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FORM PENILAIAN RUANGAN TERBAIK

SUB KOMITE ETIK DAN DISIPLIN

PENILAIAN
ETIKA DAN DISIPLIN PEGAWAI

RUANGAN :

WAKTU : Hari / Tanggal - - / Jam WIB

PENILAI :

NO INDIKATOR RENTANG SKOR SKOR


1 Absensi 1 s.d. 15
2 Senyum salam dan sapa 1 s.d. 15
3 Pengetahuan dan penerapan SOP etika dan disiplin 1 s.d. 15
4 Pengetahuan tentang peraturan dan kebijakan 1 s.d. 15
Rumah Sakit
5 Pengisian papan pengumuman dan status pasien 1 s.d. 14
6 Ketertiban pengunjung 1 s.d. 13
7 Penerapan etika bicara (tolong, maaf, trimakasih) 1 s.d. 13
TOTAL SKOR 100

Catatan : .....................................................................................................................................

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TTD PENILAI

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