EMCM Leadership Rounding

• Document No.

• Audit Title

• Leader's name:

• Location
  Address

• Conducted on

  Date

• Prepared by

Patient Demographic

• Patient Name

• Patient Number

Summary of Visit

• What was working well today?

• Are there any specific individuals whom we should be recognizing and what made them notable?

• Are there any physicians whom we should be recognizing and what made them notable?

• Did you receive any negative feedback from patients, visitors, employees, or physicians? If so, how do you plan to address and resolve the issues?

  Yes

  No

  N/A

• Any suggestions on how to enhance / improve service delivery?

Quarterly Focus

• Within the next two weeks you will receive a satisfaction survey from NRC Picker. This survey is an important tool for Einstein Medical Center Montgomery to share your patient experience with our leaders and peers in the acute hospital community. Receiving the highest score is the goal of our hospital leadership, staff and caregivers. Can we count on you to complete and return the survey?

  Yes

  No

  N/A

• Did EMCM meet your needs in a manner that would give you confidence to respond to the NRC Picker satisfaction survey with the highest score? If no, why?

  Yes

  No

  N/A

• Do you have any recommendations to improve the issues you identified?

Patient Demographic

• Patient Name

• Patient Number

Summary of Visit

• What was working well today?

• Are there any specific individuals whom we should be recognizing and what made them notable?

• Are there any physicians whom we should be recognizing and what made them notable?

• Did you receive any negative feedback from patients, visitors, employees, or physicians? If so, how do you plan to address and resolve the issues?

  Yes

  No

  N/A

• Any suggestions on how to enhance / improve service delivery?

Quarterly Focus

• Within the next two weeks you will receive a satisfaction survey from NRC Picker. This survey is an important tool for Einstein Medical Center Montgomery to share your patient experience with our leaders and peers in the acute hospital community. Receiving the highest score is the goal of our hospital leadership, staff and caregivers. Can we count on you to complete and return the survey?

  Yes

  No

  N/A

• Did EMCM meet your needs in a manner that would give you confidence to respond to the NRC Picker satisfaction survey with the highest score? If no, why?

  Yes

  No

  N/A

• Do you have any recommendations to improve the issues you identified?

Patient Demographic

• Patient Name

• Patient Number

Summary of Visit

• What was working well today?

• Are there any specific individuals whom we should be recognizing and what made them notable?

• Are there any physicians whom we should be recognizing and what made them notable?

• Did you receive any negative feedback from patients, visitors, employees, or physicians? If so, how do you plan to address and resolve the issues?

  Yes

  No

  N/A

• Any suggestions on how to enhance / improve service delivery?

Quarterly Focus

• Within the next two weeks you will receive a satisfaction survey from NRC Picker. This survey is an important tool for Einstein Medical Center Montgomery to share your patient experience with our leaders and peers in the acute hospital community. Receiving the highest score is the goal of our hospital leadership, staff and caregivers. Can we count on you to complete and return the survey?

  Yes

  No

  N/A

• Did EMCM meet your needs in a manner that would give you confidence to respond to the NRC Picker satisfaction survey with the highest score? If no, why?

  Yes

  No

  N/A

• Do you have any recommendations to improve the issues you identified?

Patient Demographic

• Patient Name

• Patient Number

Summary of Visit

• What was working well today?

• Are there any specific individuals whom we should be recognizing and what made them notable?

• Are there any physicians whom we should be recognizing and what made them notable?

• Did you receive any negative feedback from patients, visitors, employees, or physicians? If so, how do you plan to address and resolve the issues?

  Yes

  No

  N/A

• Any suggestions on how to enhance / improve service delivery?

Quarterly Focus

• Within the next two weeks you will receive a satisfaction survey from NRC Picker. This survey is an important tool for Einstein Medical Center Montgomery to share your patient experience with our leaders and peers in the acute hospital community. Receiving the highest score is the goal of our hospital leadership, staff and caregivers. Can we count on you to complete and return the survey?

  Yes

  No

  N/A

• Did EMCM meet your needs in a manner that would give you confidence to respond to the NRC Picker satisfaction survey with the highest score? If no, why?

  Yes

  No

  N/A

• Do you have any recommendations to improve the issues you identified?

Patient Demographic

• Patient Name

• Patient Number

Summary of Visit

• What was working well today?

• Are there any specific individuals whom we should be recognizing and what made them notable?

• Are there any physicians whom we should be recognizing and what made them notable?

• Did you receive any negative feedback from patients, visitors, employees, or physicians? If so, how do you plan to address and resolve the issues?

  Yes

  No

  N/A

• Any suggestions on how to enhance / improve service delivery?

Quarterly Focus

• Within the next two weeks you will receive a satisfaction survey from NRC Picker. This survey is an important tool for Einstein Medical Center Montgomery to share your patient experience with our leaders and peers in the acute hospital community. Receiving the highest score is the goal of our hospital leadership, staff and caregivers. Can we count on you to complete and return the survey?

  Yes

  No

  N/A

• Did EMCM meet your needs in a manner that would give you confidence to respond to the NRC Picker satisfaction survey with the highest score? If no, why?

  Yes

  No

  N/A

• Do you have any recommendations to improve the issues you identified?