DOH - SPMS Form 3

INDIVIDUAL PERFORMANCE COMMITMENT AND REVIEW (IPCR)

I, ____RITCHIE C. REALES_ , of the ____Medical Department of Margosatubig Regional Hospital ____ , commit to deliver and agree to be rated on the attainment of the following targets in accordance with the indicated
measures for the period __ JANUARY to ____JUNE____ , 20__19__ .

Name of Emp. Date:

Approved By: Date

MELDRED QUINCO-ARTES
Name of Supervisor
5 – Outstanding
4 – Very Satisfactory
3 – Satisfactory
2 - Unsatisfactory
1 - Poor
RATING SCALE

RATING
Success indicator QLY
Output
(Target + Measure)
Actual Accomplishment QTY T A Remarks
(1) (3) (4)
(2)
___ patients examined, diagnosed & given medical care within ____ minutes __ patients examined, diagnosed & given medical care within ___ minutes per
Patients examined, diagnosed & given medical care.
per patient. patient.

All medical certificates issued. ___ medical certificates issued within ____minutes per patient upon request. ___ medical certificates issued within ___ minutes per patient upon request.

___ medical / clinical records completed within ____ minutes per patient upon ___ medical / clinical records completed within ____minutes per patient upon
Clinical records completed.
receipt. receipt.

___ minor surgical operations performed within ____ minutes per patient upon ___ minor surgical operations performed within ___ minutes per patient upon
Minor surgical operations performed.
arrival. arrival.

RATING
Total Overall Rating
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

MELDRED QUINCO-ARTES, MD / ELBERTO A. BUCOY, MD JOVER C. PUNSALAN, MD, FPOA, PFSS

Employee Supervisor Next Higher Supervisor

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

EXD-FM-HRMO-012 Revision: 1 Effectivity Date: April 12, 2018

 DOH - SPMS Form 3

INDIVIDUAL PERFORMANCE COMMITMENT AND REVIEW (IPCR)

I, MELDRED QUINCO-ARTES, MD , of the Medical Service of Margosatubig Regional Hospital , commit to deliver and agree to be rated on the attainment of the following targets in accordance with the
indicated measures for the period January to June , 20 19 .

Name of Emp. MELDRED QUINCO-ARTES Date:

Approved By: Date

JOVER C. PUNSALAN, MD, FPOA, FPSS

Name of Supervisor

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

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

100% patients examined, diagnosed & given medical care within 100% patients examined, diagnosed & given medical care
Patients examined, diagnosed & given medical care. 5minutes per patient. within 5minutes per patient. 5 5 5 5.00

100% patients examined, diagnosed, and given medical care within 5 100% patients examined, diagnosed, and given medical care
Accepts and attends to referrals in the Emergency Room.
minutes per patient. within 5 minutes per patient. 5 5 5 5.00

100% duties and responsibilities as Emergency Room Head

Duties and responsibilities as Emergency Room Head. 100% duties and responsibilities as Emergency Room Head performed.
performed. 5 5 4 4.67

Duties and responsibilities as HEMB Chairperson and 100 % Duties and responsibilities as HEMB Chairperson, and Sentinel 100 % Duties and responsibilities as HEMB Chairperson, and
Sentinel Officer. Officer. Sentinel Officer. 5 5 4 4.67

RATING
Total Overall Rating 20 20 18 19.34
Final Average Rating 5.00 5.00 4.50 4.83
Adjectival Rating O O VS VS
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

MELDRED QUINCO-ARTES, MD JOVER C. PUNSALAN, MD, FPOA, FPSS JOVER C. PUNSALAN, MD, FPOA, FPSS
Employee Supervisor Next Higher Supervisor

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

EXD-FM-HRMO-012 Revision: 1 Effectivity Date: April 12, 2018