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Quality, Planning & Performance Policies & Forms

Policy #TitleRationaleDateSummaryLink
ORG.1810.PL.004Research Application and Approval ProcessTo establish the process for conducting an operational impact assessment on research applications submitted to Southern Health-Santé Sud, and to ensure research adheres to regulatory standards within our organizational framework.Oct 20, 2025
ORG.1810.PL.004.FORM.01.FApplication to Conduct Research French | ARCHIVE NOTICEOct 20, 2025
ORG.1810.PL.004.FORM.01Application to Conduct Research | ARCHIVE NOTICEOct 20, 2025
ORG.1810.PL.004.FORM.0lResearch AgreementTo establish the process for conducting an operational impact assessment on research applications submitted to Southern Health-Santé Sud, and to ensure research adheres to regulatory standards within our organizational framework.Oct 20, 2025
ORG.1810.PL.006Recalls and Alerts ARCHIVE NOTICEJul 21, 2025
ORG.1810.PL.006.SD.02Management of a Recall Alert Checklist for Food ARCHIVE NOTICEJul 21, 2025
ORG.1810.PL.006.SD.03Management of a Recall Alert Checklist for Medication ARCHIVE NOTICEJul 21, 2025
ORG.1810.PL.006.SD.01Management of a Recall Alert Checklist for Equipment and or Product ARCHIVE NOTICEJul 21, 2025
ORG.1810.PL.005.FORM.01Ethical Decision Making FrameworkJun 16, 2025
ORG.1810.PL.005Ethical Decision MakingMay 5, 2025
ORG.1810.PL.005.SD.01Ethical Decision Making PosterMay 5, 2025
ORG.1810.PL.005.FORM.02Tracking Ethical Dilemma Discussion FormApr 14, 2025
ORG.1810.PL.010.SD.10Mandatory Reporting PosterFeb 10, 2025
ORG.1810.PL.001.FORM.01Safety Event ReportUpdate after hours information under Notifications section of reportAug 28, 2024
Quality Improvement Plan TemplateJul 2, 2024
ORG.1810.PL.003.SD.01Compliments and Concerns Management ChecklistTo simplify the complaint process as there were 19 documents attached to the previous policy. The revised P&P title was modified as Compliments and Concerns Management to improve staff morale, productivity and retention. It has a total of 3 documents.Mar 1, 2024
ORG.1810.PL.003Compliments and Concerns ManagementTo simplify the complaint process as there were 19 documents attached to the previous policy. The revised P&P title was modified as Compliments and Concerns Management to improve staff morale, productivity and retention. It has a total of 3 documents.Mar 1, 2024
ORG.1810.PL.003.FORM.01Compliment and Concern FormMar 1, 2024
ORG.1810.PL.010Mandatory ReportingMandatory Reporting for Manitoba Advocate for Children and Youth added as new. Any reference to an occurrence report was updated to reflect a Safety Event Report.Jan 1, 2024
ORG.1810.PL.010.FORM.01Gunshot and Stab Wound Mandatory Reporting FormMandatory Reporting for Manitoba Advocate for Children and Youth added as new. Any reference to an occurrence report was updated to reflect a Safety Event Report.Jan 1, 2024
ORG.1810.PL.010.SD.08Management of Reportable Diseases and Conditions ChecklistMandatory Reporting for Manitoba Advocate for Children and Youth added as new. Any reference to an occurrence report was updated to reflect a Safety Event Report.Jan 1, 2024
ORG.1810.PL.010.SD.09Management of Manitoba Advocate for Children and Youth ChecklistMandatory Reporting for Manitoba Advocate for Children and Youth added as new. Any reference to an occurrence report was updated to reflect a Safety Event Report.Jan 1, 2024
ORG.1810.PL.010.FORM.02Serious Injury Report FormJan 1, 2024
ORG.1810.PL.010.SD.07Management of a Reportable Medical Condition Posing a Danger to Operate a Motor Vehicle ChecklistJan 1, 2024
ORG.1810.PL.009.FORM.03Prospective Analysis Executive SummaryFMEA P&P revised to Prospective Analysis utilizing the Canadian Incident Analysis Framework(CIAF). The CIAF can be used either retrospectively reviewing past events or prospectively (looking forward) to prevent/mitigate harm. To standardize the analysis process of reviews utilizing one methodology.Oct 12, 2023
ORG.1810.PL.009.FORM.01Prospective Analysis InvitationFMEA P&P revised to Prospective Analysis utilizing the Canadian Incident Analysis Framework(CIAF). The CIAF can be used either retrospectively reviewing past events or prospectively (looking forward) to prevent/mitigate harm. To standardize the analysis process of reviews utilizing one methodology.Oct 12, 2023
ORG.1810.PL.009Prospective AnalysisFMEA P&P revised to Prospective Analysis utilizing the Canadian Incident Analysis Framework(CIAF). The CIAF can be used either retrospectively reviewing past events or prospectively (looking forward) to prevent/mitigate harm. To standardize the analysis process of reviews utilizing one methodology.Oct 12, 2023
ORG.1810.PL.009.SD.01Prospective Analysis Checklistrevised to Prospective Analysis utilizing the Canadian Incident Analysis Framework(CIAF). The CIAF can be used either retrospectively reviewing past events or prospectively (looking forward) to prevent/mitigate harm. To standardize the analysis process of reviews utilizing one methodology.Oct 12, 2023
ORG.1810.PL.009.FORM.02Prospective Analysis TemplateFMEA P&P revised to Prospective Analysis utilizing the Canadian Incident Analysis Framework(CIAF). The CIAF can be used either retrospectively reviewing past events or prospectively (looking forward) to prevent/mitigate harm. To standardize the analysis process of reviews utilizing one methodology.Aug 11, 2023
ORG.1810.PL.001.SD.01Safety Event Report Resource GuideMay 10, 2023
ORG.1810.PL.001Safety Event ReportingMay 10, 2023
ORG.1810.PL.001.SD.04Management of a Critical Occurrence ChecklistMay 10, 2023
ORG.1810.PL.001.SD.03Management of a Critical Incident ChecklistMay 10, 2023
ORG.1810.PL.001.SD.02Management of a Near Miss and Occurrence ChecklistMay 10, 2023
ORG.1810.PL.010.SD.01Management of a Serious Adverse Drug Reactions and Medical Device Incidents ChecklistMar 27, 2023
ORG.1810.SG.004.SD.01Duty to Warn Guideline ChecklistMar 27, 2023
ORG.1810.SG.004.FORM.01Duty to Warn Guideline FormMar 27, 2023
ORG.1810.SG.004Duty to Warn GuidelineMar 27, 2023
ORG.1810.PL.010.SD.03Management of a Gunshot and Stab Wound ChecklistMar 27, 2023
ORG.1810.PL.010.SD.06Management of a Sexually Transmitted and Blood Borne Infection ChecklistMar 27, 2023
ORG.1810.PL.010.SD.02Management of an Adverse Event Following Immunization ChecklistMar 27, 2023
ORG.1810.PL.010.SD.04Management of Suspected Adult Abuse and Neglect ChecklistMar 27, 2023
ORG.1810.PL.010.SD.05Management of Suspected Child Abuse and Neglect ChecklistMar 27, 2023
ORG.1810.PL.002.FORM.01Disclosure Record to Clients Patients and FamiliesJan 5, 2023
ORG.1810.PL.002Disclosure Process Critical IncidentsJan 5, 2023
ORG.1810.PL.011.FORM.01Tool for Guided Learning and DiscussionDec 1, 2022
ORG.1810.PL.011Patient Safety Learning AdvisoryDec 1, 2022
ORG.1810.PL.008Audit Client ServiceOct 4, 2021
ORG.1810.PL.008.FORM.01Regional Annual Audit Schedule TEMPLATEOct 4, 2021
ORG.1810.PL.008.SD.01Regional Audit GuideOct 4, 2021
ORG.1810.PL.008.FORM.02Regional Audit Report TemplateOct 4, 2021
ORG.1810.SG.001.FORM.01Occurrence Data Request FormJan 26, 2017
ORG.1810.SG.001Occurrence Data Request GuidelineMay 26, 2015

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