Template

KRMC PS Go To Gemba Audit

by Shawn Butler, from the Community

This Go to Gemba audit tool supports hospital patient safety rounds across units. Use it to verify environment of care standards, life safety and egress, equipment condition, hazardous room security, eyewash and refrigeration logs, and biomedical maintenance. Confirm protection of confidential patient information, proper storage and labeling, and staff identification. Review infection prevention practices, PPE availability and use, hand hygiene supplies, biohazard and sharps disposal, and separation of clean and soiled items. Assess medication management, controlled substance security, expirations, and cold-chain controls. Capture unit quality dashboards, posted patient rights, and point-of-care testing controls. Record team engagement and observations to drive continuous improvement.

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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

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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
KRMC PS Go To Gemba Audit Tool
KRMC PS Go To Gemba is a healthcare audit checklist designed for hospital units to support patient safety and continuous improvement. It guides teams through information management, performance improvement posting, environment of care, life safety, infection prevention, medication management, and point-of-care testing. Use it to verify badge use, confidentiality practices, hazardous room security, eyewash and refrigerator logs, electrical and preventative maintenance, compressed gas storage, egress and fire safety, cleanliness, waste handling, hand hygiene supplies, medication labeling and storage, and QC documentation. Ideal for rounding, tracer activities, and compliance checks.
by Jenna Marshall, from the Community
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Template
Environment of Care Checklist
This Environment of Care checklist supports hospital teams in assessing safety and compliance across patient care areas. It covers corridors and egress, life safety systems and fire equipment, glucometer hygiene, crash cart readiness, and equipment warmers with documented temperature ranges. Inspect clean and dirty utility rooms, storage practices, oxygen cylinder handling, and nutrition room logs. Review medication room security, labeling, and cold-chain monitoring. Verify eyewash stations, infection control practices, hand hygiene, isolation signage, and biohazard labeling. Includes staff competency checks, preventative maintenance tags, alarm response, and protection of patient information.
by Nicole Tietz, from the Community
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Environment of Care Rounds Current Version
This Environment of Care Rounds checklist supports hospitals and healthcare facilities in auditing safety, infection prevention, privacy and information security, engineering and life safety systems, interior design, patient safety, supply chain and sterile storage, and food service operations. It covers requirements such as emergency power and lighting, medical gas procedures, housekeeping and waste handling, sharps and PPE, HIPAA privacy safeguards, fire and egress compliance, hazardous materials and spill response, refrigeration and temperature logs, and VA-specific security practices. Use it to standardize rounds, document findings, and drive corrective actions that enhance compliance and patient safety across inpatient and outpatient areas.
by Chris Braun, from the Community
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Environment of Care Rounds Checklist
This Environment of Care Rounds checklist helps hospitals and clinics inspect critical safety domains across clinical and non-clinical areas. It covers review of previous inspections, fire prevention and door compliance, electrical safety, general safety and housekeeping, hazardous materials and biohazard controls, medication storage, security management, utilities and building systems, primary care office readiness, cleanliness of patient and public areas, and food and nutrition standards. Use it to document findings, maintain compliance, and improve patient and staff safety during routine rounds.
by Judy Reamy, from the Community
Downloads: 10+
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KRMC PS Go To Gemba Audit

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