Sample Chief Executive Officer Performance Appraisal Process And Assessment Form Page 5
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22Assessment of Essential CEO Accountabilities (cont.)
Circle the Applicable Performance Rating and
Include Your Comments
Medical Staff Relations
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N/A
•
Comments:
Develops and maintains effective relationships with
physicians employed by and associated with the organization
•
Encourages open communication and dialogue with
physicians
•
Encourages physician collaboration across the system of care
to foster commitment to a shared vision
•
Meaningfully involves the medical staff in efforts related to
quality improvement, patient safety and patient satisfaction
•
Develops and implements a medical staff development plan
consistent with the organization’s strategic plan and goals
•
Inspires loyalty among the medical staff to further the mission
and vision of the organization
•
Ensures an adequate supply of physicians and physician
specialties exists to meet the health needs of the community
CEO Self-Rating: [Insert CEO rating from self-evaluation here before giving to Board members]
CEO Comments: [Insert CEO comments from self-evaluation here before giving to Board members]
AHA 2017 Sample CEO Performance Appraisal Process and Assessment Form
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