Take 2 | UAMS Health

Use this form below to submit a nursing process or practice that needs to be reviewed that could improve safety and patient outcomes.

Take Two Submission Form

Employee Name: (optional)

First Last

Employee Workday ID: (optional)

Employee Email: (optional)

Unit/Area/Clinic:(Required)

Supervisor/CS:(Required)

CS (Clinical Specialist):

Current Process/Practice(Required)

Briefly describe the current process/practice that you want reviewed.

Concerns about current process/practice:(Required)

What are your concerns about the current process/practice?

Impact:(Required)

Do you have an example of the impact of this process/practice? (patient or nurse story)

Department(s) Involved:(Required)

What department(s) will be involved with this change? (Informatics, Pharmacy, Supply Chain, EVS, Agility, Interpreting Services, etc.)

Policy # Affected:

Please enter the policy number and name pertaining to the suggested Take Two suggestion. If you need help finding the policy, please talk with your CS or your CSM.