Employee of the Month Nomination Form Leadership holds our staff to very high standards. We do an excellent job of meeting these standards. We are also fortunate enough to have employees that EXCEED these standards. Please take a few minutes to recognize those you feel go above and beyond. + Atthe beginning of the month, nomination forms will be available for two (2) weeks. Once completed, please give form to Mary or Frank. If unavailable, please slide under their door. * Leadership will then ensure requirements are met, choose employee, and we will celebrate employee at staff meeting the following month, Ex. Dec 1-14 nominations will be for January EOM, recognized at January staff meetin; + Leadership will be in charge of picking until the Unit based council is established «Leadership will use judgment when picking based on both quality and quantity of nominations Nominee must meet following requirements: * Work Status: Full or Part time employee (RN, CNA, ACP, PSC) who successfully completed new hire orientation with satisfactory follow up. + Performance: Employee must not have poor performance indicators (write-ups, disciplinary action) within last year + Rationale for nomination must have occurred within the last 90 days + Employee should exemplify our Standards of Excellence (Service, Quality, Team, Personal, Communication) © Please give descriptive examples of how employee goes above and beyond one or all standards Employee of the Month receives: * Name on plaque * Get out of Float Free card‘Name of Nominee: Title: Date: [additional space is needed, please include attachments. « Describe the employee’s accomplishments/contributions that were above and beyond the normal duties expected of their job description. (Provide descriptive examples) + Utilizing the Standards of Excellence sheet provided, describe how employee has EXCEEDED one or all of these standards. (Service, Quality, Team, Personal, Communication) (Please include as much detail as possible) Nominated by: __ Date:aS Wate aa AA SSS) SCHOO emer ue [am hart sore my customers Tis naan romp, Hendy an cual serie | pray respod pation reques, phone cals and custo need |conmuricas ina respec and professional manne Novara communeatonisesimparar as hat sy. asa patent and ter needs, waking to rover potions and crnmuricate frequent bouthowlog 8 paien. stor or cluague may tpettova proce repr upstes wal queso loeation and soak ot hose wh loko | soeko undecang andingrou are mousues, quay nati, best pracices past saitacion macsures and apoyee srgoponert messes. respect te carey of pts and coleagues repo cancens andtake apron sts inate att vistr ardor employe saftyhazars ident opps ar ston for sence and sae impeovemerts In mywarkerea an ssume aecounabiy for our succes |i he feiyand my work are ose, reenable, unlatared ncaa. ‘i eke aproprac scion when pubic e068 6 not mache stands, ten to understand one sponéina conpassonate manner. ‘encourage my coleaques ond fer word of praise or axle rk, ‘porter wit my callesguesto manage te werkow my eam ant ling pach into cher. 'alprew ress oxprenced colesques fal welcome tankers forte nd tons aka resort ory ett ad actions eat thrs wth ty ndrospect rudeness nt accept, ‘am supportive an ax when change occurs "consist ary ot work est te best my ality sits ‘nding, uncersanding at my work makes. diarncein he cae scurptens dol cotietnaconsructie maaner and welcare pcsoral faoiback improve perfomance and reatonshps ooo pporuntes further ny etn. | dot vig ting bacauseitis teria hing do, wether saynels watching tae responsbty ous UCHeat resources appropiate tata stpsto maaan personal haath ané wetness. isin positive nage snd fatow he UCHeath des code weary bag soi easy read by pats, vstorsard calaagues Anyi am Inustom oc havemy badge, reeset UCHesthn 8 poste ight. | sho rego o all manbere fhe UCHesth aan: volume employees, mensgors, meal sa, sens ard oes. Before pa6k. conser who might sering and whats ppronritln watsuaton ep cut on rgarizatnainerato, ES UNIVERSITY COLORADO HEALTH