Awards Catalog

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INTERNATIONAL ASSOCIATION OF HEALTHCARE CENTRAL SERVICE MATERIEL MANAGEMENT AWARDS 2016 CONFIDENCE BUILDER AWARD CS SUPERVISOR/MANAGER OF THE YEAR AWARD DECONTAMINATOR OF THE YEAR AWARD EDUCATOR OF THE YEAR AWARD HUMANITARIAN AWARD GOLDEN SLIPPER AWARD FOR SERVICE EXCELLENCE PAST PRESIDENTS AWARD PURDUE UNIVERSITY SCHOLARSHIP AWARDS TECHNICIAN ACHIEVEMENT AWARD

Transcript of Awards Catalog

Page 1: Awards Catalog

INTERNATIONAL ASSOCIATION OF HEALTHCARE CENTRAL SERVICE MATERIEL MANAGEMENT

AWARDS2016

CONFIDENCE BUILDER AWARD

CS SUPERVISOR/MANAGER OF THE YEAR AWARD

DECONTAMINATOR OF THE YEAR AWARD

EDUCATOR OF THE YEAR AWARD

HUMANITARIAN AWARD

GOLDEN SLIPPER AWARD FOR SERVICE EXCELLENCE

PAST PRESIDENTS AWARD

PURDUE UNIVERSITY SCHOLARSHIP AWARDS

TECHNICIAN ACHIEVEMENT AWARD

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CONFIDENCE BUILDER AWARD | CS SUPERVISOR/MANAGER OF THE YEAR AWARD

DECONTAMINATOR OF THE YEAR AWARD | EDUCATOR OF THE YEAR AWARD

GOLDEN SLIPPER AWARD FOR SERVICE EXCELLENCE | HUMANITARIAN AWARD

PAST PRESIDENTS AWARD | PURDUE UNIVERSITY SCHOLARSHIP AWARDS

TECHNICIAN ACHIEVEMENT AWARD

INTERNATIONAL ASSOCIATION OF HEALTHCARE CENTRAL SERVICE MATERIEL MANAGEMENT

AWARDS2016

The Central Service (CS) profession is dynamic, ever evolving and critical to patient safety and positive outcomes. Those who comprise this challenging, yet rewarding discipline and consistently go the extra mile in the name of service excellence are certainly worthy of formal recognition. The IAHCSMM Awards Program does just that by paying tribute to CS professionals’ many contributions and successes, and their commitment to delivering safe, high quality service to healthcare customers each day. Nominations for these prestigious awards are being accepted through February 8, 2016. Awards will be presented during the 2016 IAHCSMM Annual Conference & Expo, April 24-27, in San Antonio, Texas. I hope you will review this brochure and the many awards available, and take a moment to nominate yourself or another deserving individual. Thank you for your hard work and commitment to doing what’s right in the name of quality and patient safety!

David Jagrosse, CRCST IAHCSMM President

SUBMIT YOUR 2016 IAHCSMM AWARD NOMINATION TODAY!

• The submission deadline is February 8, 2016.• IAHCSMM Awards are open to all IAHCSMM members.• Applicants may submit nominations for more than one award, but are eligible to win only one award per year.• All submissions must be the original work of the nominee; after official acceptance, materials/documents may not be revised or changed.

• If selected as an award winner, all submissions become the property of IAHCSMM.• Work submitted for an award must be current and may not have been submitted in previous years.• Current Executive Board members are not eligible for nomination of awards.

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To enter, explain what your team is doing to build confidence within your CS department to deliver the best in instrument processing. Examples could include education programs or events, team-building activities, mentoring programs, policy or procedure improvements, training (including manufacturer inservices on proper handling, etc.) and other key initiatives for CS staff. The winning team will be recognized during the 2016 IAHCSMM Annual Conference and Expo, and will receive:• A $1,000 educational grant from Halyard Health.• Healthcare industry and local community recognition through news releases and features in the Halyard Health Wrap Sheet e-newsletter.• A commemorative Confidence Builder Award plaque.

The Confidence Builder Award recognizes a Central Service (CS) team that is building confidence within their organization with programs that empower the team and the hospital to deliver the best in patient outcomes.

SPONSORED BY

CONFIDENCE BUILDER AWARD

• Nominations for this award must be submitted by an IAHCSMM member, an affiliated chapter member or an administrator in their facility.• The Confidence Builder Award nomination form must be completed and returned with the required sub- mission documents. Be sure to include names of the team manager/ supervisor and all participants.• Include a brief written description (one page or less) of the Confidence Building program or initiative and include results achieved to date (include photographs, video clips or supporting documents, if available).

• Applications will be scored based on innovation and impact of the program in building CS team confidence and capability.• Only programs or activities begun or completed between January 1, 2015, and December 31, 2015, will be considered.

AWARD ELIGIBILITY AND SUBMISSION CRITERIA

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CONFIDENCE BUILDER AWARD NOMINATION FORMTitle of Entry: ____________________________________________________________________________________

Participating Department (s): _______________________________________________________________________

Hospital: ________________________________________________________________________________________

Address: ________________________________________________________________________________________

City/State/Zip ____________________________________________________________________________________

Submitted by (name): _____________________________________________________________________________

Title: ____________________________________________________________________________________________

Place of Employment: _____________________________________________________________________________

Address: ________________________________________________________________________________________

City/State/Zip: ___________________________________________________________________________________

Telephone: _______________________________________________________________________________________

Email: ___________________________________________________________________________________________

Names/titles of all program participants: ______________________________________________________________

________________________________________________________________________________________________

________________________________________________________________________________________________

________________________________________________________________________________________________

________________________________________________________________________________________________

________________________________________________________________________________________________

________________________________________________________________________________________________

________________________________________________________________________________________________

________________________________________________________________________________________________

Deadline: February 8, 2016

Mail: IAHCSMM, 55 West Wacker Drive, Suite 501, Chicago, IL 60601

Fax: 312.440.9474

Email: [email protected]

Online: www.iahcsmm.org/about/awards.html

Note: All papers become the property of IAHCSMM and cannot be reproduced, published or edited in any form without the written permission of IAHCSMM. Applicant grants permission to IAHCSMM to reprint and distribute this submission.

INTERNATIONAL ASSOCIATION OF HEALTHCARE CENTRAL SERVICE MATERIEL MANAGEMENT

AWARDS2016

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This award recognizes a Central Service (CS) supervisor or manager who has made significant contributions to their facility and the advancement of the CS profession. The recipient of this award will be recognized during the 2016 IAHCSMM Annual Conference and Expo and will receive an engraved plaque, plus a monetary award in the amount of $1,000. In addition, a press release acknowledging the award winner and an announcement letter will be sent to the award recipient’s hospital administrator.

SPONSORED BY

CS SUPERVISOR/ MANAGER OF THE YEAR AWARD

Candidates for this award must:• Be nominated by an IAHCSMM member, an affiliated chapter member, or an administrator in their facility.• Be an active member of IAHCSMM in good standing for a minimum of five years, and must have been employed in the CS field for a minimum of 10 years.• Have consistently demonstrated contributions to: » Customer relations; » Facility-wide operational/financial performance; » Overall value of CS as a profession; » Education and training.• Have attended an IAHCSMM Annual Conference in the last three years.

Nominees must submit the following:• A completed CS Manager/Supervisor of the Year Award nomination form.• A typewritten narrative explaining why the candidate is deserving of this award (no more than three single-sided, double-spaced pages). The narrative must contain examples of how the candidate consistently demonstrated contributions to customer relations; facility-wide operational/financial performance; overall value of CS as a profession; or other educational training.• At least two, but no more than three, letters of support and recommendation from peers, community health professionals, former or current CS

employees, managers or administrators. Letters should be two pages or less in length.• A resume (two-page maximum) for the candidate.

AWARD ELIGIBILITY AND SUBMISSION CRITERIA

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INTERNATIONAL ASSOCIATION OF HEALTHCARE CENTRAL SERVICE MATERIEL MANAGEMENT

AWARDS2016

CS SUPERVISOR/MANAGER OF THE YEAR AWARD NOMINATION FORM

Name of Nominee: ________________________________________________________________________________

Title: ____________________________________________________________________________________________

Place of Employment: _____________________________________________________________________________

Address: ________________________________________________________________________________________

City/State/Zip: ___________________________________________________________________________________

Telephone: _______________________________________________________________________________________

Email: ___________________________________________________________________________________________

Nominated by: ___________________________________________________________________________________

Title: ____________________________________________________________________________________________

Place of Employment: _____________________________________________________________________________

Address: ________________________________________________________________________________________

City/State/Zip: ___________________________________________________________________________________

Telephone: _______________________________________________________________________________________

Email: ___________________________________________________________________________________________

Deadline: February 8, 2016

Mail: IAHCSMM, 55 West Wacker Drive, Suite 501, Chicago, IL 60601

Fax: 312.440.9474

Email: [email protected]

Online: www.iahcsmm.org/about/awards.html

Note: All papers become the property of IAHCSMM and cannot be reproduced, published or edited in any form without the written permission of IAHCSMM. Applicant grants permission to IAHCSMM to reprint and distribute this submission.

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This award was established in honor of Anne Cofiell. Cofiell was an active member of IAHCSMM until her retirement in 2006. Anne served as the IAHCSMM representative to AAMI where she chaired numerous working groups. Cofiell also authored many articles and spoke on Central Service (CS) topics at IAHCSMM conferences and numerous educational programs around the country. She was well connected in Washington, D.C., and advocated on behalf of the CS profession for the regulation of reuse of single-use devices to include the importance of proper cleaning instructions. The recipient of this award will be recognized during the 2016 IAHCSMM Annual Conference and Expo, and will receive an engraved plaque, plus a monetary award in the amount of $1,000.

SPONSORED BY

DECONTAMINATOR OF THE YEAR AWARD

• The nominee must be an active member of IAHCSMM.• The topic of the paper must focus on understanding the importance of decontamination in the workplace.• Previously published papers will not be considered for this award.• Papers must be presented in essay form, typewritten and approximately 1,000 words in length.• References must be given in standard citation format.• The author’s name and contact information must appear on the title page.

• Pages must be numbered.• All submissions must include a vitae sheet on the author.

All papers will be judged by Anne Cofiell or her designee.

The Decontaminator of the Year nomination form must be completed and returned with the required submission documents.

AWARD ELIGIBILITY AND SUBMISSION CRITERIA

healthmarkINDUSTRIES CO.

health care products

800-521-6224www.hmark.com

The Decontaminator of the Year Award, sponsored by Healthmark, recognizes the author of an outstanding paper focusing on understanding the importance of decontamination in the workplace.

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INTERNATIONAL ASSOCIATION OF HEALTHCARE CENTRAL SERVICE MATERIEL MANAGEMENT

AWARDS2016

DECONTAMINATOR OF THE YEAR AWARD NOMINATION FORM

Name of Nominee: ________________________________________________________________________________

Title: ____________________________________________________________________________________________

Place of Employment: _____________________________________________________________________________

Address: ________________________________________________________________________________________

City/State/Zip: ___________________________________________________________________________________

Telephone: _______________________________________________________________________________________

Email: ___________________________________________________________________________________________

Nominated by: ___________________________________________________________________________________

Title: ____________________________________________________________________________________________

Place of Employment: _____________________________________________________________________________

Address: ________________________________________________________________________________________

City/State/Zip: ___________________________________________________________________________________

Telephone: _______________________________________________________________________________________

Email: ___________________________________________________________________________________________

Deadline: February 8, 2016

Mail: IAHCSMM, 55 West Wacker Drive, Suite 501, Chicago, IL 60601

Fax: 312.440.9474

Email: [email protected]

Online: www.iahcsmm.org/about/awards.html

Note: All papers become the property of IAHCSMM and cannot be reproduced, published or edited in any form without the written permission of IAHCSMM. Applicant grants permission to IAHCSMM to reprint and distribute this submission.

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The Educator of the Year Award was established in honor of Dr. Bertha Litsky, an environmental microbiologist, researcher and educator at the University of Massachusetts. Her passion, commitment and dedication to her profession propelled her to the status of an international legend and pioneer in healthcare infection control. Dr. Litsky was a consultant throughout the world to many hospitals, food service entities, manufacturers and suppliers of medical devices. She worked with many institutions, corporations and municipalities to improve sanitation and promote public health and safety. Dr. Litsky became a strong advocate and mentor for the CS profession and was an active participant in IAHCSMM, ASHCSP, AAMI and AORN. Her expertise and contributions blazed the way to the establishment of many principles and standards of practice relative to infection control, reprocessing, packaging and sterilization. She published several articles and books on related topics. Dr. Litsky became a sought-after speaker and educator throughout the world. Her wit and humor allowed her to deliver her lectures and messages in a manner that left her students with an everlasting impression to guide their future behaviors. She would frequently incorporate props, such as marionettes dressed as bacteria, and rely on humorous yet educational skits and stories to emphasize her message. The closing words of all her lectures, delivered with the loud BANG of a starter pistol, still resonate throughout the CS profession: “An unsterile item used in surgery is as dangerous as a loaded gun.”

3M Health Care is pleased to announce the Educator of the Year Award. This award recognizes a member of IAHCSMM who has demonstrated dedication to the advancement of education in the Central Service (CS) profession. The recipient of this award will be recognized during the 2016 Annual Conference and Expo, and will receive an engraved plaque, plus a monetary award in the amount of $1,000.

SPONSORED BY

EDUCATOR OF THE YEAR AWARD

• The nominee must be an active member of IAHCSMM.• The nominee of this award must demonstrate significant contributions to CS education in the calendar year preceding the award. Personal accomplishments related to educational endeavors, citations or acknowledgments, etc., will be considered.• Nominees are eligible for consideration if they have contributed to CS education in at least five of the following categories:

» IAHCSMM CE-approved presentation at a national conference » IAHCSMM CE-approved presenta- tion at a local/regional conference » Published article in a national publication » Published article in a local publication » Teaching a CS-related training course » Teaching healthcare facility inservices » Other CS-related educational projects » IAHCSMM committee membership/ support for association programs

• A narrative explaining why the nominee should receive this award, and documentation to substantiate the nominee’s educational contribution for the previous calendar year, must be submitted with the nomination.

The Educator of the Year Award nomina-tion form must be completed and returned with the required submission documents.

AWARD ELIGIBILITY AND SUBMISSION CRITERIA

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INTERNATIONAL ASSOCIATION OF HEALTHCARE CENTRAL SERVICE MATERIEL MANAGEMENT

AWARDS2016

EDUCATOR OF THE YEAR AWARD NOMINATION FORM

Name of Nominee: ________________________________________________________________________________

Title: ____________________________________________________________________________________________

Place of Employment: _____________________________________________________________________________

Address: ________________________________________________________________________________________

City/State/Zip: ___________________________________________________________________________________

Telephone: _______________________________________________________________________________________

Email: ___________________________________________________________________________________________

Nominated by: ___________________________________________________________________________________

Title: ____________________________________________________________________________________________

Place of Employment: _____________________________________________________________________________

Address: ________________________________________________________________________________________

City/State/Zip: ___________________________________________________________________________________

Telephone: _______________________________________________________________________________________

Email: ___________________________________________________________________________________________

Deadline: February 8, 2016

Mail: IAHCSMM, 55 West Wacker Drive, Suite 501, Chicago, IL 60601

Fax: 312.440.9474

Email: [email protected]

Online: www.iahcsmm.org/about/awards.html

Note: All papers become the property of IAHCSMM and cannot be reproduced, published or edited in any form without the written permission of IAHCSMM. Applicant grants permission to IAHCSMM to reprint and distribute this submission.

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The Golden Slipper Award for Service Excellence symbolizes extraordinary service (“going the extra mile”). The award is based on the rendering of a story about a patient’s slippers that were lost in the hospital and could not be found. The hospital administrator offered to pay the patient for his lost slippers, but he was not satisfied by that offer. He wanted a pair like the ones that were lost. Next, the staff offered to replace his slippers. The patient was given a different pair of slippers, but he was still not satisfied because the slippers were not like the ones that were lost. Recognizing that the slippers were very important to the patient, a caring staff member searched for and located an identical pair of slippers, which were purchased and given to the patient. This gesture was met with the patient’s complete satisfaction and clearly demonstrated the staff member’s commitment to service excellence. The recipient of this award will be recognized during the 2016 IAHCSMM Annual Conference and Expo, and will receive an engraved plaque, plus a personal gift and a monetary award in the amount of $500.

SPONSORED BY

GOLDEN SLIPPER AWARD FOR SERVICE EXCELLENCE

Candidates for this award must:• Be an active member of IAHCSMM.• Demonstrate a caring, compassionate attitude.• Offer a creative, helpful solution.• Go beyond the technical requirements of the job.• Be a role model for the department.

Nominees must submit the following:• A completed Golden Slipper Award for Service Excellence nomination form.• A typed, one-page essay of (500 words of less) or a brief audio-tape describing why service excellence is important in today’s healthcare environment. This essay should also include the nominee’s contribution(s) relative to

service excellence in the healthcare setting (e.g., an individual contribution that made a difference, or how a process improved customer service).• A letter of reference from an immediate supervisor.

AWARD ELIGIBILITY AND SUBMISSION CRITERIA

The Golden Slipper Award formally recognizes a Central Service (CS) professional (technician, supervisor or manager) who is committed to providing service excellence.

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INTERNATIONAL ASSOCIATION OF HEALTHCARE CENTRAL SERVICE MATERIEL MANAGEMENT

AWARDS2016

GOLDEN SLIPPER AWARD FOR SERVICE EXCELLENCE NOMINATION FORM

Name of Nominee: ________________________________________________________________________________

Title: ____________________________________________________________________________________________

Place of Employment: _____________________________________________________________________________

Address: ________________________________________________________________________________________

City/State/Zip: ___________________________________________________________________________________

Telephone: _______________________________________________________________________________________

Email: ___________________________________________________________________________________________

Nominated by: ___________________________________________________________________________________

Title: ____________________________________________________________________________________________

Place of Employment: _____________________________________________________________________________

Address: ________________________________________________________________________________________

City/State/Zip: ___________________________________________________________________________________

Telephone: _______________________________________________________________________________________

Email: ___________________________________________________________________________________________

Deadline: February 8, 2016

Mail: IAHCSMM, 55 West Wacker Drive, Suite 501, Chicago, IL 60601

Fax: 312.440.9474

Email: [email protected]

Online: www.iahcsmm.org/about/awards.html

Note: All papers become the property of IAHCSMM and cannot be reproduced, published or edited in any form without the written permission of IAHCSMM. Applicant grants permission to IAHCSMM to reprint and distribute this submission.

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The William B. Dennis Humanitarian Award was established by the former ASHCSP in honor and memory of Bill Dennis, who passed away in January 2001. It’s an award and tradition that IAHCSMM is pleased to continue offering its members. Dennis was an active member of his local CS chapter, the North Carolina Hospital Central Service Association, and Director of Sterile Processing at Duke University Hospital in Durham, NC. A member of ASHCSP for more than 20 years, Dennis served as President and on the Board of Directors, and was a nationally recognized leader in the CS profession. He was on numerous committees and spoke at various conferences, and was the 1983 recipient of ASHCSP’s highest honor – the Leonard Leipus Award. In 1982, he received the Dr. John J. Perkins Award for his contributions to the field. Dennis also had a deep commitment to humanitarian causes. He actively provided humanitarian aid through church organizations and traveled to Panama and Cuba to distribute much-needed medical supplies. In the mid-70s, Dennis encouraged African-Americans and women to move into prominent positions within his department, far beyond the conventions and expectations of the time. Friends and co-workers described Dennis as modest, generous and always ready to crack a joke. He was committed to his vocation and to his outside philanthropic endeavors. Much like Dennis, the recipient of this award exemplifies a deep commitment to humanitarian issues and the CS profession. This annual scholarship, now being awarded by IAHCSMM, is intended to promote professional development by assisting in ongoing education, and can be used to fund an IAHCSMM member’s annual conference attendance or other educational activity leading to professional development and certification. The recipient of this award will be recognized during the 2016 IAHCSMM Annual Conference and Expo, and will receive an engraved plaque, plus a monetary award in the amount of $1,000.

SPONSORED BY

HUMANITARIANAWARD

• The nominee must be an active member of IAHCSMM and in good standing for at least one year.• The candidate must be involved in humanitarian causes at the local, state or national level.

Nominees must submit the following:• A completed Humanitarian Award nomination form.• A one-page statement detailing the nominee’s humanitarian efforts, including their years of participation (supporting documentation of humanitarian efforts is required).

Note: IAHCSMM members may receive this award only once.

AWARD ELIGIBILITY AND SUBMISSION CRITERIA

The Humanitarian Award recognizes an individual who exemplifies a deep commitment to humanitarian issues and the Central Service (CS) profession.

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HUMANITARIANAWARD INTERNATIONAL ASSOCIATION OF HEALTHCARE

CENTRAL SERVICE MATERIEL MANAGEMENT

AWARDS2016

HUMANITARIAN AWARD NOMINATION FORM

Name of Nominee: ________________________________________________________________________________

Title: ____________________________________________________________________________________________

Place of Employment: _____________________________________________________________________________

Address: ________________________________________________________________________________________

City/State/Zip: ___________________________________________________________________________________

Telephone: _______________________________________________________________________________________

Email: ___________________________________________________________________________________________

Nominated by: ___________________________________________________________________________________

Title: ____________________________________________________________________________________________

Place of Employment: _____________________________________________________________________________

Address: ________________________________________________________________________________________

City/State/Zip: ___________________________________________________________________________________

Telephone: _______________________________________________________________________________________

Email: ___________________________________________________________________________________________

Deadline: February 8, 2016

Mail: IAHCSMM, 55 West Wacker Drive, Suite 501, Chicago, IL 60601

Fax: 312.440.9474

Email: [email protected]

Online: www.iahcsmm.org/about/awards.html

Note: All papers become the property of IAHCSMM and cannot be reproduced, published or edited in any form without the written permission of IAHCSMM. Applicant grants permission to IAHCSMM to reprint and distribute this submission.

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This award was established in honor of Ruth Anne Brooks, RN, CRCST, who served as IAHCSMM President from 1993-1995. Brooks served on the IAHCSMM Board of Directors for many years and was President of the Delaware Valley Chapter. Brooks was Director of Material Central Service at the Medical Center of Delaware, in Newark, Del., until her death in 1997. In 1994, while serving as IAHCSMM President, Brooks worked with Robert Mood, ASHCSP President, to oversee a committee that formulated and published the first joint position paper entitled “Reprocessing Medical Devices.” The recipient of this award will be recognized during the 2016 IAHCSMM Annual Conference and Expo, and will receive an engraved plaque, plus a monetary award in the amount of $1,000.

The Past Presidents Award, sponsored by IAHCSMM, recognizes an author of an outstanding paper on the challenges and developments to the Central Service (CS) profession.

SPONSORED BY

PAST PRESIDENTS AWARD

• The nominee must be an active member of IAHCSMM.• Papers must contain original work related to the challenges and developments of the CS profession. Previously published papers will not be considered for this award.• Research undertaken by the author is desirable and must be performed within the same calendar year.• Successful submissions for IAHCSMM Fellowship may be considered for this award.• Papers must be presented in essay form, typewritten and at least 2,000 words in length.• References must be given in standard citation format.

• The author’s name and contact information must appear on the title page.• Pages must be numbered.• All submissions must include a vitae sheet on the author.

All papers will be judged by the Past Presidents Committee of IAHCSMM. The Past Presidents Awards nomination form must be completed and returned with the required submission documents.

AWARD ELIGIBILITY AND SUBMISSION CRITERIA

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INTERNATIONAL ASSOCIATION OF HEALTHCARE CENTRAL SERVICE MATERIEL MANAGEMENT

AWARDS2016

PAST PRESIDENTS AWARD NOMINATION FORM

Name of Nominee: ________________________________________________________________________________

Title: ____________________________________________________________________________________________

Place of Employment: _____________________________________________________________________________

Address: ________________________________________________________________________________________

City/State/Zip: ___________________________________________________________________________________

Telephone: _______________________________________________________________________________________

Email: ___________________________________________________________________________________________

Nominated by: ___________________________________________________________________________________

Title: ____________________________________________________________________________________________

Place of Employment: _____________________________________________________________________________

Address: ________________________________________________________________________________________

City/State/Zip: ___________________________________________________________________________________

Telephone: _______________________________________________________________________________________

Email: ___________________________________________________________________________________________

Deadline: February 8, 2016

Mail: IAHCSMM, 55 West Wacker Drive, Suite 501, Chicago, IL 60601

Fax: 312.440.9474

Email: [email protected]

Online: www.iahcsmm.org/about/awards.html

Note: All papers become the property of IAHCSMM and cannot be reproduced, published or edited in any form without the written permission of IAHCSMM. Applicant grants permission to IAHCSMM to reprint and distribute this submission.

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IAHCSMM and Purdue University jointly offer two different scholarships. The purpose of these awards is to provide financial assistance to individuals who wish to continue their educational and individual growth. Two categories have been established for these awards:1. Central Service Technicians2. Central Service Managers/Supervisors

One winner in each category will receive a free registration and all course materials for the respective Purdue/IAHCSMM non-credit correspondence course (these awards are nontransferable, and all course requirements must be met for successful completion). If a suitable applicant is not found in a category, that award will not be given until the following year. Applicants will be evaluated on a personal essay, letter of reference from an immediate supervisor, and the following criteria:1. Financial need2. Interest in pursuing educational and individual growth goals3. Participation in activities (Association, hospital department, community)4. Years of service in Central Service. Applicants must complete the approved application and send it, along with their personal essay and a letter of reference, to:

Christy Marks Purdue Scholarship AwardsDistance LearningPURDUE UNIVERSITYStewart Center G-59128 Memorial MallWest Lafayette, IN 47907-2034

All applications will be reviewed by a representative from Purdue University. The recipients of the scholarships will be announced at the 2016 Annual Conference and Expo. All decisions of the panel will be final.

SPONSORED BY

PURDUE UNIVERSITY SCHOLARSHIP AWARDS

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INTERNATIONAL ASSOCIATION OF HEALTHCARE CENTRAL SERVICE MATERIEL MANAGEMENT

AWARDS2016

PURDUE UNIVERSITY SCHOLARSHIP AWARDS NOMINATION FORMApplication for (check one) Correspondence Courses

q Central Service Technical Training q Supervision Principles: Leadership Strategies for Healthcare Facilities

Name ___________________________________________________________________________________________

Home Address ___________________________________________________________________________________

Telephone _______________________________________________________________________________________

Business Address _________________________________________________________________________________

Business Telephone ____________________________ Email ____________________________________________

Immediate Supervisor’s Name _______________________________________________________________________

IAHCSMM Status q Member q Non-Member

Years of Service in the Central Service Department and/or Material Management _____________________________

Activities (describe): Association, hospital department, community, volunteer, or other.

1. ______________________________________________________________________________________________

2. ______________________________________________________________________________________________

3. ______________________________________________________________________________________________

Personal Essay:Please attach a 150-word essay describing your interest in pursuing educational goals for individual and personal improvement, your financial need and any other information that would be helpful in understanding why you wish to be awarded this scholarship.

Letter of Reference:Please attach one letter of reference from your immediate supervisor verifying your current employment and attest-ing to your interest in receiving this scholarship.

Mail completed application and required material to:Christy Marks Purdue Scholarship AwardsDistance LearningPurdue UniversityStewart Center G-59 • 128 Memorial MallWest Lafayette, IN 47907-2034

Deadline: February 8, 2016

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This award was established in honor of Margaret J. (Peggy) Ryan, RN. Peggy graduated from St. Luke’s Hospital School of Nursing in Denver, Colo. and has had extensive experience in Emergency Department, Operating Room, Labor & Delivery, Service Department and Materials Management. She has worked at several hospitals in the Denver area and served as a hospital consultant for many years. She has been active in AORN and is a past president of ASHCSP. She has won numerous awards and has served as a nurse consultant for several companies. She is the author of many articles, including what many consider to be the definitive article on implementing a CS/OR case cart system. She is also a renowned lecturer. The recipient of this award will be recognized during the 2016 Annual Conference and Expo, and will receive an engraved plaque, plus a monetary award in the amount of $1,000.

SPONSORED BY

Candidates for this award must:• Be an active member of IAHCSMM. • Be nominated by their department director, manager, supervisor or coordinator.• Be employed in the field of CS for a minimum of three years at the time of nomination, documented by a letter from human resources or the department manager.• Have developed, instituted and exhibited a workable, documented concept that has improved CS functions and operations.

Nominees must submit the following: • A completed Technician Achievement Award nomination form.• Documentation that includes a statement of the positive outcomes that occurred as a result of the instituted concept, and how other departments and/or facilities may utilize this program.

AWARD ELIGIBILITY AND SUBMISSION CRITERIA

TECHNICIAN ACHIEVEMENT AWARDThe Technician Achievement Award is presented to an active member of IAHCSMM to recognize outstanding achievement by a Central Service (CS) Technician.

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INTERNATIONAL ASSOCIATION OF HEALTHCARE CENTRAL SERVICE MATERIEL MANAGEMENT

AWARDS2016

TECHNICIAN ACHIEVEMENT AWARD NOMINATION FORM

Name of Nominee: ________________________________________________________________________________

Title: ____________________________________________________________________________________________

Place of Employment: _____________________________________________________________________________

Address: ________________________________________________________________________________________

City/State/Zip: ___________________________________________________________________________________

Telephone: _______________________________________________________________________________________

Email: ___________________________________________________________________________________________

Nominated by: ___________________________________________________________________________________

Title: ____________________________________________________________________________________________

Place of Employment: _____________________________________________________________________________

Address: ________________________________________________________________________________________

City/State/Zip: ___________________________________________________________________________________

Telephone: _______________________________________________________________________________________

Email: ___________________________________________________________________________________________

Deadline: February 8, 2016

Mail: IAHCSMM, 55 West Wacker Drive, Suite 501, Chicago, IL 60601

Fax: 312.440.9474

Email: [email protected]

Online: www.iahcsmm.org/about/awards.html

Note: All papers become the property of IAHCSMM and cannot be reproduced, published or edited in any form without the written permission of IAHCSMM. Applicant grants permission to IAHCSMM to reprint and distribute this submission.