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National Health Office Medical Zhengfa [2022] No.
16
Health commissions of all provinces, autonomous regions, municipalities directly under the Central Government and the Xinjiang Production and Construction Corps:
In order to strengthen the quality management of daytime medical care in medical institutions, standardize the behavior of daytime medical services, and ensure the quality and safety of daytime medical care, according to the Measures for the Management of Medical Quality, combined with the actual situation of daytime medical work in medical institutions, our committee organized and formulated the "Interim Regulations on Daytime Medical Quality Management of Medical Institutions"
.
It is now issued to you, please follow it
.
General Office of the National Health Commission
November 20, 2022
(Information disclosure form: active disclosure)
Related link: Policy interpretation of the Interim Regulations on the Quality Management of Daytime Medical Care in Medical Institutions
Interim Regulations on Daytime Medical Quality Management in Medical Institutions
Chapter I General Provisions
Article 1: These Regulations
are formulated for the purpose of strengthening the management of daytime medical quality and safety in medical institutions, standardizing the conduct of daytime medical services, improving the level of scientific management of daytime medical care, and ensuring the quality and safety of daytime medical care.
Article 2: "Day medical care" as used in these Provisions refers to the medical service model
in which medical establishments provide patients with full-process diagnosis and treatment services within 24 hours under the premise of ensuring medical quality and safety.
Article 3: Medical establishments and medical personnel carrying out day medical treatment shall comply with these Provisions
.
Chapter II: Organization and Operation Management
Article 4: As day medicine is an integral part of inpatient services in medical establishments, medical establishments shall strengthen the quality management
of day medical services in accordance with the responsibility system at the hospital and department levels.
Article 5: Hospitals at or above level 2 that carry out day medical care, maternal and child health hospitals, and specialized disease prevention and control institutions shall establish special organizations for day medical quality management under the Medical Quality Management Committee, composed of
relevant management personnel such as medical management, quality control, nursing, medical insurance, hospital infections, cases, and information, as well as clinical professionals with qualifications for senior technical positions 。 The medical management or quality control department is specifically responsible for the day-to-day management work, and the main responsibilities include:
(1) In accordance with the relevant requirements of the national medical quality management, formulate the institution's daytime medical service related work system, including patient assessment system, follow-up system, medical staff training system, disinfection and isolation system, etc
.
(2) Establish mechanisms for the selection of daytime medical patients, diseases, and technologies and mechanisms for the review and authorization management of medical personnel, and organize their implementation
.
(3) Organize and carry out the institution's daytime medical quality monitoring, early warning, analysis, feedback, as well as assessment and assessment work, and periodically release information related to
the institution's daytime medical quality.
(4) Formulate plans and programs for continuous improvement of the quality of daytime medical care in the institution and organize their implementation
.
Article 6 The quality management team of each clinical department carrying out day medicine shall be responsible for the quality management of day medicine in the department, and its main responsibilities include:
(1) Implement the rules and regulations related to the daytime medical care of the institution and the daytime medical quality management system
of the department.
(2) Incorporate day medical quality management into the annual work plan
of medical quality management and control of the department.
(3) Regularly analyze and evaluate the quality of daytime medical care in the department, propose corrective measures for the weak links of daytime medical quality, and organize their implementation
.
(4) Regularly organize training for medical staff of the department on the system, mechanism, process and diagnosis and treatment routine of day medicine
.
(5) Submit relevant information on the quality management of daytime medical care in the department in accordance with relevant
requirements.
Article 7: Medical establishments carrying out day medical care shall be equipped with medical resources that meet the needs of day medical care, including relatively fixed day operating rooms, anesthesia resuscitation rooms, medical beds, equipment and facilities, and medical personnel, to ensure the efficient development
of day medical care 。
Article 8: Medical establishments shall clarify the contents of diagnosis and treatment of day medical patients before, during, and after discharge, and complete patient selection, formulation of diagnosis and treatment plans, appointments, and pre-hospital education before hospitalization; Complete surgery/pre-treatment re-evaluation, operation/treatment measures, pre-discharge evaluation and education during hospitalization, etc.
; Timely follow-up of patients after discharge and provision of appointments for follow-up
appointments.
Article 9: Medical establishments shall mobilize the enthusiasm of medical personnel to carry out day medical care, and use the management of daytime medical care quality of departments and medical personnel as the basis
for regular evaluations and promotions of physicians.
Chapter III: Quality Control
Article 10: Medical establishments shall strengthen their own daytime medical disease and technical management
.
Follow the principles of science, safety and standardization, formulate the daytime medical disease and technology catalogue of the institution and implement dynamic management
.
The catalogue of day medical diseases and technologies of each clinical department shall be deliberated and approved by the special organization for day medical quality management; Daytime medical technology that belongs to the new technologies and projects of the institution shall also be reviewed and approved by the relevant technical management committee and medical ethics committee of the institution; National restricted technologies shall not be included in the catalogue
of day medical technologies.
Article 11: Medical establishments shall strengthen the management
of their own day medical departments and physicians' review and authorization.
According to the technical ability of departments and physicians and the quality and safety of medical treatment, combined with the application of the department, review and authorize the content of day medical treatment carried out by departments and physicians, and include the authorization of physicians in the technical files of physicians, and carry out dynamic management
.
Article 12: Medical establishments shall strengthen the management of
day medical patients.
Comprehensively evaluate the patient's general condition, underlying diseases, medical risks, etc.
, and determine whether the patient is suitable for day medicine
.
Article 13: Medical establishments shall strengthen the assessment and management
of day medical patients.
The assessment is carried out at key nodes such as before treatment, after treatment, and before discharge, and the assessment content
is adjusted according to the patient's condition changes and the medical services received.
For patients receiving invasive diagnosis and treatment and anesthesia diagnosis and treatment, the risk of anesthesia, surgery/treatment, anesthesia recovery, pain score, etc.
should be evaluated in a timely manner 。
Article 14: Medical establishments shall strengthen the management of follow-up visits for daytime medical patients, clarifying the time, frequency, content, and form of follow-up visits based on the characteristics of different diseases and the rules of diagnosis and treatment, and arrange for specialized medical personnel to conduct follow-up visits and accurately record them, so as to provide patients in need with continuous and safe extended medical services after discharge; Follow-up records should be included in the patient's medical record or kept in a separate record; Patients undergoing day surgery should have their first follow-up
visit within 24 hours of discharge.
Article 15: Medical establishments shall strengthen management of the quality of day medical records, ensuring that the content of day medical records is objective, truthful, accurate, timely, complete, and standardized
.
Daytime medical records shall include the homepage of the inpatient case, admission and discharge records within 24 hours, preoperative discussion conclusions, surgery/treatment records, surgical safety verification records, surgical inventory records, all kinds of informed consent forms, medical orders, auxiliary examination and test reports, temperature sheets, nursing records, and medical documents related to this diagnosis and treatment completed before admission
.
The content of the admission and discharge record within 24 hours shall include the patient's main complaint, admission situation, pre-admission examination and test results, pre-treatment evaluation, diagnosis and treatment process, post-treatment evaluation, pre-discharge evaluation, discharge medical advice, and other content
.
Any medical act that has been completed before surgery/treatment should be written or completed
before surgery/treatment.
Article 16: Medical establishments and medical personnel shall follow the principle of informed consent of patients, respect patients' right to independent choice and privacy, and protect patients' privacy
.
Article 17: Medical establishments shall actively carry out monitoring and assessment of daytime medical quality in strict accordance with the relevant requirements of health administrative departments and quality control organizations, and promote continuous improvement
of daytime medical quality.
(1) Medical establishments shall supervise and inspect
the implementation of systems and mechanisms related to daytime medical quality management.
(2) Medical establishments shall establish and improve the relevant index system
for daytime medical quality management of the institution based on the daytime medical quality control indicators issued by the health administrative department or quality control organization.
(3) Medical establishments shall strengthen data collection, analysis, and feedback on day medical care; Use medical quality management tools and information technology to carry out daytime medical quality management, analyze and warn the risk factors of daytime medical quality and safety, take effective intervention measures for existing problems and evaluate the intervention effect
。
(4) Medical establishments shall strengthen the management of daytime medical quality (safety) adverse events, establish mechanisms for collecting and analyzing the occurrence of daytime medical quality (safety) adverse events, clarify the scope, grading, event classification, reporting principles, reporting methods and procedures, and handling procedures of daytime medical quality (safety) adverse events, carry out targeted improvement work according to the type, location, and time of occurrence, while increasing the reporting rate of medical quality (safety) adverse events.
Reduce the incidence of adverse events in the quality of
care (safety).
Article 18: Medical establishments shall establish daytime medical emergency response plans and improve daytime medical treatmentMedical consultation and referral mechanisms, clarify the mechanism for the allocation and emergency allocation of daytime medical rescue resources, ensure that rescue equipment and drugs are available at any time in each daytime medical unit, strengthen emergency drills, and ensure the smooth implementation
of daytime medical emergency plans.
Article 19: Medical establishments shall strengthen daytime medical information security management, strengthen security protections for daytime medical-related information systems, do a good job of secure storage and disaster recovery of medical data, strictly implement provisions on information security and confidentiality of health and medical data, and ensure information security
.
Article 20: Medical establishments shall strengthen the management
of open daytime medical information.
Daytime medical disease and technology catalogs, physician information, and so forth shall be included in the scope of the institution's hospital affairs disclosure, and periodically and proactively disclosed to the public and accepted by the public
.
Article 21: Medical establishments shall strengthen the management of day medical training, periodically carrying out training on the systems, procedures, and skills of day medical work; According to the actual work situation of the day medical treatment of the institution, timely revise and improve the training plan and training content
of relevant personnel.
Chapter IV: Supervision and Management
Article 22 Administrative departments of health at all levels shall be responsible for the supervision and management
of the daytime medical quality management of medical institutions within their respective administrative areas.
Medical establishments shall actively cooperate, and must not refuse or obstruct oversight and inspections or conceal relevant circumstances
.
Article 23: Based on actual conditions, administrative departments of health at all levels shall organize or entrust professional institutions to use information technology to analyze and assess the quality of daytime medical care within their administrative areas, periodically publish assessment results within the industry, and accept social oversight
.
Article 24: Administrative departments of health at all levels shall include the management of daytime medical quality and the results of supervision and inspection in the evaluation and other work of medical institutions, and adopt appropriate forms to praise and encourage medical establishments and medical personnel who provide high-quality daytime medical services, and actively promote advanced experience and practices
.
Chapter V Supplementary Provisions
Article 25 These Provisions shall take effect
on January 1, 2023.
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