ham Reg
gional Ho
ospital Ambass
A sador Intternship
p Progra
am
Studen
nt Applicatiion
Ple
ease review program des
scriptions an
nd select (on
ne) program :
Emerg
gency Dep
partment Periope
erative Se
ervices
Name
Add
dress
Em
mail (ccell)
Date of birth Ge
ender
Sch
hool M
Major
Yea
ar in College
e H
Hometown
Em
mergency Co
ontact Name
e P
Phone
White/C
Caucasian American n Indian/Alaskan Native
African American
Black/A Multi-raccial
Asian/In
ndian I do not wwish to desccribe my race
e
Native Hawaiian/Ot
H ther Pacific Islander
c or Latino? Yes No
Are yyou Hispanic nswer
No An
1. W
Why do you wish to be an
a Emergenc
cy Departme
ent /Periope rative Amba
assador? Ple
ease explain
n:
2. H
Have you ev
ver been invo
olved in a stressful healtthcare situattion? Please
e explain (op
ptional):
4. D
Do you have
e transportation to and frrom Durham
m Regional H es No
Hospital? Ye
((Please note
e that Durham
m Regional is unable to provide tran
nsportation b
but is located
d on several Durham
b sing the bus as primary transportatio
bus routes. Students us t on are not pe
ermitted to w
work eveninggs.)
Co
ompany / Org
ganization Job
b Duty / Title
e Start Date
e End Date
Sign
nature (type if submitted electronically) Date
e
Emergency Department
Ambassador Program
Customer Service
Serving as the face of Durham Regional for Emergency Department Patients
Addressing complaints , questions and patient issues
Assisting with transportation and other services
Conducting customer service rounds
Proactively meeting patient needs
Patient satisfaction survey data collection and analysis
Improving patient satisfaction survey scores and increasing survey response
rates
Quality
Monitoring deterioration in condition
Maintaining ED waiting room
Assisting the charge nurse in managing patient flow
Escorting/transporting patients
Work Culture
Develop relationships with ED staff
Foster a team environment
Emergency Department Ambassador Program
Internship Requirements
bianca.briola@duke.edu
Perioperative Services
Ambassador Program
Customer Service
Serving as the face of Durham Regional for Perioperative Department Patients
Addressing complaints , questions and patient issues
Conducting customer service rounds
Proactively meeting patient /family needs
Patient satisfaction survey data collection and analysis
Improving patient satisfaction survey scores and increasing survey response
rates
Quality
Rounding on waiting rooms
Escorts families to PACU, ACU, or nursing units as appropriate
Work Culture
Develop relationships with Perioperative staff
Foster a team environment
Collaborate with Perioperative Coordinator and department charge nurses to
communicate patient flow changes (ie delays, etc).
Available to Perioperative staff to intervene in special circumstances.
Perioperative Department Ambassador Program
Internship Requirements