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How to save the PDF
- Click Download PDF. Your browser's print window opens with a clean, formatted copy of the agreement.Pop-up blocked? Press Ctrl+P (Windows) or Cmd+P (Mac).
- Set the destination or printer to Save as PDF.On a Mac, that's the PDF button at the bottom. On an iPhone or iPad, tap Share, then Save to Files.
- Save it, then send it to everyone who signed, and to the owner if they weren't in the room.Want to keep editing later? Use Save progress file and open it here again.
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This agreement comes from Module 2 of TRIAGE™, PIVOT's leadership program: name the owner, define authority, set escalation, and don't take it back. Hospitals enroll their leaders together.
See team enrollmentAbout this worksheet
What is a leadership role agreement?
A short written agreement between a hospital's leaders about who owns each recurring responsibility, what that person can decide without asking, when an issue moves up and to whom, and what support makes the role workable. It turns "I thought you had that" into one named owner.
Who should fill it in?
The medical director, practice manager, and nursing or technician lead, together. If one person holds two of those roles, list both roles. Include the owner or hospital director when the agreement changes role scope, staffing, or budget.
How often should we review it?
Set a first check-in about 30 days out, then review it whenever a leader joins or leaves, or a responsibility keeps coming back to the wrong person.