DIVISION PERFORMANC

I,___________________________, Division Chief of the ____________________________________, co

measures for the period _______________ to __________________, 20_____.

Approved By:

Name of Superv

RATING
SCALE

Major Final
Functional Objectives PERFORMANCE INDICATORS
Output

MFO 3: To ensure patient's satisfaction to all IM 80% overall customer satisfaction rate
HOSPITAL health care services
SERVICES

To decrease the mortality rate among

admitted patients by meeting the WHO- < 5 percent NDR
DOH accepted net death rate (NDR)

To maintain the accepted infection rate

(NIR) among managed patients (following <2% NIR
the CPG's) at the medical wards

To achieve on discharge as improved rate increase the number of discharged patient

(DIR) of 70% among patients admitted at with an improved status by 20% from the
the medical wards borderline of 70%
 To ensure provision of quality continuing 50% of residents pass PSBIM exam.
education and training programs for Attaining 50 place in the RITE among 94
consultants, resident physicians and other accredited PCP RTP
health personnel

80% completed research on or before date

To understand the quality residents of graduation actual number of
activities research/actual number of required
research X 100

RATING
Total Overall Rating
Final Average Rating

Comments and Recommendation for Development Purposes

Discussed Assessed by: Date
With:
I certify that I discussed my assessment of the perfomance with the
employee

Employee Supervisor

Legend: 1- Quantity 2 -Quality 3 - Timeliness 4 - Average

SION PERFORMANCE COMMITMENT AND REVIEW (DPCR)

_________________, commit to deliver and agree to be rated on the attainment of the following targets in accordance with the

Name of Division Chief CHIEF ADMINISTRATIVE OFFICER

Name of Supervisor

5 – Outstanding
4 – Very Satisfactory
3 – Satisfactory
2 - Unsatisfactory
1 - Poor

RATING
Alloted Person
E INDICATORS Actual Accomplishment QTY QLY
Budget Accountable
(1) (2)

satisfaction rate PACU,HR

Chair, TO,
consultant
ent NDR residents, nurses
and ancilliary
working staf
Chair, TO,
consultant
NIR residents, nurses
and ancilliary
working staf
Chair, TO,
of discharged patient consultant
tus by 20% from the residents, nurses
e of 70% and ancilliary
working staf
 training core of
pass PSBIM exam. the department
the RITE among 94
(or department
d PCP RTP of nursing

rch on or before date

ctual number of TO of head and head
research committee
umber of required (IM department)
h X 100

Average Rating x 70%

Next Higher Supervisor

 DOH - SPMS Form 2

in accordance with the indicated

Date: _______________

Date

ng
sfactory
ry
tory

RATING
T A Remarks
(3) (4)
Date
 DOH - SPMS Form 3
INDIVIDUAL PERFORMANCE COMMITMENT AND REVIEW (IPCR)

I, SINSUAN, KRISTOFFER B. of the Department of Internal Medicine, commit to deliver and agree to be rated on the attainment of the following targets in accordance with the indicated measures for the period June to
December, 2018
Name of Emp. KRISTOFFER B. SINSUAN Date:

Approved By: JEROME R. BARRERA Date

Medical Officer III

RATING
Success indicator
Output Actual Accomplishment Q E T A Remarks
(Target + Measure)
(1) (2) (3) (4)

Able to complete history and PE and requests adequate diagnostic work ups
on 1000 patients in 6 months (20mins/patient)
Performs a complete and a legibly written history and PE on a patient. 160 patients/ month (15 minutes/patient) 4 4 4 4.0

Conducts daily rounds and makes progress notes and manages able to do daily rounds, complete progress notes and manages 2880 patients
16 patients/day ( 15 minutes per day) 4 4 4 4.0
his/her assigned patients with diligence in 6months 20minutes per/patient

Refers promptly his/her patient to his/her assigned consultant/s and Refered 1000 patients in 6 months to consultants and actively gives updates
6 patients/day ( 10 minutes per patient) 4 4 4 4.0
responsively gives the updates of his/her patient/s 10-15 mins/day

Actively participates in all conferences 8 conferences/month (1 hour) participated 98 conferences in 6 months (1 1/2 hr per conference) 5 5 4 4

Completes the patient's medical record accurately from admission able to complete the 400 patient's medical record accurately from admission
2 charts /day (15 minutes/patient) 4 4 3 4.0
to discharge to discharge in 6 months (1 1/2 hour per research update)

Attends Research Updates 2 research updates in 6 months (1 hr per research update) Attended 4 research updates in 6 months (15 minutes per patient) 5 5 4 4.0

Conducts diligently health education to his/her patient 5 patients/day ( 10 minutes per patient) Able to conduct health education in 950 patients (10minutes per patient) 4 4 3 4.0

1 community engagement every 6 months (1 Able to participates 3 activities in department's community engagement 4.0
Participates actively in the department's community engagement hour/engagement) (1hr/engagement) 5 5 3

Total Overall Rating 35 35 29 4

Final Average Rating
Adjectival Rating
Comments and Recommendation for Development Purposes
Discussed With: Assessed by: Date Final Rating by: Date
I certify that I discussed my assessment of the perfomance with the employee

KRISTOFFER B. SINSUAN JEROME R. BARRERA, MD DR. BRIDGET R. CRISTOBAL

Employee Supervisor Next Higher Supervisor
Legend: 1- Quantity 2 -Efficiency 3 - Timeliness 4 - Average