2 (Example)

IM002F - Health Sciences Library Needs Assessment Form

IM003F - Behavioral Health Medical Record Review Form/Survey Materials to Have Available

IM004F - Information Management Needs Assessment

IM005P - Medical Records Policy - Includes issues related to electronic signatures

IM006O - Information Management Plan

IM007P - Internet Policy

Surveillance, Prevention, and Control of Infection

IC001F - Refrigerator Temperature Log

IC002F - Refrigerator Temperature Graph

IC003F - Temperature Plotting Graph

Governing Body

GO001F - Governing Body Self Assessment

Submit Ideas and Suggestions

Submit a Document for Sharing

Additional Topics Requested - If you have information on these, Please Share!