Dept.

/Unit/: ___________________

(Manager keep original and send co

Date: __________________________________ Initiated by: _____________

No

What is the concern or opportunity

for improvement?

. HOSPITAL
IDENTIFICATION AND TRACKING SHEET POTENTIAL OPPORTUNITY FOR

__________

(Manager keep original and send copy to Dept Head and to Quality Mgt.)

____________________ Initiated by: ________________________________________

How do you know this is

an opportunity for improvement?

How does this (or could this)

affect consumer care?

TIAL OPPORTUNITY FOR IMPROVEMENT PERFORMANCE

ad and to Quality Mgt.)

________________

What action(s) could be taken, and

What are the possible causes
by whom to resolve the concern or
or sources of the situation?
improve care/services?

QUALITY IMPROVEMENT PROJECT WORKS

PROJECT TITLE :
TEAM LEADER
TEAM MEMBER :

WHO WILL BENEFIT :

PROBLEM / OPPORTUNITY STATEMENT
(WHAT'S WRONG WITH QUALITY ?)
AIM :
(WHAT ARE WE TRYING TO ACCOMPLISH?)
SMART : (TARGET & TIME)
MEASURE :
STRUCTURE MEASURES :
PROCESS MEASURES :
OUTCOME MEASURES :

PATIENTS/

CLIENTS/

VEMENT PROJECT WORKSHEET

FAMILY /

STFF

FLOW CHART

FISHBO
Number of Main Causes:

Methods
Manpower

..

..

Environment
Machines

FISHBONE DIAGRAM

..

..

..

..

Material

0
0
0
0
0
0

Causes

Criteria
Impact on
patient
Reputation
Acceptance
Time
Needed
Total Score

SKOR
PROBABILIT
Y

Level
1
2

Frekuensi
Sangat jarang
Jarang

Kejadian
Dapat terjadi dalam l
Dapat terjadi dalam 2

Mungkin

Dapat terjadi tiap 1

Sering

Dapat terjadi beberap

setahun

Sangat sering

Terjadi dalam minggu

SEVERITY

Level

DESKRIPSI

I nsignifcant

Minor

CONT

Tidak ada cedera,

Dapat

diatasi den

Level

DESKRIPSI

I nsignifcant

Minor

Moderate

Major

CONT

Tidak ada cedera,

Dapat diatasi den

kerugian keuanga
Berkurangnya

fu
psi k ol ogi s at a
semipermanent
berhubungan den
Setiap kasus
perawatan
Cedera luas
Kehilangan

fun

(motorik,
intelektual), perm
berhubungan den
Kerugian keuang
5

Cathastropic

Kematian

yang t
perjalanan penyak
Kerugian keuang

Kejadian aktual
at terjadi dalam lebih dari 5 tahun
at terjadi dalam 2 5 tahun

at terjadi tiap 1 2 tahun

at terjadi beberapa kali dalam

etahun

adi dalam minggu / bulan

CONTOH DESKRIPSI

dak ada cedera, kerugian keuangan kecil

Dapat diatasi dengan pertolongan pertama,

CONTOH DESKRIPSI

dak ada cedera, kerugian keuangan kecil

Dapat diatasi dengan pertolongan pertama,

kerugian keuangan sedang

Berkurangnya fungsi motorik / sensorik /

si k ol ogi s at au i nt el ek tua l secar a
emipermanent / reversibel / tidak
erhubungan dengan penyakit
Setiap kasus yang memperpanj ang
erawatan

Cedera luas
Kehilangan fungsi utama
permanent
motorik,
sensorik, psikologis,
ntelektual), permanen / irreversibel/ tidak
erhubungan dengan penyakit
Kerugian keuangan besar

Kematian yang tidak berhubungan dengan

erjalanan penyakit.
Kerugian keuangan sangat besar.

n kecil

pertama,

n kecil

pertama,

ensorik /
secar a
/ tidak

panj ang

rmanent
sikologis,
el/ tidak

n dengan

Pareto Analysis
[Brief Project Description]
[Date]

[Chart Title]
25

100%

20

80%

15

60%

10

40%

20%

Defects

Cumulative %

[42]

0%

Causes
Vital Few

Useful Many

[42]

Labels

Cumulative%

Cut Off %

The first 9 Causes cover 84.42% of the Total Defects

Cumulative Percentage Cutoff:

# Causes
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15

2009 Vertex42 LLC

Less number of experience and special dentist

No Policy
Finish patient one by one
Material not available
Short of experience Technicians
Increase Load of Patients
Space for lab not enough.
Low Encouraged Culture
No Computer available to save data
Not Fixed one responsible on waiting list
Patient not came in his appointment
Waiting list not accurate because hand writing
Patient Late more than three times

80%

Defects

Cumulative%

20
18
16
16
14
14
12
10
10
8
6
6
4

13.0%
24.7%
35.1%
45.5%
54.5%
63.6%
71.4%
77.9%
84.4%
89.6%
93.5%
97.4%
100.0%
100.0%
100.0%

Templates by Vertex42.com

ACTION PLAN TOOL

WHAT
ACTION 1
ACTION 2
ACTION 3
ACTION 4

WHO

WHEN

WHERE

Gantt Chart

Version 1.7.3

[Project Name]
[Company Name]
Project Lead: [Name]
Start Date: 1/2/2012

Monday

[42]

Tasks

Task
Lead

Task Category 1

[Name]

1.1
1.2

WBS

Start

End
1/2/12

1/31/12

Sub Task level 2

1/2/12

1/6/12

Sub Task level 2

1/7/12

1/11/12

1.2.1

Sub Task level 3

1/12/12

1/16/12

1.2.2

Sub Task level 3

1/17/12

1/21/12

1.3

Sub Task level 2

1/22/12

1/26/12

1.4

Sub Task level 2

1/27/12

1/31/12

Task Category 2

1/2/12

1/27/12

2.1

Sub Task level 2

1/2/12

1/6/12

2.2

Sub Task level 2

1/9/12

1/13/12

2.3

Sub Task level 2

1/16/12

1/20/12

2.4

Sub Task level 2

1/23/12

1/27/12

Task Category 3

1/2/12

1/28/12

3.1

Sub Task level 2

1/2/12

1/7/12

3.2

Sub Task level 2

1/9/12

1/14/12

3.3

Sub Task level 2

1/16/12

1/21/12

3.4

Sub Task level 2

1/23/12

1/28/12

Task Category 4

1/2/12

1/21/12

4.1

Sub Task level 2

1/2/12

1/6/12

4.2

Sub Task level 2

1/7/12

1/11/12

4.3

Sub Task level 2

1/12/12

1/16/12

4.4

Sub Task level 2

1/17/12

1/21/12

[Name]

[Name]

[Name]

TEMPLATE ROWS: Copy and insert the entire section, or just the specific sub tasks, depending on which level you want to use (formulas are different for diff

Task Category 1

1/5/09

1/5/09

1.1

Sub Task level 2

1/5/09

1/5/09

1/5/09

1/5/09

1/5/09

1/5/09

1.1.1
1.1.1.1

Level 3 Task
Level 4 task

 2006-2012 Vertex42 LLC

HELP

Today's Date:

2/24/2009

Days Remaining

(vertical red line)

Duration
(Days)

% Complete

Working Days

Days Complete

First Day of Week (Mon=2):

30

0%

22

30

0%

0%

0%

0%

0%

0%

26

25%

20

20

25%

25%

25%

25%

27

50%

20

13

14

50%

50%

50%

50%

20

0%

15

20

0%

0%

0%

0%

ch level you want to use (formulas are different for different WBS levels)

0%

0%

0%

0%

Tuesday

1/16/2012

1/17/2012

1/18/2012
16 - Jan - 12

1/9/2012###
09 - Jan - 12

1/2/2012
02 - Jan - 12

16 - Jan - 12

1/19/2012

1/20/2012

1/21/2012

1/22/2012

1/23/2012

1/25/2012

1/26/2012
23 - Jan - 12

1/24/2012

1/27/2012

1/28/2012

1/30/2012

1/31/2012

2/1/2012

2/2/2012
30 - Jan - 12

1/29/2012

2/4/2012

2/5/2012

2/6/2012

2/7/2012
06 - Feb - 12

30 - Jan - 12

2/3/2012

2/9/2012
06 - Feb - 12

2/8/2012

2/10/2012

2/11/2012

2/12/2012

2/14/2012

2/15/2012

2/16/2012
13 - Feb - 12

2/13/2012

2/17/2012

2/19/2012

2/20/2012

2/21/2012

2/22/2012
20 - Feb - 12

2/18/2012

20 - Feb - 12

2/23/2012

2/24/2012

2/25/2012

2/26/2012

2/27/2012

2/29/2012

3/1/2012
27 - Feb - 12

2/28/2012

3/2/2012

3/3/2012

3/5/2012

3/6/2012

3/7/2012

3/8/2012
05 - Mar - 12

3/4/2012

3/10/2012

3/11/2012

3/12/2012

3/13/2012
12 - Mar - 12

05 - Mar - 12

3/9/2012

3/15/2012
12 - Mar - 12

3/14/2012

3/16/2012

3/17/2012

3/18/2012

3/20/2012

3/21/2012

3/22/2012
19 - Mar - 12

3/19/2012

3/23/2012

3/25/2012

3/26/2012

3/27/2012

3/28/2012
26 - Mar - 12

3/24/2012

26 - Mar - 12

3/29/2012

3/30/2012

3/31/2012

4/1/2012

4/2/2012

4/4/2012

4/5/2012
02 - Apr - 12

4/3/2012

4/6/2012

4/7/2012

4/9/2012

4/10/2012

4/11/2012

4/12/2012
09 - Apr - 12

4/8/2012

4/14/2012

4/15/2012

4/16/2012

4/17/2012
16 - Apr - 12

09 - Apr - 12

4/13/2012

4/19/2012
16 - Apr - 12

4/18/2012

4/20/2012

4/21/2012

4/22/2012

4/24/2012

4/25/2012

4/26/2012
23 - Apr - 12

4/23/2012

4/27/2012

4/29/2012

4/30/2012

5/1/2012

5/2/2012
30 - Apr - 12

4/28/2012

30 - Apr - 12

5/3/2012

5/4/2012

5/5/2012

5/6/2012

5/7/2012

5/9/2012

5/10/2012
07 - May - 12

5/8/2012

5/11/2012

5/12/2012

5/14/2012

5/15/2012

5/16/2012

5/17/2012
14 - May - 12

5/13/2012

5/19/2012

5/20/2012

5/21/2012

5/22/2012
21 - May - 12

14 - May - 12

5/18/2012

5/24/2012
21 - May - 12

5/23/2012

5/25/2012

5/26/2012

5/27/2012

5/29/2012

5/30/2012

5/31/2012
28 - May - 12

5/28/2012

6/1/2012

6/3/2012

6/4/2012

6/5/2012

6/6/2012
04 - Jun - 12

6/2/2012

04 - Jun - 12

6/7/2012

6/8/2012

6/9/2012

6/10/2012

6/11/2012

6/13/2012

6/14/2012
11 - Jun - 12

6/12/2012

6/15/2012

6/16/2012

6/18/2012

6/19/2012

6/20/2012

6/21/2012
18 - Jun - 12

6/17/2012

6/23/2012

6/24/2012

6/25/2012

6/26/2012
25 - Jun - 12

18 - Jun - 12

6/22/2012

6/28/2012
25 - Jun - 12

6/27/2012

6/29/2012

6/30/2012

7/1/2012

7/3/2012

7/4/2012

7/5/2012
02 - Jul - 12

7/2/2012

7/6/2012

7/8/2012

7/9/2012

7/10/2012

7/11/2012
09 - Jul - 12

7/7/2012

09 - Jul - 12

7/12/2012

7/13/2012

7/14/2012

7/15/2012

7/16/2012

7/18/2012

7/19/2012
16 - Jul - 12

7/17/2012

7/20/2012

7/21/2012

7/23/2012

7/24/2012

7/25/2012

7/26/2012
23 - Jul - 12

7/22/2012

7/28/2012

7/29/2012

7/30/2012

7/31/2012
30 - Jul - 12

23 - Jul - 12

7/27/2012

8/2/2012
30 - Jul - 12

8/1/2012

8/3/2012

8/4/2012

8/5/2012

8/7/2012

8/8/2012

8/9/2012
06 - Aug - 12

8/6/2012

8/10/2012

8/12/2012

8/13/2012

8/14/2012

8/15/2012
13 - Aug - 12

8/11/2012

13 - Aug - 12

8/16/2012

8/17/2012

8/18/2012

8/19/2012

8/20/2012

8/22/2012

8/23/2012
20 - Aug - 12

8/21/2012

8/24/2012

8/25/2012

8/26/2012

Graphs of Key Measures

Put Your Center Name Here

LATIHAN SOAL ENTRI DATA INDIKATOR

Month

Pasien Baru
(Denum)

Pengkajian Awal
selesai dlm wkt
24 j (Num)

Jumlah Pasien yg
Melakukan
Pemeriksaan Kritis

Pemeriksaan Kritis

Waktu Pelaporan
Hasil Kritis < 1 jam

Waktu pelaporan

Jan

#N/A

100

feb

#N/A

80.0

maret

#N/A

80

90.0

april

#N/A

90

45.0

mei

#N/A

juni

#N/A

juli

#N/A

agustus

#N/A

september

#N/A

okt

#N/A

nov

#N/A

des

#N/A

50.0

#N/A
#N/A
#N/A
#N/A

#DIV/0!

Graphs of Key Measures

Put Your Center Name Here

Goal for
% with
Notification
w/in 1 hr

Goal for Acknowledgement Time

100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100
100

60
60
60
60
60
60
60
60
60
60
60
60
60
60
60
60
60