Required for I.A: A multi-disciplinary, When was this task initiated? Copies of minutes from the Bronze and Silver site-based task force or How often does it meet? task force’s last three committee structure is How are ideas and input from patients/residents incorporated into meetings. established to oversee the work plans of this task force? A current task force and assist with Do members of the medical staff participate on this task force? If membership list, which implementation and no, describe efforts to expand medical staff representation on this includes each member’s maintenance of task force. name, title, and practices. Active How are committee members prepared and oriented to the role department/role. Identify participants on the task they will play? which staff are force include: and which are Patients/residents supervisory, and which and/or family members are members; patients/residents/family A mix of members. supervisory and management staff; A combination of clinical and staff (Note: For home care providers, this task force is based out of the administrative office / staff headquarters.) Required for I.B: A person-centered What is the coordinator’s name and job title? Coordinator’s job Bronze and Silver care coordinator or point Approximately how many per week does this person spend on description of contact person is person-centered tasks and responsibilities? Summarize the person-centered activities coordinated by the appointed who is able to commit the time required contact person within the last twelve months. to coordinate related activities on an ongoing basis. This individual will have direct access to, and support from, senior level
Required for Bronze and Silver I.A: A multi-disciplinary, site-based task force or committee structure is established to oversee and assist with implementation and maintenance of practices. Active participants on the task force include: Patients/residents and/or family members; A mix of and management staff; A combination of clinical and staff (Note: For home care providers, this task force is based out of the administrative office / staff headquarters.) When was this task initiated? How often does it meet? How are ideas and input from patients/residents incorporated into the work plans of this task force? Do members of the medical staff participate on this task force? If no, describe efforts to expand medical staff representation on this task force. How are committee members prepared and oriented to the role they will play? Copies of minutes from the task force’s last three meetings. A current task force membership list, which includes each member’s name, title, and department/role. Identify which staff are and which are supervisory, and which members are patients/residents/family members. Required for Bronze and Silver I.B: A person-centered care coordinator or point of contact person is appointed who is able to commit the time required to coordinate related activities on an ongoing basis. This individual will have direct access to, and support from, senior level What is the coordinator’s name and job title? Approximately how many per week does this person spend on person-centered tasks and responsibilities? Summarize the person-centered activities coordinated by the contact person within the last twelve months. Coordinator’s job description supervisory
Self-Assessment-for-Planetree-International-Designation-or-Tiered-Recogn....docx