Bulan : .................
NAMA UNIT : Instalasi Bedah Sentral ( IBS )
INDIKATOR SASARAN MUTU : Kelengkapan Assesmen Pra Sedasi dan Pra Anestesi
NUMERATOR :
DENUMERATOR :
FORMULA :
TARGET : 100%
HASIL INDIKATOR MUTU UNIT :
KESIMPULAN : Tercapai Tidak Tercapai
ANALISA UNIT (Tercapai/Tidak tercapai, alasan dan usulan):
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REKOMENDASI :...........................................................................................................................................
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