Awards Catalog 2014

2014 AWARDS2014 AWARDS2014 AWARDSInternational Association of Healthcare Central Service

Materiel Management 2014 Awards

Central Service professionals’ job on any given day is difficult, challenging and rewarding. Your ongo-ing commitment to quality has a very real and direct

impact on patient safety and quality outcomes. IAHCSMM would like to formally honor your hard work and on-the-job success with the 2014 IAHCSMM Awards.

Nominations are now being accepted for this prestigious awards program that recognizes excellence in CS leader-ship, knowledge, service, and skills. The awards presenta-tion will take place during the 2014 IAHCSMM Annual Conference and Expo, May 4-7 in Columbus, OH. Each award recipient will earn the industry’s respect, along with an engraved plaque and monetary award.

Now is the time to nominate yourself or another deserving CS professional who is going above and beyond to ensure that quality and safety remain a top priority.

Thank you for all you do!

Sharon Greene-GoldenSharon Greene-Golden, CRCST, FCSIAHCSMM President

• Deadlineforsubmissionis February 1, 2014

• OpentoallIAHCSMMmembers

• Applicantsmaysubmitnominationsfor more than one award, but are eligible to win only one award per year

• Allsubmissionsmustbetheoriginal work of the nominee; after official acceptance, materials/documents may not be revised or changed

• Ifselectedasanawardwinner,all submissions become the property of IAHCSMM

• Worksubmittedforanawardmust be current and may not have been submitted in previous years

• Comparableserviceinother associations may be substituted, when appropriate, for service in IAHCSMM

• CurrentExecutiveBoardmembersare not eligible for nomination of awards

IAHCSMM 2014 AwardsSUBMIT YOUR

2014 IAHCSMM AWARD NOMINATION TODAY!•Educatorofthe Year Award

•PastPresidents Award

•Technician Achievement Award

•CSSupervisor/ Manager of the Year

•GoldenSlipper Award for Service Excellence

•Decontaminator of the Year Award

•ConfidenceBuilder Award

•Humanitarian Award

• IAHCSMM – Purdue University Scholarship Awards

•Chapterofthe Year Awards

2013 Award WinnersJoin These PasT award reciPienTs and Be recognized Too!

Educator of thE YEar awardKui-Bi Lin, CRCSTTaipei Veterans General HospitalTaipei County, Taiwan, ROC

tEchnician achiEvEmEnt awardJulie Spallino, CRCSTKindred Hospital, Las Vegas, NV

cS SupErviSor/managEr of thE YEar awardLori Ferrer, CRCSTFairview Health Services, Minneapolis, MN

goldEn SlippEr award for SErvicE ExcEllEncEBill Kras, CRCSTH. Lee Moffitt Cancer Center & Research Institute, Tampa, FL

dEcontaminator of thE YEar awardJhosue Vasquez, CRCSTMount Auburn Hospital, Cambridge, MA

confidEncE BuildEr awardGulf Breeze Hospital, Gulf Breeze, FLandSterile Processing Workflow Team, Veterans Health Administration

iahcSmm – purduE univErSitY ScholarShip awardSMarjorie HartmannandKim Hughes, CRCSTGood Samaritan Hospital, Carlisle, IN

chaptEr of thE YEar awardSLarge Chapter: Long Island Association for Central ServiceSmall Chapter: Western Wisconsin ChapterRunner Up Large Chapter: New Jersey Healthcare Central Service Association ChapterRunner Up Small Chapter: Keystone State Association of Sterile Processing Professionals

healthmarkINDUSTRIES CO.

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• Nomineemustbeanactivememberof IAHCSMM• Thenomineeofthisawardwill have demonstrated significant contributions to CS education in the calendar year preceding the award. Personal accomplishments related to educational endeavors, citations or acknowledgments, etc., will be considered• Nomineesareeligibleforconsideration if they have contributed to CS education in at least 5 of the following categories: • IAHCSMMCE-Approved presentation at a national conference • IAHCSMMCE-Approvedpresentation at a local/regional conference • Publishedarticleinanational publication

• Publishedarticleinalocal publication • TeachingaCS-relatedtraining course • Teachinghealthcarefacility inservices • OtherCS-relatededucational projects • IAHCSMMcommitteemembership/ support for association programs• Anarrativeexplainingwhythe nominee should receive this award, and documentation to substantiate the nominee’s educational contribution for the previous calendar year, must be submitted with the nomination

The Educator of the Year Award Nomination

form must be completed and returned with the

required submission documents.

Sponsored by

3M Health Care is pleased to announce the Educator of the Year Award. This award recognizes a member of IAHCSMM who has demonstrated dedica-tion to the advancement of education in the Cen-tral Service profession. The recipient of this award will be recog-nized during the 2014 Annual Conference and Expo and will receive an engraved plaque, plus a monetary award in the amount of $1,000.

BErtha YaniS litSkY, ph. d.TheEducatoroftheYearAwardwasestablishedinhonorofDr.BerthaLitsky,whowas an environmental microbiologist, researcher and educator at the University of Massachusetts. Her passion, commitment and dedication to her profession propelled her to the status of an international legend and pioneer in healthcare infection control. Dr.Litskywasaconsultantthroughouttheworldtomanyhospitals,foodserviceentities, manufacturers and suppliers of medical devices. She worked with many institutions, corporations and municipalities to improve sanitation and promote public healthandsafety.Dr.LitskybecameastrongadvocateandmentorfortheCentralService profession and was an active participant in IAHCSMM, ASHCSP, AAMI, andAORN.Herexpertiseandcontributionsblazedthewaytotheestablishmentofmany principles and standards of practice relative to infection control, reprocessing, packaging, and sterilization. She published several articles and books on relative topics.Dr.Litskybecameasought-afterspeakerandeducatorthroughouttheworld.Her wit and humor allowed her to deliver her lectures and messages in a manner that left her students with an everlasting impression to guide their future behaviors. She would frequently incorporate props, such as marionettes dressed as bacteria, and rely on humorous yet educational skits and stories to emphasize her message. The closing words of all her lectures, delivered with the loud BANG of a starter pistol, still resonate throughout the CS profession: “An unsterile item used in surgery is as dangerous as a loaded gun.”

award eLigiBiLiTY and sUBMission criTeria

Educator of The Year Award

edUcaTor of The Year award noMinaTion forM

Name of Nominee: __________________________________________________________________________________________________

Title: ______________________________________________________________________________________________________________

PlaceofEmployment: _______________________________________________________________________________________________

Address: ___________________________________________________________________________________________________________

City/State/Zip: ______________________________________________________________________________________________________

Telephone: _________________________________________________________________________________________________________

Email: _____________________________________________________________________________________________________________

Nominated by: _____________________________________________________________________________________________________

Title: ______________________________________________________________________________________________________________


Address: ___________________________________________________________________________________________________________

City/State/Zip: ______________________________________________________________________________________________________

Telephone: _________________________________________________________________________________________________________

Email: _____________________________________________________________________________________________________________

deadline: february 1, 2014

mail:IAHCSMM,55WestWackerDrive,Suite501,Chicago,IL60601

fax:312.440.9474

Email: [email protected]

note: All papers become the property of IAHCSMM and cannot be reproduced, published or edited in any form without the written permission of IAHCSMM. Applicant grants permission to IAHCSMM to reprint and distribute this submission.

• Nomineemustbeanactivememberof IAHCSMM• Papersmustcontainoriginalwork related to the challenges and developments of the Central Service profession. The paper must contain original work and previously published papers will not be considered for this award• Researchundertakenbytheauthoris desirable, and must be performed within the same calendar year

• SuccessfulsubmissionsforFellowship may be considered for this award• Papersmustbepresentedinessay form,typedandatleast2,000words in length• Referencesmustbegiveninstandard citation form• Theauthor’snameandcontactinformation must appear on the title page • Pagesmustbenumbered• Allsubmissionsmustincludeavitae sheet on the author

Past Presidents AwardaBout ruth annE BrookS, rn, paSt prESidEntThis award was established in honor of Ruth Anne Brooks, RN,CRCST,whoservedasIAHCSMMPresidentfrom1993-1995.BrooksservedontheIAHCSMMBoardofDirectorsformanyyearsandwasPresidentoftheDelawareValleyChapter.BrookswasDirectorofMaterialCentralServiceattheMedicalCenterofDelaware,inNewark,DE,untilherdeathin1997.In1994,whileservingasIAHCSMMPresident,Brooksworkedwith Robert Mood, ASHCSP President, to oversee a committee that formulated and published the first joint position paper entitled“ReprocessingMedicalDevices.” The recipient of this award will be recognized during the 2014AnnualConferenceandExpoandwillreceiveanen-gravedplaque,plusamonetaryawardintheamountof$1,000.


All papers will be judged by the Past Presidents Committee of IAHCSMM. The Past Presidents Awards Nomination Form must be completed and returned with the required submission documents.

The Past Presidents Award, sponsored by IAHCSMM, recognizes an author of an outstanding paper on the challenges and developments to the Central Service profession.

Sponsored by

PasT PresidenTs award noMinaTion forM

Name of Nominee: __________________________________________________________________________________________________

Title: ______________________________________________________________________________________________________________


Address: ___________________________________________________________________________________________________________

City/State/Zip: ______________________________________________________________________________________________________

Telephone: _________________________________________________________________________________________________________

Email: _____________________________________________________________________________________________________________

Nominated by: _____________________________________________________________________________________________________

Title: ______________________________________________________________________________________________________________


Address: ___________________________________________________________________________________________________________

City/State/Zip: ______________________________________________________________________________________________________

Telephone: _________________________________________________________________________________________________________

Email: _____________________________________________________________________________________________________________



fax:312.440.9474



Candidates for this award must be:• NominatedbytheirDepartment Director,Manager,Supervisor,or Coordinator• AnactivememberofIAHCSMM• Musthavebeenemployedinthefield of CS for a minimum of three years at the time of nomination, documented by a letter from human resources or the department manager• Musthavedeveloped,institutedand exhibitedaworkable,documented concept that has improved CS functions and operations

SubmissionDocuments:• CompletedTechnicianAchievement Award Nomination Form• Documentationthatincludesa statement of the positive outcomes that occurred as a result of the instituted concept, and how other departments and/or facilities may utilize this program

Technician Achievement AwardpEggY rYan, rnThis award was established in honor of Margaret J. (Peggy) Ryan, RN. Peggy graduated from St. Luke’s Hospital School ofNursinginDenver,CO,andhashadextensiveexperienceinEmergencyRoom,OperatingRoom,DeliveryRoom,ServiceDepartmentandMaterialsManagement.ShehasworkedatseveralhospitalsintheDenverareaandservedasahospitalconsultant for many years. She has been active in AORN and is a past president of ASHCSP. She has won numerous awards and has served as a nurse consultant for several companies. She is the author of many articles, including what many consid-er to be the definitive article on implementing a CS/OR case cart system. She is also a renowned lecturer. The recipient of this award will be recognized during the 2014AnnualConferenceandExpo,andwillreceiveanen-gravedplaque,plusamonetaryawardintheamountof$1,000.


Sponsored by

The Technician Achievement Award is presented to an Active Member of IAHCSMM to recognize outstanding achievement by a CS Technician.

Technician achieveMenT award noMinaTion forM

Name of Nominee: __________________________________________________________________________________________________

Title: ______________________________________________________________________________________________________________


Address: ___________________________________________________________________________________________________________

City/State/Zip: ______________________________________________________________________________________________________

Telephone: _________________________________________________________________________________________________________

Email: _____________________________________________________________________________________________________________

Nominated by: _____________________________________________________________________________________________________

Title: ______________________________________________________________________________________________________________


Address: ___________________________________________________________________________________________________________

City/State/Zip: ______________________________________________________________________________________________________

Telephone: _________________________________________________________________________________________________________

Email: _____________________________________________________________________________________________________________



fax:312.440.9474



Candidates for this award must be:• NominatedbyanIAHCSMMmember, an affiliated chapter member, or an administrator in their facility• AnactivememberofIAHCSMMin good standing for a minimum of five years, and must have been employed in the Central Service field for a minimumof10years• Musthaveconsistentlydemonstrated contributions to: • Customerrelations; • Facility-wideoperational/financial performance; • OverallvalueofCentralService asaprofession; • Educationandtraining• HaveattendedanIAHCSMMAnnual Conference in the last three years

SubmissionDocuments:• CompletedCSManager/Supervisor oftheYearAwardNominationForm• Documentationmustincludea typewrittennarrativeexplainingwhy the candidate is deserving of this award (no more than three single- sided, double-space pages)• Narrativemustcontainexamplesof how candidate consistently demonstrated contributions to customer relations;facilitywideoperational/ financialperformance;overallvalueof CentralServiceasaprofession;or other educational training• Provideatleasttwo,butnomorethan three, letters of support and recom- mendation from peers, community health professionals, former or current CS employees, managers or admin- istrators. Letters should be two pages or less in length• Includecandidate’srésumé(maximum of two pages)

CS Supervisor/Manager of the Year AwardThisawardrecognizesaCentralServiceDepartmentSupervi-sor or Manager who has made significant contributions to their facility and the advancement of the Central Service profession. The recipient of this award will be recognized during the 2014IAHCSMMAnnualConferenceandExpoandwillreceivean engraved plaque, plus a monetary award in the amount of $1,000.Inaddition,apressreleaseacknowledgingtheawardwinner and an announcement letter will be sent to the award recipient’s hospital administrator.


Sponsored by

cs sUPervisor/Manager of The Year award noMinaTion forM

Name of Nominee: __________________________________________________________________________________________________

Title: ______________________________________________________________________________________________________________


Address: ___________________________________________________________________________________________________________

City/State/Zip: ______________________________________________________________________________________________________

Telephone: _________________________________________________________________________________________________________

Email: _____________________________________________________________________________________________________________

Nominated by: _____________________________________________________________________________________________________

Title: ______________________________________________________________________________________________________________


Address: ___________________________________________________________________________________________________________

City/State/Zip: ______________________________________________________________________________________________________

Telephone: _________________________________________________________________________________________________________

Email: _____________________________________________________________________________________________________________



fax:312.440.9474



The Golden Slipper Award provides an opportunity for a CS professional (Technician, Supervisor or Manager) who is committed to “Service Excellence” to receive formal recognition.

Candidates for this award must:• BeanactivememberofIAHCSMM• Demonstrateacaring,compassionate attitude• Offeracreative,helpfulsolution• Gobeyondthetechnicalrequirements of the job• Bearolemodelforthedepartment

SubmissionDocuments:• CompletedCSManager/Supervisor oftheYearAwardNominationForm• Submitatyped,one-pageessayof 500wordsorless,orabriefaudio- tape describing why you believe serviceexcellenceisimportantin today’s healthcare environment, and describing your participation/contribution(s)relativetoserviceexcellence in the healthcare setting (i.e., an individual contribution that “made the difference” or how customer service was improved through a process)• Providealetterofreferencefromyour immediate Supervisor

Golden Slipper Award for Service ExcellenceTheGoldenSlipperAwardforServiceExcellencesymbolizesextraordinaryservice(“goingtheextramile”).Theawardisbased on the rendering of a story about a patient’s slippers that were lost in the hospital and could not be found. The hospital administrator offered to pay the patient for his lost slippers, but he was not satisfied by that offer. He wanted a pair like theonesthatwerelost.Next,thestaffofferedtoreplacehisslippers. The patient was given a different pair of slippers, but he was still not satisfied because the slippers were not like the ones that were lost. Recognizing that the slippers were very im-portant to the patient, a caring staff member searched for and located an identical pair of slippers, which were purchased and given to the patient. This gesture was met with the patient’s complete satisfaction, and clearly demonstrated the staff mem-ber’scommitmenttoserviceexcellence. The recipient of this award will be recognized during the 2014IAHCSMMAnnualConferenceandExpoandwillreceivean engraved plaque, plus a personal gift and a monetary award intheamountof$500.


Sponsored by

goLden sLiPPer award for service exceLLence noMinaTion forM

Name of Nominee: __________________________________________________________________________________________________

Title: ______________________________________________________________________________________________________________


Address: ___________________________________________________________________________________________________________

City/State/Zip: ______________________________________________________________________________________________________

Telephone: _________________________________________________________________________________________________________

Email: _____________________________________________________________________________________________________________

Nominated by: _____________________________________________________________________________________________________

Title: ______________________________________________________________________________________________________________


Address: ___________________________________________________________________________________________________________

City/State/Zip: ______________________________________________________________________________________________________

Telephone: _________________________________________________________________________________________________________

Email: _____________________________________________________________________________________________________________



fax:312.440.9474



• Nomineemustbeanactivememberof IAHCSMM• Thetopicofthepapermustfocuson understanding the importance of decontamination in their workplace• Previouslypublishedpaperswillnotbe considered for this award• Papersmustbepresentedinessay form,typedandatleast1,000words or less in length• Referencesmustbegiveninstandard citation form• Author’snameandcontactinformation must appear on the title page

• Pagesmustbenumbered• Allsubmissionsmustincludeavitae sheet on the author

All papers will be judged by Anne Cofiell or her designee.

The Decontaminator of the Year nom-ination form must be completed and returned with the required submission documents.

Decontaminator of the Year AwardannE cofiEllThis award was established in honor of Anne Cofiell. Cofiell was an active member of IAHCSMM until her retirement in 2006.AnneservedastheIAHCSMMrepresentativetoAAMIwhere she chaired numerous working groups. Cofiell also authored many articles and spoke on CS topics at IAHCSMM conferences and at numerous educational programs around thecountry.ShewaswellconnectedinWashingtonD.C.andwas an advocate on behalf of the Central Service profession for the regulation of reuse of single-use devices to include the importance of proper cleaning instructions. The recipient of this award will be recognized during the 2014IAHCSMMAnnualConferenceandExpoandwillreceivean engraved plaque, plus a monetary award in the amount of$1,000.


healthmarkINDUSTRIES CO.

health care products

800-521-6224www.hmark.com

The Decontaminator of the Year Award, spon-sored by Healthmark, recognizes the author of an outstanding paper focusing on understand-ing the importance of decontamination in their workplace environment.

Sponsored by

deconTaMinaTor of The Year award noMinaTion forM

Name of Nominee: __________________________________________________________________________________________________

Title: ______________________________________________________________________________________________________________


Address: ___________________________________________________________________________________________________________

City/State/Zip: ______________________________________________________________________________________________________

Telephone: _________________________________________________________________________________________________________

Email: _____________________________________________________________________________________________________________

Nominated by: _____________________________________________________________________________________________________

Title: ______________________________________________________________________________________________________________


Address: ___________________________________________________________________________________________________________

City/State/Zip: ______________________________________________________________________________________________________

Telephone: _________________________________________________________________________________________________________

Email: _____________________________________________________________________________________________________________



fax:312.440.9474



• Nominationsforthisawardmustbe submitted by an IAHCSMM member, an affiliated chapter member, or an administrator in their facility• TheConfidenceBuilderAward Nomination form just be completed and returned with the required submission documents. Be sure to include names of the team Manager/Supervi- sor and all participants

• Includeabriefwrittendescription(one page or less) of the Confidence Building program or initiative and include results achieved to date. (Include photographs, video clips or supporting documents, if available)• Applicationswillbescoredbasedon innovation and impact of the program in building CS team confidence and capability• Onlyprogramsoractivitiesbegunor completedbetweenJanuary1,2013, andDecember31,2013,areeligible for consideration

Confidence Builder AwardTo enter, tell us what your team is doing to build confidence within your CS to deliver the best in instrument processing. Examplescouldbeeducationprogramsorevents,team-build-ing activities, mentoring programs, improving policies and pro-cedures, training (including manufacturer inservices on proper handling, etc.) and other key initiatives for the CS staff. Thewinningteamwillberecognizedduringthe2014IAHCSMMAnnualConferenceandExpo,andwillreceive:• A$1,000educationalgrantfromKimberly-Clark• Healthcareindustryandlocalcommunityrecognitionthrough news releases and features in the Kimberly-Clark Wrap Sheet e-newsletter.• AcommemorativeConfidenceBuilderAwardplaque.


Sponsored by

The Confidence Builder Award recognizes a Central Service team that is building confi-dence within their orga-nization with programs that empower the team and the hospital to de-liver the best in patient outcomes.

confidence BUiLder award noMinaTion forMTitleofEntry: _______________________________________________________________________________________________________

ParticipatingDepartment(s): _________________________________________________________________________________________

Hospital: ___________________________________________________________________________________________________________

Address: ___________________________________________________________________________________________________________

City/State/Zip ______________________________________________________________________________________________________

Submitted by (name): _______________________________________________________________________________________________

Title: ______________________________________________________________________________________________________________


Address: ___________________________________________________________________________________________________________

City/State/Zip: ______________________________________________________________________________________________________

Telephone: _________________________________________________________________________________________________________

Email: _____________________________________________________________________________________________________________

Names/titles of all program participants: _______________________________________________________________________________

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fax:312.440.9474



• Nomineemustbeanactivememberof IAHCSMM in good standing for at least one year• Thecandidatemustbeinvolvedin humanitarian causes at the local, state or national level

SubmissionDocuments:• CompletedHumanitarianAward Nomination Form• Aone-pagestatementdetailingthe nominee’s humanitarian efforts, including their years of participation (supporting documentation of humanitarian efforts is required)

Humanitarian AwardTheWilliamB.DennisHumanitarianAwardwasestablishedbytheformerASHCSPinhonorandmemoryofBillDennis,whopassedawayinJanuary2001.It’sanawardand tradition that IAHCSMM is pleased to continue offering its members. DenniswasanactivememberofhislocalCentralServicechapter,theNorthCaro-linaHospitalCentralServiceAssociation,andDirectorofSterileProcessingatDukeUniversityHospitalinDurham,NC.AmemberofASHCSPformorethan20years,DennisservedasPresidentandontheBoardofDirectors,andwasanationallyrecognized leader in the Central Service field. He was on numerous committees and spokeatvariousconferences,andwasthe1983recipientofASHCSP’shighesthon-or–theLeonardLeipusAward.In1982,hereceivedtheDr.JohnJ.PerkinsAwardforhis contributions to the field. Dennisalsohadadeepcommitmenttohumanitariancauses.Heactivelyprovidedhumanitarian aid through church organizations, and traveled to Panama and Cuba todistributemuch-neededmedicalsupplies.Inthemid-70s,Dennisencouraged African-Americans and women to move into prominent positions within his department,farbeyondtheconventionsandexpectationsofthetime. Friendsandco-workersdescribedDennisasmodest,generousandalwaysreadyto crack a joke. He was committed to his vocation and to his outside philanthropic endeavors.MuchlikeDennis,therecipientofthisawardexemplifiesadeepcommit-ment to humanitarian issues and the Central Service field. This annual scholarship, now being awarded by IAHCSMM, is intended to promote professional development by assisting in ongoing education, and can be used to fund an IAHCSMM member’s annual conference attendance or other educational activity leading to professional development and certification. Therecipientofthisawardwillberecognizedduringthe2014IAHCSMMAnnualConferenceandExpo,andwillreceiveanengravedplaque,plusamonetaryawardintheamountof$1,000.


Note: IAHCSMM members may receive this award one time only.

Sponsored by

The Humanitarian Award recognizes a person who exemplifies a deep commitment to human-itarian issues and the Central Service field.

hUManiTarian award noMinaTion forM

Name of Nominee: __________________________________________________________________________________________________

Title: ______________________________________________________________________________________________________________


Address: ___________________________________________________________________________________________________________

City/State/Zip: ______________________________________________________________________________________________________

Telephone: _________________________________________________________________________________________________________

Email: _____________________________________________________________________________________________________________

Nominated by: _____________________________________________________________________________________________________

Title: ______________________________________________________________________________________________________________


Address: ___________________________________________________________________________________________________________

City/State/Zip: ______________________________________________________________________________________________________

Telephone: _________________________________________________________________________________________________________

Email: _____________________________________________________________________________________________________________



fax:312.440.9474



IAHCSMM-Purdue University Scholarship AwardsIAHCSMM and Purdue University join together to offer two different schol-arships. The purpose of these awards is to provide financial assistance to individuals who wish to continue their educational and individual growth. Two categories have been established for these awards:1.CentralServiceTechnicians2.CentralServiceManagers/Supervisors

One winner in each category will receive a free registration and all course materials for the respective Purdue/IAHCSMM non-credit correspondence course. (These awards are nontransferable, and all course requirements must be met for successful completion.) If a suitable applicant is not found in a category, that award will not be given until the following year. Applicants will be evaluated on the following criteria from the complet-ed application, personal essay and letter of reference from an immediate supervisor.1.Financialneed2.Interestinpursuingeducationalandindividualgrowthgoals3. Participation in activities (Association, hospital department, community)4.YearsofserviceinCentralService. Applicants must complete the approved application and send it, along with their personal essay and a letter of reference to:

John WellmanIAHCSMM-Purdue Scholarship AwardsDistanceLearningPURDUEUNIVERSITYStewartCenterG-59128MemorialMallWestLafayette,IN47907-2034

All applications will be reviewed by a representative from IAHCSMM and Purdue University. The recipients of the scholarships will be announced at the 2014 Annual Conference and Expo. All decisions of the panel will be final.

Sponsored by

iahcsMM – PUrdUe UniversiTY schoLarshiP awards noMinaTion forMApplication for (check one) Correspondence Courses

q Central Service Technical Training q Supervision Principles: Leadership Strategies for Healthcare Facilities

Name _____________________________________________________________________________________________________________

Home Address _____________________________________________________________________________________________________

Telephone _________________________________________________________________________________________________________

Business Address __________________________________________________________________________________________________

Business Telephone _____________________________________Email _____________________________________________________

Immediate Supervisor’s Name ________________________________________________________________________________________

IAHCSMM Status q Member q Non-Member

YearsofServiceintheCentralServiceDepartmentand/orMaterialManagement ___________________________________________

Activities (describe): Association, hospital department, community, volunteer, or other.

1. _________________________________________________________________________________________________________________

2 _________________________________________________________________________________________________________________

3. _________________________________________________________________________________________________________________

personal Essay:Pleaseattacha150-wordessaydescribingyourinterestinpursuingeducationalgoalsforindividualandpersonalimprovement,your financial need, and any other information that would be helpful in understanding why you wish to be awarded this scholarship.

letter of reference:Pleaseattachone(1)letterofreferencefromyourimmediatesupervisorverifyingyourcurrentemploymentandattestingtoyourinterest in receiving this scholarship.

mail completed application and required material to:John WellmanIAHCSMM-Purdue Scholarship AwardsDistanceLearningPurdue UniversityStewartCenterG-59•128MemorialMallWestLafayette,IN47907-2034


ChapterswishingtoparticipateintheChapteroftheYearAwardsmustsubmitanapplicationalongwiththeirAnnualRecharter,byFebruary1,2014.Formore informationortorequesttheChapteroftheYearapplication,pleasecontact SusanAdamsat800.962.8274.

Chapter of the Year AwardsChapteroftheYearAwardsaregivenintwoCategories:•LargeChapteroftheYear–Chapterswithover50IAHCSMM members•SmallChapteroftheYear–Chapterwithfewerthan50 IAHCSMM members Winners of each category will receive an engraved plaque, plusamonetaryawardintheamountof$1,500fromSTERISCorporation.DeterminationofoutstandingChaptersisdeter-minedbyapointsystemofsubmittedmaterials.Extraordinaryaccomplishments, originality and creativity of materials will be favorably considered when selecting the winning entry.

Sponsored by

The Chapter of the Year Awards, sponsored by STERIS Corporation, recognizes an IAHCSMM Chapter that has significantly advanced and embraced the Central Service in 2013.


oHIo2014 IAHCSMM

Annual Conference

& Expo

May 4 -7, 2014Columbus Convention Center

Columbus, Ohio (Pre-Conference Events available May 3, 2014)

Plan ahead for….

International Association of Healthcare Central Service Materiel Management

55 West Wacker Drive, Suite 501, Chicago, IL 60601

www.iahcsmm.org