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我院是一所拥有800张床位的教学医院,进修医生、实习医生你来我往,本院低年资医生要轮科学习和外出培训,主任和主治医生不仅要完成医疗任务,还要承担很重的教学任务,所以和普通医院比较,具有明显的医务人员流动性大的特点。这一特点给我院病案质量管理带来很大困难。进入80年代以来,由于领导重视、全体医护人员认真负责,使全院的病案质量有了很大提高。几年来,病案甲级率保持在90％以上,抽查病案平均分均在
Our hospital is a teaching hospital with 800 beds. You will study doctors and intern doctors. My senior doctors in this hospital want to study and go out for training. The director and the doctors not only have to complete the medical tasks, but also undertake the tasks. Due to the heavy teaching tasks, it is obvious that the medical staff is more mobile than ordinary hospitals. This feature has brought great difficulties to the quality management of medical records in our hospital. Since the 1980s, due to the leadership’s attention and the serious responsibility of all medical staff, the quality of medical records in the hospital has greatly improved. Over the past few years, the A-level rate of medical records has remained above 90%, and the average scores for random inspections are