Before proceeding to the application page, please read and mark your acceptance of the organization’s Standards of Practice. A copy of this form will be sent to the Human Resources Department, along with your completed application.

Image/Appearance/Workplace Pride

Our personal and facility appearance represents the image of North Alabama Medical Center to our customers.  While we are on duty, we will demonstrate professionalism and good judgment at all times related to clothing and appearance.  We will take pride in our facility and do our part to maintain a clean, uncluttered and litter free workplace.

I agree to consistently comply with organization’s professional image and dress code policy by projecting a clean, neat and professional appearance.

I will wear approved identification badge correctly at all times so that name and photo are clearly visible.

I will take pride in hospital appearance by consistently putting supplies, equipment, and trash in its place and keeping work areas around department and facility clean, neat and orderly.

I will submit work order(s) to Plant Operations or Environmental Services for issues that need to be corrected inside and outside facility.

Commitment to Team Members and Physicians

We will establish and maintain a relationship of trust with every member of our team, commit to finding solutions to problems and affirm co-workers contributions to the quality of our work.

I will provide service to our team members and physicians by following through on commitments and accepting fair share of assignments.

I will support and welcome new team members by offering help and being a positive role model.

I will inspire and encourage enthusiasm, camaraderie and a positive attitude toward the department, organization and co-workers.

I will be a good steward of organizational resources, including time and supplies.

I will arrive at work on time and as scheduled.

Attitude/Courtesy

We will always exhibit a positive attitude when interacting with our patients, co-workers, families, visitors, physicians, and others.  We will provide the highest quality of service delivered with compassion, respect and courtesy. 

I will make customers feel welcome and respected as individuals, treating them with courtesy and addressing their needs.

I will demonstrate personal responsiveness to customers and organizational needs by initiating actions to prevent and handle problems.

Responsiveness

We recognize that our customer’s time is valuable.  We will explain the services that we provide and follow up quickly to requests and concerns.  We will strive to provide our customers with prompt service.

I will respond to call lights promptly; assist with call lights if clinical staff is not available.

I will walk customers to their destination.

I will offer assistance to customers.

I will respond in a timely manner to customer requests.

I will always inform customers promptly of any unforeseen delays, keeping them comfortable while they wait and sincerely apologizing if necessary.

Privacy/Confidentiality

We will maintain a protected environment that will ensure patients and co-workers right to privacy and confidentiality.  We will treat all medical information and records as private.  We will protect confidentiality of organizational issues.

I will comply with organizational confidentiality policy.

I will comply with protected health information policy.

I will comply with IS policies on use of computer system and Meditech.

Safety Awareness

Safety is the responsibility of all North Alabama Medical Center employees.  It is everyone’s duty to understand the safety and infection control policies and procedures of the hospital.  Prevention of patient and employee injury is of utmost concern.

I will adhere to the organization’s worker’s comp/work related injury policy and procedure, following receipt of and acknowledgement of understanding of said policy.

I will maintain a safe/exposure free environment by adherence to safety/infection control guidelines.

I will take immediate personal action to correct safety/infection control deficiencies or by notifying appropriate personnel.

I will attend mandatory safety/infection control programs as offered.

I will practice proper hand washing.

I will use caution when operating equipment/machinery, operate/use it in the proper manner and report it if not in good working order.

Communication

Our goal of communication is to understand.  We will actively listen to our customers in order to fully comprehend their needs.  We will acknowledge questions, make appropriate eye contact and explain our responses in clear and concise terms that can be easily understood.  We will pay close attention to both verbal and non-verbal messages.

I will speak in terms that are easily understood and are respectful and professional.

I will make eye contact, acknowledge customers and verbally greet them.

I will practice proper phone, e-mail and elevator etiquette.

Accountability

We will exhibit a sense of ownership in our job and take responsibility for the outcome of our actions.

I will accept responsibility for actions within the scope and performance of assigned job duties.

I will accept responsibility that our patient/customer gets the highest quality of care/service using best practices.

Background Info

Have you ever been convicted of any criminal violation of the laws, or are you now under pending investigation of charges of violation of criminal law?
No Yes

If yes, please explain:

Have you been the subject of any adverse action(s) by any duly authorized sanctioning or disciplinary agency for either conduct based or performance based actions?
No Yes

If yes, please explain:

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