Self-examination and self-correction report of medical institutions practicing according to law;
In order to further strengthen the awareness of medical institutions to practice according to law, crack down on illegal medical practice, strengthen the supervision of medical institutions by health and family planning administrative departments, improve the quality of medical services, and ensure medical safety, according to the Notice of xx Municipal Health and Family Planning Commission on Carrying out Comprehensive Law Enforcement Inspection of Medical Institutions (Shi Guang Wei Ban Fa [2016] No.78), the Municipal Health Planning Commission is required to organize relevant personnel of the Comprehensive Supervision Department, the Medical Administration Department and the Health Law Enforcement Detachment to notify the relevant information as follows:
I. Basic information
This inspection randomly selected 30 medical institutions including municipal medical institutions, including 2 public medical institutions above Grade III, 5 public medical institutions above Grade II, 4 other public medical institutions, 9 private medical institutions and township hospitals 10. In view of the medical institutions with many problems found in daily supervision and strong reaction from the masses, it is important to check whether there is any behavior of renting contracted departments or renting contracted departments in disguised form in each medical institution, whether it goes beyond the approved and registered diagnosis and treatment subjects to carry out diagnosis and treatment activities, whether it uses non-health technicians to engage in medical and health technical work, whether the naming of medical institutions is standardized, whether the clinical application of medical technology is prohibited for filing according to regulations, and whether there is any behavior of prohibiting clinical application of medical technology. The inspection team will feedback the inspection situation to the inspected unit on the spot, and send the problems found to the health and family planning bureaus of all districts, cities and counties in the form of "Health Administrative Law Enforcement Proposal" to urge the rectification to be in place and investigate and deal with the illegal acts found according to law.
Second, the existing problems
(1) Management of medical institutions: Most medical institutions can apply for verification on schedule, and carry out diagnosis and treatment activities according to the diagnosis and treatment subjects approved and registered by the health administrative department, and there is no behavior of renting contracted departments or renting contracted departments in disguised form. However, on the whole, the awareness of legal practice and medical quality of medical institutions still need to be improved, and the phenomenon of illegal medical practice still exists. First, there is still the phenomenon of using non-health technicians. During the inspection, it was found that most private medical institutions are relatively short of qualified health technicians, especially the functional auxiliary departments such as B-ultrasound room, radiology department and laboratory department. There is a phenomenon that qualified personnel are absent for a long time and qualified personnel do not issue relevant inspection reports. At the same time, grassroots medical institutions such as private medical institutions and township hospitals lack qualified pharmaceutical personnel, and it is common for people who do not have pharmaceutical qualifications to review and distribute drugs; The registered address of medical practitioners in individual medical institutions has not been changed in time to carry out diagnosis and treatment activities or the medical practitioners registered in hospitals are not on the job. Second, the setting and naming of departments are not standardized, and some medical institutions still have dummy departments or additional departments. Third, occupational radiation management is not standardized. During the inspection, it was found that some medical institutions failed to obtain the Radiological Diagnosis and Treatment Permit, or failed to carry out the radiation diagnosis and treatment activities on time, and the details of the radiation device were not registered in the copy. The radiation workers did not wear personal dose detectors and did not undergo pre-job physical examination. Fourth, the management of medical records and prescriptions is not standardized. There are some problems such as untimely and imperfect writing of medical records, untimely printing of printed medical records and signature of doctors, untimely examination and signature of doctors by unqualified personnel, and irregular prescription writing and medication.
(II) Management of clinical application of medical technology: There are 15 medical institutions registered to carry out Class II medical technology in the city, and there is no medical institution registered to carry out Class III medical technology. The second-class medical technology for the record is mainly concentrated in medical institutions above the second level, mainly focusing on the development of endoscope and hip and knee replacement technology above the third level. According to the inspection, among the 30 medical institutions randomly selected, 23 have not restricted the clinical application of medical technology, 6 have filed with the health and family planning administrative department as required, and 1 family has not filed the hip replacement technology. Among the medical institutions for filing, individual medical institutions are unable to provide filing announcements, the medical technology management carried out is not standardized, and relevant rules and regulations have not been established.
(3) Medical advertisement management: some medical institutions have irregular medical publicity in hospitals, such as listing? Cooperate with xx Hospital? Post a cooperation introduction? Expert? Exaggerate the therapeutic effect of medical technology propaganda. No request has been received from the industrial and commercial department to revoke the diagnosis and treatment subjects or the practice license of medical institutions.
(4) Naming management of medical institutions: Generally speaking, the naming of public medical institutions is relatively standardized, and the naming of some private medical institutions needs to be further standardized. For example, the names of medical institutions with irregular place names are involved, such as Linshui Chuandong Hospital, Linshui Southwest Stomatological Hospital, xx Citizen Health Hospital, etc. Use homophones to create ambiguous or misleading names of medical institutions, such as Sheikh Hospital in Linshui County, Huaxi Hospital in Linshui County, xx Huaxi Hospital, Vu Thang Pok Oi Hospital, and Vu Thang Huaxi Hospital.
Third, the next work requirements
(1) Sort out the problems and investigate and deal with them according to law. All localities and units should take the problems found in this inspection as clues, carefully sort out the existing problems, organize and urge law enforcement departments to further investigate and collect evidence, and once the violations of laws and regulations of medical institutions are verified, resolutely investigate and deal with them in accordance with the Regulations on the Administration of Medical Institutions and other relevant regulations, and will never tolerate them.
(2) Strengthen daily supervision and management. All localities and units should attach great importance to this work, strengthen the daily management of medical institutions under their jurisdiction, and urge medical institutions to standardize their practice. The first is to standardize the establishment and management of departments in medical institutions. It is forbidden to rent contracted departments, use non-health technical personnel and practice beyond the scope. The second is to strengthen the supervision of clinical application of medical technology. Strengthen the post-event supervision of the clinical application of medical technology in this area, and incorporate the clinical application of medical technology into the daily supervision focus. The third is to strengthen the management of medical advertisements and conduct examination and certification according to law. The fourth is to further standardize the naming management of medical institutions.
(three) to strengthen the verification and review of medical institutions. For medical institutions that propose calibration, it is necessary to strictly review relevant documents, medical records and materials to see whether they meet the basic standards of medical institutions. Those who do not meet the relevant requirements of the Regulations on the Administration of Medical Institutions and the Measures for the Administration of Verification of Medical Institutions shall be ordered to make rectification within a time limit and given a suspension period of 1 to 6 months. If the suspension period has not passed the verification, the registration authority shall cancel the practice license of the medical institution.
For the problems found in the inspection and supervision of the list, all responsible units should rectify and put them in place before the end of July. Overdue rectification or rectification is not in place, according to its situation into the year-end performance target management part. The rectification report shall be submitted to the Comprehensive Supervision Section of the Municipal Health Planning Commission before the end of July.
Report on self-examination and self-correction of medical institutions practicing according to law;
20 14-20 16 health supervision institutions at all levels in Zhejiang province have been developing medical institutions for three consecutive years? Practise according to law to protect health? The action has achieved remarkable results.
I. Overview of actions
Since 20 1 1, the provincial health department has carried out health protection actions for medical institutions to practice according to law throughout the province, requiring health administrative departments at all levels to take measures such as training and publicity, supervision according to law, interview punishment, scoring notification, rectification and review, etc. to standardize the practice behavior of various medical institutions at all levels. At the same time, the provincial health department organizes various forms of inspections every year: 20 1 1, and the leaders of the department lead a team to inspect the provincial hospitals, and the municipal health bureaus observe and inspect them on the spot; 20 12 for intercity? Push mill type? Inspection, the municipal health bureau teamed up to check each other, and the provincial health department informed the inspection results; 20 13 launch? Check the city by province and the provincial hospitals by city? Level check.
Two. manage
During the three-year operation, the province dispatched 2818.59 million health supervisors to supervise and inspect medical institutions1452.89 million, with an annual supervision coverage rate of 100%. * * * Signed a letter of commitment for legal practice of medical institutions with 73,335 medical institutions, and distributed 654,380+million copies.
Before the actions were carried out in various places, meetings were held one after another to publicize and deploy health protection actions in accordance with the law; In the course of action, Huzhou, Quzhou, Jinhua, Lishui and other places have taken various forms of supervision and inspection in light of the actual situation. Law enforcement month? Form, organized by the Municipal Health Bureau team to check all medical institutions above the second level in the city; Hangzhou, Ningbo, Shaoxing transferred hospital sense, nursing, medical quality control experts to participate in joint law enforcement; Wenzhou City organizes inter-county counterpart inspection and mutual inspection of medical institutions above the second level; Lishui specially issued a document in recognition of outstanding units and individuals in the action.
Three. administrative penalty
During the three-year operation, the province warned 20 19 medical institutions at all levels, fined 4,000, fined19,227,800 yuan, confiscated illegal income of 2,283,800 yuan, suspended verification of 12 households, revoked the practice licenses of 83 medical institutions and revoked the practice certificates of medical personnel1.
During the operation, a number of typical cases, such as illegal kidney transplantation, were investigated and dealt with, and the administrative punishment for illegal acts of large public medical institutions was increased according to law. Only provincial and municipal hospitals were fined 39 times, with a fine of18.10.2 million yuan, and the score of bad practice was 50 times. Effectively standardized the legal practice of medical institutions, especially large public medical institutions.
Fourth, the effectiveness of the action.
After three years' efforts, not only the awareness of legal management and legal practice of medical institutions has been improved year by year, but also the awareness of legal management, legal supervision mechanism and legal supervision ability of health administrative departments have been greatly improved. Mainly manifested in:
1. The awareness of managing medical institutions according to law has improved, and the situation of practicing according to law has improved year by year. During the operation, it was found that the illegal activities of medical institutions were decreasing year by year, and the illegal problems could be actively rectified. At the same time, through the analysis of administrative punishment cases of medical institutions since its operation, it is found that medical institutions? Principle? The phenomenon of violating laws and regulations has been significantly reduced. Like what? Carry out diagnosis and treatment activities beyond the approved scope of practice? 、? Unauthorized radiation diagnosis and treatment equipment? And other serious violations of the law have decreased significantly year by year.
2. The health administrative department has strengthened the consciousness of administration according to law. Through actions, health administrative departments at all levels have been strengthened. Practise according to law to protect health? The awareness of special actions, the importance attached by leaders have increased year by year, the awareness of administration according to law has been continuously enhanced, and the cases of punishment for illegal acts in medical institutions above the second level have increased year by year, which has reversed the previous treatment of public medical institutions, especially those above the second level? Just check and not punish? Situation.
3. The legal supervision mechanism is more perfect, and the legal supervision ability is constantly enhanced. A comprehensive law enforcement mechanism covering medical administration, disease control, hospital awareness and quality control has been initially established, and a relatively unified regulatory standard has been established, enriching various forms of supervision such as provincial and municipal linkage, grading inspection and cross-inspection; At the same time, the ability of medical and health law enforcement has also been continuously improved, especially for hospital infection management and? Medical technology? Such as illegal acts of technical operation, never dare to investigate, not only dare to investigate, but also can find out the problems and investigate them according to law.
Verb (abbreviation for verb) subsequent steps
1. Further consolidate and enhance the regulatory achievements of legal practice of medical institutions.
According to the new round of medical reform? By 2020, a relatively complete medical service system will be basically established? What is the goal of the reform? Promote the comprehensive reform of public hospitals? As the basic principle of medical practice, the key task, practicing according to law, requires not only strict compliance by medical institutions and medical personnel, but also strong supervision by health administrative departments to ensure people's medical safety. In the future, medical institutions should continue to carry out health protection actions according to law.
2 to further improve the supervision mechanism of practicing according to law.
Health administrative departments at all levels should further establish the awareness of administration according to law, earnestly implement the supervision responsibility of medical institutions according to law, establish a comprehensive supervision mechanism, implement a preventive examination system for medical institution licenses, and strictly implement a comprehensive examination system for medical institution licenses to further promote the in-depth supervision of legal practice.
3. Further enhance the ability of practicing supervision according to law.
All localities should strengthen the construction of comprehensive law enforcement ability, and comprehensively improve the supervision ability of practicing according to law through systematic law enforcement theory training, practice base training, advanced education and skill competition. At the same time, it is necessary to introduce industry management mechanism and give full play to the technical support role of medical quality control center, medical association and nursing society; In addition, it is necessary to innovate information-based supervision methods, establish a supervision information system for practicing according to law, gradually promote online monitoring of medical waste and control of disinfection hospital infection, and improve the timeliness and effectiveness of supervision.