DOCUMENTATION OF EXCELLENCE IN PATIENT CARE List achievements and provide examples or documentation of clinical excellence. 1. QUALITATIVE DOCUMENTATION OF ACHIEVEMENT CATEGORY OR TYPE OF ACTIVITY Please list qualitative examples of clinical excellence. EXAMPLES AND DOCUMENTATION Include explanations or examples in the space Where applicable, please attach additional evidence. provided. Add lines as needed. Clinical Quality Measures For example, InterQual, Joint the Commission, “Get with Guidelines” Customer/Patient Satisfaction Surveys For example, Press Ganey scores from past three years or patient comments Clinical Care Awards or Other Recognition of Excellence Physician of the Year, Outstanding Clinician Award from department, etc. Peer Faculty Evaluations For example, other physicians identify you as a “go-to” clinician. Learner/Trainee Evaluations For example, student, resident, and/or fellow teacher evaluations Referring Physician Evaluations or Recommendations Such as referrals from community-based providers or network physicians Citizenship Activities or Recognition Alignment with Service Line Goals Other Evidence
DOCUMENTATION OF EXCELLENCE IN PATIENT CARE List achievements and provide examples or documentation of clinical excellence. 1. QUALITATIVE DOCUMENTATION OF ACHIEVEMENT CATEGORY OR TYPE OF ACTIVITY Please list qualitative examples of clinical excellence. Include explanations or examples in the space provided. Add lines as needed. EXAMPLES AND DOCUMENTATION Where applicable, please attach additional evidence. Clinical Quality Measures For example, InterQual, Joint Commission, “Get with the Guidelines” Customer/Patient Satisfaction Surveys For example, Press Ganey scores from past three years or patient comments Clinical Care Awards or Other Recognition of Excellence Physician of the Year, Outstanding Clinician Award from department, etc. Peer Faculty Evaluations For example, other physicians identify you as a “go-to” clinician. Learner/Trainee Evaluations For example, student, resident, and/or fellow teacher evaluations Referring Physician Evaluations or Recommendations Such as referrals from community-based providers or network physicians Citizenship Activities or Recognition Alignment with Service Line Goals Other Evidence
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