Title Page
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Conducted on
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Prepared by
Management Coverage Area: Supervisor/Lead
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Patient Divisions: East, West, Rand Johnson & Queeny Towers.
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AM Tour:
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Afternoon Tour:
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PM. Tour:
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Complaints?
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Has complaints been resolved?
Management Coverage Area: Supervisor/Lead
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Patient Divisions: ED, OR, CSPD, PACU, Mallincrodt, Lobbies, Labs & IOH
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AM Tour:
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Afternoon Tour:
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PM. Tour:
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Complaints?
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Has complaints been resolved?
Discharge Information:
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Number of beds left from previous shift?
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Daily response time?
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Daily turnover time?
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Current census?
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Number of beds passed over to next shift?
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Contact isolation curtain change?
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Any Discharge Issues?
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Has The discharge issues been resolved?
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Additional work passed on to next shift?
Trash Chute & Carts (Cleared & Cleaned)?
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Queeny Tower
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West Pavilion
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Peters
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East Pavilion
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Any trash issues?
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Has the trash issues been resolved?
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Time compactor picked up?
Staffing: Call offs/Late ins & issues:
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BJH Staff: Call off /Late ins
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MWS Staff: Call offs/Late ins
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Staffing issues?
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Has staffing issues been resolved or need further investigation?