Here is my table of contents. I modeled this from a manual called "JCAHO Standards for Volunteer Departments" published by CAHHS published in 1998. The manual is no longer available.
I. MISSION
•A. Mission, Vision and Values of Saint Joseph Health System
•B. Organizational Philosophy and Goals
•C. Mission Statement of Volunteer Services
•II. ORGANIZATIONAL CHARTS
•A. Saint Joseph Health System Organizational Chart
•B. Organizational Chart for Volunteer Services
•III. PATIENT RIGHTS
•IV. SCOPE OF SERVICE
•V. BUDGETS
•A. Saint Joseph Hospital - Volunteer Services: Department Budget - Fiscal Year July - June
•B. Saint Joseph East - Volunteer Services: Department Budget - Fiscal Year July - June
•VI. POLICIES AND PROCEDURES
•088-VS-001 Age-Appropriate Care
•088-VS-002 Alcohol and Drugs
•088-VS-003 Awards
•088-VS-004 Volunteer Benefits
•088-VS-005 Volunteer Competency Assessment
•088-VS-006 Confidentiality
•088-VS-007 Contingency Backup Plan
•088-VS-008 Safety Management Disaster Plan
•088-VS-009 Dress Code for Volunteers
•088-VS-010 Equal Opportunity
•088-VS-011 Evaluation
•088-VS-012 Food and Beverages
Addendum: 094-WR-5
•088-VS-013 Grievance
•088-VS-014 Identification Badges and Time Reporting
•088-VS-015 Infection Control
•088-VS-016 Purpose of Volunteer Handbook and Policy Manual
•088-VS-017 Records Administration and Retention
•088-VS-018 Selection and Placement of In-Service Volunteers
•088-VS-019 Orientation for In-Service Volunteers
•088-VS-020 Selection and Placement of Non-Traditional Volunteers
•088-VS-021 Volunteer Services by College Students
•088-VS-022 Volunteer Services by Teens
•088-VS-023 Volunteer Services by Adults
•088-VS-024 Sexual Harassment
•088-VS-025 Solicitation or Distribution of Literature
Addendum: 094-GP-8
•088-VS-026 Use of Telephones and Personal Pagers
Addendum: 094-WR-21
•088-VS-027 Utility Plan
•088-VS-028 Volunteer Placement with Relatives
•088-VS-029 Volunteer Services by Employees
•088-VS-030 Volunteer Service in Patient Care Areas
Addendum: PCS-VII-08B
•088-VS-031 Discipline/Termination of Volunteer
•088-VS-033 Patient Representative Program
Addendum: 093-P-85H
Additional Hospital Policies and Information:
Letter: Insurance Coverage for Injured Volunteers
081-RMP-010D: Incident/Accident Reporting-Variance Reports
094-E-34: Human Resources - Agency, Contract, and Volunteer Personnel
098-D-11B: Chaplaincy Services - Volunteers
098-PS-1B: Chaplaincy Services - Department Orientation
098-PS-18B: Chaplaincy Services – Temporary Help
098-R-3C: Chaplaincy Services – Memorial Services
EMS-VII-10A: Emergency Department – Volunteers in the E.D.
PCS-II-09C: Patient Care – Discharge of Patients
PCS-VII-33B: Patient Care – Plan for Provision of Patient Care Services
Document: Saint Joseph Health System Corporate Responsibility Plan
•VII. HIPAA SECURITY
•A. Computer and Software HIPAA Security Policy (088-VS-032)
•B. Application Specialist Task List
•C. Memorandum Regarding HIPAA Policy 8 – Volgistics
•D. Memorandum Regarding HIPAA Policy 8 – Maternity Education
•E. 093-SEC -08 Physical and Environmental Security
•F. Memorandum Regarding HIPAA Policy 9 – Maternity Education
•G. 093-SEC-09 Access Controls
•H. Memorandum Regarding HIPAA Policy 11 - Volgistics
•I. Volgistics Service Agreement
•J. 093-SEC-11 Internet Use and Access
•K. 093-SEC-14 Remote Computer Access
•L. 093-SEC-16 Change Management
•M. 093-SEC-20 Electronic Signatures
•N. 093-SEC-21 Monitoring Security Events
•O. Memorandum Regarding HIPAA Policy 25 – Volgistics
•P. Memorandum Regarding HIPAA Policy 25 – Maternity Education
•Q. 093-SEC-25 Business Continuity Planning
•R. Memorandum Regarding HIPAA Policy 26 - Volgistics
•S. Memorandum Regarding HIPAA Policy 26 – Maternity Education
•T. 093-SEC-26 Software Licenses and Copyrights
•VIII. VOLUNTEER ASSIGNMENT DESCRIPTIONS
•IX. Material Safety Data Sheets
