The Use of Medical Record Information in the 2011 Version of the Accreditation Standards for a Level 3 General Hospital

Abstract

AbstractThe 2011 version of the accreditation standards for a level 3 general hospital relates to descriptions about the use of medical record information; 636 entries in 378 items and 48 core indexes in seven chapters relate to medical record information. Of these items, 103, accounting for 27.25%, relate to all chapters, and 22 relate to core entries, accounting for 45.83%. Chapter seven almost fully concerns daily statistical evaluation. There are at least about 150 links that should be carried out in combination with medical records in the process of accreditation, and therefore, the importance and effect of medical records in accreditation becomes obvious. The hospital accreditation standards further suggest that the science, discipline construction, and continuous improvement of medical information management should be given the same priority as record writing quality in hospital development, and thereby medical information can be used effectively.