Self-inspection report of designated medical institutions

# Report # Introduction Self-inspection report is a report style of a unit or department for self-inspection of the problems existing in the execution of a certain work within a certain period of time. The following is an unorganized self-examination report of designated medical institutions, welcome to read!

A self-inspection report of a designated medical institution

In order to implement the spirit of the "Notice on Inspection and Assessment of Designated Medical Institutions and Retail Drugstores with Basic Medical Insurance in * * City" issued by the Municipal People's Social Security Bureau, according to the requirements of the Municipal Medical Insurance Department on annual inspection and assessment of designated medical institutions with basic medical insurance, our hospital attached great importance to it, carefully arranged it and put it in place. Led by the dean in charge of business and specifically in charge of the medical department, a special inspection was carried out in the whole hospital, and now the self-inspection situation is reported as follows:

1. Attach great importance to and improve the medical insurance management responsibility system

After the notice was received, our hospital immediately set up a self-inspection leading group headed by the dean in charge, and compared with the evaluation indicators, carefully searched for deficiencies and actively rectified them. Our hospital has always attached great importance to medical insurance. In our daily work, we strictly abide by the relevant national, provincial and municipal medical insurance laws and regulations, conscientiously implement the relevant medical insurance policies, set up a medical insurance leading group, which is in charge of the business dean and part-time worked by the medical department and the nursing department, improved the management system, held several special meetings for research and deployment, and conducted regular medical insurance training for doctors. The medical insurance work is planned at the beginning of the year, and the medical insurance work is summarized regularly, and the medical care and expenses of the insured patients are analyzed.

II. Strict management to realize the standard of medical treatment management

In recent years, under the correct leadership and guidance of the Municipal Bureau of Human Resources and Social Security and the Medical Insurance Department, our hospital has established and improved various rules and regulations, set up a "basic medical insurance policy bulletin board" and a "complaint box", issued basic medical insurance publicity materials in time, announced consultation and complaint telephone numbers, enthusiastically provided consulting services for insured personnel, and properly handled complaints from insured patients. Simplify the process and provide convenient and high-quality medical services.

The insured employees shall be strictly identified when they are hospitalized, so as to prevent the phenomenon of false medical treatment and false hospitalization, and stop hanging up the bed for hospitalization. Strictly grasp the indications of patients' admission and discharge, and it is strictly forbidden to have irregularities such as "minor illness and big care, hanging bed". Strict implementation of medical insurance dosage regulations for outpatient prescriptions, outpatient prescriptions for 7 days, chronic diseases for up to 15 days. No more than 7 days' dose of medicine should be taken by hospitalized patients after discharge. Implement the principle of treatment due to illness, so as to achieve reasonable inspection, reasonable treatment and rational drug use; No forgery or change of medical records. Actively cooperate with the medical insurance department to supervise and audit the diagnosis and treatment process and medical expenses, and provide medical records and relevant materials that need to be consulted in time. Strictly implement the charging standards set by the relevant departments, and there is no independent project charging or raising the charging standards.

in the publicity of medical insurance policies in Juqiang, the departments regularly organize to study the Selected Medical Insurance Policies and Regulations, the Catalogue of Basic Medical Insurance and Work Injury Insurance Drugs in * * City and other documents issued by the Municipal Medical Insurance Department, so that every medical staff can become more familiar with the catalogue and become the propagandist, interpreter and executor of medical insurance policies.

third, strengthen supervision to ensure the quality and safety of medical services

first, do a good job in implementing the system and strictly operate the procedures. We continue to strengthen the implementation of the medical core system and the operating rules of diagnosis and treatment nursing, focusing on the responsibility system of first diagnosis, the system of three-level doctor rounds, the system of surgical safety check, the system of medical record writing and prescription review to ensure medical safety. Continue to carry out in-depth activities to create "quality service demonstration wards", do a good job in basic and graded nursing, and improve the level of comprehensive nursing services.

Second, on the basis of strengthening the implementation of the core system, we should pay attention to the improvement and continuous improvement of medical quality. Gradually establish and improve the hospital and department medical quality management system, implement hospital-wide and whole-process quality control, implement inspection and spot check evaluation system, make the results public, reward the excellent and punish the poor, and make the medical work in our hospital regular and orderly.

Third, medical staff should memorize the core medical system and strictly implement it in actual clinical work. Actively learn advanced medical knowledge, improve their professional and technical level, improve medical quality, serve patients well, and at the same time strengthen the study and cultivation of humanistic knowledge and etiquette knowledge, and enhance their communication skills.

Fourthly, medical documents should be regarded as an important link to control medical quality and prevent medical disputes. The hospital medical records were graded, the department director reviewed the initial evaluation, and the hospital quality control reviewed it again. At the same time, actively carry out medical record quality inspection and appraisal activities, the quality and operation of medical records have been effectively monitored, and the medical quality has been significantly improved.

Fifth, strengthen safety awareness, and the doctor-patient relationship is becoming more and more harmonious. Our hospital has continuously strengthened medical safety education, raised the awareness of quality responsibility, standardized medical operation procedures, established and improved the communication system between doctors and patients, adopted various ways to strengthen communication with patients, and patiently and meticulously explained or explained the illness to patients. Be careful before operation, be proficient in operation and be strict after operation.

the sixth is to further optimize the service process to facilitate patients to seek medical treatment. By adjusting the layout of departments, the links of seeking medical treatment are simplified and the waiting time of patients is shortened. The outpatient service hall is equipped with medical guidance desk and wheelchair service facilities to provide information guidance and medical service for patients and solve all kinds of difficulties encountered by patients in time. Standardize service terms, strengthen the training of nursing etiquette, be enthusiastic about patients' nursing service, care carefully, operate carefully, answer patiently, and put an end to the phenomenon of being raw, cold, hard, pushing and pushing, which is well received by patients.

IV. Strengthening hospitalization management, standardizing hospitalization procedures and charging management

In order to strengthen the standardized management of medical insurance and fully implement various policies and regulations of medical insurance, according to the requirements of the Municipal Medical Insurance Office, our hospital reported the hospitalization declaration form within 48 hours of hospitalization of medical insurance patients, and registered the admission certificate and discharge certificate. At the same time, according to the provisions of the time, type and quantity to submit the settlement report, the insured medical expenses are true and accurate, and the cost details are consistent with the medical records and doctor's advice.

all the doctors who have been treated should treat the disease, check it reasonably and use drugs rationally. Strengthen the quality management of medical records, strictly implement the responsibility system for first-time doctors, and standardize clinical medication. The attending doctors should consciously use drugs in the Drug List that are safe, effective and reasonable in price according to clinical needs and medical insurance policies, and the drug preparation rate in the list is above 6%. Because of illness, it is really necessary to use self-funded drugs outside the Drug Catalogue, medical materials and related self-funded items. The attending physician should explain the reasons to the insured person, fill out the "informed consent form", and attach it to the inpatient medical record after the patient or his family agrees to sign it. The proportion of the service items outside the catalogue to the total cost is controlled below 5%.

our hospital strictly implements the charging standards set by the provincial and municipal price departments, publicizes the drug prices, checks the charging standards, provides patients with a list of expenses in time, and strictly implements the relevant provisions of the agreement, so that the insured can clearly understand the consumption.

V. Strengthening system maintenance to ensure the safe operation of the system

Our hospital strengthens the maintenance and management of the medical insurance information management system, eliminates the obstacles of the hospital information management system in time, and ensures the normal operation of the system. According to the requirements of the Municipal Medical Insurance Office, the special management personnel who are familiar with computer technology are responsible for it, and the medical insurance special computer is required to be dedicated to the special plane in strict accordance with the regulations. In case of problems, contact the medical insurance office in time, so as not to cause the problem that medical expenses cannot be settled due to program problems, and ensure the insured person to be timely. At the same time, ensure that the information data and materials are true, complete, accurate and timely, and put an end to arbitrarily canceling the hospitalization registration information of the insured.

in a word, our hospital has completed the medical service for the insured personnel by strictly checking the requirements of the Municipal People's Social Security Bureau's Reference Index for the Evaluation of Designated Hospitals for Basic Medical Insurance, further strengthening quality management, improving service awareness and service level, and strengthening the construction of medical ethics, which meets the setting and requirements of designated hospitals for basic medical insurance, and strives to reach the A-level level in this assessment.

Self-inspection report of two designated medical institutions

Under the correct leadership of the higher authorities, our outpatient department strictly abides by the relevant national, provincial and municipal medical insurance laws and regulations, and earnestly implements the medical insurance policy:

First, attach great importance to it, strengthen leadership, and improve the medical insurance management responsibility system

Our unit has always attached great importance to medical insurance, held many special meetings to conduct research and deployment, and regularly conducted medical insurance training for doctors. The medical insurance work is planned at the beginning of the year, summarizing the medical insurance work regularly, and analyzing the medical care and expenses of the insured patients. A leading group for medical insurance was set up with the main leaders as the team leader and the leaders in charge as the deputy team leader, and the systems of Medical Insurance Management System, Prescription Management System, Medical Insurance Medical Records and Prescription Audit System, and Medical Insurance Reward Report were established and strictly observed. We know that basic medical care is an important part of the social security system. Deepening the policy of basic medical insurance system is an inevitable requirement for the development of socialist market economy and an important measure to ensure basic medical care for employees and improve their health level.

second, standardize management to realize standardization, institutionalization and standardization of medical insurance services

under the correct leadership and guidance of the county medical insurance office, establish and improve various rules and regulations, such as the basic medical insurance referral management system, medical insurance work system, fee bill management system and outpatient management system. Set up "basic medical insurance policy publicity column" and "complaint box"; Announce the consultation and complaint telephone number 6961572; Enthusiastic to provide consulting services for insured persons and properly handle complaints from insured patients. Simplify the process and provide convenient and high-quality medical services. Insured personnel shall strictly identify themselves when they see a doctor, so as to prevent the phenomenon of impersonation. Do reasonable examination, reasonable treatment and rational drug use; No forgery or change of medical records. Actively cooperate with medical insurance agencies to supervise and audit the diagnosis and treatment process and medical expenses, and provide medical files and related materials that need to be consulted in time. Strictly implement the charging standards formulated by the relevant departments, and prohibit self-supporting projects from charging or raising the charging standards.

The publicity of Juqiang medical insurance policy makes every doctor more familiar with the catalogue. The hospital set up a special person to pay a telephone call back to outpatients and inpatients. The return visit rate was 81.4%, and the satisfaction rate of service quality was 98%, which was well received by the majority of insured people.

Third, strengthen management to provide quality assurance for the insured.

First, strictly implement the routine and technical operation procedures of diagnosis and treatment. Conscientiously implement the medical core system such as the system of first-visit doctor's responsibility, the system of succession, the system of medical record writing, and the system of technology access. Second, on the basis of strengthening the implementation of the core system, pay attention to the improvement and continuous improvement of medical quality. The medical quality management control system, evaluation system and incentive and restraint mechanism have been generally improved, the medical quality management objectives have been decomposed layer by layer, and the responsibility has been placed on people. The inspection and supervision barriers have been moved forward, and the problems and hidden dangers existing in medical work have been discovered and solved in time in the clinical front line. Third, employees memorize the core medical system and strictly implement it in actual clinical work. Actively learn advanced medical knowledge, improve their professional and technical level, improve medical quality, serve patients well, and at the same time strengthen the study and cultivation of humanistic knowledge and etiquette knowledge, and enhance their communication skills. Fourth, medical documents are regarded as an important link to control medical quality and prevent medical disputes. Fifth, strengthen safety awareness, and the relationship between doctors and patients is becoming increasingly harmonious. Our hospital has continuously strengthened medical safety education, raised the awareness of quality responsibility, standardized medical operation procedures, established and improved the communication system between doctors and patients, adopted various ways to strengthen communication with patients, and patiently and meticulously explained or explained the illness to patients. Standardize service terms, strengthen the training of nursing etiquette, put an end to the phenomenon of health, cold, hardness, pushing and pushing, be enthusiastic about patient care services, care carefully, operate carefully and be patient in answering questions. Through a series of attentive services, the customer service department regularly conducts patient satisfaction surveys, and the patient satisfaction has been above 98%.

IV. Maintenance and management of the system

We attach importance to the maintenance and management of the insurance information management system, remove the obstacles of the information management system in time, and ensure the normal operation of the system. According to the requirements of the county medical insurance office, the special computer for medical insurance is required to be dedicated in strict accordance with the regulations. In case of problems, we should contact Tianfeng Software Company and the medical insurance office in time, so as not to lead to the problem that medical expenses cannot be settled due to program problems, and ensure the insured to settle in time and quickly.

we always adhere to patient-centered, quality-centered, and wholeheartedly serve patients as the starting point, and strive to achieve standardization of rules and regulations, humanization of service concept, standardization of medical quality, and self-consciousness of correcting work habits, and actively provide high-quality, efficient and inexpensive medical services and a warm medical environment for the insured, which has been praised by the majority of the insured and received good social and economic benefits.

Self-inspection report of three designated medical institutions

As an important part of China's health care, designated medical institutions at the prefecture level play an important role in developing China's medical undertakings and ensuring people's health. However, in the face of the new situation of continuous development and the new requirements put forward by the people, there are still some problems, some of which are urgent and need to be solved urgently, from the point of view that designated medical institutions at the prefecture and city levels should do their duty and do a good job in medical work and create designated medical institutions that the people are satisfied with. As a department director of the designated medical institutions at the prefecture level, I talked about the problems existing in the designated medical institutions at the prefecture level and their solutions.

1. Existing problems and reasons

1. Insufficient attention paid by leading institutions of medical services

Leading institutions of medical services pay insufficient attention to designated medical institutions at the prefecture and city levels, especially lack of inspection and supervision on basic medical work, resulting in some designated medical institutions at the prefecture and city levels paying more attention to benefits than management; The phenomenon of attaching importance to economic benefits and neglecting social benefits still exists; The assessment index of medical insurance management in some prefecture-level designated medical institutions is not perfect, the medical insurance management and medical quality control management are not well combined, the rewards and punishments are unknown, and there is no incentive and restraint effect; Some medical staff are unfamiliar with and do not understand the medical insurance policy. In the implementation of the policy, the explanation and publicity of the "information for insured patients" is not enough, and even there are behaviors that mislead patients; The inspection of medical insurance rules and regulations in some prefecture-level designated medical institutions is not implemented enough; As a result, the social benefits of municipal designated medical institutions are not high, and the people's satisfaction is not satisfactory.

2. The reform of medical institutions is not in place, and there is a problem of "supporting doctors with medicine"

The reform of medical institutions is the key to the smooth progress of the basic medical insurance system. At present, the medical institutions in China are still a system of integrating medicine with medicine, and the expenditure of medical insurance fund is realized through the services of designated medical institutions and designated pharmacies. However, due to the inadequate reform of medical institutions at present, it is difficult for medical institutions to fundamentally solve the problem of "supporting medicine with medicine", especially after the medical technology charging standard has been raised in some medical institutions, the inflated price of medicines has not been completely reduced. According to relevant data, drug income accounts for about 55% of the total medical income, and the profit of medical institutions selling drugs is as high as 28%. The huge profit has formed a situation that hospitals rely too much on drug income, which has also distorted the behavior of a few hospitals and a few doctors, giving targeted examinations to medical insurance patients, prescribing unreasonable drugs, etc., resulting in a sharp rise in medical expenses and an increase in personal burden, leading to patients' incomprehension and complaints about medical insurance reform.

3, the burden of medical expenses is heavy, and the average cost is too high

Under the mode of combining medical insurance with unified accounts, due to our society,