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form ketepatan identifikasi Pasien

Pengam Sebelum
Hari/Tanggal Pemberi Pemberian Pemberian bilan melakukan
No Pasien
an Obat Nutrisi Darah Specime tindakan
n diagnostik
3/9/2019 1 By.Ny.D B 1 1 1 1 1
4/9/2019 1 By.Ny.P.S 1 1 1 1 1
5/9/2019 1 By.Ny.P.S 1 1 1 1 1
6/9/2019 1 By.Ny.P.S 1 1 1 1 1
7/9/2019 1 By.Ny.P.S 1 1 1 1 1
8/9/2019 1 By.Ny.P.S 1 1 1 1 1
2 By.Ny. Y.N 1 1 1 1 1
9/9/2019 1 By.Ny.P.S 1 1 1 1 1
2 By.Ny. Y.N 1 1 1 1 1
10/9/2019 1 By.Ny.P.S 1 1 1 1 1
2 By.Ny. Y.N 1 1 1 1 1
3 By.Ny. B. L 1 1 1 1 1
11/9/2019 1 By.Ny.P.S 1 1 1 1 1
2 By.Ny. B. L 1 1 1 1 1
3 By.Ny. R.N 1 1 1 1 1
12/9/2019 1 By.Ny.P.S 1 1 1 1 1
2 By.Ny. B. L 1 1 1 1 1
3 By.Ny. R.N 1 1 1 1 1
13/9/2019 1 By.Ny.P.S 1 1 1 1 1
2 By.Ny. R.N 1 1 1 1 1
17/09/2019 1 By.Ny. E.K 1 1 1 1 1
18/09/2019 1 By.Ny. E.K 1 1 1 1 1
19/09/2019 1 By.Ny. Y.S 1 1 1 1 1
2 By.Ny. O.B 1 1 1 1 1
20/09/2019 1 By.Ny. Y.S 1 1 1 1 1
2 By.Ny. O.B 1 1 1 1 1
3 By.Ny. M.B 1 1 1 1 1
21/09/2019 1 By.Ny. Y.S 1 1 1 1 1
2 By.Ny. O.B 1 1 1 1 1
3 By.Ny. M.B 1 1 1 1 1
22/09/2019 1 By.Ny. O.B 1 1 1 1 1
2 By.Ny. M.B 1 1 1 1 1
3 By.Ny. A.P 1 1 1 1 1
4 BY.NY. D.A II 1 1 1 1 1
5 BY.NY.D.A I 1 1 1 1 1
23/09/2019 1 By.Ny. O.B 1 1 1 1 1
2 By.Ny. M.B 1 1 1 1 1
3 BY.NY. D.A II 1 1 1 1 1
4 BY.NY.D.A I 1 1 1 1 1
24/09/2019 1 By.Ny. O.B 1 1 1 1 1
2 By.Ny. M.B 1 1 1 1 1
3 BY.NY. D.A II 1 1 1 1 1
4 BY.NY.D.A I 1 1 1 1 1
5 BY.NY.n.o 1 1 1 1 1
25/09/2019 1 By.Ny. M.B 1 1 1 1 1
2 BY.NY. D.A II 1 1 1 1 1
3 BY.NY.D.A I 1 1 1 1 1
4 BY.NY.n.o 1 1 1 1 1
5 BY.D.K 1 1 1 1 1
6 BY.D.S 1 1 1 1 1
26/09/2019 1 BY.NY. D.A II 1 1 1 1 1
2 BY.NY.D.A I 1 1 1 1 1
3 BY.D.K 1 1 1 1 1
4 BY.D.S 1 1 1 1 1
5 NY.NY. M.T 1 1 1 1 1
27/09/2019 1 BY.NY. D.A II 1 1 1 1 1
2 BY.NY.D.A I 1 1 1 1 1
3 BY.D.K 1 1 1 1 1
4 BY.D.S 1 1 1 1 1
5 NY.NY. M.T 1 1 1 1 1
28/09/2019 1 BY.D.S 1 1 1 1 1
2 NY.NY. M.Ta 1 1 1 1 1
Denominator

5 3
5 13
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
5
Form Ketepatan jam visite dokter spesialis
Nama Pasien : BY.NY.D.B

Tanggal/ Waktu Visite Keteranga


No Hari Rawat Visite
n
Ke
<14.00 ≥14.00
3/9/2019
1 dr. Dodik 09.00 - 10.00
(1)

Nama Pasien : BY.NY.P.S


Waktu Visite
Tanggal/
Keteranga
No Hari Rawat Visite
<14.00 ≥14.00 n
Ke

4/9/2019
1 dr. Dodik 09.00 - 10.00
(1)
5/9/2019
2 dr. Dodik 09.00 - 10.00
(2)
6/9/2019
3 dr. Dodik 09.00 - 10.00
(3)
7/9/2019
4 dr. Dodik 09.00 - 10.00
(4)
8/9/2019
5 dr. Dodik Hari minggu
(5)
9/9/2019
6 dr. Dodik 09.00 - 10.00
(6)
10/9/2019
7 dr. Dodik 09.00 - 10.00
(7)
11/9/2019
8 dr. Dodik 09.00 - 10.00
(8)
12/9/2019
9 dr. Dodik 09.00 - 10.00
(9)
13/9/2019
10 dr. Dodik 09.00 - 10.00
(10)

Nama Pasien : BY.NY.Y.N


Waktu Visite
Tanggal/
Keteranga
No Hari Rawat Visite
<14.00 ≥14.00 n
Ke

8/9/2019
1 dr. Dodik Hari minggu
(1)
9/9/2019
2 dr. Dodik 09.00 - 10.00
(2)
10/9/2019
3 dr. Dodik 09.00 - 10.00
(3)
Nama Pasien : BY.NY.B.L
Tanggal/ Waktu Visite
Keteranga
No Hari Rawat Visite
<14.00 ≥14.00 n
Ke
10/9/2019
1 dr. Dodik 09.00 - 10.00
(1)
11/9/2019
2 dr. Dodik 09.00 - 10.00
(2)
12/9/2019
3 dr. Dodik 09.00 - 10.00
(3)

Nama Pasien : BY.NY.R.N


Tanggal/ Waktu Visite
Keteranga
No Hari Rawat Visite
<14.00 ≥14.00 n
Ke
11/9/2019
1 dr. Dodik 09.00 - 10.00
(1)
12/9/2019
2 dr. Dodik 09.00 - 10.00
(2)
13/9/2019
3 dr. Dodik 09.00 - 10.00
(3)

Nama Pasien : BY.NY.E.K


Tanggal/ Waktu Visite
Keteranga
No Hari Rawat Visite
<14.00 ≥14.00 n
Ke

17/9/2019
1 dr. Dodik 09.00 - 10.00
(1)
18/9/2019
2 dr. Dodik 09.00 - 10.00
(2)

Nama Pasien : BY.NY.Y.S


Tanggal/ Waktu Visite
Keteranga
No Hari Rawat Visite
<14.00 ≥14.00 n
Ke
19/9/2019
1 dr. Dodik 09.00 - 10.00
(1)
20/9/2019
2 dr. Dodik 09.00 - 10.00
(2)
21/9/2019
3 dr. Dodik 09.00 - 10.00
(3)

Nama Pasien : BY.NY.O.B


Tanggal/ Waktu Visite
Keteranga
No Hari Rawat Visite
<14.00 ≥14.00 n
Ke
19/9/2019
1 dr. Dodik 09.00 - 10.00
(1)
20/9/2019
2 dr. Dodik 09.00 - 10.00
(2)
21/9/2019
3 dr. Dodik 09.00 - 10.00
(3)
22/9/2019
4 dr. Dodik Hari minggu
(4)
23/9/2019
5 dr. Dodik 09.00 - 10.00
(5)
24/9/2019
6 dr. Dodik 09.00 - 10.00
(6)
Nama Pasien : BY.NY.M.B
Tanggal/ Waktu Visite Keteranga
No Hari Rawat Visite
n
Ke <14.00 ≥14.00
20/9/2019
1 dr. Dodik 09.00 - 10.00
(1)
21/9/2019
2 dr. Dodik 09.00 - 10.00
(2)
22/9/2019
3 dr. Dodik Hari minggu
(3)
23/9/2019
4 dr. Dodik 09.00 - 10.00
(4)
24/9/2019
5 dr. Dodik 09.00 - 10.00
(5)
25/9/2019
6 dr. Dodik 09.00 - 10.00
(6)
Nama Pasien : BY.NY.A.P
Tanggal/ Waktu Visite
Keteranga
No Hari Rawat Visite
<14.00 ≥14.00 n
Ke
22/9/2019
1 dr. Dodik 09.00 - 10.00 Hari minggu
(1)
Nama Pasien : BY.NY.D.A I
Tanggal/ Waktu Visite
Keteranga
No Hari Rawat Visite
<14.00 ≥14.00 n
Ke
22/9/2019
1 dr. Dodik Hari minggu
(1)
23/9/2019
2 dr. Dodik 09.00 - 10.00
(2)
24/9/2019
3 dr. Dodik 09.00 - 10.00
(3)
25/9/2019
4 dr. Dodik 09.00 - 10.00
(4)
26/9/2019
5 dr. Dodik 09.00 - 10.00
(5)
27/9/2019
6 dr. Dodik 09.00 - 10.00
(6)
Nama Pasien : BY.NY.D.A II
Tanggal/ Waktu Visite
Keteranga
No Hari Rawat Visite
<14.00 ≥14.00 n
Ke
22/9/2019
1 dr. Dodik Hari minggu
(1)

2 23/9/2019 dr. Dodik 09.00 - 10.00


(2)
24/9/2019
3 dr. Dodik 09.00 - 10.00
(3)
25/9/2019
4 (4) dr. Dodik 09.00 - 10.00

26/9/2019
5 dr. Dodik 09.00 - 10.00
(5)
27/9/2019
6 dr. Dodik 09.00 - 10.00
(6)
Nama Pasien : BY.NY.N.O
Tanggal/ Waktu Visite
Keteranga
No Hari Rawat Visite
<14.00 ≥14.00 n
Ke

22/9/2019
1 dr. Dodik Hari minggu
(1)
23/9/2019
2 dr. Dodik 09.00 - 10.00
(2)
Nama Pasien : BY.D.K
Tanggal/ Waktu Visite
Keteranga
No Hari Rawat Visite
<14.00 ≥14.00 n
Ke
24/9/2019
1 dr. Dodik 09.00 - 10.00
(1)
25/9/2019
2 dr. Dodik 09.00 - 10.00
(2)
Nama Pasien : BY.D.S
Waktu Visite
Tanggal/
Keteranga
No Hari Rawat Visite
<14.00 ≥14.00 n
Ke

24/9/2019
1 dr. Dodik 09.00 - 10.00
(1)
25/9/2019
2 dr. Dodik 09.00 - 10.00
(2)
26/9/2019
3 dr. Dodik 09.00 - 10.00
(3)
27/9/2019
4 dr. Dodik 09.00 - 10.00
(4)
28/9/2019
5 dr. Dodik 09.00 - 10.00
(5)
Nama Pasien : BY.NY.M.T
Tanggal/ Waktu Visite
Keteranga
No Hari Rawat Visite
<14.00 ≥14.00 n
Ke

1 26/9/2019 dr. Dodik 09.00 - 10.00


(1)
27/9/2019
2 dr. Dodik 09.00 - 10.00
(2)
Nama Pasien : BY.NY.M.Ta
Tanggal/ Waktu Visite
Keteranga
No Hari Rawat Visite
<14.00 ≥14.00 n
Ke
28/9/2019
1 dr. Dodik 09.00 - 10.00
(1)
Formulir kecepatan respon terhadap komplain
Kategori Waktu Waktu Keterang
Tanggal No Nama Pasien No. RM Komplain Komplain selesai an
3/9/2019 1 By.Ny.D B 044929
4/9/2019 By.Ny.P.S 044938
8/9/2019 By.Ny. Y.N 045044
10/9/2019 By.Ny. B. L 045092
11/9/2019 By.Ny. R.N 043728
17/9/2019 By.Ny. E.K 045203
19/9/2020 By.Ny.Y.S 039156
19/9/2020 By.Ny. O.B 044660
20/9/2020 By.Ny. M.B 045336
22/9/2020 By.Ny. A. P 045267
22/9/2021 By.Ny. D.A I 045369
22/9/2022 By.Ny. D.A II 045370
24/9/2020 By.Ny. N.O 045321
25/9/2020 By.D.K 045416
25/9/2020 By.D. S 044938
26/9/2021 By.Ny.M.T 045485
28/9/2022 By.Ny.M.Ta 045489
ketepatan waktu pemberian ASI

Tanggal No Nama Pasien No. RM waktu Keterangan


<48 j > 48 j
3/9/2019 1 By.Ny.D B 044929
4/9/2019 By.Ny.P.S 044938
8/9/2019 By.Ny. Y.N 045044
10/9/2019 By.Ny. B. L 045092
11/9/2019 By.Ny. R.N 043728
17/9/2019 By.Ny. E.K 045203
19/9/2020 By.Ny.Y.S 039156
19/9/2020 By.Ny. O.B 044660
20/9/2020 By.Ny. M.B 045336
22/9/2020 By.Ny. A. P 045267
22/9/2021 By.Ny. D.A I 045369
22/9/2022 By.Ny. D.A II 045370
24/9/2020 By.Ny. N.O 045321
25/9/2020 By.D.K 045416
25/9/2020 By.D. S 044938
26/9/2021 By.Ny.M.T 045485
28/9/2022 By.Ny.M.Ta 045489

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