1. Basic standards for hospitals at all levels: This standard is a standard that hospitals at all levels must meet and also a standard for determining hospital qualifications. Basic standards and scoring standards are evaluated separately. Can not meet the requirements of the "basic standards", will not be passed, as unqualified hospitals. The newly applied hospital will not be approved.
2. Classification standard of hospitals at all levels: According to different tasks and functions, hospitals are divided into three levels, namely, first-class hospitals, second-class hospitals and third-class hospitals. According to the technical level, quality level and management level of hospitals at all levels, and referring to the necessary facilities, they are divided into A, B and C. , tertiary hospitals plus special classes.
3. Evaluation criteria: Before establishing the mathematical model scoring method, the thousand-point method is used for evaluation temporarily. In the evaluation, qualified hospitals will rate the grade according to the total score. Grade A: The evaluation standard must reach more than 900 points (including 900 points). Grade B: The grading standard must reach 750 to 899. Grade C: The scoring standard is below 749. (including 749 points) A three-level first-class specialized hospital should not only meet the standards of a three-level first-class hospital, but also meet the necessary conditions of the hospital.
4. Hospital accreditation application: It is a necessary procedure for a hospital to apply to the accreditation committee, and it is also the main basis for the accreditation committee to identify the hospital accreditation qualification. All hospitals are required to fill in the declaration item by item seriously and realistically.
5. Other relevant annexes of this standard: explanations of specific indicators, requirements and key points of assessment and inspection of this standard. The grading management standard of general hospitals formed this time is still far from perfect and can only be tried out as a draft in the whole country. It is hoped that all localities will propose amendments to this standard in the trial and gradually improve it. Hospitals and primary hospitals (first-class hospitals) Standard primary hospitals are primary medical institutions that directly provide medical treatment, prevention, health care and rehabilitation services to communities with a certain population (≤65438+ 10,000). They are primary medical institutions that implement primary health care in China and realize the global goal of "universal health protection". Basic standards for first-class hospitals This standard is a necessary condition for approving the qualification of first-class hospitals. Only the qualified line that meets this standard can participate in the grade review. The basic standards include the following seven aspects: First, the hospital scale should adapt to the functions, tasks and management requirements of the third-class first-class hospitals. 1. The number of beds shall not be less than 20. If it is lower than the above limit, a reasonable explanation must be made. 2. The necessary facilities of each bed unit in the ward meet the specified requirements (see Annex 6). 3. The construction area of each bed is not less than 45 square meters. 4. The ratio of sickbed to hospital staff is 1: 1- 1.4. 5. Health technicians account for 80-85% of the total number of employees in the hospital (non-health technicians are not allowed to engage in medical treatment, medical technology and nursing mode technology. )
Second, the functions and tasks of the hospital The top three hospitals should undertake various medical and health services and certain health administrative work in this community.
(1) preventive health care 1. Do a good job in community health and epidemic prevention, including the prevention and control of planned immunization, infectious diseases, parasites and endemic diseases, and implement health supervision and management under the guidance of the health and epidemic prevention department at a higher level. 2. Actively carry out the work of maternal and child health care, carry out the general survey and treatment of frequently-occurring diseases of women and babies, carry out systematic health care for marriage and childbearing, and promote scientific delivery. 3. Do a good job in family planning surgery and technical guidance. 4. Take various forms to carry out health education, popularize health knowledge and improve people's self-care ability and overall health level.
(2) medical services 1. Complete the diagnosis and treatment tasks of common diseases and frequently-occurring diseases in the community (including family sickbeds), carry out vital signs maintenance of acute, severe and dangerous patients, and organize referrals. 2. To popularize the knowledge and technology of first aid to the masses, the medical staff in the hospital must master effective unarmed cardiopulmonary resuscitation. 3. Carry out community rehabilitation medical care, mental health services and prevention and treatment of chronic non-communicable diseases according to conditions.
(3) health administration 1. Under the leadership of the local government and the superior health administrative department, assist in the formulation and implementation of community primary health planning according to the local social and economic development planning. 2 with the relevant departments to mobilize and organize the masses to carry out patriotic health activities, and gradually improve the level of community health. 3. Implement national health laws and regulations, and supervise and manage related industries in the community. 4 responsible for the management and technical guidance of village health organizations and individual practitioners, and training rural doctors, health workers and midwives.
Third, the hospital management hospital should have a sound management system with corresponding systems, measures, supervision, assessment and evaluation. Someone is in charge of administration. Enterprise management and ideological and political work. (I) Necessary system According to the relevant provisions of the Ministry of Health 1982 "National Hospital Work Regulations, Hospital Work System and Responsibilities of Hospital Staff", combined with the actual situation of the hospital, we must carefully formulate and strictly implement various rules and regulations, mainly including: 1. Hospital working system. In addition to the general hospital work system, it should also include maternal and child health care, health and epidemic prevention, family sickbed work system, rural doctor guidance and other work systems. 2. Post responsibility system for all kinds of personnel at all levels. 3. Technical operating procedures. 4. Staff continuing education system. (ii) Information management 1. According to the provisions of the Ministry of Health's Health Statistics Work System (Trial), it is equipped with full-time (part-time) comprehensive information management personnel. 2 timely collection, storage, analysis, feedback and utilization of information, and fruitful. 3. There is a book management system and an appropriate number of medical books and periodicals. (3) Financial management 1. There are financial institutions or full-time accountants. 2 accounting vouchers, accounting books and statements conform to the accounting system. 3. Establish accounting files and management system. 4. Perfect accounting supervision and auditing system, strictly abide by financial discipline, and no arbitrary charges are allowed. (4) Equipment management 1. The equipment in the whole hospital is managed by special personnel or part-time personnel. 2. There is a system of storage, use, maintenance and regular maintenance of medical equipment to ensure the needs of medical work. 3. Establish files for important equipment. (v) General management 1. General materials are subject to quota management, and there is a sound system of procurement, acceptance, storage, distribution and scrapping. 2. Actively and timely serve the whole hospital, ensure the supply of water, electricity, clothing and meals, and maintain various facilities in time. (vi) Building management 1. Hospital buildings meet the health requirements, with a maintenance system for old buildings and a renovation plan for unreasonable buildings. 2. Don't use dangerous houses, especially don't engage in medical activities in dangerous houses.
Four. Quality Management (1) There are full-time (part-time) staff responsible for the quality management of the whole hospital, and establish and improve the quality assurance system step by step. (two) there is a hospital quality management plan, and seriously implement it. (3) Hospital infection control: 1. The control of infected organizations should comply with the provisions of the Ministry of Health's Interim Measures for Establishing and Perfecting Hospital Infection Management Organizations (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 procedures. 4. There is an education system for hospital infection control, and medical staff must establish a sterile concept and carry out correct aseptic technical operation. 5. There are management measures for rational use of antibiotics. 6. Special areas (such as operating room, treatment room, supply room, delivery room, etc.). 7. The disinfection supply room shall meet the requirements of the Acceptance Standard for Disinfection Supply Room in Hospitals (Trial) issued by the Ministry of Health.
Verb (abbreviation of verb) Ideological and political work and the construction of medical ethics 1. To implement the party's line, principles and policies, the party and government trade unions should formulate plans for ideological work and medical ethics construction, and organize their implementation. 2 with the ideological and political work management system and the corresponding work system. 3. Conscientiously implement the medical ethics norms and implementation methods of medical staff, and carry out and adhere to the pre-job education system. 4. Establish a mass supervision system. 5. The survey shows that patients, communities or contracting units are satisfied with the hospital. 6. There are sound and honest medical practice measures.
Six, hospital safety 1. Establish and improve the hospital safety management system, with special personnel or part-time personnel in charge. 2. Make the safety management plan in peacetime and emergency, and check it regularly. 3. There are special safety management measures for high-risk equipment and areas such as high-voltage system, operating room, radiation room and power distribution room. 4. Equipped with necessary fire fighting equipment. 5 toxic drugs, narcotic drugs and psychotropic drugs management system, and strictly enforced. 6. When the lighting system has an accident, there is a safe alternative light source to ensure the emergency needs.
Seven, the hospital environment 1. Pay attention to the cleanliness of the hospital. There are cleaning systems and measures, and someone is in charge. 2. Smoking is prohibited in clinics, wards and other medical areas. 3. Pay attention to the greening in the hospital, and have a green area suitable for the hospital (including indoor and outdoor flowers and trees planting and three-dimensional greening). 4. Sewage and dirt shall be treated harmlessly, and the treated sewage shall meet the hygiene standards. 5 outpatient noise is not higher than 50 decibels, ward, operating room noise is not higher than 38 decibels. 6. The total lighting of the operating room is1000 m candle, and the comprehensive lighting of the working area is 2000-3000m candle. Classification standard of tertiary hospitals This standard is the standard for the construction and development of tertiary hospitals and the basis for evaluating their level and quality. First, the establishment of departments should be adapted to the functions, tasks and actual needs of tertiary hospitals. 1. clinic: internal medicine, surgery, obstetrics and gynecology and emergency room should be set up. Conditional establishment of pediatrics, five palaces, Chinese medicine, family sickbed department (group), etc. 2. Medical technology department: there should be pharmacy (including preparation room), laboratory (if the inspection center has unified arrangements, it is not required), radiation room, operating room, disposal room, supply room, medical record statistics room, library, etc. 3. Administration Department: set up the hospital office (responsible for medical treatment, nursing module, personnel, secretary, security, finance, logistics, etc.). ) .4. Prevention and health care (department) room: set up health and epidemic prevention room and maternal and child health care room (including family planning technical guidance). Two, staffing to meet the basic requirements of the ratio of beds to personnel. The proportion of all kinds of personnel is as follows: all kinds of personnel, administrative workers, health technicians, all kinds of health technicians, Chinese and western doctors (doctors), laboratory, radiology, medicine, others, 15-2080-8538384488, among which more than 25% are engaged in preventive health care.
Three, the technical level of technical construction should proceed from reality, to carry out the diagnosis and treatment of common diseases and frequently-occurring diseases in various subjects in the community, and generally to provide ambulance services for critically ill patients. Basic requirements: (1) medical treatment 1. Emergency medical treatment: community emergency cases can be treated 24 hours a day (including home visits). 2. Internal medicine and pediatrics: correctly handle common diseases and properly handle and refer difficult diseases. It can make a preliminary diagnosis and carry out life-sustaining rescue treatment for general emergency patients such as circulatory, urinary and respiratory system failure, acute poisoning and shock. Master the treatment, disinfection and isolation technology of endemic infectious diseases. 3. Surgery, obstetrics and gynecology: able to make clinical diagnosis and timely and correct treatment of surgical acute abdomen. Can perform general upper abdominal surgery. Can complete hemostasis, suture, dressing, fracture fixation and other surgical treatments. Can complete the treatment of some common diseases in physiological obstetrics and pathological obstetrics and caesarean section. 4. Otolaryngology: able to diagnose and treat common diseases and some emergencies. Carry out the work of preventing blindness, caries and deafness. 5. Chinese medicine: it can treat common diseases and some intractable diseases in internal medicine, surgery, gynecology and pediatrics. Acupuncture, massage, etc. 6. Be familiar with all kinds of diseases and strictly implement technical operation procedures. Do a good job in ward management and classification, and correctly write five forms (temperature list, doctor's order list, doctor's order record, nurse shift change and record). 7. Medical technology department: able to conduct electrocardiogram and ultrasound examination. Can carry out blood routine, urine routine, stool routine and some biochemical tests. (In the centralized inspection area, relevant arrangements shall be contracted). X-ray, radiography and general gastrointestinal radiography can be performed. (2) preventive health care 1. Can carry out planned immunization and epidemic treatment, and provide technical guidance for "two management and five reform". 2. Be able to carry out perinatal health care and children's systematic health care, and master the four technologies of family planning. 3. Community prevention and treatment of chronic non-communicable diseases, health care for the elderly, mental health and community rehabilitation can be carried out. (3) teach 1. Training rural doctors, health workers and midwives. 2. Can accept part of the clinical study of health school students. Fourth, hospital management 1. The dean should be familiar with the management of a first-class hospital and have received short-term hospital management training. 2. The hospital has a long-term development plan and specific implementation steps. 3. Hospital employees' satisfaction with hospital leaders is 80% or higher. 4. The community, contracting units and patients' satisfaction with the hospital is ≥80%. 5. Information management: grasp the incidence of various infectious diseases in the population, and establish and improve the registration and reporting system of infectious diseases. The registration pass rate is ≥95%, and the omission rate is ≤0.5%. Do a good job in hospital statistics, equip statisticians to master the dynamic data of community population, life and diseases (frequently-occurring diseases, chronic diseases and endemic diseases), analyze them in time and put forward countermeasures; Complete all kinds of health statistics in time and accurately according to the regulations. Establish a medical record management system, with a special person or part-time staff in charge, and gradually manage according to the International Classification of Diseases (ICD), requiring outpatient medical records and inpatient medical records to be written completely; Written according to the standard, the first-level medical records are ≥80%, and the third-level medical records are eliminated. Five, the main departments of basic equipment (Annex 7). 6. All statistical indicators are 1. The coincidence rate of admission diagnosis and discharge diagnosis is ≥ 85%. 2. The coincidence rate of diagnosis before and after operation is ≥ 95%. 3. Outpatient referral rate ≤ 20%. 4. The cure and improvement rate of single disease: compared with hospitals at the same level, on average. 5. Prevalence rate of single disease: compared with hospitals at the same level, on average. 6. The success rate of single-disease critically ill patients: the average level is 7. The transfer rate of hospitalized patients is ≤ 3%. 8. The qualified rate of technical operation is ≥ 85%. 9. The frequency of bedsore in coma and paralysis patients: 0 10. Hospital infection rate ≤3% 1 1. The infection rate of aseptic operation incision is ≤ 1% 12. One needle and one tube per person implementation rate 100% 13. The qualified rate of conventional instruments is 65. The annual hospital bed turnover is ≥32 times 16. Average hospitalization time ≥ 6 days 17. The qualified rate of outpatient prescriptions is ≥98% 18. The qualified rate of outpatient medical record writing is ≥90% 19. The qualified rate of in-patient medical record writing is ≥98% 20. The X-ray rate of Grade A is ≥ 40% 265433 0 23. Equipment utilization rate ≥80% 24. The positive rate of special diagnostic equipment is ≥20% (mainly B-ultrasound), and the card-building rate of children aged 25.0 ~ 7 years is ≥98% in rural areas ≥ 100% 26. The coverage rate of live measles vaccine is ≥90% in rural areas and ≥ 95% in urban areas. The vaccination rate of live polio vaccine in rural areas is ≥90%. ≥95% 29. BCG vaccination rate ≥90% in rural areas and ≥ 95% in urban areas 30. The full coverage rate of four seedlings in rural areas is ≥85% and in cities ≥92.5% 3 1. The diagnosis and treatment rate of gynecological diseases is ≥60% in rural areas and ≥ 90% in urban areas. The perinatal mortality rate is ≤20% in rural areas and ≤90% in cities. Vision in rural areas is ≥70%, and in cities ≥80%. 36. The pass rate of "Three Basics Examination" for health technicians 100%. 37. The intact rate of first-aid articles is 100%. 38. The foundation qualification rate is 80% or higher. 39. The qualified rate of first-class hospitals is 80% or higher. The hospital should be responsible for its construction, management, technical level and work quality. The local (city) hospital evaluation committee shall evaluate the quality outside the hospital according to this standard. According to the evaluation results, the first-class hospitals are divided into three grades: A, B and C. The hospital construction of the first-class hospitals has achieved remarkable results, and the comprehensive level of department setting, staffing, management level, technical level, work quality and hospital infrastructure has reached 900 points or above through assessment. Second, the first-class and second-class hospitals have made good achievements in hospital construction, and their comprehensive levels such as department setting, staffing, management level, technical level, work quality and hospital infrastructure have reached 750-899 points through examination. Third, the construction of tertiary hospitals has achieved certain results, and the basic standards have passed the examination, but there is still a big gap with the requirements of grading standards. After comprehensive examination, it is below 749 points (including 749 points). Third-level hospitals should have feasible improvement measures and development plans. Standard for Secondary Hospitals Secondary hospitals are health institutions that provide medical treatment, prevention, health care and rehabilitation services for multiple communities (with a radius of more than 654.38+ 10,000), and are at a medium level in the tertiary medical and health system.
In particular, there is a higher level above the "third class A"-"third class special"! Approved by the Ministry of Health, it seems that it is difficult to apply to the leading top three hospitals in China. Some hospitals in Beijing have achieved "three specialties", such as Peking Union Medical College Hospital, PLA General Hospital (30 1 hospital), and the third-level specialized class is the best hospital!