Organization Address: 

The role of Executive Sponsor is key to the success of the Schwartz Rounds program. The Executive Sponsor shows willingness to serve as a champion of the program and advocates for dedicated staff time, supports succession planning, and promotes the Schwartz Rounds program as a culture change agent.

The Executive Sponsor may have a variety of titles but should be able to act with organizational decision-making authority on behalf of Schwartz Center programming. This may include the authority to sign agreements on behalf of the organization and oversight of departmental or organizational budget with the ability to approve financial commitments.

Please identify your Executive Sponsor for the program, should your organization be selected:

Your Schwartz Rounds Leadership Team is tasked with implementing and running your Schwartz Rounds program. The five person team includes up to 3 Facilitator(s), Clinical Leader or Equivalent, and a Program Coordinator/Administrator. Please use our Roles and Responsibilities document to help guide your decision-making process.

We ask that you identify your Clinical Leader or Equivalent, a minimum of one Facilitator, and Program Coordinator/Administrator below.

Program Coordinator/Administrator
The person in this role will be responsible for reporting to the Schwartz Center including but not limited to submitting the Schwartz Rounds session information form and evaluations. 

Please upload a letter of support from a member of the C-suite at your organization describing the following:

• Reason for implementing the Schwartz Rounds program and how it aligns with your current well-being and/or patient safety and quality work at your organization. 
• Commitment to allocating the needed resources to implement and sustain the program

Please download, review, sign and upload this Stanzler Open Doors Fund Readiness and Eligibility Form as part of your application.

Optional: Please upload any additional materials to support your application.