human touch awards NOMINATION PACKAGE A GUIDE TO THE 2018 HUMAN TOUCH AWARDS NOMINATION PROCESS - KIDNEY CARE PROFESSIONALS, PROVIDERS AND VOLUNTEERS

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human touch awards 2018 NOMINATION PACKAGE A GUIDE TO THE 2018 HUMAN TOUCH AWARDS NOMINATION PROCESS - KIDNEY CARE PROFESSIONALS, PROVIDERS AND VOLUNTEERS Together, we will celebrate the value of the Human Touch in the kidney care system!

2015 HUMAN TOUCH AWARDS NOMINATION FORM 2 Nomination Process Please review this document prior to beginning your online nomination. Nomination Deadline: March 7, 2018 What are the Human Touch Awards? CCO, through the Ontario Renal Network and Cancer Care Ontario, is proud to recognize exemplary and compassionate patient care by healthcare professionals, providers and volunteers in the kidney and cancer care systems. For the past 12 years, the Human Touch Awards have been made possible as a result of those in the healthcare community who participate by nominating their outstanding colleagues for this achievement. This year, we look forward to your continued support and participation. How will nominations be evaluated? Nominations will be evaluated against the criteria below. Nominations that do not meet at least two of the following criteria in their category may not be considered for the award. Professionals & Providers Provides exemplary compassionate, person-centred patient care with demonstrable, real-life examples. Actively participates in or leads programs or initiatives to improve patients experience, quality of life, quality of care and/or knowledge in the kidney care system. Demonstrates exceptional leadership in their area of work by acting as a role model for others. Helps to improve access to services, including responding to the diverse needs of patients. In general, goes above and beyond the expectations and responsibilities of their health professional role and demonstrates sustained contribution. Volunteers Note: Only individuals who offer their time without remuneration will qualify as a volunteer. Demonstrates a commitment to care through exceptional volunteer work that enhances the quality of life and/or access to care for patients with chronic kidney disease. Works to improve the patient experience at any stage in the kidney care. Demonstrates creativity and innovation in their volunteer contributions, beyond that which would be expected of volunteers in their organization. Has a meaningful impact on the lives of patients with chronic kidney disease and/or the healthcare professionals who treat them. While long service is commendable, awards will not be issued based on duration of service. Please consider the extent of the nominee s outstanding contributions to many patients. 2

2015 HUMAN TOUCH AWARDS NOMINATION FORM 3 Nomination Form Completing the online nomination form When completing the nomination using the online tool, be prepared to input all of the nomination information at one time. Once an application is started, it must be completed in one session as you cannot save your work as you proceed. To save time and ensure you are able to submit the nomination, we recommend you prepare your nomination ahead of time. Below you will find a list of questions that are asked in the nomination form, an FAQ segment and a nomination checklist. Nomination Form Questions To submit your nomination please visit: ccohealth.ca/humantouchnomination Professionals & Providers Please provide at least two demonstrable, real-life examples of how the nominee provides exemplary compassionate, person-centred care. Has the nominee actively participated in programs or initiatives that support improving patients experience, quality of life, quality of care and/or knowledge in the kidney care system? If yes, please provide more Has the nominee demonstrated exceptional leadership in their area of work and acted as a role model for others? If yes, please provide more Has the nominee s work focused on helping to improve access to services, including responding to the diverse needs of patients? If yes, please provide more information and examples of how the nominee meets A successful nomination should demonstrate how the nominee makes a sustained contribution in going above and beyond the expectations and responsibilities of their health professional role. Please summarize how the individual meets Volunteers Please provide at least two written examples of how the nominee demonstrates a commitment to care through exceptional volunteer work that enhances the quality of life and/or access to care for patients with chronic kidney disease. Has the nominee actively worked to improve the patient experience at any stage in their kidney care? If yes, please provide more information and examples of how the nominee meets Does the nominee demonstrate creativity and innovation in their volunteer contributions, beyond that which would be expected of volunteers in their organization? If yes, please provide more information and examples of how the nominee meets Has the nominee had a meaningful impact on the lives of patients with chronic kidney disease and/or the healthcare professionals who treat them? If yes, please provide more A successful nomination should demonstrate how the nominee goes above and beyond the expectations and responsibilities of their volunteer role. In the text box below please summarize how the individual meets 3

2015 HUMAN TOUCH AWARDS NOMINATION FORM 4 Nomination Information & FAQs 1. Who can be nominated for a Human Touch Award? All part-time and full-time healthcare professionals, providers and volunteers who work directly with patients receiving kidney care are eligible to be nominated. 2. Who can submit a nomination? Nominations can be submitted by anyone, including patients, patients families, peers, Regional Vice-Presidents, Regional Directors, supervisors and managers. The nomination should include real-life examples that demonstrate the nominee s effective impact. It is strongly encouraged to include statements/testimonials/stories from patients. 3. Who is a volunteer? A volunteer is someone who, without personal financial gain, provides benefit or support to patients and families receiving care in the kidney care system. Their contribution can be direct or indirect, and can be offered as an individual or as part of a team. Volunteers can be part of a recognized, not-for-profit organization or part of a volunteer program within a healthcare organization. Paid employees of not-for-profit organizations, although serving the communities in question, are not considered volunteers and are not eligible for a Volunteer Human Touch Award but instead would fall under the Professional and Providers category. 4. Who will review the nominations and decide on the award recipients? A panel of regionally diverse and interdisciplinary members with representation from the kidney and cancer care communities will review the nominations and recommend who should receive the awards. The panel includes clinicians, patient and family advisors, social workers, past award recipients, volunteers, administrators, and members of associated organizations. The evaluation is based on the criteria outlined in the nomination instructions and will be determined by the strength of the submission. Recommendations made by this panel will be reviewed and approved by the Ontario Renal Network, Cancer Care Ontario and CCO s Executive Team. 5. How many awards will be given in the kidney care system? Up to five awards will be distributed this year to the kidney care community, including two volunteer awards. Each recipient will be presented with an etched glass plaque to commemorate their achievement. 6. When is the submission deadline? Please complete the nomination form and submit it with your nomination package by March 7, 2018. 7. Who should I contact if I have questions about the nomination process? If you have questions about the nomination process, please contact CCO at communications@cancercare.on.ca. 4

2015 HUMAN TOUCH AWARDS NOMINATION FORM 5 Nomination Checklist To complete this nomination form, you will need to provide: Your name and email/phone contact information. The name, title, location of employment and email/phone contact information for the nominee. Where possible, the name and email/phone contact information of the nominee s supervisor. Any supporting documentation (e.g., patient and colleague testimonials, articles, etc.) you wish to attach to the document with the nomination. It is recommended that you draft your responses to the questions listed above prior to starting the online nomination form. This will allow you to easily type or paste your responses into the form for submission. If you are a patient or family member and would like support in completing the nomination form, please contact communications@cancercare.on.ca. If you are having technical difficulties with the nomination form, please contact communications@cancercare.on.ca. Nomination deadline: March 7, 2018 5