加强在院病人病历书写质量监控  

Practice and Experience on Strengthening Quality Control of Medical Records

作　　者：陈传本[1] 陈少雄[1] 

机构地区：[1]福建省肿瘤医院质控办

出　　处：《中国病案》2010年第5期30-31,共2页Chinese Medical Record

摘　　要：提高病历的书写质量,必然要加强对病人住院期间病历书写的环节质量进行实时监控,把缺陷消灭在病历形成过程中,保证病历书写及时、客观、真实、全面,进而保障医院安全,防范医疗纠纷。To improve writing quality of medical records,it’s necessary to strengthen real-time monitoring on quality for the link of running medical records to make up for deficiencies in the process of medical records formation,which ensure that records write timely,objectively,truthfully and comprehensively,and thus to guarantee hospital safety and prevent medical disputes.

关 键 词：病历 质量控制 方法 体会 

分 类 号：R197.3[医药卫生—卫生事业管理]