Pilot Application - HHI

Thank you for your interest in participating in the Healing Healthcare Initiative Pilot. Please complete and submit this application no later than Monday, October 31. You will be notified of the status of your application by mid-November. If you have questions, please contact membership@theschwartzcenter.org.
Name(Required)
If you think your organization is a Schwartz Center healthcare member but do not see it listed above, please contact membership@theschwartzcenter.org.

Healing Healthcare Initiative (HHI) Team Information

What is your role on the HHI Team?(Required)
The HHI team includes the Executive Sponsor and Senior Leadership Team. This group is expected to actively participate in HHI activities and will meet on a regular basis.
Contact Information for the <b>Executive Sponsor</b>(Required)
The Executive Sponsor (CEO, President, or equivalent) is responsible for identifying the HHI Leadership Team that participates in the program.
First Name
Last Name
Title
Email address
Phone number
Contact Information for the <b>HHI Leadership Team</b>(Required)
The HHI Team is composed of senior leaders who report directly to the Executive Sponsor and should include those in roles like: CEO, CMO, CNO, COO, CHRO, CWO, CDEIO, CXO, etc. We ask that you identify 4 – 6 individuals for the team. Please use the + button to add more rows
First Name
Last Name
Title
Email address
Phone number
 
Which person on your HHI Team will be responsible for managing interactions with your organization’s Institutional Review Board (IRB) for research approval and oversight?(Required)
We anticipate that the evaluation component of HHI will be deemed an exempt or expedited IRB proposal.
First Name
Last Name

Organizational Information

The Key Principles are:
• Psychological and physical safety
• Mental health and well-being
• Diversity and equity
• Inclusion, voice and choice
• Trust and trustworthiness
• Team cohesiveness and collaboration
Please list the metrics you currently collect in the following areas:
Organizational Commitment
If our organization is selected to participate in the pilot, our full HHI Team will commit to the program from January - December 2023 and will be available to participate in the following meetings:(Required)
Kick-Off Meeting: January 19th at 3:00 pm ET
Schwartz Rounds®: March 16th at 3:00 pm ET
Mid-Course Meeting: July 20th at 3:00 pm ET
Schwartz Rounds: November 16th at 3:00 pm ET
Closing: December 7th at 3:00 pm ET

There will also be a Learning Collaboratives held monthly on Thursdays in April, May, and June – specific dates TBD
We have reviewed the <a href="https://www.theschwartzcenter.org/" target="_blank">informational webinar (live or recording), FAQs and organizational expectations</a> provided by the Schwartz Center and are prepared to participate in the pilot if selected.(Required)
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