Leaders in Clinical Excellence, Patient and Family Recognition Award

This award honors clinical faculty whose dedication to the compassionate, respectful delivery of exceptional patient care has garnered the highest degree of patient trust and satisfaction.

Award Eligibility Criteria

All clinical UTSW clinical faculty, regardless of site of service, are eligible for nomination.

Anyone – faculty colleague, Health System staff, patient or family member – may submit a nomination.

Nomination Information

Nomination should include the following details:

How the nominee’s delivery of care has resulted in an exceptional degree of patient and family trust and satisfaction.
Patient feedback, such as letters, emails, and other communication describing patient confidence in his or her clinician.

Nominee First Name

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Nominee Last Name:

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Nominee Title

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Nominee Department

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Nominee Phone

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Nominee Email

* must provide value

Nominator First Name

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Nominator Last Name

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Your role

I am a UT Southwestern faculty, staff member, or student

I am a patient or family member

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Nominator Title

* must provide value

Nominator Department

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Nominator Phone

* must provide value

Nominator Email

* must provide value

Please provide specific examples of the nominee's focus on patient and family needs during the course of clinical care (please refrain from including any patient identification within these examples).

* must provide value

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What qualities does the nominee display that garner the most positive feedback from appreciative patients and families?

* must provide value

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What can UT Southwestern as an institution learn from the day-today care practice of the nominee that can help elevate the overall level of quality care for all UT Southwestern patients?

* must provide value

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What additional information would you like to add?

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This submission requires a copy of the nominee's CV, along with any other documents you would like for the Award Review Committee to consider in evaluating this nomination. How would you like to submit it?

* must provide value

I have those documents and would like to upload them.

I or someone in my office will email them.

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Upload the nominee's CV here.

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You or someone from your office can email the nominee's CV to clinicalawards@utsouthwestern.edu. Please include in the subject line "LCE, Patient and Family Recognition Award, ______ ______." Don't worry, we'll send you an email reminding you of that address! Please note that this nomination will not be considered complete until we have received the nominee's CV.

Do you have any additional documents you would like to submit for the committee's consideration?

* must provide value

Yes, I have those documents and would like to upload them now.

Yes, and I or someone in my office will email them.

No, I do not have any additional documents

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How many files would you like to upload?

* must provide value

Upload one file here.

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Upload one file here.

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Upload one file here.

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Upload one file here.

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Upload one file here.

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You or someone from your office can email the remainder of your documents to clinicalawards@utsouthwestern.edu. Please include in the subject line "LCE, Patient and Family Recognition Award, ______ ______." Don't worry, we'll send you an email reminding you of that address!

Date

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HR Use Only-- This candidates is:

Why is this candidate ineligible?

Other,

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Why is this candidate ineligible? Please type why this candidate is ineligible within a self-contained sentence.

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HR Use Only-- Did this candidate win?

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