Mass General Hospital - Department of Radiology - RCSC - 2007 Radiology Clinical Excellence Award Form

Candidate Nomination Form - 2008

All fields are required.

Date:

(00/00/0000)

Candidate's name:

Job Title:

Division/Location:

Area Manager:

Business Address:

Nominator's Name:

Nominator's Email Address:

Please include a narrative that is a minimum of 200 words in length. The narrative must describe how the candidate provides exemplary patient-focused service by applying the five F.O.C.U.S. Guiding Principles in their clinical role. Although some principles may be more prevalent than others due to the candidate's responsibilities, each of the five principles must be addressed at a minimum level.

F.O.C.U.S Guiding Principles:

Creates and fosters an environment that recognizes and supports the needs of the patient/customer.

Accepts accountability for each action on all levels, individual as well as departmental. Recognize success and work collectively to identify and improve failure points.

Maintain a professional and positive attitude while practicing active listening skills to enhance the channels of communication with all patients/customers.

Demonstrate compassionate and genuine interest while interacting with each patient/customer

Commit to quality patient / customer focused programs with measurable outcomes

1. A copy of this nomination form must be submitted for approval to the nominee’s Operations Manager no later than Friday, October 24th. This form can be submitted automatically upon completion by selecting the submit nomination button above, however it must be approved by the manager prior to submission.

2. Operations Managers must approve the nomination and make sure that it is submitted to the Customer Service Council representative (Jennifer McGowan and Michael Conners) by the end of the business day, Monday, October 27th.

3. The award is to be presented at the Radiology Technologist Luncheon held on Wednesday, November 5th.