FORM PENGUMPULAN DATA INDIKAT

JUDUL INDIKATOR :PELAPORAN HASIL KRITIS LABORATORIUM <30 MENIT (100%)

UNIT / BULAN : LABORATORIUM/ NOVEMBER 2021

Tanggal keluar Jam keluar hasil

No No RM Diagnosa Medik hasil kritis kritis laboratorium
laboratorium (pkl……WIB)

1 2 3 4 5
1 35279 DIABETES MELLITUS 11/1/2021 9:37:00
Spontaneous vertex
2 42964 delivery 11/3/2021 21:38:00
3 42080 Anaemia, unspecified 11/5/2021 13:05:00
Essential (primary)
4 50213 hypertension 11/6/2021 16:44:00
5 58020 - 11/7/2021 2:20:00
6 58038 - 11/8/2021 0:34:00
Other and unspecified
7 46982 abdominal pain 11/8/2021 23:55:00
Other specified
8 58232 postsurgical states 11/11/2021 17:17:00
Feeding problem of
9 57877 newborn, unspecified 11/11/2021 18:45:00
Feeding problem of
10 34847 newborn, unspecified 11/12/2021 5:17:00
11 58390 Febrile convulsions 11/16/2021 3:45:00
Care and examination
12 58482 Follow-up
immediatelyexamination
after delivery 11/17/2021 22:11:00
after other treatment for
13 58482 other conditions 11/17/2021 20:14:00
14 58434 - 11/17/2021 9:09:00
15 58446 - 11/17/2021 13:34:00
16 58526 - 11/19/2021 0:41:00
17 28906 - 11/19/2021 9:44:00
18 58635 Anaemia, unspecified 11/21/2021 15:37:00
Other and unspecified
19 58640 abdominal pain 11/21/2021 17:13:00
20 58606 - 11/20/2021 11:10:00
21 39835 - 11/23/2021 14:42:00
22 38068 Hypertensive heart
Pneumonia, unspecified 11/24/2021 6:57:00
disease without
23 28906 (congestive) heart failure 11/25/2021 15:37:00
24 45367 - 11/28/2021 6:40:00
25 29490 Congestive heart failure 11/29/2021 18:13:00
26 58570 - 11/30/2021 17:59:00
27
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161
162
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167
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169
170
171
172
173
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175
176
177
178
179
180
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182
183
184
185
186
187
188
189
190
191
192
193
194
195
196
197
198
199
200

KESIMPULAN (%) :

PIC DATA
LAN DATA INDIKATOR MUTU

30 MENIT (100%)

Tanggal pelaporan Jam pelaporan hasil Rentang < 30 Menit

hasil kritis kritis laboratorium Waktu
laboratorium (pkl……WIB) (kolom 7-5) (Ö)

6 7 8 9

11/1/2021 9:52:00 0:15:00 ✔

11/3/2021 21:50:00 0:12:00 ✔

11/5/2021 13:25:00 0:20:00 ✔

11/6/2021 16:50:00 0:06:00 ✔

11/7/2021 2:27:00 0:07:00 ✔

11/8/2021 0:50:00 0:16:00 ✔

11/8/2021 0:05:00 0:10:00 ✔

11/11/2021 17:25:00 0:08:00 ✔

11/11/2021 18:55:00 0:10:00 ✔

11/12/2021 5:33:00 0:16:00 ✔

11/16/2021 3:55:00 0:10:00 ✔

11/17/2021 22:31:00 0:20:00 ✔

11/17/2021 20:25:00 0:11:00 ✔

11/17/2021 9:19:00 0:10:00 ✔

11/17/2021 13:54:00 0:20:00 ✔

11/19/2021 0:50:00 0:09:00 ✔

11/19/2021 9:50:00 0:06:00 ✔

11/21/2021 15:42:00 0:05:00 ✔

11/21/2021 17:18:00 0:05:00 ✔

12/20/2021 11:20:00 0:10:00 ✔

11/23/2021 14:52:00 0:10:00 ✔

11/24/2021 7:12:00 0:15:00 ✔

11/25/2021 15:45:00 0:08:00 ✔

11/28/2021 6:55:00 0:15:00 ✔

11/29/2021 18:23:00 0:10:00 ✔

11/30/2021 18:10:00 0:11:00 ✔

JUMLAH PASIEN 673

JUMLAH PELAPORAN HASIL KRITIS LABORATORIUM <30 MENIT= 251

JUMLAH SAMPEL PERHITUNGAN 251

251 / 251 = 100%

 FORM PENGUMPULAN DATA INDIKAT

JUDUL INDIKATOR :PELAPORAN HASIL KRITIS LABORATORIUM <30 MENIT

UNIT / BULAN : LABORATORIUM/DESEMBER 2021

Tanggal keluar Jam keluar hasil

No No RM Diagnosa Medik hasil kritis kritis laboratorium
laboratorium (pkl……WIB)

1 2 3 4 5
Care and examination
1 59042 immediately after delivery 12/1/2021 22:47:00

Non-insulin-dependent
2 45367 -diabetes mellitus with 12/1/2021 6:44:00
peripheral circulatory
3 59045 complications 12/2/2021 10:46:00
Other and unspecified
4 49256 abdominal pain 12/3/2021 14:49:00
Other and unspecified
5 49256 abdominal pain 12/3/2021 10:48:00

6 59114 - 12/3/2021 14:49:00

7 59185 - 12/5/2021 12:49:00

Acute nasopharyngitis
8 34356 [common cold] 12/5/2021 10:36:00
Other specified
9 42798 postsurgical states 12/7/2021 0:51:00
Care and examination
10 59336 immediately after delivery 12/8/2021 13:30:00
Care and examination
11 59272 immediately after delivery 12/9/2021 7:28:00

12 59396 -Non-insulin-dependent 12/9/2021 17:38:00

diabetes mellitus without
13 57671 complications
Refractory anaemia 12/10/2021 16:25:00
without sideroblasts, so
14 59493 stated 12/12/2021 7:23:00
Care and examination
15 59106 immediately after delivery 12/12/2021 9:01:00

16 59642 - 12/14/2021 15:15:00

17 29490 Congestive heart failure 12/15/2021 13:54:00

18 39564 - 12/16/2021 1:51:00

19 58245 - 12/17/2021 0:25:00

20 39835 -Anaemia due to other 12/22/2021 8:18:00

disorders of glutathione
21 38838 metabolism 12/19/2021 21:39:00

22 59882 - 12/21/2021 6:33:00

23
24
25
26
27
28
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171
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180
181
182
183
184
185
186
187
188
189
190
191
192
193
194
195
196
197
198
199
200

KESIMPULAN (%) :

PIC DATA
LAN DATA INDIKATOR MUTU

30 MENIT

Tanggal pelaporan Jam pelaporan hasil Rentang < 30 Menit

hasil kritis kritis laboratorium Waktu
laboratorium (pkl……WIB) (kolom 7-5) (Ö)

6 7 8 9

✔
12/1/2021 22:57:00 0:10:00
✔
12/1/2021 6:54:00 0:10:00
✔
12/2/2021 10:55:00 0:09:00
✔
12/3/2021 14:59:00 0:10:00
✔
12/3/2021 10:56:00 0:08:00
✔
12/3/2021 14:59:00 0:10:00
✔
12/5/2021 12:55:00 0:06:00
✔
12/5/2021 10:40:00 0:04:00
✔
12/7/2021 1:10:00 0:19:00
✔
12/8/2021 13:40:00 0:10:00
✔
12/9/2021 7:43:00 0:15:00
✔
12/9/2021 17:48:00 0:10:00
✔
12/10/2021 16:35:00 0:10:00
✔
12/12/2021 7:35:00 0:12:00
✔
12/12/2021 9:15:00 0:14:00
✔
12/14/2021 15:30:00 0:15:00
✔
12/15/2021 14:00:00 0:06:00
 ✔
12/16/2021 2:00:00 0:09:00
✔
12/17/2021 0:35:00 0:10:00
✔
12/22/2021 8:28:00 0:10:00
✔
12/19/2021 21:49:00 0:10:00
✔
12/21/2021 6:40:00 0:07:00
 FORM PENGUMPULAN DATA INDIKATOR MUTU NAS

6. JUDUL INDIKATOR : PELAPORAN HASIL KRITIS LABORATORIUM ≤30 MENIT (100%)

UNIT / BULAN : LABORATORIUM / JANUARI 2022

Jam keluar hasil kritis

Tanggal keluar hasil
No No RM Diagnosa Medik laboratorium (pkl……
kritis laboratorium
WIB)
1 2 3 4 5
p3a0 post partum spontan rw
1 58409 pendarahan post partum 1/6/2022 9:50:00
primer
2 60850 - 1/15/2022 12:36:00
3 47299 - 1/21/2022 22:07:00
4 61195 - 1/25/2022 17:10:00
Haematemesis, Melaena,
5 61285 Hereditary sideroblastic 1/26/2022 20:26:00
anaemia

Hypertensive heart disease

6 35423 with (congestive) heart failure 1/31/2022 12:00:00

Fever, unspecified, febris ec

7 45432 laukositosis ec infeksi 1/31/2022 14:45:00
bakterial anemia melena LBP
8 44038 - 1/1/2022 13:33:00
9 59288 - 1/1/2022 15:55:00
10 60363 - 1/2/2022 17:15:00
11 60363 1/3/2022 6:03:00
Prolonged first stage (of
12 48958 1/4/2022 14:13:00
labour)
13 60520 - 1/5/2022 13:10:00
Care and examination
14 26967 1/8/2022 15:39:00
immediately after delivery
15 35376 Thypoid fever 1/10/2022 0:43:00
Other and unspecified
16 60720 1/11/2022 17:00:00
convulsions, Dyspepsia
17 38916 - 1/12/2022 11:15:00
Prolonged first stage (of
18 60462 labour), Spontaneous vertex 1/12/2022 15:00:00
delivery
19 60803 - 1/13/2022 19:14:00
20 38916 - 1/14/2022 6:23:00
21 48584 - 1/15/2022 0:45:00
22 60881 - 1/16/2022 18:00:00
23 37638 - 1/17/2022 7:06:00
24 60174 - 1/17/2022 9:10:00
25 59812 - 1/17/2022 17:55:00
26 60945 - 1/18/2022 1:07:00
27 60976 - 1/19/2022 11:00:00
Other specified surgical
28 13679 1/21/2022 14:17:00
follow-up care
29 60705 - 1/21/2022 22:00:00
30 59915 - 1/24/2022 20:05:00
Haematemesis,Melaena,Here
31 61285 1/26/2022 20:35:00
ditary sideroblastic anaemia
32 36620 - 1/27/2022 3:45:00
33 61301 - 1/27/2022 11:20:00
34 61426 - 1/30/2022 21:15:00
35 61469 Prolonged first stage (of 1/31/2022 21:11:00
labour)
36 36620 - 1/27/2022 3:40:00
Surgical follow-up care,
37 60426 1/4/2022 9:42:00
unspecified
38 60976 - 1/19/2022 11:00:00

A. JUMLAH HASIL KRITIS LABORATORIUM YANG DILAPORKAN ≤30 MENIT =

B. JUMLAH HASIL KRITIS LABORATORIUM YANG DIOBSERVASI (Total Sampel) =

KESIMPULAN A / B X 100 (%) =

A INDIKATOR MUTU NASIONAL (IMN)

Jam pelaporan hasil

Tanggal pelaporan hasil Rentang Waktu ≤ 30 Menit
kritis laboratorium
kritis laboratorium (kolom 7-5) (Y=1)
(pkl……WIB)
6 7 8 9

1/6/2022 10:08:00 0:18:00 1

1/15/2022 12:46:00 0:10:00 1

1/21/2022 22:17:00 0:10:00 1
1/25/2022 17:20:00 0:10:00 1

1/26/2022 20:36:00 0:10:00 1

1/31/2022 12:10:00 0:10:00 1

1/31/2022 14:52:00 0:07:00 1

1/1/2022 13:43:00 0:10:00 1

1/1/2022 16:02:00 0:07:00 1
1/2/2022 17:20:00 0:05:00 1
1/3/2022 6:10:00 0:07:00 1
1/4/2022 14:23:00 0:10:00 1

1/5/2022 13:21:00 0:11:00 1

1/8/2022 15:49:00 0:10:00 1

1/10/2022 0:48:00 0:05:00 1

1/11/2022 17:05:00 0:05:00 1

1/12/2022 11:22:00 0:07:00 1

1/12/2022 15:11:00 0:11:00 1

1/13/2022 19:22:00 0:08:00 1

1/14/2022 6:33:00 0:10:00 1
1/15/2022 0:52:00 0:07:00 1
1/16/2022 18:05:00 0:05:00 1
1/17/2022 7:16:00 0:10:00 1
1/17/2022 9:15:00 0:05:00 1
1/17/2022 18:00:00 0:05:00 1
1/18/2022 1:12:00 0:05:00 1
1/19/2022 11:10:00 0:10:00 1

1/21/2022 14:25:00 0:08:00 1

1/21/2022 22:10:00 0:10:00 1

1/24/2022 20:15:00 0:10:00 1

1/26/2022 20:40:00 0:05:00 1

1/27/2022 3:53:00 0:08:00 1

1/27/2022 11:25:00 0:05:00 1
1/30/2022 21:25:00 0:10:00 1
1/31/2022 21:21:00 0:10:00 1
1/27/2022 3:55:00 0:15:00 1

1/4/2022 9:50:00 0:08:00 1

1/19/2022 11:15:00 0:15:00 1

PENGUMPUL DATA
38 (Data Sekunder Laporan Hasil Tes Kritis Laboratorium)

38

100 GALIH SETIADI, AMD. AK

 FORM PENGUMPULAN DATA INDIKATOR MUTU NAS

6. JUDUL INDIKATOR : PELAPORAN HASIL KRITIS LABORATORIUM ≤30 MENIT (100%)

UNIT / BULAN : LABORATORIUM / FEBRUARI 2022

Jam keluar hasil kritis

Tanggal keluar hasil
No No RM Diagnosa Medik laboratorium (pkl……
kritis laboratorium
WIB)

1 2 3 4 5

1 061985 - 2/14/2022 14,06

Premature rupture of
2 001349 membranes, onset of 2/20/2022 16.05
labour within 24 hours
3 062408 2/23/2022 10.00
4 039564 2/23/2022 14.43
5 062628 2/28/2022 13.44
Spontaneous vertex
delivery, g2p1a0 uk
6 045086
41+1mgg inpartu kala
2/2/2022 16.11
2+GH+Hbsag(+)

7 060581 Cellulitis, unspecified 2/3/2022 13.44

8 061646 2/4/2022 15.18
9 061317 2/5/2022 23.46
Febrile convulsions, Fever,
10 061706 Acute abdomen, Diarrhoea 2/6/2022 14.25
unspecified
11 050711 and gastroenteritis of 2/7/2022 23.27
presumedKronic
Bronkitis infectious origin
Terinfeksi
12 061841 2/9/2022 14.36
Dispneu
13 061875 2/10/2022 20.18

14 018848 2/13/2022 6.02

Follow-up examination after

15 038178 other treatment for other 2/12/2022 19.21
conditions

16 061969 2/14/2022 15.13

17 061531 2/18/2022 8.42

18 062296 2/21/2022 11.38

19 017253 2/24/2022 10.21

20 062466 2/24/2022 13.09
21 062554 2/27/2022 4.22
22 062612 Anaemia, unspecified, Dysp 2/28/2022 15.45
A. JUMLAH HASIL KRITIS LABORATORIUM YANG DILAPORKAN ≤30 MENIT =

B. JUMLAH HASIL KRITIS LABORATORIUM YANG DIOBSERVASI (Total Sampel) =

KESIMPULAN A / B X 100 (%) =

A INDIKATOR MUTU NASIONAL (IMN)

Jam pelaporan hasil

Tanggal pelaporan hasil Rentang Waktu ≤ 30 Menit
kritis laboratorium
kritis laboratorium (kolom 7-5) (Y=1)
(pkl……WIB)

6 7 8 9

2/14/2022 14.20 14.00 1

2/20/2022 16.30 25.00 1

2/23/2022 10.15 15.00 1

2/23/2022 14.53 10.00 1
2/28/2022 13.55 11.00 1

2/2/2022 16.25 14.00 1

2/3/2022 13.55 11.00 1

2/4/2022 15.38 20.00 1
2/5/2022 23.59 13.00 1
2/6/2022 14.35 10.00 1
2/7/2022 23.38 11.00 1

2/9/2022 14.55 19.00 1

2/10/2022 20.29 11.00 1

2/13/2022 6.20 18.00 1

2/12/2022 19.35 14.00 1

2/14/2022 15.33 20.00 1

2/18/2022 8.58 16.00 1

2/21/2022 11.50 12.00 1

2/24/2022 10.39 18.00 1

2/24/2022 13.34 25.00 1
2/27/2022 4.39 17.00 1
2/28/2022 15.59 14.00 1
 PIC DATA

22 (Data Sekunder Laporan Hasil Tes Kritis Laboratorium)

22

100 GALIH SETIADI, AMD. AK

 FORM PENGUMPULAN DATA INDIKATOR MUTU NAS

6. JUDUL INDIKATOR : PELAPORAN HASIL KRITIS LABORATORIUM ≤30 MENIT (100%)

UNIT / BULAN : LABORATORIUM / MARET 2022

Jam keluar hasil kritis

Tanggal keluar hasil
No No RM Diagnosa Medik laboratorium (pkl……
kritis laboratorium
WIB)

1 2 3 4 5
Other specified postsurgical
1 037170 3/14/2022 03:51:00 PM
states
2 63057 - 3/13/2022 06:51:00 PM
Iron deficiency anaemia
3 43442 secondary to blood loss 3/26/2022 02:17:00 PM
(chronic)
4 63090 - 3/14/2022 04:06:00 PM
5 63228 - 3/18/2022 06:48:00 PM
6 63347 - 3/23/2022 11:09:00 AM
7 62742 - 3/4/2022 11:06:00 AM
Other specified postsurgical
8 37170 3/17/2022 07:20:00 AM
states
9 62371 - 3/18/2022 12:00:00 PM
10 63042 - 3/13/2022 03:23:00 AM
Other specified postsurgical
11 37170 3/18/2022 12:04:00 PM
states
12 62371 - 3/23/2022 06:33:00 AM
13 62371 - 3/23/2022 10:46:00 AM
14 63386 - 3/24/2022 05:58:00 PM
15 63042 - 3/13/2022 03:23:00 AM
16 61981 - 3/18/2022 11:13:00 PM
17 62694 - 3/2/2022 01:37:00 PM
18 62905 - 3/9/2022 10:09:00 AM
19 62371 - 3/1/2022 12:20:00 PM
20 38312 - 3/11/2022 08:58:00 AM
21 62371 - 3/18/2022 12:00:00 PM
22 63257 - 3/19/2022 07:02:00 PM
23 63011 - 3/12/2022 07:31:00 AM
24 61539 - 3/10/2022 02:09:00 AM
25 63241 - 3/19/2022 07:31:00 AM
26 62818 - 3/7/2022 01:13:00 AM
27 62694 - 3/2/2022 01:37:00 PM
28 62748 - 3/4/2022 01:55:00 PM
29 62746 - 3/4/2022 11:45:00 AM
30 62680 - 3/4/2022 09:23:00 AM
31 37170 - 3/14/2022 03:51:00 PM
32 62975 - 3/17/2022 07:09:00 AM
33 43442 - 3/26/2022 02:32:00 PM
34 63057 - 3/13/2022 06:51:00 PM
35 63090 - 3/14/2022 04:06:00 PM
36 62742 - 3/4/2022 11:06:00 AM
37 63228 - 3/18/2022 06:49:00 PM
38 63042 - 3/13/2022 03:23:00 AM
39 62371 - 3/18/2022 12:00:00 PM
40 63347 - 3/23/2022 11:09:00 AM
41 37170 - 3/17/2022 07:20:00 AM
42 60863 - 3/25/2022 11:28:00 AM
43 62371 - 3/20/2022 09:05:00 AM
Follow-up examination after
44 38312 other treatment for other 3/13/2022 10:35:00 AM
conditions
45 61636 - 3/28/2022 13:05
46 59576 - 3/2/2022 02:18:00 PM
47 36766 - 3/24/2022 08:55:00 PM
48 038316 - 29/03/2022 10:10

A. JUMLAH HASIL KRITIS LABORATORIUM YANG DILAPORKAN ≤30 MENIT =

B. JUMLAH HASIL KRITIS LABORATORIUM YANG DIOBSERVASI (Total Sampel) =

KESIMPULAN A / B X 100 (%) =

A INDIKATOR MUTU NASIONAL (IMN)

Jam pelaporan hasil

Tanggal pelaporan hasil Rentang Waktu ≤ 30 Menit
kritis laboratorium
kritis laboratorium (kolom 7-5) (Y=1)
(pkl……WIB)

6 7 8 9
3/14/2022 04:05:00 PM 12:14:00 AM 1

3/13/2022 07:05:00 PM 12:14:00 AM 1

3/26/2022 02:32:00 PM 12:15:00 AM 1

3/14/2022 16:17 12:11:00 AM 1

3/18/2022 18:59 12:11:00 AM 1
3/23/2022 11:25 12:16:00 AM 1
3/4/2022 11:16 12:10:00 AM 1
3/17/2022 07:35 12:15:00 AM 1
3/18/2022 12:20:00 PM 12:20:00 AM 1
3/13/2022 03:43 12:20:00 AM 1
3/18/2022 12:24 12:20:00 AM 1
3/23/2022 06:43 12:10:00 AM 1
3/23/2022 10:59 12:13:00 AM 1
3/24/2022 18:10 12:12:00 AM 1
3/13/2022 03:43 12:20:00 AM 1
3/18/2022 23:25 12:12:00 AM 1
3/2/2022 13:47 12:10:00 AM 1
3/9/2022 10:20 12:11:00 AM 1
3/1/2022 12:35 12:15:00 AM 1
3/11/2022 09:15 12:17:00 AM 1
3/18/2022 12:25 12:25:00 AM 1
3/19/2022 19:12 12:10:00 AM 1
3/12/2022 07:41 12:10:00 AM 1
3/10/2022 02:19 12:10:00 AM 1
3/19/2022 07:41 12:10:00 AM 1
3/7/2022 01:24 12:11:00 AM 1
3/2/2022 13:47 12:10:00 AM 1
3/4/2022 14:15 12:20:00 AM 1
3/4/2022 11:55 12:10:00 AM 1
 3/4/2022 09:43 12:20:00 AM 1
3/14/2022 16:11 12:20:00 AM 1
3/17/2022 07:19 12:10:00 AM 1
3/26/2022 14:43 12:11:00 AM 1
3/13/2022 19:10 12:19:00 AM 1
3/14/2022 16:16 12:10:00 AM 1
3/4/2022 11:26 12:20:00 AM 1
3/18/2022 18:59 12:10:00 AM 1
3/13/2022 03:45 12:22:00 AM 1
3/18/2022 12:22 12:22:00 AM 1
3/23/2022 11:29 12:20:00 AM 1
3/17/2022 07:35 12:15:00 AM 1
3/25/2022 11:48 12:20:00 AM 1
3/20/2022 09:29 12:24:00 AM 1

3/13/2022 10:55 12:20:00 AM 1

3/28/2022 13:25 12:20:00 AM 1

3/2/2022 14:38 12:20:00 AM 1
3/24/2022 21:20 12:25:00 AM 1
29/03/2022 10:25 12:15:00 AM 1

PIC DATA

48 (Data Sekunder Laporan Hasil Tes Kritis Laboratorium)

48

100 GALIH SETIADI, AMD. AK

 FORM PENGUMPULAN DATA INDIKATOR MUTU N

6. JUDUL INDIKATOR : PELAPORAN HASIL KRITIS LABORATORIUM ≤30 MENIT (100%)

UNIT / BULAN : LABORATORIUM / APRIL 2022

Jam keluar hasil kritis

Tanggal keluar hasil
No No RM Diagnosa Medik laboratorium (pkl……
kritis laboratorium
WIB)
1 2 3 4 5
1 063565 - 4/1/2022 10:45:00 AM

2 063555 Other specified aplastic 4/2/2022 06:31:00 AM

anaemias
3 063599 - 4/3/2022 08:49:00 AM

4 063638 - 4/5/2022 08:15:00 AM

5 063681 - 4/6/2022 08:20:00 PM

6 063657 - 4/7/2022 06:00:00 AM

7 063657 - 4/7/2022 07:50:00 AM

8 063657 - 4/8/2022 06:00:00 AM

9 062746 Prolonged first stage (of 4/9/2022 11:57:00 PM

labour)
10 057997 - 4/11/2022 08:31:00 PM

11 063764 - 4/11/2022 09:53:00 PM

12 063786 - 4/13/2022 06:22:00 AM

13 062701 - 4/13/2022 06:22:00 AM

14 64065 - 4/27/2022 06:13:47 PM

15 63913 - 4/25/2022 06:13:00 PM
16 63913 - 4/19/2022 05:21:00 PM
17 64117 - 4/30/2022 09:56:34 AM
18 63913 - 4/26/2022 06:32:15 AM
19 36816 - 4/30/2022 02:43:37 AM
20 64002 - 4/25/2022 11:51:30 AM

JUMLAH HASIL KRITIS LABORATORIUM YANG DILAPORKAN >30 MENIT

A. JUMLAH HASIL KRITIS LABORATORIUM YANG DILAPORKAN ≤30 MENIT =

B. JUMLAH HASIL KRITIS LABORATORIUM YANG DIOBSERVASI (Rumus Slovin) =

KESIMPULAN A / B X 100 (%) =

ATA INDIKATOR MUTU NASIONAL

Jam pelaporan hasil

Tanggal pelaporan hasil Rentang Waktu
kritis laboratorium ≤ 30 Menit
kritis laboratorium (kolom 7-5)
(pkl……WIB)
6 7 8 9
4/1/2022 10:55:00 AM 12:10:00 AM ✔

4/2/2022 06:45:00 AM 12:14:00 AM ✔

4/3/2022 09:00:00 AM 12:11:00 AM ✔

4/5/2022 08:22:00 AM 12:07:00 AM ✔

4/6/2022 08:42:00 PM 12:22:00 AM ✔

4/7/2022 06:20:00 AM 12:20:00 AM ✔

4/7/2022 08:00:00 AM 12:10:00 AM ✔

4/8/2022 06:15:00 AM 12:15:00 AM ✔

4/9/2022 12:12:00 AM 12:15:00 AM ✔

4/11/2022 08:42:00 PM 12:11:00 AM ✔

4/11/2022 10:13:00 PM 12:20:00 AM ✔

4/13/2022 06:32:00 AM 12:10:00 AM ✔

4/13/2022 06:38:00 AM 12:16:00 AM ✔

4/27/2022 06:23:00 PM 12:09:13 AM ✔

4/25/2022 06:23:00 PM 12:10:00 AM ✔

4/19/2022 05:45:00 PM 12:24:00 AM ✔

4/30/2022 10:15:00 AM 12:18:26 AM ✔

4/26/2022 06:45:00 AM 12:12:45 AM ✔

4/30/2022 02:53:00 AM 12:09:23 AM ✔

4/25/2022 12:15:00 PM 12:23:30 AM ✔

PIC DATA
0

20 (Data Sekunder Laporan Hasil Tes Kritis Laboratorium)

20

100 GALIH SETIADI, AMD. AK

 FORM PENGUMPULAN DATA INDIKATOR MUTU N

6. JUDUL INDIKATOR : PELAPORAN HASIL KRITIS LABORATORIUM ≤30 MENIT (100%)

UNIT / BULAN : LABORATORIUM / MEI 2022

Jam keluar hasil kritis

Tanggal keluar hasil
No No RM Diagnosa Medik laboratorium (pkl……
kritis laboratorium
WIB)
1 2 3 4 5
Fatty (change of) liver, not
1 036346 5/3/2022 04:20:00 PM
elsewhere classified
2 064180 Spontaneous vertex delivery 5/3/2022 12:07:00 AM

3 064223 - 5/5/2022 07:27:00 AM

Prolonged first stage (of
4 064295 5/7/2022 08:20:00 AM
labour)
5 064401 Abdomen 5/11/2022 08:20:00 AM
6 064401 Abdomen 5/11/2022 08:20:00 AM
7 064401 Abdomen 5/11/2022 11:16:00 AM
8 063993 - 5/1/2022 09:24:00 AM

9 064227 - 5/5/2022 10:06:00 PM

10 064369 - 5/9/2022 10:06:00 PM

11 064369 - 5/9/2022 09:10:00 PM
12 064435 Abdomen 5/11/2022 07:29:00 AM
13 064295 Spontaneous vertex delivery 5/7/2022 04:23:00 PM
g2p1a0 uk 39+2mgg inpartu
14 64180 5/3/2022 08:17:00 PM
kala 1 fase aktif
15 64478 - 5/13/2022 05:50:00 PM
16 64279 - 5/6/2022 06:28:00 AM
17 36346 - 5/3/2022 08:08:00 AM
18 64401 - 5/11/2022 11:16:00 AM
19 63993 - 01/05//22 11:17:00 AM
20 39564 - 5/13/2022 07:26:00 PM
21 57781 - 5/14/2022 08:26:00 PM
22 64141 - 5/20/2022 12:32:00 PM
Non-insulin-dependent
23 33521 diabetes mellitus without 5/23/2022 01:27:00 PM
complications
24 64747 - 5/24/2022 02:24:00 PM
Gastro-oesophageal reflux
25 61400 5/24/2022 03:51:00 PM
disease with oesophagitis
26 64723 - 5/23/2022 05:58:00 PM

27 64728 - 5/23/2022 07:00:00 PM

28 50104 Congestive heart failure 5/26/2022 03:59:00 PM

Other and unspecified
29 24931 5/28/2022 07:03:00 AM
abdominal pain
30 64784 - 5/26/2022 09:31:00 AM
Feeding problem of newborn,
31 38455 5/30/2022 07:16:00 PM
unspecified
32

JUMLAH HASIL KRITIS LABORATORIUM YANG DILAPORKAN >30 MENIT

A. JUMLAH HASIL KRITIS LABORATORIUM YANG DILAPORKAN ≤30 MENIT =

B. JUMLAH HASIL KRITIS LABORATORIUM YANG DIOBSERVASI (Rumus Slovin) =

KESIMPULAN A / B X 100 (%) =

ATA INDIKATOR MUTU NASIONAL

Jam pelaporan hasil

Tanggal pelaporan hasil Rentang Waktu
kritis laboratorium ≤ 30 Menit
kritis laboratorium (kolom 7-5)
(pkl……WIB)
6 7 8 9
5/3/2022 04:35:00 PM 12:15:00 AM ✔

5/3/2022 12:24:00 AM 12:17:00 AM ✔

5/5/2022 07:39:00 AM 12:12:00 AM ✔

5/7/2022 08:42:00 AM 12:22:00 AM ✔

5/11/2022 08:34:00 AM 12:14:00 AM ✔

5/11/2022 08:35:00 AM 12:15:00 AM ✔

5/11/2022 11:32:00 AM 12:16:00 AM ✔

5/1/2022 09:36:00 AM 12:12:00 AM ✔

5/5/2022 10:20:00 PM 12:14:00 AM ✔

5/9/2022 10:18:00 PM 12:12:00 AM ✔

5/9/2022 09:28:00 PM 12:18:00 AM ✔

5/11/2022 07:39:00 AM 12:10:00 AM ✔

5/7/2022 04:40:00 PM 12:17:00 AM ✔

5/3/2022 08:27:00 PM 12:10:00 AM ✔

5/13/2022 05:58:00 PM 12:08:00 AM ✔

5/6/2022 06:39:00 AM 12:11:00 AM ✔

5/3/2022 08:18:00 AM 12:10:00 AM ✔

5/11/2022 11:27:00 AM 12:11:00 AM ✔

01/05//22 11:30:00 AM 12:13:00 AM ✔

5/13/2022 07:39:00 PM 12:13:00 AM ✔

5/14/2022 08:36:00 PM 12:10:00 AM ✔

5/20/2022 12:45:00 PM 12:13:00 AM ✔

5/23/2022 01:42:00 PM 12:15:00 AM ✔

5/24/2022 02:45:00 PM 12:21:00 AM ✔

5/24/2022 04:10:00 PM 12:19:00 AM ✔

5/23/2022 06:12:00 PM 12:14:00 AM ✔

5/23/2022 07:10:00 PM 12:10:00 AM ✔

5/26/2022 04:12:00 PM 12:13:00 AM ✔

5/28/2022 07:18:00 AM 12:15:00 AM ✔

5/26/2022 09:45:00 AM 12:14:00 AM ✔

5/30/2022 07:28:00 PM 12:12:00 AM ✔

PIC DATA
0

31 (Data Sekunder Laporan Hasil Tes Kritis Laboratorium)

31

100 GALIH SETIADI, AMD. AK

 FORM PENGUMPULAN DATA INDIKATOR MUTU N

6. JUDUL INDIKATOR : PELAPORAN HASIL KRITIS LABORATORIUM ≤30 MENIT (100%)

UNIT / BULAN : LABORATORIUM / JUNI 2022

Jam keluar hasil kritis

Tanggal keluar hasil
No No RM Diagnosa Medik laboratorium (pkl……
kritis laboratorium
WIB)
1 2 3 4 5
1 064924 - 6/2/2022 10:59:00 AM

2 064987 - 6/4/2022 02:30:00 PM

3 065015 - 6/6/2022 01:49:00 PM

Excessive and frequent
4 065019 menstruation with regular 6/6/2022 01:03:00 PM
cycle
Noninfective gastroenteritis
5 035430 6/9/2022 03:28:00 PM
and colitis, unspecified
Iron deficiency anaemia,
6 035430 6/9/2022 09:38:00 PM
unspecified
7 065079 - 6/8/2022 09:43:00 PM
8 065099 - 6/9/2022 04:00:00 PM
Iron deficiency anaemia,
9 035430 6/9/2022 09:38:00 PM
unspecified
10 065131 Anorexia 6/12/2022 12:00:00 AM
11 065131 Hyperglycaemia, unspecified 6/12/2022 11:26:00 AM
12 065136 - 6/12/2022 01:27:00 PM
13 065131 Hyperglycaemia, unspecified 6/12/2022 11:26:00 AM
14 65148 - 6/13/2022 11:38:00 AM
15 65185 - 6/14/2022 10:12:00 AM
16 47990 - 6/14/2022 01:57:00 PM
17 65219 - 6/15/2022 06:00:00 PM
18 65222 - 6/15/2022 11:10:00 PM
19 65219 - 6/15/2022 05:58:00 PM
20 65338 - 6/21/2022 07:56:00 AM
21 65390 - 6/23/2022 08:14:00 PM
22 64458 - 6/27/2022 05:20:00 PM

23 65520 - 6/29/2022 09:01:00 AM

24 65406 - 6/28/2022 07:31:00 AM

25 65418 - 6/25/2022 05:07:00 PM

26 65520 - 6/29/2022 08:30:00 AM

27 65545 - 6/30/2022 09:41:00 AM

28

JUMLAH HASIL KRITIS LABORATORIUM YANG DILAPORKAN >30 MENIT

A. JUMLAH HASIL KRITIS LABORATORIUM YANG DILAPORKAN ≤30 MENIT =

B. JUMLAH HASIL KRITIS LABORATORIUM YANG DIOBSERVASI (Rumus Slovin) =

KESIMPULAN A / B X 100 (%) =

ATA INDIKATOR MUTU NASIONAL

Jam pelaporan hasil

Tanggal pelaporan hasil Rentang Waktu
kritis laboratorium ≤ 30 Menit
kritis laboratorium (kolom 7-5)
(pkl……WIB)
6 7 8 9
6/2/2022 11:15:00 AM 12:16:00 AM ✔

6/4/2022 02:38:00 PM 12:08:00 AM ✔

6/6/2022 02:00:00 PM 12:11:00 AM ✔

6/6/2022 01:18:00 PM 12:15:00 AM ✔

6/9/2022 03:39:00 PM 12:11:00 AM ✔

6/9/2022 09:47:00 PM 12:09:00 AM ✔

6/8/2022 09:59:00 PM 12:16:00 AM ✔

6/9/2022 04:20:00 PM 12:20:00 AM ✔

6/9/2022 09:49:00 PM 12:11:00 AM ✔

6/12/2022 12:16:00 AM 12:16:00 AM ✔

6/12/2022 11:48:00 AM 12:22:00 AM ✔

6/12/2022 01:38:00 PM 12:11:00 AM ✔

6/12/2022 11:36:00 AM 12:10:00 AM ✔

6/13/2022 11:49:00 AM 12:11:00 AM ✔

6/14/2022 10:25:00 AM 12:13:00 AM ✔

6/14/2022 02:15:00 PM 12:18:00 AM ✔

6/15/2022 06:15:00 PM 12:15:00 AM ✔

6/15/2022 11:25:00 PM 12:15:00 AM ✔

6/15/2022 06:09:00 PM 12:11:00 AM ✔

6/21/2022 08:06:00 AM 12:10:00 AM ✔

6/23/2022 08:26:00 PM 12:12:00 AM ✔

6/27/2022 05:30:00 PM 12:10:00 AM ✔

6/29/2022 09:16:00 AM 12:15:00 AM ✔

6/28/2022 07:45:00 AM 12:14:00 AM ✔

6/25/2022 05:19:00 PM 12:12:00 AM ✔

6/29/2022 08:45:00 AM 12:15:00 AM ✔

6/30/2022 09:52:00 AM 12:11:00 AM ✔

PIC DATA
0

27 (Data Sekunder Laporan Hasil Tes Kritis Laboratorium)

27

100 GALIH SETIADI, AMD. AK

 FORM PENGUMPULAN DATA INDIKATOR MUTU NAS

6. JUDUL INDIKATOR : PELAPORAN HASIL KRITIS LABORATORIUM ≤30 MENIT (100%)

UNIT / BULAN : LABORATORIUM / JULI 2022

Jam keluar hasil kritis

Tanggal keluar hasil
No No RM Diagnosa Medik laboratorium (pkl……
kritis laboratorium
WIB)
1 2 3 4 5
1 042818 Anaemia, unspecified 7/7/2022 06:31:00 PM

2 065709 - 7/8/2022 06:40:00 PM

3 065520 - 7/1/2022 03:20:00 AM

4 065601 - 7/3/2022 02:20:00 PM
5 041490 - 7/7/2022 09:57:00 PM
6 065520 - 7/5/2022 07:11:00 AM
7 065681 - 7/6/2022 05:03:00 PM
Care and examination
8 037527 immediately after 7/5/2022 11:48:00 AM
delivery
9 065577 - 7/1/2022 02:47:00 PM

10 065577 - 7/2/2022 09:06:00 AM

11 065577 - 7/3/2022 06:09:00 AM
12 065577 - 7/4/2022 06:47:00 AM
13 042818 Anaemia, unspecified 7/7/2022 06:31:00 PM
14 42818 Anaemia, unspecified 7/8/2022 07:14:00 AM

15 Prolonged first stage (of

65646 7/7/2022 10:06:00 AM
labour)
16 42818 Anaemia, unspecified 7/8/2022 06:31:00 PM
17 42818 Anaemia, unspecified 7/8/2022 07:14:00 AM
18 65712 - 7/7/2022 12:07:00 PM
19 65705 - 7/4/2022 09:31:00 PM
20 65428 Single live birth 7/4/2022 05:21:00 PM

21 Mild and moderate birth

65353 7/9/2022 04:56:00 PM
asphyxia
22 65755 - 7/9/2022 02:15:00 PM
23 42818 Anaemia, unspecified 7/15/2022 07:14:00 AM

24 Whooping cough due to

26249 7/15/2022 02:08:00 AM
other Bordetella species

25 65886 - 7/16/2022 10:36:00 AM

26 57991 - 7/16/2022 09:31:00 AM

27 45874 - 7/16/2022 01:56:00 AM
Anaemia complicating
28 65954 pregnancy, childbirth 7/18/2022 03:06:00 PM
and the puerperium
29 66090 - 7/24/2022 05:59:00 PM

30 66194 - 7/27/2022 04:41:00 PM

31 Prolonged first stage (of

66223 7/29/2022 02:11:00 AM
labour
32 66090 - 7/24/2022 05:59:00 PM
33 66173 - 7/23/2022 06:25:00 PM

34 Prolonged first stage (of

65674 7/25/2022 06:25:00 PM
labour)
35 66131 - 7/28/2022 02:29:00 PM
36 66222 - 7/24/2022 04:48:00 PM
37 66090 - 7/27/2022 08:18:00 PM
38 36346 - 7/27/2022 05:59:00 PM
39 66222 - 7/28/2022 10:58:00 PM
40 65731 Single live birth 7/25/2022 04:52:00 PM
41 66230 - 7/29/2022 11:59:00 AM
42 66223 - 7/29/2022 02:11:00 AM
43 66271 - 7/31/2022 07:29:00 PM
44 66230 - 7/29/2022 11:57:00 AM
45

JUMLAH HASIL KRITIS LABORATORIUM YANG DILAPORKAN >30 MENIT

A. JUMLAH HASIL KRITIS LABORATORIUM YANG DILAPORKAN ≤30 MENIT =

B. JUMLAH HASIL KRITIS LABORATORIUM YANG DIOBSERVASI (Rumus Slovin) =

KESIMPULAN A / B X 100 (%) =

A INDIKATOR MUTU NASIONAL (IMN)

Jam pelaporan hasil

Tanggal pelaporan hasil Rentang Waktu
kritis laboratorium ≤ 30 Menit
kritis laboratorium (kolom 7-5)
(pkl……WIB)
6 7 8 9
7/7/2022 06:42:00 PM 12:11:00 AM ✔

7/8/2022 06:58:00 PM 12:18:00 AM ✔

7/1/2022 03:35:00 AM 12:15:00 AM ✔

7/3/2022 02:32:00 PM 12:12:00 AM ✔

7/7/2022 10:08:00 PM 12:11:00 AM ✔

7/5/2022 07:30:00 AM 12:19:00 AM ✔

7/6/2022 05:16:00 PM 12:13:00 AM ✔

7/5/2022 11:58:00 AM 12:10:00 AM ✔

7/1/2022 02:59:00 PM 12:12:00 AM ✔

7/2/2022 09:17:00 AM 12:11:00 AM ✔

7/3/2022 06:18:00 AM 12:09:00 AM ✔

7/4/2022 06:59:00 AM 12:12:00 AM ✔

7/7/2022 06:46:00 PM 12:15:00 AM ✔

7/8/2022 07:29:00 AM 12:15:00 AM ✔

7/7/2022 10:25:00 AM 12:19:00 AM ✔

7/8/2022 06:45:00 PM 12:14:00 AM ✔

7/8/2022 07:26:00 AM 12:12:00 AM ✔

7/7/2022 12:18:00 PM 12:11:00 AM ✔

7/4/2022 09:42:00 PM 12:11:00 AM ✔

7/4/2022 05:35:00 PM 12:14:00 AM ✔

7/9/2022 05:16:00 PM 12:20:00 AM ✔

7/9/2022 02:26:00 PM 12:11:00 AM ✔

7/15/2022 07:26:00 AM 12:12:00 AM ✔

7/15/2022 02:19:00 AM 12:11:00 AM ✔

7/16/2022 10:46:00 AM 12:10:00 AM ✔

7/16/2022 09:46:00 AM 12:15:00 AM ✔

7/16/2022 02:12:00 AM 12:16:00 AM ✔

7/18/2022 03:15:00 PM 12:09:00 AM ✔

7/24/2022 06:16:00 PM 12:17:00 AM ✔

7/27/2022 04:54:00 PM 12:13:00 AM ✔

7/29/2022 02:26:00 AM 12:15:00 AM ✔

7/24/2022 06:15:00 PM 12:16:00 AM ✔

7/23/2022 06:35:00 PM 12:10:00 AM ✔

7/25/2022 06:35:00 PM 12:10:00 AM ✔

7/28/2022 02:39:00 PM 12:10:00 AM ✔

7/24/2022 04:58:00 PM 12:10:00 AM ✔

7/27/2022 08:27:00 PM 12:09:00 AM ✔

7/27/2022 06:10:00 PM 12:11:00 AM ✔

7/28/2022 11:15:00 PM 12:17:00 AM ✔

7/25/2022 05:15:00 PM 12:23:00 AM ✔

7/29/2022 12:15:00 PM 12:16:00 AM ✔

7/29/2022 02:32:00 AM 12:21:00 AM ✔

7/31/2022 07:38:00 PM 12:09:00 AM ✔

7/29/2022 12:12:00 PM 12:15:00 AM ✔

PIC DATA
0

44 (Data Sekunder Laporan Hasil Tes Kritis Laboratorium)

44

100 GALIH SETIADI, AMD. AK

 FORM PENGUMPULAN DATA INDIKATOR MUTU N

6. JUDUL INDIKATOR : PELAPORAN HASIL KRITIS LABORATORIUM ≤30 MENIT (100%)

UNIT / BULAN : LABORATORIUM / JANUARI 2022

Jam keluar hasil kritis

Tanggal keluar hasil
No No RM Diagnosa Medik laboratorium (pkl……
kritis laboratorium
WIB)
1 2 3 4 5

2
3
4

8
9
10
11
12

13

14

15

16

17

18

19
20
21
22
23
24
25
26
27

28

29
30

31

32
33
34
35
36

37
38
39
40
41

A. JUMLAH HASIL KRITIS LABORATORIUM YANG DILAPORKAN ≤30 MENIT =

B. JUMLAH HASIL KRITIS LABORATORIUM YANG DIOBSERVASI (Rumus Slovin) =

KESIMPULAN A / B X 100 (%) =

ATA INDIKATOR MUTU NASIONAL

Jam pelaporan hasil

Tanggal pelaporan hasil Rentang Waktu
kritis laboratorium ≤ 30 Menit
kritis laboratorium (kolom 7-5)
(pkl……WIB)
6 7 8 9

✔
✔
✔

✔
✔
✔
✔
✔

✔
✔
✔
 ✔
✔
✔
✔
✔
✔

✔
✔

✔
✔
✔
✔
✔

✔
✔
✔
✔
✔

PIC DATA
62 (Data Sekunder Laporan Hasil Tes Kritis Laboratorium)

62

100 GALIH SETIADI, AMD. AK

 FORM PENGUMPULAN DATA INDIKATOR

6. JUDUL INDIKATOR : PELAPORAN HASIL KRITIS LABORATORIUM ≤30 MENIT (100%)

UNIT / BULAN : LABORATORIUM / JANUARI 2022

Jam keluar hasil jadi

Tanggal keluar hasil
No No RM Diagnosa Medik laboratorium (pkl……
kritis laboratorium
WIB)

1 2 3 4 5
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27

28

29
30
31

32
33
34
35
36

37
38
39
40
41

A. JUMLAH HASIL KRITIS LABORATORIUM YANG DILAPORKAN ≤30 MENIT =

B. JUMLAH HASIL KRITIS LABORATORIUM YANG DIOBSERVASI (Rumus Slovin) =

KESIMPULAN A / B X 100 (%) =

PULAN DATA INDIKATOR MUTU NASIONAL

Jam pelaporan hasil jadi

Tanggal pelaporan hasil
laboratorium (pkl…… Perawat/ Bidan Lama ≤ 30 Menit
kritis laboratorium
WIB)
Jam Lapor DPJP
6 7 9
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔

✔
✔
 ✔

✔
✔
✔
✔
✔

✔
✔
✔
✔
✔

PIC DATA
34 (Data Sekunder Laporan Hasil Tes Kritis Laboratorium)

34

100 GALIH SETIADI, AMD. AK

 FORM PENGUMPULAN DATA INDIKATOR

6. JUDUL INDIKATOR : PELAPORAN HASIL KRITIS LABORATORIUM ≤30 MENIT (100%)

UNIT / BULAN : LABORATORIUM / JANUARI 2022

Jam keluar hasil jadi

Tanggal keluar hasil
No No RM Diagnosa Medik laboratorium (pkl……
kritis laboratorium
WIB)

1 2 3 4 5
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27

28

29
30
31

32
33
34
35
36

37
38
39
40
41

A. JUMLAH HASIL KRITIS LABORATORIUM YANG DILAPORKAN ≤30 MENIT =

B. JUMLAH HASIL KRITIS LABORATORIUM YANG DIOBSERVASI (Rumus Slovin) =

KESIMPULAN A / B X 100 (%) =

PULAN DATA INDIKATOR MUTU NASIONAL

Jam pelaporan hasil jadi

Tanggal pelaporan hasil
laboratorium (pkl…… Perawat/ Bidan Lama ≤ 30 Menit
kritis laboratorium
WIB)
Jam Lapor DPJP
6 7 9
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔

✔
✔
 ✔

✔
✔
✔
✔
✔

✔
✔
✔
✔
✔

PIC DATA
34 (Data Sekunder Laporan Hasil Tes Kritis Laboratorium)

34

100 GALIH SETIADI, AMD. AK

 FORM PENGUMPULAN DATA INDIKATOR

6. JUDUL INDIKATOR : PELAPORAN HASIL KRITIS LABORATORIUM ≤30 MENIT (100%)

UNIT / BULAN : LABORATORIUM / JANUARI 2022

Jam keluar hasil jadi

Tanggal keluar hasil
No No RM Diagnosa Medik laboratorium (pkl……
kritis laboratorium
WIB)

1 2 3 4 5
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27

28

29
30
31

32
33
34
35
36

37
38
39
40
41

A. JUMLAH HASIL KRITIS LABORATORIUM YANG DILAPORKAN ≤30 MENIT =

B. JUMLAH HASIL KRITIS LABORATORIUM YANG DIOBSERVASI (Rumus Slovin) =

KESIMPULAN A / B X 100 (%) =

PULAN DATA INDIKATOR MUTU NASIONAL

Jam pelaporan hasil jadi

Tanggal pelaporan hasil
laboratorium (pkl…… Perawat/ Bidan Lama ≤ 30 Menit
kritis laboratorium
WIB)
Jam Lapor DPJP
6 7 9
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔

✔
✔
 ✔

✔
✔
✔
✔
✔

✔
✔
✔
✔
✔

PIC DATA
34 (Data Sekunder Laporan Hasil Tes Kritis Laboratorium)

34

100 GALIH SETIADI, AMD. AK

 FORM PENGUMPULAN DATA INDIKATOR

6. JUDUL INDIKATOR : PELAPORAN HASIL KRITIS LABORATORIUM ≤30 MENIT (100%)

UNIT / BULAN : LABORATORIUM / JANUARI 2022

Jam keluar hasil jadi

Tanggal keluar hasil
No No RM Diagnosa Medik laboratorium (pkl……
kritis laboratorium
WIB)

1 2 3 4 5
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27

28

29
30
31

32
33
34
35
36

37
38
39
40
41

A. JUMLAH HASIL KRITIS LABORATORIUM YANG DILAPORKAN ≤30 MENIT =

B. JUMLAH HASIL KRITIS LABORATORIUM YANG DIOBSERVASI (Rumus Slovin) =

KESIMPULAN A / B X 100 (%) =

PULAN DATA INDIKATOR MUTU NASIONAL

Jam pelaporan hasil jadi

Tanggal pelaporan hasil
laboratorium (pkl…… Perawat/ Bidan Lama ≤ 30 Menit
kritis laboratorium
WIB)
Jam Lapor DPJP
6 7 9
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔
✔

✔
✔
 ✔

✔
✔
✔
✔
✔

✔
✔
✔
✔
✔

PIC DATA
34 (Data Sekunder Laporan Hasil Tes Kritis Laboratorium)

34

100 GALIH SETIADI, AMD. AK