We Value Your Input

Have you, a family member or friend had a recent experience with the Carleton Place & District Memorial Hospital (CPMDH)? Was it a favourable experience? Or, was it not so great? Either way, would you like to improve how the hospital operates? If interested, please continue reading. The hospital has a committee composed of volunteers who have had experiences, good and bad, with the hospital over the last three years. These folks work together to ensure patients and their families’ views are heard and incorporated into the hospital operations.

CPDMH has a Joint Patient and Family Advisory Committee (with Almonte General Hospital) and we welcome your feedback and ideas to help us improve the care we provide. Advisors will reflect on their own experiences, or those of family members, to offer meaningful input on all aspects of care. Advisors do not need special qualifications. Any required training will be provided. What is most important is your experience as a patient, caregiver or family member within the past two years. The committee meets a minimum of four times per year.

Get Involved
PFAC is currently recruiting members who represent the diverse cultures and needs of our community.

To learn more or become a potential PFAC member, please review the PFAC brochure. If you would like more details please contact Lianne Learmonth, Vice President, Patient/Resident Services & Chief Nursing Executive at 613-256-2514 ext. 2235 or Cindy Skebo, Integrated Assistant at 613-256-2500 ext. 2505 or inquire by emailing info@carletonplacehosp.com. You can also visit the Almonte General Hospital website for more details.

To apply, please complete the online application below. If you would prefer to mail the application, please print the PFAC Application Form and mail to:

Joint Patient Family Advisory Committee

AGH/CPDMH

75 Spring Street

Almonte, ON K0A 1A0
Attention: Cindy Skebo, Administrative Assistant

or email info@carletonplacehosp.com

Thanks for your interest!


Name
Address
City
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Phone	ext.
1. Please tell us a bit about yourself and your interest in being a member of the Patient and Family Advisory Committee.
2. Tell us a little bit about your (or your family member’s) experience at Carleton Place & District Memorial Hospital?
3. What are some suggestions you have for improvement?
4. The role of a Patient and Family Advisor requires the ability to share your personal experiences in ways that will help foster change and improvements. What qualities do you see in yourself that would help you in fulfilling this part of the advisor role?

5. Describe a group that you were a member of, and tell us why you think the group worked well together. What was your role on the team? What was your contribution?

6. The Advisory Committee expects to meet quarterly. Do you foresee any potential challenges, such as attendance at meetings or conflicts of interest, for participating on this committee?

When are you most available to attend the meetings? (please check):	Days (8am – 4pm) Evenings (6pm – 9pm)

7. Do you have any questions for us or would you like to add anything else to your application?