No Dokumen No Revisi Halaman

445/49/101.14/PF/2014 0 1/3
Tanggal Ter i! Di!e!a"kan
Ke"ala UPT Ruma# Saki! Kus!a
Sum erglaga#
PROSEDUR TETAP
POKJA FUNGSIONAL
1 Juli 2014
$r%& UDIASTUTI KUSHARJUNI S"%KK
NIP. 19590625 198711 2 001

PENGERTIAN Kegiata !a g "ila#u#a $le% &etuga' (u)a% 'a#it u tu# )e

"a&at#a "ata * "ata atau i +$()a'i "a(i &a'ie u)u), #%u'u' )
au&u e)e(ge 'i atau &a'ie ga-at "a(u(at !a g 'ela ut !a
"ila#u#a &e)e(i#'aa la uta u tu# &e eta&a "iag $'a )e"i' "a
&e) e(ia te(a&i #e&a"a 'e)ua &a'ie !a g "ata g e($ at #e (u)a%
'a#it 'e(ta &e e tua a&a#a% &a'ie i'a &ula g, la ut (a-at i a& "i
Ru)a% a#it Ku'ta u) e(glaga% atau &e(lu "i(u u# #e (u)a%
T J AN 'a#it lai .
1. e)a'ti#a te(la#'a a a!a &e(a-ata &a'ie !a g e(#ualita', a)a ,
"a e+i'ie 'e a# &a'ie )a'u# "a "ite(i)a "i Te)&at &e "a+ta(a
Pa'ie 'a)&ai 'ele'ai &e)e(i#'aa atau &e g$ ata , "a 'a)&ai
&a'ie &ula g "a(i Ru)a% a#it
2. e i g#at#a #$ ti uita' "a) #ualita' &e(a-ata 'e(ta &e g$ ata
)e"i'
3. e "a&at#a &ela!a a &e g$ ata 'e'uai &e !a#it !a g "i"e(ita.
KE IJAKAN
1. N$)$( 44 ta%u 2009 te ta g Ru)a% a#it &a'al 40
2. Ke&utu'a Ke&ala PT Ru)a% a#it Ku'ta u) e(glaga% N$)$
( 440/ /101.14/2014 Te ta g Pa "ua A''e')e Pa'ie "i Ru)a%
PR E R a#it Ku'ta u) e(glaga%
1. Pa'ie atau #elua(ga )e u u #e te)&at &e e(i)aa &a'ie
Screening Ra-at Jala
Ruma# Saki! Kus!a
ASSES'EN A(AL PASIEN RA(AT JALAN U'U'
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2. a#u#a &($'e' '#(i i g "a a'e')e a-al a ta(a lai

1 ele#'i &a'ie e("a'a(#a #elu%a "a #$ "i'i &a'ie
2 tu# &a'ie ga-at "a(u(at a(a%#a #e (ua g G
3 tu# &a'ie !a g ti"a# ga-at "a(u(at a(a%#a #e &$li
tu ua 'e'uai "e ga #elu%a "a &e !a#it &a'ie
3. A(a%#a &a'ie u tu# )ela#u#a &e "a+ta(a #e Te)&at Pe
"a+ta(a Pa'ie TPP .
4. a#u#a :e(i+i#a'i i"e tita' &a'ie "i'e'uai#a "e ga 'tatu'
(e#a) )e"i' !a 'aat &a'ie 'a)&ai "i(ua ga &e)e(i#'aa $le%
"$#te( / &e(a-at / i"a
5. K$la $(a'i a ta(a $#te( "a &e(a-at / i"a u tu# )ela#u#a
a''e')e a-al &a"a &a'ie !a g "ata g e($ at.
6. a#u#a a'e')e a-al e("a'a( u'ia / #el$)&$# / #a'u' &e !a#it

&a'ie "e ga )e gi'i )i i)al AP !a g e( e tu# a(a'i

7. a#u#a (u u#a #e &e)e(i#'aa &e u a g lai ila "i&e(lu#a

8. Te tu#a "iag $'i' &a'ie e("a'a(#a a'e')e , uat (e ;a a "a ti
"a#a )e"i' / #e&e(a-ata !a g "i'u'u e("a'a(#a '#ala &(i$
(ita' )ulai "a(i &e ilaia #ea"aa u)u) &a'ie , &e)e(i#'aa
+i'i# "a te(a#%i( &e)e(i#'aa &e u a g u tu# )e e tu#a &e)
e(ia te(a&i, ti "a#a atau &ela!a a 'ela ut !a, ila &e(lu
#$la $(a'i "e ga te aga #e'e%ata lai "$#te( '&e'iali' lai
atau a%li gi<i
9. I +$()a'i#a 'e)ua (e ;a a "a ti "a#a &a"a &a'ie / #elua(ga
u tu# )e e tu#a #e&utu'a !a g "ia) il u tu# &ela!a a 'ela
ut !a "a "i"$#u)e ta'i#a "i le) a( e"u#a'i &a'ie
10. a#u#a e:alua'i %a'il &e) e(ia te(a&i "a ti "a##a !a g tela
% "ila#u#a a&a#a% &a'ie i'a "i&ula g#a atau &e(lu
 Ruma# Saki! Kus!a
ASSES'EN A(AL PASIEN RA(AT JALAN U'U'
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u tu# (a-at i a& atau la uta

11. K%u'u' &a"a &a'ie !a g a#a )ela#u#a atau )e)e(lu#a ti
"a##a &e) e"a%a "a a e't%e'i, "$#u)e ta'i#a a'e')e )e"i'
a-al 'e elu) ti "a##a a e't%e'i "a e"a% "ila#u#a "i le) a(
&e('etu ua ti "a#a "i (e#a) )e"i' / le) a( (e ;a a &ela!a a
"a ;atata &ela!a a
12. Tuli'#a %a'il a'e')e )e"i' a-al "i 'tatu' &a'ie (a-at ala )
elalui 'i'te) I R "i#e( a#a $le% "$#te(
13. A&a ila &a'ie &e(lu "i(a-at i a&#a "e ga ti"a# ga-at
"a(u(at )a#a &e(a-at / i"a )ela#u#a a'e')e a-al #e&e(a-
ata "a )e "$#u)e ta'i#a "i I R , &e g#a ia #e&e(a-ata ,
&e)e(i#'aa e("a'a(#a u'ia / #el$)&$# / #a'u' &e !a#it
&a'ie !a g te("i(i "a(i ta "a*ta "a :ital, &e g#a ia !e(i, &e
g#a ia atu% "a (i-a!at #e'e%ata , u tu# #a'u' #e i"a a /
#a "u ga a'e')e a-al 'a)&ai "e ga (i-a!at #e i"a a

14. ila &a"a &e g#a ia !e(i "i"a&at#a '#ala !e(i (i ga , 'e"a
g atau %e at )a#a la#u#a i te(:e'i "a i)&le)e ta'i 'e'uai
"e ga &a "ua )a a e)e !e(i "a "i"$#u)e ta'i#a "i I R

15. $#u)e ta'i#a a'e')e )e"i' "a #e&e(a-ata a-all, "a 'ele'ai#a
)a#'i)al 24 a) 'etela% &a'ie )a'u# (u)a% 'a#it, ila "i(a-at
i a&#a atau le i% ;e&at le i% ai# #a(e a #$ "i'i &a'ie
16. A&a ila &a'ie &e(lu "i(u u# "a &a'ie ti"a# "ala) #$ "i'i
ti"a# ga-at "a(u(at, e(i#a 'u(at (u u#a !a g "i uat $le%
"$#te( #e Ru)a% a#it !a g 'e'uai "e ga &e !a#it &a'ie
1. P KJA F NG I NA
2. REKAE I
NIT TERKAIT
3. RA=AT JA AN
 Ruma# Saki! Kus!a ASSES'EN A(AL PASIEN RA(AT JALAN KUSTA
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Tanggal Ter i! Di!e!a"kan
Ke"ala UPT Ruma# Saki! Kus!a
PROSEDUR TETAP Sum erglaga#
POKJA FUNGSIONAL 1 Juli 2014
$r%& UDIASTUTI KUSHARJUNI S"%KK
NIP. 19590625 198711 2 001
PENGERTIAN Kegiata !a g "ila#u#a $le% &etuga' (u)a% 'a#it u tu# )e "a&at#a

"ata * "ata atau i +$()a'i "a(i &a'ie u)u), #%u'u' )au&u

e)e(ge 'i atau &a'ie ga-at "a(u(at !a g 'ela ut !a "ila#u#a
&e)e(i#'aa la uta u tu# &e eta&a "iag $'a )e"i' "a &e) e(ia
te(a&i #e&a"a 'e)ua &a'ie !a g "ata g e($ at #e (u)a% 'a#it 'e(ta
&e e tua a&a#a% &a'ie i'a &ula g, la ut (a-at i a& "i Ru)a% a#it
Ku'ta u) e(glaga% atau &e(lu "i(u u# #e (u)a% 'a#it lai .
T J AN 1. e)a'ti#a te(la#'a a a!a &e(a-ata &a'ie !a g e(#ualita',
a)a , "a e+i'ie 'e a# &a'ie )a'u# "a "ite(i)a "i Te)&at
&e "a+ta(a Pa'ie 'a)&ai 'ele'ai &e)e(i#'aa atau &e g$ ata ,
"a 'a)&ai &a'ie &ula g "a(i Ru)a% a#it
2. e i g#at#a #$ ti uita' "a) #ualita' &e(a-ata 'e(ta &e g$ ata
)e"i'
3. e "a&at#a &ela!a a &e g$ ata 'e'uai &e !a#it !a g
"i"e(ita.
KE IJAKAN 1.N$)$( 44 ta%u 2009 te ta g Ru)a% a#it &a'al 40
2. Ke&utu'a Ke&ala PT Ru)a% a#it Ku'ta u) e(glaga% N$)$(
440/ /101.14/2014 Te ta g Pa "ua A''e')e Pa'ie "i Ru)a%
a#it Ku'ta u) e(glaga%
PR E R 1. Pa'ie atau #elua(ga )e u u #e te)&at &e "a+ta(a &a'ie TPP
Ruma# Saki! Kus!a
ASSES'EN A(AL PASIEN RA(AT JALAN KUSTA
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2. a#u#a :e(i+i#a'i i"e tita' &a'ie "i'e'uai#a "e ga 'tatu'
(e#a) )e"i' !a 'aat &a'ie 'a)&ai "i(ua ga &e)e(i#'aa $le%
"$#te( / &e(a-at / i"a
3. K$la $(a'i a ta(a $#te( "a &e(a-at / i"a u tu# )ela#u#a
a''e')e a-al &a"a &a'ie !a g "ata g e($ at.
4. a#u#a a'e')e a-al e("a'a( u'ia / #el$)&$# / #a'u' &e !a#it

&a'ie "e ga )e gi'i )i i)al AP !a g e( e tu# a(a'i

5. a#u#a (u u#a #e &e)e(i#'aa &e u a g lai ila "i&e(lu#a

6. Te tu#a "iag $'i' &a'ie e("a'a(#a a'e')e , uat (e ;a a "a ti
"a#a )e"i' / #e&e(a-ata !a g "i'u'u e("a'a(#a '#ala &(i$(ita'
)ulai "a(i &e ilaia #ea"aa u)u) &a'ie , &e)e(i#'aa +i'i# "a
te(a#%i( &e)e(i#'aa &e u a g u tu# )e e tu#a &e) e(ia
te(a&i, ti "a#a atau &ela!a a 'ela ut !a, ila &e(lu #$la $
(a'i "e ga te aga #e'e%ata lai "$#te( '&e'iali' lai atau a
%li gi<i
7. I +$()a'i#a 'e)ua (e ;a a "a ti "a#a &a"a &a'ie / #elua(ga
u tu# )e e tu#a #e&utu'a !a g "ia) il u tu# &ela!a a 'ela
ut !a "a "i"$#u)e ta'i#a "i le) a( e"u#a'i &a'ie
8. a#u#a e:alua'i %a'il &e) e(ia te(a&i "a ti "a##a !a g tela
% "ila#u#a a&a#a% &a'ie i'a "i&ula g#a atau &e(lu u
tu# (a-at i a& atau la uta
 Ruma# Saki! Kus!a
ASSES'EN A(AL PASIEN RA(AT JALAN KUSTA
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9. K%u'u' &a"a &a'ie !a g a#a )ela#u#a atau )e)e(lu#a ti

"a##a &e) e"a%a "a a e't%e'i, "$#u)e ta'i#a a'e')e )e"i'
a-al 'e elu) ti "a##a a e't%e'i "a e"a% "ila#u#a "i le)
a( &e('etu ua ti "a#a "i (e#a) )e"i' /
le) a( (e ;a a &ela!a a "a ;atata &ela!a a
10. Tuli'#a %a'il a'e')e )e"i' a-al "i 'tatu' &a'ie (a-at ala )
elalui 'i'te) I R "i#e( a#a $le% "$#te(
11. A&a ila &a'ie &e(lu "i(a-at i a&#a "e ga ti"a# ga-at
"a(u(at )a#a &e(a-at / i"a )ela#u#a a'e')e a-al #e&e(a-
ata "a )e "$#u)e ta'i#a "i I R , &e g#a ia #e&e(a-ata ,
&e)e(i#'aa e("a'a(#a u'ia / #el$)&$# / #a'u' &e !a#it
&a'ie !a g te("i(i "a(i ta "a*ta "a :ital, &e g#a ia !e(i, &e
g#a ia atu% "a (i-a!at #e'e%ata , u tu# #a'u' #e i"a a /
#a "u ga a'e')e a-al 'a)&ai "e ga (i-a!at #e i"a a

12. ila &a"a &e g#a ia !e(i "i"a&at#a '#ala !e(i (i ga , 'e"a g
atau %e at )a#a la#u#a i te(:e'i "a i)&le)e ta'i 'e'uai "e
ga &a "ua )a a e)e !e(i "a "i"$#u)e ta'i#a "i I R

13. $#u)e ta'i#a a'e')e )e"i' "a #e&e(a-ata a-all, "a 'ele'ai#a
)a#'i)al 24 a) 'etela% &a'ie )a'u# (u)a% 'a#it, ila "i(a-at i
a&#a atau le i% ;e&at le i% ai# #a(e a #$ "i'i &a'ie
14. A&a ila &a'ie &e(lu "i(u u# "a &a'ie ti"a# "ala) #$ "i'i
ti"a# ga-at "a(u(at, e(i#a 'u(at (u u#a !a g "i uat $le%
"$#te( #e Ru)a% a#it !a g 'e'uai "e ga &e !a#it &a'ie
1. P KJA F NG I NA
2. REKAE I
NIT TERKAIT
3. RA=AT JA AN K TA
 Ruma# Saki! Kus!a
ASSES'EN A(AL PASIEN IGD
Sum erglaga# No Dokumen No Revisi Halaman
445/51/101.14/PF/2014 0 1/4
Tanggal Ter i! Di!e!a"kan
Ke"ala UPT Ruma# Saki! Kus!a
Sum erglaga#
PROSEDUR TETAP
POKJA FUNGSIONAL
1 Juli 2014
$r%& UDIASTUTI KUSHARJUNI S"%KK
NIP. 19590625 198711 2 001

PENGERTIAN Kegiata !a g "ila#u#a $le% &etuga' (u)a% 'a#it u tu# )e

"a&at#a "ata * "ata atau i +$()a'i "a(i &a'ie u)u), #%u'u' )
au&u e)e(ge 'i atau &a'ie ga-at "a(u(at !a g 'ela ut !a
"ila#u#a &e)e(i#'aa la uta u tu# &e eta&a "iag $'a )e"i' "a
&e) e(ia te(a&i #e&a"a 'e)ua &a'ie !a g "ata g e($ at #e (u)a%
'a#it 'e(ta &e e tua a&a#a% &a'ie i'a &ula g, la ut (a-at i a& "i
Ru)a% a#it Ku'ta u) e(glaga% atau &e(lu "i(u u# #e (u)a%
T J AN 'a#it lai .
1. e)a'ti#a te(la#'a a a!a &e(a-ata &a'ie !a g e(#ualita', a)a ,
"a e+i'ie 'e a# &a'ie )a'u# "a "ite(i)a "i Te)&at &e "a+ta(a
Pa'ie 'a)&ai 'ele'ai &e)e(i#'aa atau &e g$ ata , "a 'a)&ai
&a'ie &ula g "a(i Ru)a% a#it
2. e i g#at#a #$ ti uita' "a) #ualita' &e(a-ata 'e(ta &e g$ ata
)e"i'
3. e "a&at#a &ela!a a &e g$ ata 'e'uai &e !a#it !a g
 "i"e(ita.
KE IJAKAN 1. N$)$( 44 ta%u 2009 te ta g Ru)a% a#it &a'al 40
2. Ke&utu'a Ke&ala PT Ru)a% a#it Ku'ta u) e(glaga% N$)$(
440/ /101.14/2014 Te ta g Pa "ua A''e')e Pa'ie "i Ru)a%
a#it Ku'ta u) e(glaga%
PR E R 1. Pa'ie / #elua(ga / #e(a at / &e ga ta( )e u u I tala'i Ga-at

a(u(at
Ruma# Saki! Kus!a
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2. a#u#a &($'e' '#(i i g, t(iage "a a'e')e a-al a ta(a lai 1

ele#'i &a'ie e("a'a(#a ti g#at #ega-ata
2a'u##a &a'ie ga-at "a(u(at 'e'uai "e ga
#la'i+i#a'i TRIAGE
3 a#u#a ti "a##a #e&e(a-ata atau )e"i' 'e'uai
"e ga #$ "i'i &a'ie
4 a#u#a (u u#a 'ege(a #e &e)e(i#'aa &e u a g ila
"i&e(lu#a
3. a#u#a a'e')e )e"i' a-al 'aat &a'ie "ata g "e ga i'i )i i)al
AP "e ga (e'&$ ti)e ti"a# le i% "a(i 5 )e it, "a "i"$#u)e
ta'i#a "i I R "i 'tatu' a'e')e "a &e)e(i#'aa +i'i# $le%
"$#te(
4. a#u#a a'e')e #e&e(a-ata a-al 'aat &a'ie "ata g
e("a'a(#a u'ia / #el$)&$# / #a'u' &e !a#it &a'ie !a g
te("i(i "a(i ta "a*ta "a :ital, &e g#a ia !e(i, &e g#a ia
atu% "a (i-a!at #e'e%ata . tu# #a'u' #e i"a a a'e')e a-al
'a)&ai "e ga (i-a!at #e i"a a "a "i"$#u)e ta'i#a "i 'tatu'
a''e')e &a'ie )elalui I R
5. ila &a"a &e g#a ia !e(i "i"a&at#a '#ala !e(i (i ga , 'e"a
g atau e(at )a#a "$#te(/ &e(a-at )ela#u#a i te(:e 'i "a
i)&le)e ta'i 'e'uai "e ga &a "ua )a a e)e !e(i
6. a#u#a (u u#a #e &e)e(i#'aa &e u a g lai ila "i&e(lu#a .
7. Te tu#a "iag $'i' &a'ie e("a'a(#a a'e')e !a g te("i(i "a(i
"iag $'i' #e( a, a "i g, 'e#u "e( "a #$)&li#a'i ila a"a , uat
(e ;a a "a ti "a#a #e&e(a-ata / )e"i' !a g "i'u'u e("a'a(#a
'#ala &(i$(ita' )ulai "a(i &e ilaia #ea"aa u)u) &a'ie ,
&e)e(i#'aa +i'i# !a, "a te(a#%i( &e)e(i#'aa &e u a g u
tu# )e e tu#a &e) e(ia te(a&i, ti "a#a atau &ela!a a 'ela
ut !a, ila &e(lu #$la $(a'i#a
Ruma# Saki! Kus!a
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"e ga te aga #e'e%ata lai "$#te( '&e'iali'
8. I +$()a'i#a 'e)ua (e ;a a "a ti "a#a &a"a &a'ie /
#elua(ga u tu# )e e)u#a #e&utu'a !a g "ia) il u tu#
&ela!a a 'ela ut !a "a "i"$#u)e ta'i#a "i le) a( e"u#a'i

9. a#u#a e:alua'i %a'il &e) e(ia te(a&i "a ti "a#a !a g tela

% "ila#u#a , a&a#a% &a'ie i'a "i&ula g#a atau &e(lu
u tu# (a-at i a&
10. Pa'ie !a g a#a "ila#u#a ti "a#a &e) e"a%a "a a ae't
%e'i u tu# a'e')e )e"i' a-al %a(u' "i"$#u)e ta'i#a 'e elu)
ti "a#a a e'te'i "a e"a% "ila#u#a "i le) a( &e('etu ua ti
"a#a a a) e'e "a &e)e(i#'aa +i'i# $le% "$#te( "a (e ;a a
&ela!a a /;atata &ela!a a
11. ila &a'ie ti"a# (a-at i a& )a#a "i e(i#a i +$()a'i "a
e"u#a'i "a "i "$#u)e ta'i#a "i le) a( KIE (e#a) )e"i', ila
&a'ie "i(a-at i a&#a )a#a e(#a' (e#a) )e"i' !a g te("i(i
"a(i u(at Pe('etu ua Ra-at I a& "a General Consent
"i'e(ta#a #e (ua g (a-at i a& 'a)&ai &a'ie &ula g
12. A&a ila &a'ie &e(lu "i(u u# "a &a'ie ti"a# "ala) #$ "i'i
ti"a# ga-at "a(u(at, "$#te( )e) e(i#a 'u(at (u u#a #e
Ru)a% a#it !a g 'e'uai "e ga &e !a#it &a'ie
 Ruma# Saki! Kus!a
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13. A&a ila &a'ie &e(lu "i(u u# "a &a'ie "ala) #ea"aa ga-at
"a(u(at, )a#a &a'ie -a i "ita ga i #ega-at "a(u(ata !a
te(le i% "a%ulu 'a)&ai #$ "i'i 'ta il, a(u #e)u"ia "i(u u#
14. A&a ila &a'ie "ata g #e IG "a $le% &etuga' !a g )
ela#u#a screening )e !ata#a a%-a &a'ie te('e ut )e i
ggal "u ia, )a#a e(i#a i +$()a'i #e&a"a #elua(ga &a'ie
te ta g #$ "i'i &a'ie $le% "$#te( IG
NIT TERKAIT 1. P KJA F NG I NA
2. REKAE I
3. IG
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Tanggal Ter i! Di!e!a"kan
Ke"ala UPT Ruma# Saki! Kus!a
Sum erglaga#
PROSEDUR TETAP
POKJA FUNGSIONAL
1 Juli 2014
$r%& UDIASTUTI KUSHARJUNI S"%KK
NIP. 19590625 198711 2 001
PENGERTIAN Kegiata !a g "ila#u#a $le% &etuga' (u)a% 'a#it u tu# )e
"a&at#a "ata * "ata atau i +$()a'i "a(i &a'ie u)u), #%u'u' )
au&u e)e(ge 'i atau &a'ie ga-at "a(u(at !a g 'ela ut !a
"ila#u#a &e)e(i#'aa la uta u tu# &e eta&a "iag $'a )e"i' "a
&e) e(ia te(a&i #e&a"a 'e)ua &a'ie !a g "ata g e($ at #e (u)a
% 'a#it 'e(ta &e e tua a&a#a% &a'ie i'a &ula g, la ut (a-at i
a& "i Ru)a% a#it Ku'ta u) e(glaga% atau &e(lu "i(u u# #e
T J AN (u)a% 'a#it lai .
1. e)a'ti#a te(la#'a a a!a &e(a-ata &a'ie !a g e(#ualita', a)a ,
"a e+i'ie 'e a# &a'ie )a'u# "a "ite(i)a "i Te)&at &e "a+ta(a
Pa'ie 'a)&ai 'ele'ai &e)e(i#'aa atau &e g$ ata , "a 'a)&ai
&a'ie &ula g "a(i Ru)a% a#it
2. e i g#at#a #$ ti uita' "a) #ualita' &e(a-ata 'e(ta &e g$ ata
)e"i'
3. e "a&at#a &ela!a a &e g$ ata 'e'uai &e !a#it !a g "i"e(ita.
KE IJAKAN
1. N$)$( 44 ta%u 2009 te ta g Ru)a% a#it &a'al 40
2. Ke&utu'a Ke&ala PT Ru)a% a#it Ku'ta u) e(glaga% N$)$
( 440/ /101.14/2014 Te ta g Pa "ua A''e')e Pa'ie "i Ru)a%
PR E R a#it Ku'ta u) e(glaga%
1. Pa'ie ti a "i(ua g &e(a-ata "ia ta( $le% &etuga' IG&e(a-at
atau i"a atau &etuga' I 'tala'i Ra-at Jala
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2. a)&ai "i I 'tala'i Ra-at I a&, &e(a-at )ela#u#a :e(i+i#a'i i"e
tita' &a'ie a)a, ta ggal la%i(, ala)at, e i' #ela)i 'a) il

)e ;$;$##a "e ga 'tatu' &a'ie "a gela g i"e tita' ila 'u"a

% te(&a'a g e('a)aa "e ga le) a( 'e(a% te(i)a &a'ie

3. Pe(a-at )ela#u#a a'e')e #e&e(a-ata a-al e("a'a(#a u'ia/

#el$)&$#/ #a'u' &e !a#it &a'ie
4. Pe(a-at "i I 'tala'i Ra-at I a& )e e(u'#a a'e')e / &e g#a ia
a-al "a(i &e g#a ia +i'i# 'a)&ai "e ga "a+ta( )a'ala%
#e&e(a-ata !a g ti) ul "a "i"$#u)e ta'i#a "i 'tatu' &a'ie )
elalui I R
5. A'e')e (e ;a a #e utu%a &e)ula ga &a'ie "i#a i 'e a#

&a'ie R , "i"$#u)e ta'i#a "i 'tatu' &a'ie )elalui I R

6. $#te( )ela#u#a a'e')e )e"i' a-al "i 'tatu' &a'ie "a

&e)e(i#'aa +i'i# $le% "$#te( )elalui I R !a g te("i(i "a(i
AP
7. ila &a"a &e g#a ia !e(i "i"a&at#a '#ala !e(i (i ga , 'e"a
g atau e(at )a#a "$#te(/ &e(a-at )ela#u#a i te(:e 'i "a
i)&le)e ta'i 'e'uai "e ga &a "ua )a a e)e !e(i
8. Te tu#a "iag $'i' &a'ie , uat (e ;a a "a ti "a#a #e&e(a-
ata / )e"i' e("a'a(#a '#ala &(i$(ita' )ulai "a(i &e ilaia
#ea"aa u)u) &a'ie , &e)e(i#'aa +i'i# !a, "a te(a#
%i( &e)e(i#'aa &e u a g , #$la $(a'i#a "e ga
"$#te( '&e'iali' lai atau !a g )e(a-at u tu# ti "a#a )e"i',
&e) e(ia te(a&i "a ti "a#a / &ela!a a 'ela ut !a atau
#$la $(a'i "e ga ti) )e"i' lai ila "i&e(lu#a .
9. I +$()a'i#a / e(i#a e"u#a'i #e&a"a #elua(ga/ &a'ie u tu#
i#ut "ala) &e ga) ila #e&utu'a u tu# &ela!a a
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'ela ut !a "a "$#u)e ta'i#a "i le) a( KIE.
10. Tuli' %a'il a'e')e )e"i' "a #e&e(a-ata a-al "i "ala) 'tatu'
&a'ie "a %a(u' 'ele'ai )a#'i)al 24 a) 'e a# &a'ie "i(a-at i
a&#a le i% ;e&at le i% ai# #a(e a #$ "i'i &a'ie ,
te(uta)a &a"a &a'ie !a g a#a "ila#u#a ti "a#a &e) e"a
%a , a'e')e )e"i' a-al %a(u' "i"$#u)e ta'i#a 'e elu) ti
"a#a a ae'te'i atau e"a% "i e) a( Pe('etu ua Ti "a#a

11. Pe( a(ui / ula gi &e)e(i#'aa +i'i# "a :e(i+i#a'i (i-a!at

#e'e%ata &a'ie 'aat )a'u# (u)a% 'a#it ila 'u"a% le i%
"a(i 30 %a(i 'e elu) &a'ie "i(a-at i a& ;atat 'e)ua %a'il
a'e')e te()a'u# &e(u a%a #$ "i'i &a'ie !a g 'ig i+i#a "i
'tatu' &a'ie .
NIT TERKAIT 1. P KJA F NG I NA
2. REKAE I
3. IN TA A I RA=AT INAP
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Tanggal Ter i! Di!e!a"kan
Ke"ala UPT Ruma# Saki! Kus!a
PROSEDUR TETAP Sum erglaga#
POKJA FUNGSIONAL 1 Juli 2014
$r%& UDIASTUTI KUSHARJUNI S"%KK
NIP. 19590625 198711 2 001
PENGERTIAN A'e')e atau &e g#a ia atau &e ilaia ula g !a g "ila#u#a &a"a

i te(:al te(te tu ata' "a'a( #$ "i'i "a &e g$ ata &a'ie , u tu#
)e geta%ui (e'&$ &a'ie te(%a"a& &e g$ ata !a g tela% "i e(i#a
'e;a(a &e(i$"i# 'etela% &e) e(ia &e g$ ata "a &e) uata
(e ;a a &e g$ ata'ela ut !a 'e(ta )e e tu#a (e ;a a
&e)ula ga &a'ie .
T J AN 1. e agai t$la# u#u( (e ;a a &e g$ ata 'ela ut !a 'e(ta (e ;a a
&e)ula ga &a'ie
2. e i g#at#a #$ ti uita' "a) #ualita' &e(a-ata 'e(ta &e g$ ata
)e"i'
3. e "a&at#a &ela!a a &e g$ ata 'e'uai &e !a#it !a g "i"e(ita.
KE IJAKAN 1.N$)$( 44 ta%u 2009 te ta g Ru)a% a#it &a'al 40
2. Ke&utu'a Ke&ala PT Ru)a% a#it Ku'ta u) e(glaga% N$)$(
440/ /101.14/2014 Te ta g Pa "ua A''e')e Pa'ie "i Ru)a%
a#it Ku'ta u) e(glaga%

PR E R 1. I"e ti+i#a'i #e e a(a i"e tita' &a'ie !a g a#a "ila#u#a

a'e')e ula g.
2. $#te(, &e(a-at, i"a , a%li gi<i, +i'i$te(a&i' atau &'i#$l$g

)ela#u#a $ 'e(:a'i atau &e)e(i#'aa la g'u g &a"a &a'ie !a g

te("i(i "a(i (e'&$ &a'ie , ta "a* ta "a :ital "a #e utu%a
&a'ie lai !a 'e'uai "e ga i"a g !a )a'i g* )a'i g
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3. I"e ti+i#a'i (e'&$ &a'ie !a g tela% "ila#u#a &e g$ ata

atau te(a&i 'e elu) !a "i'e(tai #$la $(a'i "e ga %a'il
&e)e(i#'aa &e u a g lai !a la $(at$(iu), (a"i$l$gi, (e%a
ilita'i )e"i' 'e;a(a &e(i$"i# )a#'i)al 24 a) 'etela% &e) e(ia
&e g$ ata % ala) ta%a& i i "a&at "ite tu#a &ula
&e(e ;a aa &a'ie &ula g ila #$ "i'i &a'ie )e) ai# "a "i !
ata#a $le% &ula g $le% "$#te( !a g )e(a-at
4. $#u)e ta'i#a a'e')e ula g &a"a +$()at !a g tela%
"i'e"ia#a 'e agai +$ll$- u& #e'e%ata &a'ie te('e ut, "a
tuli'#a "i 'tatu' &a'ie )elalui I R "$#u)e ta'i te("i(i "a(i a
ali'a (e'&$ &a'ie , &e(u a%a #$ "i'i &a'ie , !a g 'ig i+i#a
"a (e ;a a &e) e(ia te(a&i 'ela ut !a
5. $#u)e ta'i#a a'e')e ula g !e(i "a (e'i#$ atu% "i 'tatu'
&a'ie , la ut#a a'e')e a-al 'e'uai +$()at, la#u#a 'e'uai "e
ga &a "ua )a a e)e !e(i "a &a "ua (e'i#$ atu%
6. ila "i&e(lu#a u tu# #$ 'ulta'i &a"a &i%a# atau i"a g lai '&e'iali' lai

'e'uai #e utu%a &a'ie "ituli' &a"a 'tatu' &a'ie )elalui I R "a uga le) a(

#$ 'ulta'i !a g "ituli' $le% "$#te( !a g )e g$ 'ul#a "ituu#a &a"a "$#te(

#$ 'ula atau a%li i"a g #e'e%ata lai

7. ila "i"a&at#a #$ "i'i !a g )e)e(lu#a ti "a##a )e"i' la uta
"ii +$()a'i#a &a"a &a'ie "a #elua(ga u tu# )e)i ta
&e('etuua "e ga )e a "ata ga i 'u(at &e('etuua ti "a#a
'e elu) "ila#u#a ti "a##a te('e ut.
NIT TERKAIT 1. P KJA F NG I NA
2. REKAE I
3. IN TA A I RA=AT INAP