SERVICE AWARDS FOR GERIATRIC EXCELLENCE: NOMINATION PACKAGE

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SERVICE AWARDS FOR GERIATRIC EXCELLENCE: NOMINATION PACKAGE

14th Annual Service Awards for Geriatric Excellence SAGE celebrates the accomplishments of those who are passionate and committed to improving the quality of life of seniors. Take time to recognize an individual or group you know that makes a difference! Nominations are invited from the regions of Brant, Halton, Hamilton, Haldimand and Norfolk, Niagara, Waterloo and Wellington-Dufferin. Nominations OPEN: Monday October 17 th, 2016 at 12:00am (midnight) Nomination DEADLINE: Saturday December 31 st, 2016 at 11:59pm If you have questions about the SAGE program, please contact: Julia Mantle Regional Geriatric Program central 905-777-3837 ext.12460 / mantlej@hhsc.ca Date: Thursday June 1 st, 2017 Location: Sarcoa Restaurant, Hamilton, Ontario Time: Early registration, 5:30pm The 2017 Service Awards for Geriatric Excellence are presented by:

Executive/Senior Leadership Leads innovative program development that improves care for the elderly. Promotes clinical and/or administrative service excellence. Demonstrates leadership and inspiring vision of how care for the elderly can be improved. Individual Exemplary performance and accomplishments in area of responsibility. Demonstrates leadership within their peer group, with innovative and creative thinking, cooperation and hard work in the provision of care or service that optimizes the health, independence and quality of life of seniors. NOTE: Individual nominees can be from ANY level or profession within an organization (e.g. staff, management, clinicians, personal support workers, activity workers, recreation therapists, social service workers, researchers, etc.). Volunteer Contribution often exceeds expectations. Dedication to making a positive impact on the quality of life of seniors. Strong commitment to the organization s mission that is demonstrated through an excellent attendance record and a willingness to give extra effort to duties and responsibilities. Exhibits compassion and caring when working with clients, patients, and staff. Team Highly effective team, network, working group, committee or collaborative partnership. Demonstrates a far-reaching impact on seniors, services and/or care. Demonstrates leadership, innovation and dedication to enhanced capacity, coordination and collaboration in the provision of services to seniors. Student/ New Learners Individual new to the field and working in care of the elderly for 3 years or less. A student in a post-secondary program related to the care of the elderly. An undergrad student/ graduate student/ medical resident. Demonstrates dedication, leadership and innovation. The Rosalie Senior s Choice Award Nominated by any senior person resident in hospital, a long term care facility or the community, with or without the assistance of a family member. Nominee can be an individual or team that demonstrates excellence in all aspects of their work. Nominee can be an individual or team that demonstrates a high level of compassion and care when working with clients, patients and staff. Nominee can be an individual or team that shows initiative and innovation and goes above and beyond to meet the needs of the client or patient.

There are two ways to submit your nomination, email or by fax. In both cases, nominations MUST include a completed nomination form AND two (2) letters of reference; 250 words maximum for each. EMAIL: Please email your nomination package and supporting documents to mantlej@hhsc.ca In the subject line, please state the category of nomination (i.e. SAGE Nomination- Team) FAX: Send a completed nomination form and supporting material by fax. Attn: Julia Mantle, Regional Geriatric Program central Fax #: 905-575-5121 Description of Achievement (REQUIRED) Please complete the description of achievement on the next page (using additional sheets if required). If this section is not completed, the nomination will NOT be assessed. IMPORTANT NOTES: Nominations can only be assessed based on the information provided. In addition to the two (2) reference letters, the more detail provided in the description of achievements, the better a nominee s chances of winning an award. Incomplete nominations will not be accepted. If a nomination does not meet the requirements outlined above, the nominator will be notified. Please do not send original documents as they will not be returned. Upon closing of the nomination period, nominees will be notified of the nomination and by whom they were nominated. Nominators of the Rosalie Senior s Choice Award are NOT required to obtain 2 letters of reference. Simply share a personal story!

Region: Brant Haldimand/Norfolk Hamilton Halton Niagara Waterloo Wellington/Dufferin Category: Executive/ Individual Volunteer Senior Leadership Team NOMINEE INFORMATION Student/ New Learners Rosalie Senior s Choice First Name Last Name Title/Position *Please complete all fields and ensure the nominee name is spelled correctly. This is how the name will appear in all written materials and on the nominee or winner plaque presented at the awards ceremony. Organization Name Street Number Street Name City Postal Code This is the nominee s: Home Address Work Address Telephone Ext. Email address NOMINATOR INFORMATION *Please complete all fields. First Name Last Name Title/Position Organization Street Number Street Name City Postal Code Telephone Email address

When writing your nomination please include all details relevant to the category you are nominating this person/team/organization in. For more information please review the category descriptions under Award Categories and Criteria. I am nominating this person/team/organization in the category. a)describe the nominee s achievements in detail, including examples. Examples could include how the nominee has demonstrated leadership dedication innovation utilization of best practices commitment to optimizing the health, independence and quality of life for seniors

b) State how long and in what capacity have you known the nominee.