Template

Environmental Services Accountability MMM Report

by Terry Treadwell, from the Community

10+

Use this Environmental Services Accountability Monthly Meeting Model (MMM) report template to drive consistent hospital EVS performance. The checklist guides leaders through service metrics like HCAHPS, cleaning scores, AIDET validations, and patient rounding; people metrics such as staff rounding, engagement scores, action plans, recognition, and 30/60/90 check-ins; and finance and growth measures including productivity, cost management, contract compliance, contract labor reduction, FPC status, supply scanning, and overtime. Capture wins, identify support needs, and align on next steps before the next MMM.

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With SafetyCulture you can

Digitize any process, procedure or policy

Eliminate mistakes made by paper-based processes

Create and share professional reports instantly

Confirm accountability and compliance with a digital log

About author

Community

This community page makes available free workplace checklists and templates created by other users within the SafetyCulture community. SafetyCulture has re-published this content and where possible, has credited the original author. SafetyCulture has not verified the accuracy, reliability or suitability of any community content. You agree that your use of any of this content is in accordance with SafetyCulture’s Terms and Conditions.

Template
Facility Rounding General
Use this department rounding template to streamline hospital unit checks. Capture unit location, date, and preparer, confirm scanner status, connect with providers, and verify tracker boards and WOW/admissions carts. Log up to 10 issues, note whether they were previously reported, track corrections, and record status and corrective actions. Includes guidance for routing issues to BioMed, EVS, Infection Prevention, Safety, Supply Chain, and for submitting facility work orders. Supports AIDET communication and consistent hospital operations.
by eric ndzeru, from the Community
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Template
Facility Rounding General Checklist
This facility rounding template supports hospital and health service departments in conducting consistent unit rounds. It guides staff to introduce themselves using AIDET, verify scanner and tracker board functionality, check WOW and admissions carts, and document up to ten issues with ticket numbers and status. Teams can record prior issues, note corrections, and assign clear corrective actions. The checklist includes escalation guidance for BioMed, EVS, Infection Prevention, Safety, Supply Chain, and facility work orders, helping managers track follow-ups and maintain safe, efficient operations across units.
by John Patterson, from the Community
Downloads: 60+
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Template
ACH Leadership Rounding Template
This ACH Leadership Rounding template supports hospital leaders during staff and patient rounding. It captures staff details across departments, what is working well, issues affecting patient care and safety, and resource needs. The patient section checks responsiveness, pain management, and concerns, and includes a survey reminder. Use it to standardize leadership rounds, surface improvement opportunities, and enhance patient experience and clinical quality.
by ACH ACH, from the Community
Downloads: 10+
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Template
EOC Rounding Checklist
This EOC rounding checklist helps healthcare teams assess Environment of Care compliance across units. Review environmental cleanliness, hazardous materials handling, life safety and emergency preparedness, utilities and facilities, medical equipment maintenance, infection prevention practices, patient safety measures, and HIPAA considerations. Capture findings, attach evidence, assign follow-ups, and drive continuous improvement in hospital safety and compliance.
by Ashley Cook, from the Community
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Environmental Services Accountability MMM Report

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