EVS Supervisor - E.O.S. Report (MC)*

• Conducted on

  Date

• Supervisor:

• Lead:

Daily Tours:

• Areas Toured?

  Select 1-4 PVT 5800 6800

  • 1-4 PVT
  • 5800
  • 6800

E.Q.E. / HRO / EOC Rounds completed:

• E.Q.E.?

  Select 1-4 PVT 5800 6800

  • 1-4 PVT
  • 5800
  • 6800

• HRO’s?

  Select 1-4 PVT 5800 6800

  • 1-4 PVT
  • 5800
  • 6800

• EOC Rounds?

  Select 1-4 PVT 5800 6800

  • 1-4 PVT
  • 5800
  • 6800

Customer Touch-Base:

• Patient Divisions?

Discharge Information:

• Number of beds in your area passed over at 3:00pm?

• Any Discharge Issues?

  yes

  No

• Has The discharge issues been resolved?

  Yes

  No

  N/A

Projects:

• Projects Completed

Complaints:

• Marbella Complaints?

• Has Marbella complaint been resolved in the system?

  Yes

  Need Further investigation

  N/A

• Other Complaints?

• Has Complaints been resolved or need further investigation?

  Yes

  Need Further investigation

  N/A

Staffing: Call offs/Late ins & issues:

• BJH Staff: Call off /Late ins

• MWS Staff: Call offs/Late ins

Pertinent Information:

• Any Pertinent information management needs to be aware of?

  yes

  No

Additional Coverage:

• Additional Coverage Information: