Please enable JavaScript in your browser to complete this form.What is a FISH? FISH stands for Facilitating Innovation for Service, Support, and Savings in Healthcare. The FISH Form is your official entry into the Shark Tank. By submitting this form, you are asking the Shark Tank Review Committee to analyze your idea and help you bring it to life.Entries will be recognized and rewarded on various levels! No idea is too big or too small! ALL FIELDS ARE REQUIRED.Name *FirstLastEmail *Please enter your email, so we can follow up with you.Phone NumberPlease provide a phone number where you can be reached.Department *1. What is the current problem/situation? *What is wrong or could be improved? Describe in detail the present practice, condition, method, etc., that you believe should be changed.2. What is your proposed solution/recommendation? *Specifically describe your proposed improvement. 3. How will your idea eliminate the problem or improve the current method, procedure, or working conditions? *4. How will your idea increase productivity or improve the quality of work performed? *5. How does your idea improve working conditions (morale) or reduce safety hazards? *6. Does this solution save us time, money, stress, or hassle? *7. How does this solution generate revenue for the hospital or a specific department? *8. How will implementing this idea better Jefferson Regional as an organization? *9.) List the steps of your procedure. How would your idea be implemented? *10.) What role will you play in the implementation of your plan/solution? *File UploadIf there is any additional documentation that you feel is relevant, upload it here. Multiple files should be in a zip. Note: If your entry meets Shark Tank criteria, you will receive correspondence from a committee member within 30 days.NameSubmit
