1. Basic standards for hospitals at all levels: this standard is a standard that must be met at all levels of hospitals, but also hospitals are qualified to open the accreditation standards. Basic standards are assessed and evaluated separately, and separate from the classification standard assessment and scoring. If you do not meet the requirements of the "basic standards", not pass, as unqualified hospitals, new applications for the opening of the hospital will not be approved.
2. Hospitals at all levels of grading standards: according to the different tasks and functions, the hospital is divided into three levels, namely, the first level of hospitals, second level hospitals and third level hospitals. Also according to the level of technical level, quality level and management level of hospitals at all levels, and with reference to the necessary facilities and conditions, respectively, are divided into A, B, C, and the third-level hospitals to add a special class.
3. Review of the determination criteria: the establishment of the mathematical model scoring method before the temporary adoption of the thousand-point system approach to evaluation. In the review, qualified hospitals according to the total number of points to assess the grade. Grade A: the standardized assessment shall reach 900 points or more (including 900 points). Grade B: The standardized assessment of grading must reach 750 to 899 points. Grade C: The standardized assessment of grading shall be less than 749 points (including 749 points). (Including 749 points.) In addition to meeting the standards of the third-class hospitals, the third-class hospitals must also meet the conditions necessary for hospitals.
4 . Hospital accreditation application: the hospital to the accreditation committee to apply for the necessary procedures, but also the accreditation committee to determine the qualifications of the hospital accreditation is the main basis. Requirements of the hospital must be serious, realistic and fill out the item by item, declaration.
5. Other relevant annexes of the standard: is the standard of specific indicators, requirements and assessment and inspection points such as the description. The formation of the "general hospital grading management standards" is still very imperfect, only as a draft in the country on a trial basis. It is hoped that the localities will put forward amendments to this standard during the trial implementation, so that it can be gradually improved. Standards for health centers and primary hospitals (level 1 hospitals) Level 1 hospitals are primary health care institutions that directly provide medical, preventive, health care and rehabilitation services to communities with a certain population (≤100,000), and they are the primary health care institutions for the implementation of primary health care and the realization of the global goal of "health security for all" in China. Basic Standards for Level I Hospitals These standards are the necessary conditions for the qualification of Level I hospitals, and only those who have reached the qualifying line of these standards can participate in the level assessment. The basic standards include the following seven aspects: I. Scale of the hospital The scale of the hospital should be compatible with the functions, tasks and management requirements of a first-class hospital. 1. The number of hospital beds shall not be less than 20. If it is less than the above limit, a reasonable explanation must be given. 2. The necessary facilities per bed unit in the ward meet the prescribed requirements (see Annex VI). 3. The floor area per bed is not less than 45 square meters. 4. The ratio of beds to the number of regular hospital employees is: 1:1-1.4. 5. The ratio of health technicians to the total number of employees in the hospital is 80-85% (non-health technicians, shall not be engaged in medical, medical technology and nursing model technical work.)
Two, hospital functions and tasks A hospital shall undertake the community's various medical and health services and certain health administrative management.
(a) preventive health care 1. do a good job of community health epidemic prevention and control, including immunization, infectious diseases, parasites and endemic diseases, under the guidance of the higher level of health epidemiological departments, the implementation of health supervision and management work. 2. to actively carry out maternal and child health care work, carry out universal treatment for women, infants and young children with frequent diseases, carry out health care for marriage, childbearing and maternity systems, and promote scientific midwifery. 3. To do a good job in family planning surgery and technical guidance. 4. To take various forms of health education, popularize health knowledge on factors that endanger the health of the community, and improve the self-care ability and overall health of the population.
(2) medical services 1. Complete outpatient and inpatient (including family hospital beds) treatment of common and frequent diseases in the community, and carry out rescue of emergency, serious and critical patients to maintain their vital signs, and organize referrals. 2. Popularize first-aid knowledge and techniques among the public, and the medical staff of the hospital must master effective hands-only cardiopulmonary resuscitation (Hands-Only Cardiopulmonary Resuscitation). 3. According to the conditions to carry out community rehabilitation medical care, mental health services, chronic non-communicable diseases of the population prevention and treatment.
(3) health administration 1. Under the leadership of the local government and higher health administrative departments, based on the local socio-economic development planning, assist in the development and implementation of community-based primary health planning. 2 with the relevant departments to mobilize and organize the masses to carry out patriotic health activities, and gradually improve the community health situation. 3. To carry out the implementation of various national health laws and regulations, and to supervise and manage the relevant industries in the community. 4. To be responsible for the management and technical guidance of village-level health organizations and individual practitioners, and to train village doctors, health workers and midwives.
Three, hospital management The hospital should have a sound management system, with appropriate systems, measures, supervision, assessment and evaluation. Some people are responsible for the division of labor administration. Business management and ideological and political work. (A) the necessary systems According to the 1982 Ministry of Health issued the "national hospital work regulations, hospital work system and hospital staff duties" relevant provisions, combined with the actual hospital, must be carefully formulated and strictly enforced rules and regulations, including: 1. In addition to the general hospital work system, should include maternal and child health care, health prevention and epidemic prevention, family hospital beds work system, guidance to rural doctors and other work systems. 2. All levels and types of personnel job responsibility system. 3. All technical operating procedures. 4. Continuing education system for employees. (B) Information management 1. According to the Ministry of Health "health statistics work system (for trial implementation)" with the provisions of the comprehensive information management special (part-time) staff. 2. Timely collection, storage, analysis, feedback and utilization of information, and effective. 3. There is a library management system, ordering an appropriate amount of medical books and periodicals. (C) financial management 1. There is a financial organization or full-time accounting staff. 2. Accounting vouchers, books and statements are in accordance with the accounting system. 3. Establishment of accounting files and management system. 4. Sound accounting supervision and audit system, strict compliance with financial and price discipline, and no arbitrary charges. (iv) Equipment management 1 . Setting up specialized or part-time personnel to manage the equipment of the whole hospital. 2. Medical equipment storage, use, maintenance, regular maintenance system to ensure that the needs of medical work. 3. Files established for important equipment. (E) General management 1. General supplies are managed on a quota basis, and there is a sound system of purchasing, acceptance, warehousing, issuing and scrapping. 2. Proactive and timely services are provided to the whole hospital to ensure the supply of water, electricity, quilts and meals, and the timely maintenance of various facilities. (F) Building management 1. Hospital buildings meet the requirements of hygiene, have a maintenance system for old buildings, and have a remodeling plan for unreasonable buildings. 2. Dangerous buildings shall not be used, in particular, shall not be engaged in medical activities in dangerous buildings.
Four, quality management (a) a full-time (part-time) staff responsible for the hospital's quality management, the establishment of a sound level-by-level quality assurance system. (B) there is a hospital-wide quality management program, and seriously implement. (C) Nosocomial infection control: 1. The infection control organization should be in accordance with the provisions of the Interim Measures for the Establishment and Improvement of Hospital Infection Management Organization of the Ministry of Health in 1988. 2. There is a hospital-wide infection control program. 3. Establish strict disinfection and isolation and infectious disease registration and reporting system and aseptic operation regulations. 4. There is a hospital infection control education system, and medical staff must establish the concept of asepsis and carry out correct aseptic technical operation. 5. There are management methods for rational use of antibiotics. 6. There are measures to protect special areas (such as operating rooms, treatment rooms, supply rooms, labor and delivery rooms, etc.). 7. Sterilization and supply room should meet the requirements of the Ministry of Health "Hospital Sterilization and Supply Room Acceptance Standards (Trial)".
V. Ideological and political work and medical ethics construction 1. Implementation of the Party's line, guidelines, policies, party, government, industry and workers **** management, the development of ideological work and medical ethics and medical construction plan, and organization and implementation. 2. To have ideological and political work management system and corresponding work system. 3. conscientiously implement the Code of Medical Ethics for Medical Personnel and Implementation Measures, and carry out and adhere to the pre-post education system. 4. Establish a mass supervision system. 5. According to the survey, the satisfaction degree of patients, communities or contracted units to the hospital meets the regulations. 6. There are sound measures for the clean practice of medicine.
Sixth, hospital security 1. Establishment of a sound hospital safety and security management system, and have a full-time or part-time staff responsible for. 2. The development of usual and emergency safety management program, and regular inspection. 3. Have special safety management measures for high-pressure systems, operating rooms, radiology rooms, power distribution rooms and other high-risk equipment and areas. 4. Equipped with necessary fire-fighting equipment. 5. There is a management system for highly toxic, narcotic and psychotropic drugs, and it is strictly enforced. 6. Lighting system in the event of an accident, there is a safe alternative source of light to ensure the needs of emergency.
VII. Hospital environment 1 . Attaching importance to hospital cleanliness and hygiene, there are cleaning systems and measures, and there are people in charge. 2. Smoking is prohibited in outpatient clinics, wards and other medical areas. 3. Attention to greening in the hospital, there is a green area (including indoor and outdoor flower planting, three-dimensional greening) appropriate to the hospital's footprint. 4. Harmless treatment of dirt and sewage is carried out, and the treatment meets hygienic standards. 5. Outpatient noise is no higher than 50 decibels, and the noise in wards and operating rooms is no higher than 38 decibels. 6. The general lighting in the operation room is 100 meter candles, and the comprehensive lighting in the working area is 2000-3000 meter candles. First-class hospital grading standards This standard is the standard for the construction and development of first-class hospitals, as well as the basis for evaluation of their level and quality. I. Section setup Section setup shall be adapted to the function, mission and actual needs of the community of the first-class hospital. 1. Clinical sciences: internal medicine, surgery, obstetrics and gynecology, emergency room should be set up. If there are conditions, set up pediatrics, five palaces, traditional Chinese medicine, family hospital beds (group) and so on. 2. Medical and technical departments: should be set up in the pharmacy (including mixing room), laboratory (test center has a unified arrangement may not be required), radiology, operating room, disposable room, supply room, medical records and statistics room, library and so on. 3. Administrative section: set up the hospital office (responsible for medical, nursing model, personnel, secretary, security, finance, logistics, etc.). 4. Preventive health care (section): set up health epidemic prevention room, maternal and child health care room (including family planning technical guidance). II. Staffing To achieve the ratio of beds to personnel in the basic requirements. Among them, the ratio of various types of personnel is as follows: Various types of personnel, administrative staff, health technicians, among them, various types of health technicians, Chinese and Western medicine teachers (doctors) % % Inspection % Radiology % Pharmacy % Other % 15-20 80-85 38 38 4 4 8 8 which is divided into preventive health care personnel accounted for more than 25% of the health technicians.
Three, the level of technology Technology construction should be based on the actual situation, and can carry out the diagnosis and treatment of common and frequent diseases in various disciplines in the community, and the ambulance service for the general critically ill patients. Basic requirements: (a) medical 1. emergency medical: emergency cases in the community can be 24 hours (including outpatient). 2. Internal medicine, pediatrics: correctly deal with common diseases, and can be difficult to deal with the appropriate treatment and referral. Be able to make initial diagnosis and conduct life-sustaining resuscitation treatment for circulatory, urinary and respiratory system failure, acute poisoning and shock and other general emergency patients. Master the treatment of local infectious diseases and sterilization and isolation techniques. 3. Surgery, obstetrics and gynecology: be able to make clinical diagnosis and timely and correct treatment of surgical emergency abdomen. Be able to carry out general upper abdominal surgery. Be able to complete surgical hemostasis, suture, bandage, fracture immobilization and other treatments. Be able to complete the physiological obstetrics, part of the common disease pathology obstetrics treatment and cesarean section surgery. 4. Pentacenter: able to diagnose and treat common diseases and some emergencies. To prevent blindness, caries and deafness. 5. Chinese medicine: can dialectic treatment of internal, external, gynecological, pediatrics, common diseases and some of the difficult and complicated diseases. Carry out acupuncture, massage, etc. 6. Skilled in a variety of diseases, strict implementation of various technical procedures. Good ward management and grading, correctly write five forms (temperature list, medical orders, medical records, nurse shift, records). 7. Medical technology department: Be able to carry out electrocardiogram and ultrasonic examination. Can carry out blood, urine, stool routine tests and some biochemical tests. (test center area, the relevant arrangements to have a contract) can carry out fluoroscopy, film, general gastrointestinal imaging and other tests. (ii) Preventive health care 1. Can carry out immunization, epidemic treatment, and technical guidance on the "two management and five reforms". 2. 2. be able to carry out perinatal health care, children's systematic health care, and master the four techniques of family planning. 3. be able to carry out community chronic non-communicable disease prevention and treatment, geriatric health care, mental health and community rehabilitation medicine. (iii) Teaching 1. To be able to train rural doctors, health workers and midwives. 2. Be able to accept some clinical studies from students of health schools. (iv) Hospital management 1. The director should be familiar with the management of a first-class hospital and have undergone short-term training in hospital management. 2. The hospital has a long-term development plan and specific implementation steps. 3. Hospital staff's satisfaction with the work of hospital leaders ≥ 80%. 4. Community, contracted units and patients' satisfaction with the hospital ≥80%. 5. Information management: To grasp the incidence of various infectious diseases in the population and establish a sound system of registration and reporting of infectious diseases. Registration pass rate ≥ 95%, omission rate ≤ 0.5%. Do a good job of hospital statistics, with statisticians to master the community population, life, disease (multiple diseases, chronic diseases, endemic diseases) dynamic information, timely analysis and countermeasures; according to the provisions of the timely and accurate completion of a variety of health statistics reports. Establishment of case management system, with full-time or part-time staff responsible for, gradually according to the International Classification of Diseases (ICD) management, requiring outpatient medical records, inpatient writing a complete medical record; written according to the standard, Class A medical records ≥ 80%, to eliminate Class C medical records. V. The basic equipment of the main departments is detailed in (Annex VII). Sixth, the statistical indicators 1. admission diagnosis and discharge diagnosis compliance rate ≥ 85% 2. pre- and post-surgery diagnosis compliance rate ≥ 95% 3. outpatient referral rate ≤ 20% 4. single-disease cure and improvement rate: compared with the same level of hospitals, at the average level 5. single-disease rate: compared with the same level of hospitals, on average 6. single-disease success rate of rescue of critically ill patients: compared with the same level of hospitals, at the average level 7. Inpatient transfer rate ≤ 3% 8. Technical operation pass rate ≥ 85% 9. Coma, paralyzed patients bed sores occurred: 0 10. Nosocomial infection rate ≤ 3% 11. Sterile surgical incision infection rate ≤ 1% 12. One person, one needle, one tube implementation rate of 100% 13. Routine instrument disinfection bacteria pass rate of 100% 14. Bed utilization rate of ≥ 60% 15. The annual turnover of the number of hospital beds ≥ 32 times 16. Average Hospitalization days 6 days 17. Outpatient prescription pass rate ≥ 98% 18. Outpatient medical record writing pass rate ≥ 90% 19. Inpatient medical record writing pass rate ≥ 98% 20. Grade A X-ray rate ≥ 40% 21. Five forms writing pass rate ≥ 85% 22. The number of medical accidents of medical responsibility above the second level 0 23. Equipment utilization rate of ≥ 80% 24. Positive rate of special diagnostic equipment examination ≥ 20% ( The positive rate of special diagnostic equipment examination is ≥20% (mainly refers to ultrasound) 25. 0 to 7-year-old children card rate of rural ≥98% urban ≥100% 26. live measles vaccination rate of rural ≥90% urban ≥95% 27. live polio vaccination rate of rural ≥90% urban ≥95% 28. vaccination rate of DPT vaccine of rural ≥90% urban ≥95% 29. vaccination rate of BCG vaccination of rural ≥90% urban ≥95% 30. four vaccines Full coverage rate of rural ≥ 85% urban ≥ 92.5% 31. women's disease detection and treatment rate of rural ≥ 60% urban ≥ 90% 32. perinatal mortality rate of rural ≤ 20% urban ≤ 90% 33. prenatal checkup rate of rural ≥ 80% urban ≥ 95% 34. new method of delivery rate of ≥ 95% 35. postpartum visit rate of rural ≥ 70% urban ≥ 80% 36. health technicians pass the three basic examination rate 100% 37. first aid items intact rate of 100% 38. basic pass rate ≥ 80% 39. first-class pass rate ≥ 80% first-class hospital grading criteria Hospitals should conduct regular self-evaluation of their construction, management, technical level, quality of work, civilized service, cost-effectiveness, etc., and formulate improvement measures. The local (municipal) hospital accreditation committee shall conduct out-of-hospital evaluation of hospital quality according to this standard. According to the evaluation results of the first-class hospitals are divided into A, B, C three levels. First, the first class A hospital Hospital construction achievements are remarkable, departmental settings, staffing, management level, technical level, quality of work and basic hospital facilities and other combined level, the assessment reached 900 points and above. Second, the first class B hospital hospital construction achievements are still good, its department settings, staffing, management level, technical level, quality of work and basic hospital facilities and other combined level of 750-899 points by the assessment and inspection. Third, the first class C hospital hospital construction has some achievements, the basic standard assessment qualified, but with the sub-class standard requirements are still a big gap. After the comprehensive assessment and inspection of 749 points or less (including 749 points). Grade C hospitals should have practical improvement measures and development planning. Standard for Level II Hospitals Level II hospitals are health institutions that provide medical, preventive, health care, and rehabilitation services to multiple communities (whose radius population is generally more than 100,000), and are the intermediate level in the three-tier medical and health care system.
In particular, there is a higher level above "Level 3A" - "Level 3 Premium"! Approved by the Ministry of Health, it seems to require that a tertiary hospital has a nationally leading specialty clinic in order to apply, which is difficult. Some hospitals in Beijing to achieve "three special", such as: Peking Union Medical College Hospital, the People's Liberation Army General Hospital (301 hospital), three special is the best hospital!