Note on Supplementary Material

CEO Awards 2015 Unsung Hero Award OFFICIAL GUIDELINES Overview of Unsung Hero Award The Unsung Hero Award will be given to one individual who demonstrates exceptional service to the patients or the organisation above and beyond the normal expectations placed upon them. They will have gone ‘the extra mile’ to either ensure patient safety, patient satisfaction or the delivery of a particular corporate objective. Criteria Nominees of the Unsung Hero Award will be evaluated according to the following criteria 1. Core Values and Excellence How the nominee met and exceeded the Saolta Group’s Guiding Values and delivery of service excellence. 2. Caring and Compassion How the nominee provided care and compassion above the normal expectation of the service 3. Selflessness Prioritising the needs of others over themselves Requirements and Eligibility 1. The nominee must be part-time or full-time, and actively employed with the Saolta University Health Care Group for at least six months on or before the closing date for nomination. 2. Volunteers are not eligible for this award. 3. Nominees can be any grade/level of staff. 4. Nominees must not have any performance/disciplinary issues within the past year. 5. Nominees must exemplify the Saolta Group’s Mission and Vision Statements and Guiding Values. Clinical Director / Senior Management Endorsement In order to be eligible for the Award, the nominator must seek endorsement from management as follows:

 As this is an individual award only, endorsement must be sought from the nominee’s line manager.

Submission Process and Instructions For Nominators: All applications must be completed in full no later than Friday 4th September 2015 @ 5pm, for consideration. Completed application forms must be sent to [email protected]. Please note that supplementary materials are limited to three pages and may not include PowerPoint presentations. Application Review Process All applications will be reviewed by a Judging Panel which includes Saolta Group Executive and Non-Executive members and leaders from outside the organisation. Any questions regarding the application process should be directed to [email protected] CEO Awards 2015 Unsung Hero Award

Application Form

Nominee Information

Nominee Name: Site:

Department: Phone:

Job Title: Line Manager:

Please note nominee must be at least 6 months working for the Saolta Group prior to nomination

Nominator Information

Nominator Name: Department:

Job Title: Phone:

Endorsement

As this is an individual award only, endorsement must be sought from the nominee’s Line Manager. Checking the box below indicates that this nomination has been reviewed and approved for submission by the endorsing manager.

Line Manager’s Name: Date of Approval:

Note on Supplementary Material You may submit up to three pages of supplementary materials including supplementary documentation or additional explanation of the nominee if added space is required. Please note limit of three pages. CEO Awards 2015 Unsung Hero Award Summary

Describe how the nominee demonstrated extraordinary service through caring, promoting the Saolta Group Vision and Mission Statements, being responsive to the needs of service users and taking initiative beyond his/her role expectations. Please note that all sections must be complete for candidate to be considered.

SECTION I: Core Values and Excellence

Provide examples how the nominee met and exceeded the Saolta Group’s Guiding Values and delivery of service excellence.

Demonstrate howSECTION the nominee II: Caring provided and Compassion care and compassion above the normal expectation of the service to either service users / fellow colleagues or the public at large. CEO Awards 2015 Unsung Hero Award

Summary (Continued)

SECTION III: Selflessness Describe how the nominee delivered service prioritising the needs of others over themselves. CEO Awards 2015 Unsung Hero Award Nomination Contact Information

This section must be completed in full for the following individuals in order for this application to receive consideration: (1) the Nominee; (2) the Nominee’s Line Manager; and (3) the Nominator. Please ensure that the information provided below is accurate prior to submission.

(1) Nominee Last Name First Name Title Job Title Department Hospital Work Mobile Home Address Email Address Site Number Number

(2) Nominee’s Line Manager Last Name First Name Title Job Title Department Hospital Work Mobile Home Address Email Address Site Number Number

(3) Nominator Last Name First Name Title Job Title Department Hospital Work Mobile Home Address Email Address Site Number Number CEO Awards 2015 Unsung Hero Award