Post Quality Control Analysis on the Front Page of Medical Records from the Perspective of Performance Appraisal of Public Hospitals
Objectives To establish the quality control rules of the front page field of inpatient medical records,and improve the quality and uploading efficiency of the front page of inpatient medical records through the post quality control.Methods According to the interface standard of performance appraisal and medical quality management inpatient medical record first page collection system of national tertiary public hospitals,49 quality control rules were established for 811 inpatient medical record first page fields,and a post-event quality control management framework was constructed by using Python software.From June 1,2022 to June 30,2023,quality control was earried out on the first page of 158513 inpatient medical records,and full quality control was carried out on the first page of inpatient medical records of the previous month before the 15th of each month,and the quality control results were timely reported to the medical records information team for rectification.Results There were an average of 12193 quality control inpatient medical records on the first page per month.The number of problems feedback on the first page of inpatient medical records decreased from 12 to 4,and the error rate decreased from 35.9％to 16.3％.Errors are mainly reported in emergency cases such as errors of medical record coders,information system failures,and undiscovered potential problems.Conclusion Monthly post quality control can improve the quality of the first page of inpatient medical records and improve the accuracy of data uploading on the first page of inpatient medical records on the performance assessment platform.
The front page of medical recordPerformance appraisalPost quality control
NETL
NSTL
万方数据
