Template

KRMC PS Go To Gemba Audit Tool

by Jenna Marshall, from the Community

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.

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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
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.
by Shawn Butler, from the Community
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Template
Environment of Care and Life Safety Rounding Checklist
Conduct comprehensive environment of care and life safety rounds with this checklist. Review safety management practices, fire doors and extinguishers, egress and storage, patient room and equipment conditions, and hand hygiene. Verify security controls, badge use, medication room access, and infant abduction procedures. Check hazmat storage, SDS access, PPE, eyewash stations, and waste handling. Assess infection control measures, air pressure relationships, and utility systems including lighting, medical gas, and emergency exits. Monitor HIPAA privacy risks and optional water management logs.
by Stephen Cranford, from the Community
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Environment of Care Rounds Tracer Checklist
Use this Environment of Care (EOC) Rounds Tracer to run Joint Commission mock surveys and verify hospital readiness. The checklist guides auditors through environment of care checks, information management and HIPAA practices, life safety, patient safety goals, performance improvement indicators, infection prevention, medication management, and waived testing. It also covers unit response to auditor arrival, equipment maintenance, storage and oxygen safety, and documentation review to support continuous compliance.
by Robert Carter, from the Community
Downloads: 20+
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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
Downloads: 20+
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KRMC PS Go To Gemba Audit Tool

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