Title Page

  • Conducted on

  • Prepared by

Management Coverage Area: Supervisor/Lead

  • Patient Divisions: East, West, Rand Johnson & Queeny Towers.

  • AM Tour:

  • Afternoon Tour:

  • PM. Tour:

  • Complaints?

  • Has complaints been resolved?

Management Coverage Area: Supervisor/Lead

  • Patient Divisions: ED, OR, CSPD, PACU, Mallincrodt, Lobbies, Labs & IOH

  • AM Tour:

  • Afternoon Tour:

  • PM. Tour:

  • Complaints?

  • Has complaints been resolved?

Discharge Information:

  • Number of beds left from previous shift?

  • Daily response time?

  • Daily turnover time?

  • Current census?

  • Number of beds passed over to next shift?

  • Contact isolation curtain change?

  • Any Discharge Issues?

  • Has The discharge issues been resolved?

  • Additional work passed on to next shift?

Trash Chute & Carts (Cleared & Cleaned)?

  • Queeny Tower

  • West Pavilion

  • Peters

  • East Pavilion

  • Any trash issues?

  • Has the trash issues been resolved?

  • Time compactor picked up?

Staffing: Call offs/Late ins & issues:

  • BJH Staff: Call off /Late ins

  • MWS Staff: Call offs/Late ins

  • Staffing issues?

  • Has staffing issues been resolved or need further investigation?

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