CRMC Standards of Behavior

May, 2008

1. WE ARE PROUD OF OUR ASSOCIATION WITH CAPITAL REGIONAL MEDICAL CENTER AND THE MISSION TO SERVE OUR COMMUNITY.

I am CAPITAL REGIONAL MEDICAL CENTER

  • I am the reputation of Capital Regional Medical Center in our community.
  • I promote a positive image of Capital Regional Medical Center in our community.
  • I listen to communication given to me about Capital Regional Medical Center , follow up with the appropriate person or department and respond back to the originator of the communication. I provide feedback and closure.
  • While I value diversity of opinion, I support organizational decision 100% in my communication and actions.

2. WE PREVENT AND RESOLVE ISSUES TO MAINTAIN CUSTOMER CONFIDENCE.

R Resolve Issues

  • I use our established problem solving method A-L-E-R-T to resolve customer complaints

…. Apologize . “I'm sorry this happened…”

…. Listen with understanding. “Help me understand your problem.”

…. Empathize. Put myself in the customer's shoes. How would I feel in

this situation?

…. Respond to resolve the customer's problem. Use my empowerment.

…. Tell Someone to make sure the problem doesn't happen again.

  • I use our established Service Recovery Norms to recover from customer complaints and problems in the short term. I use our service line PI focus to fix problems long term.
  • I solve problems and focus on the process, not the individual.

3. WE SEEK TO UNDERSTAND AND EXCEED OUR CUSTOMER'S SERVICE EXPECTATIONS

E Exceed expectations

  • I anticipate my customer's needs, deliver the service that each expects, and offer services before they are requested.
  • I provide extra comfort and reassurance to exceed my customers' expectations.
  • I encourage questions and act appropriately with each person. I actively seek information by asking questions rather than making assumptions.
  • I use the Capital Regional Medical Center Approach
    • Be considerate and thoughtful. I pay attention to my customer's body language and respond pro-actively.
    • Make eye contact with the person who is approaching me or vice versa.
    • Smile. Remember, a smile is contagious!
    • Greet customers warmly as I walk throughout the facility.
    • Be hospitable; look for people who may need assistance or may look lost as I walk through the corridors.
    • Introduce myself by name and responsibility. For example. “Hello, my name is Marie. I'm a nursing assistant.”
    • Ask the person their name and ask permission to call them by name.

….If I'm not sure what the person needs, I ask: “How may I help you?”

….If it is clear what the person needs I say, :”Let me help you….”

  • I adjust my posture to be at eye level with the person I have encountered. I bend down or escort the person to a chair and sit myself when appropriate.
  • Give the person 100% of my attention. They deserve it! I deserve it! Show patience.
  • Listen. I may be able to resolve a 10 minute issue in 2 minutes by giving my FULL attention.
  • Use my judgment. I determine if this is a situation I can handle, or if it needs to be referred. I make the referral and escort the person to the proper person/location or wait until someone arrives to escort them.
  • I will escort a person to their destination when appropriate. If I can't escort, I will give specific directions.
  • I say “Thank You”. I remember that I may be the First Impression – I will make it a good one!

4. WE CONSIDER INDIVIDUAL CUSTOMER NEEDS AND PROVIDE SERVICE WITH RESPECT, COMPASSION AND INTEGRITY.

S Service Excellence

  • I use behaviors and procedures that promote peace of mind and dignity for our customers.

…I provide appropriate attire for patients/residents in every situation.

  • I explain information to all customers with patience and use words they understand.
  • I respond to customers in a timely manner.
  • I display patience and concern when communicating about time to my customers.
  • I inform customers of time until service and offer them options.
  • I update customers if the situation changes.
  • I make customers comfortable while they are waiting.
  • I build into my conversations phrases customers love to hear:

“I can help you…” “I'd be happy to…” “Yes” “My pleasure”….

  • I remember that most of my message is communicated non-verbally by voice tone and body language.

5. WE DEMONSTRATE PRIDE IN THE PROFESSIONALISM OF OUR PERSONAL APPEARANCE AND IN THE APPEARANCE OF OUR FACILITY.

P Professionalism

  • I look professional and adhere to the dress code.
    • I take pride in my personal appearance
    • I view my appearance through my customer's eyes.
    • My appearance communicates to each customer, “ I respect you and myself.”
    • I check my appearance throughout my shift and refresh my appearance as needed.
  • I care for my equipment and my environment.
    • I preserve the cleanliness of my immediate work environment and throughout the Facility.
    • I use the staff / service elevators to allow families and visitors full access to the elevators near the lobby.
    • I keep my work area neat and uncluttered.
    • I pick up trash whenever I encounter it, inside and outside the facility.
    • I take responsibility to maintain a safe environment in my department and throughout the facility and grounds.
    • I take care of and maintain hospital equipment and resources.
    • I notify the appropriate person or department as soon as I am aware that equipment needs fixing or professional maintenance, whether it is my job or not.

6. WE IMPROVE THE PROCESSES THAT DELIVER SERVICE TO OUR CUSTOMERS.

E Enhance performance

  • I identify and eliminate service problems.
  • I continuously improve what I do, professionally and personally.
  • I “raise the bar” on service performance.

7. WE GUARANTEE CONFIDENTIALITY AND RESPECT ALL ASPECTS OF CUSTOMER PRIVACY.

C Confidentiality

  • I follow procedures to ensure privacy.
  • I focus on confidentiality and only speak about customers with appropriate individuals.
  • I do not discuss any information inappropriately.
  • I respect our customer's privacy and view the patient's/resident's room or treatment area as their personal space. I knock before entering a room and identify myself by name and department. I communicate what I am doing.
  • I coach in private, commend in public

8. WE PARTNER TOGETHER TO ENHANCE THE QUALITY OF SERVICE WE DELIVER TO OUR CUSTOMERS.

T Teamwork

Each individual provides a unique and essential contribution towards extraordinary service to all who interact with Capital Regional Medical Center .

  • I encourage and support behavior that is partner building.
  • I serve as a team member to exceed customer's needs. I am patient with others and prioritize my work around patient/resident/customer needs.
  • I communicate with others in an open, appropriate, and timely manner.
  • I value and respect others and I demonstrate that in my work each day.
  • I appreciate the diversity of background, gender, ideas and other differences people bring to my team and daily work efforts.
  • I recognize the diversity present in each situation and use it to enhance our communication, understanding, and decision making.
  • I treat others with dignity.
  • Daily, I acknowledge and recognize the contributions of others in my work environment and throughout our Health System.
  • I look for opportunities to celebrate and recognize teamwork.
  • I share appropriate information freely as a toll to enhance the service provided.
  • We recognize that fun coupled with sensitivity to meet our patient's needs belong in the workplace.

My signature below indicates I have been given a copy of the CRMC Standards of Behavior. I agree to support and role model these Standards to the best of my ability.

  Employee Signature: _______________________________________ Date: ______________

EEO Self-Identification Form

The Company is an equal employment opportunity/affirmative action employer. Certain laws and regulations regarding equal employment opportunity/affirmative action require us to compile annual statistical reports on applicants for employment. In order to comply with these laws and regulations, we are requesting your cooperation in completing this EEO Self-Identification Form.

This information on this EEO Self-Identification Form is being requested and will be used solely for equal employment opportunity/affirmative action record-keeping and reporting purposes. Submission of this form by you is voluntary. Please be assured that you will not be subjected to any adverse treatment if you do not provide the information requested. In the event that you do not provide the information requested, the information and this form will be processed and maintained separately from your employment application forms and, if you are hired by the Company, your personal file.

Sex Identification
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Minority Status Identification
American Indian or Alaskan Native
Asian or Pacific Islander
Black (Not of Hispanic Origin)
Hispanic
White (Not of Hispanic Origin)

Position Sought
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Date

Pre Check Inc.
Pre-Employment Disclosure & Release

Applicant's Full Name
City
State
Zip Code
HighSchool, College, University or Institution of Professional Training
Campus Name
Campus City
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Name used at the Institution or School
Dates of Attendance and/or Graduation
My Present Employer May Be Contacted For a Job Reference Yes   No

Pursuant to the requirements of the Fair Credit Reporting Act, I acknowledge that a credit report, consumer report2 and/or investigative consumer report3 may be made in connection with my application for employment with prospective employer. (including contract for services). I understand that these investigative background inquiries may include credit, consumer, criminal, driving, prior employment and other reports. These reports may include information as to my character, work habits performance and experience, along with reasons for termination of past employment from previous employers. Further, I understand that a prospective employer and PreCheck, Inc., may be requesting information from various federal, state, and other agencies which maintain records concerning my past activities relating to my educational/school records, driving, credit, criminal, civil and other experiences, as well as claims involving me in the files of insurance companies.

I authorize, without reservation, any party or agency contacted by PreCheck, Inc. to furnish the information mentioned above. A photocopy of this authorization shall have the same effect as the original.

I understand the information obtained will be used as one basis for employment or denial of employment. I hereby discharge, release and indemnify the prospective employer, PreCheck, Inc., their agents, servants and employees, and all parties that rely on this release and/or the information obtained with this release from any and all liability and claims arising by reason of the use of this release and dissemination of information that is false and untrue if obtained from a third party without verification.

It is expressly understood that the information obtained through the use of this release will not be verified by PreCheck, Inc. The authorization granted herein expires one year from the date hereof.

I have read and understood the above information, and assert that all information provided by me is true and accurate.

If you are denied employment, either wholly or partly because of information contained in a consumer report, a disclosure will be made to you of the name and address of the investigative agency making such report. Upon your written request within a reasonable period of time, the investigative agency compiling the report will make a complete and accurate disclosure of the nature and scope of the investigation.

1)The Age Discrimination in Employment Act of 1987 prohibits discrimination on the basis of age with respect to individuals who are at least 40 years of age. This information is for consumer report purposes only.

2)A “Consumer Report” may consist of employment records, educational verification, licensure verification, driving record, previous address and public records relative to criminal charges.

3)An “Investigative Consumer Report” means a consumer report or portion thereof in which information on a consumer's character, general reputation, personal characteristics, or mode of living is obtained through personal interviews with persons having knowledge.

APPLICATION FOR EMPLOYMENT

It is the policy of this facility to provide equal opportunity to persons regardless of race, religion, gender, disability or any other classification in accordance with federal law, state and local statutes, regulations and ordinances.

Date:

This Application to be active for a period of 60 days only.

Applicant name (Please give complete name)

Are you at least 18 years old? Yes No

Home Phone

E-mail Address

Present Address (Include City, State, Zip Code)

Previous Address (if at present address less than 12 months)
Current open position(s) for which you are applying:

1)   2)   3)

Type of Position

FT

PT
PRN

Shift

Day

Evening

Night

Weekend

Rotation

Salary Requirement

 Are you willing to travel?
Yes No		 Are you willing to relocate?
Yes No		 Do you have adequate means of transportation to get to work on time each day and when called in on short notice during normal working hours?Yes No

If overtime work is required periodically does this pose a problem for you? Yes No

Date Available for Work

 Are you legally authorized to work in the U.S.?
Yes No

Have you ever worked in a facility associated with HCA?
Yes No

If yes, what facility?

Are you related to any other facility employee?
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How did you learn about this position?

State Employment Commission

Agency

Ad

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Other:

Have you been convicted, fined, placed on probation, entered into a pre-trial diversion, or had any other types of deferred prosecution regarding any crimes for which you were arrested? This is not intended to include minor traffic violations such as speeding, improper equipment, reckless driving or other minor infractions. Yes No
If yes, give date, place and nature of each such charge.

Are you presently charged with any violation of the law? Yes No
If yes, give date, place and nature of each such charge.

Are you currently excluded from participation in any federally funded healthcare program - including Medicare and Medicaid -  and are you aware of any potential exclusion from a federally funded health program?

Yes No
Educational History

Type of School

Name of School

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Attended in School

Degree or Certificate

City, State

High School/
GED

09 10
11 12

Graduated/GED?
Yes No

College

1234

Graduated?
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College

1234

Graduated?
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Graduate School

1234

Graduated?
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Other

From (Year)
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Other

From (Year)
 To (Year)

List any professional licenses, registration you possess
(include drivers license, if applicable)

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State Issued

Expiration Date

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1)

2)

3)

4)

Clerical or other skills applicable to
the position for which you are applying.

Typing ( wpm)     PBX

Proficient in Software: (list all)

Business machines and/or equipment you can operate:

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Employment History

Please provide a minimum of the most recent 10 years employment history including any period of unemployment. Attach additional pages if needed.

Current or Most Recent

From

Mo.
Yr.

To

Mo.
Yr.

Company

Phone Number

Immediate Supervisor

Salary

Address

May we contact them?

Yes     No

Name While Employed

Job Title

Department

Other reference with this employer

Reason for Leaving

Nature of Duties

1st Previous

From

Mo.
Yr.

To

Mo.
Yr.

Company

Phone Number

Immediate Supervisor

Salary

Address

May we contact them?

Yes     No

Name While Employed

Job Title

Department

Other reference with this employer

Reason for Leaving

Nature of Duties

2nd Previous

From

Mo.
Yr.

To

Mo.
Yr.

Company

Phone Number

Immediate Supervisor

Salary

Address

May we contact them?

Yes     No

Name While Employed

Job Title

Department

Other reference with this employer

Reason for Leaving

Nature of Duties

3rd Previous

From

Mo.
Yr.

To

Mo.
Yr.

Company

Phone Number

Immediate Supervisor

Salary

Address

May we contact them?

Yes     No

Name While Employed

Job Title

Department

Other reference with this employer

Reason for Leaving

Nature of Duties
Professional References

Give two references, other than relatives, who have a good working knowledge of your work.

Name

Position

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Phone-Work/Home

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1) 

2) 

Please Review and Sign Where Indicated

In making application for employment:

- I certified that the information in this application is true and complete for all practical purposes. It may be verified by the facility or any affiliate. Should a position be offered and later it is found that the information is significantly untrue, or misrepresented, I understand and agree that the facility or its affiliates are relieved of all commitments, financial or otherwise pertinent to employment, and that I am subject to immediate discharge without recourse.

- I understand that an investigative report may be made by a consumer reporting agency to include information as to my character, general reputation, personal characteristics and mode of living, whichever may be applicable. If such an investigative report is made, I understand that I will receive notice that such report has ben requested, and that I will have the right to make a written request for a complete and accurate disclosure of additional information concerning the nature and scope of the investigation.

- I UNDERSTAND AND AGREE THAT ANY EMPLOYEE HANDBOOK WHICH I MAY RECEIVE WILL NOT CONSTITUTE AN EMPLOYMENT CONTRACT, BUT WILL BE MERELY A GRATUITOUS STATEMENT OF FACILITY POLICIES

- I understand that the facility reserves the right to require its employees to submit to blood tests or urinalyses for alcohol or drug screens, or to allow inspection of bags (including purses or briefcases) or parcels brought in or taken out of the facility. I understand that refusal to submit to a urinalysis, blood test or search, when requested to do so, may result in termination of my employment.

- Compliance with this facility's Substance Abuse Policy is a condition of employment. This facility requires that every newly hired employee be free of alcohol or drug abuse. Each offer of employment is contingent upon successfully completing a urinalysis test/screen for alcohol and drugs in accordance with facility policy. Continued employment is also contingent upon compliance with the facility's Alcohol and Drug Abuse Policy.

I agree to immediately disclose to the Company any debarment suspension, exclusion or other event that makes me ineligible in any Federal health care program, or receive a government contract.

- I UNDERSTAND AND AGREE THAT IF I AM OFFERED EMPLOYMENT BY THE FACILITY, MY EMPLOYMENT WILL BE FOR NO DEFINITE TERM AND THAT EITHER I, OR THE FACILITY WILL HAVE THE RIGHT TO TERMINATE THE EMPLOYMENT RELATIONSHIP AT ANY TIME, WITH OR WITHOUT CAUSE, AND WITH OR WITHOUT NOTICE. I ALSO UNDERSTAND THAT THIS STATUS CAN ONLY BE ALTERED BY A WRITTEN CONTRACT OF EMPLOYMENT WHICH IS SPECIFIC AS TO ALL THE MATERIAL TERMS AND IS SIGNED BY ME AND THE ADMINISTRATOR OF THE FACILITY.

Release:

I hereby authorize any prior employers to provide such information concerning my employment with them as may be requested, and also authorize the Registrar/Placement Office of all educational institutions attended to release an official copy of my transcript and, if available, faculty appraisals. I also authorize any appropriate licensing board to release full information concerning my licensure status and my licensure history.
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