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AIR MedCenter Peer Review Form
Please fill the form carefully
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Peer Review for:
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First Name
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Last Name
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Please note the rating scale for this Review
B = Below Expectations – Performance needs to improve for the incumbent to be successful in executing the requirements of the position.
S = Successful Performer – Competent, executes the attributes and achieves established goals required as a full contributor to the organization.
E = Excellent Performer – Exceptional, executes the attributes and achieves established goals required as an outstanding contributor to the organization. Makes
Please check the box that best applies to peer being evaluated.
Team Work:
B
S
E
Promotes a positive and caring attitude in the work environment
Adjusts personal work load/ assignment to assist co-workers and accommodate changes in overall unit activity
Demonstrates flexibility in scheduling and assignments
Contributes as a member of the multidisciplinary team
Supports team members through consistent and fair behavior
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Clinical Competence:
B
S
E
Demonstrates technical competence in clinical skills
Completes assigned tasks with attention to detail and accuracy
Manages patient assignments safely
Demonstrates evidence-based practice by staying current with issues related to clinical field
Gives comprehensive report
Prioritizes and anticipates patients’ needs
Recognizes change in patient status and responds appropriately
Accesses/utilizes available resources for clinical problem solving
Communication:
B
S
E
Communicates directly with team members in conflict situations
Avoids gossip
Promotes atmosphere of mutual trust, professionalism, and respect among team members
Communicates with patients and families to enhance patient knowledge, overall satisfaction with care, and compliance with treatment plan
Communicates need for as assistance with assignment
Documents patient care in a manner that effectively conveys necessary information to other healthcare team members
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Productivity:
B
S
E
Completes assigned tasks in a timely fashion
Prioritizes work to enhance unit productivity
Enhances overall team productivity and performance through professional actions
Sees beyond own personal agenda and appreciates importance of “big picture” for the team
Professionalism:
B
S
E
Supports the CHS mission, vision, and goals
Accepts responsibility and accountability for own actions
Recognizes and respects needs of team members and considers others’ suggestions thoughtfully
Presents a professional image through demeanor and attire
Serves as a positive role model within the profession
Participates in continuing education activities and shares knowledge with others
Leadership:
B
S
E
Inspires and motivates team members
Mentors others; is a role model
Recognizes and promotes common goals for the team
Acts as a resource to others
Advocates for patients and team members
Acts as an effective change agent
Delegates as appropriate
Mandatory for completion of this form, please provide comments below: Three Areas of Strength:
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Mandatory for completion of this form, please provide comments below: Three Areas of Improvement:
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