Application of Quality Control Cycle and PDCA in Quality Management of Medical Records Covered in Medical Insurance

Abstract

Objective: To investigate the quality management effect of QCC and PDCA cycle theory applied in medical insurance records. Method: QCC team is formed for the series of work plans,measures and goals themed withimproving quality of medical records and reducing payment refusal in medical insurance. All medical staff actively participate in,carry out seriously and monitor strictly the organic combination of medical insurance policy and medical quality. And the effect is evaluated according to the targeted goals. Result: All quality indicators on medical records are obviously improved after QCC activity. The number of defects in medical records decreased from 49. 3% to 13. 8% before and after the event,medical records of Class A increased from 92. 9% to 99. 6%,and the payment refusal rate caused by medical record quality reduced from 68. 2% to 15. 4%. Conclusion: The combined application of QCC and PDCA can effectively contribute to the sustainable and remarkable improvement in both the quality of medical treatment and the quality of medical records.

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