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目的探寻提高临床科室出院病案三日归档率的对策。方法采取抽样法对2011年11月和2012年4月的出院病人病案三日内归档情况进行统计和分析。结果采取改进措施后,内科增幅最高的科室达到了92.53%,平均增幅75.40%;外科增幅最高的科室达到了97.44%,平均增幅83.17%。部分科室三日归档率达到100%。结论医院各级部门提高病案管理重视程度、信息资料科成立品质管理小组、健全病案管理制度、加强病案室与其它科室工作交流是提高病案三日内归档率行之有效的措施。
Objective To explore ways to improve the filing rate of medical records in the clinical departments for three days. Methods The sampling method was used to count and analyze the archives of the discharged patients within three days in November 2011 and April 2012. Results After improvement measures were taken, the department with the highest increase rate of internal medicine reached 92.53% with an average increase rate of 75.40%; the department with the highest surge rate reached 97.44% with an average increase rate of 83.17%. Some departments archiving rate reached 100% on the 3rd. Conclusions Hospital departments at all levels should improve the management of medical record management, set up quality management team in information and information department, improve medical record management system, and strengthen the exchange of medical record rooms with other departments is an effective measure to improve the filing rate within three days.