Awards of Distinction Nomination Form

Award Nomination

"*" indicates required fields

Step 1 of 3

33%

Your Name*

First Last

Email*

Enter Email Confirm Email

Phone

Care Home/Program*

Your Role*

Staff

Resident/Client

Resident/Client Family Member

Volunteer

Are you nominating an employee or team?*

Employee

Team

What is the name of the employee you are nominating?*

First Last

What is the name of the team you are nominating?*

A team must consist of a minimum of 3 people.

Names of employees on the team you are nominating.*

List the first and last name of the employees on this team.

Employee Award Categories

What award category are you nominating this employee for?

Team Award Categories

What award category are you nominating this team for?

Mission Award

The mission award recognizes an employee that best exemplifies extending Christian hospitality in a meaningful and creative way. They embody the organizations mission statement.

How does this employee demonstrate Christian values in actions and decision-making?*

How does this employee demonstrate integration of Good Samaritans identity as a faith-based, not-for-profit care organization in their actions and decision making?*

How does this employee advocate for vulnerable and diverse populations?*

How does this employee foster an inclusive approach to team and community?*

Vision Award

The vision award recognizes an employee who continually supports our vision of being and belonging – every person, every home.

How does this employee promote inclusive, collaborative environments for residents and their family, friends, community and other employees?*

How does this employee nurture the spirit, health and wellbeing of others?*

How does this employee foster an inclusive environment where individuals of diverse backgrounds, perspectives, and identities feel welcomed and valued?*

Inclusion Award

The inclusion award recognizes an employee that fosters an organizational culture that accepts and nurtures the individuality of others and represents all people within our communities. Through their actions, they inspire others to embrace equity, diversity, inclusion, and Reconciliation and actively contribute to building a community where everyone feels a sense of belonging and acceptance.

How does this employee foster environments that are inclusive, comfortable, and welcoming for all?*

How does this employee embrace equity, diversity, inclusion, and Reconciliation?*

Healthy Relationships Award

The healthy relationships award recognizes an employee that works in supportive partnerships and opens their heart to others by affirming their goodness and potential. They make it a priority to develop and foster every relationship they are a part of.

Select 4 of the 7 Healthy Relationships criteria that this employee exhibits.*

Shows respect to others

Is eager to partner in shared responsibilities

Communicates openly and sincerely

Shows compassion to all

Upholds dignity and encourages the growth of everyone around them

Makes those around them feel truly part of the Good Samaritan family

Actively promotes the work of Good Samaritan

Using the 4 criteria you selected, describe how this employee lives these values using detailed examples.*

Excellence Award

The excellence award recognizes an employee who consistently exceeds expectations by delivering outstanding experiences to those they serve. Through their innovative approach to service, they not only meet needs but also anticipate them, leaving a lasting impact on recipients. Whether through groundbreaking solutions, creative problem-solving, or pioneering methods, recipients of this award exemplify a commitment to going above and beyond in their dedication to exceptional service.

Select 3 of the 4 Excellence criteria that this employee exhibits.*

Demonstrates a track record of developing and implementing innovative solutions that enhance the quality of service delivery.

Showcases creativity and originality in their approach to problem-solving and service delivery, bringing fresh ideas and perspectives to overcome challenges and meet diverse needs.

Demonstrates adaptability and flexibility in responding to changing needs and circumstances, adjusting their approach as necessary to ensure continued excellence in service delivery

Collaborates effectively with colleagues and stakeholders to develop and implement innovative solutions, leveraging diverse perspectives and expertise to achieve shared goals.

Using the 3 criteria you selected, describe how this employee lives these values using detailed examples.*

Servant Leadership Award

The servant leadership category recognizes an employee who continually demonstrate the core values of the Good Samaritan through exemplary servant leadership qualities. They lead through the giving of themselves in service to others, by acting with courage in a trustworthy and ethical manner.

Select 4 of the 6 Servant Leadership criteria that this employee exhibits.*

Leads by example and inspires leadership though action and results.

Demonstrates accountability for their actions and decisions.

Leads by managing resources in the most efficient manner and devises plans that reflect the current and future needs of those they serve.

Knows the resources they have been entrusted with and works towards improving services with these resources.

Excels in open and honest communication with others.

Believes in continuous learning and assisting in the growth of others.

Using the 4 criteria you selected, describe how this employee lives these values using detailed examples.*

Resident/Client Experience Award

What change or improvement has this team implemented? Provide specific examples.*

The resident/client experience award recognizes a team that has implemented a change or made an improvement to how residents/clients and their families experience healthcare services.

How does this team continually prioritize all aspects of person centered care? Provide specific examples.*

This team continually prioritizes all aspects of person centered healthcare service delivery to stay focused on those that we serve.

What improvements or positive impacts has this team made?*

Demonstrable improvements in or positive impact on culture, quality, safety and/or financial indicators will be used to determine the recipient of this award.

Quality Improvement Award

How has this team demonstrated a relentless focus on driving forward quality improvement?*

How is this team a strong advocate of quality improvement?*

This team is a strong advocate of quality improvement: leading, influencing, motivating and engaging others in improvement efforts with an unwavering focus on improving outcomes for resident/clients.

What quality improvement initiative(s) has this team implemented?*

This team has implemented a quality improvement initiative(s) focused on a single issue resulting in a measurable, positive impact within Good Samaritan.

CAPTCHA

Comments

This field is for validation purposes and should be left unchanged.