Following the idea of deepening the development of quality connotation and efficiency, the "Standard" further improves the evaluation requirements for the hosting responsibilities, functional positioning, discipline construction, medical management, and professional conduct construction of tertiary hospitals. One is to clarify the responsibilities and construction requirements of tertiary hospitals. According to the standards, third tier public hospitals should be established by provincial and municipal governments in principle. A small number of counties with high levels of economic development and large population base can jointly establish tertiary public hospitals by the county-level government or with the municipal government. Third level hospitals should adhere to high standard construction and implement the goal of "preventing serious illnesses from leaving the province". The second is to guide tertiary hospitals to reasonably control their scale and implement functional positioning. The "Standards" set indicators for the total number of beds in tertiary hospitals, the number of beds in individual physical education areas, and the number of branch areas, as well as indicators reflecting the difficulty of medical services such as the proportion of discharged patients undergoing fourth level surgeries and the case mix index (CMI), guiding tertiary hospitals to reasonably control their scale and focus more on the diagnosis and treatment services for urgent and critical illnesses and complex diseases. The third is to strengthen the integration of medical prevention and the construction of weak disciplines. The Standard stipulates that the tertiary general hospital should set up the department of pediatrics, infectious diseases, pathology, geriatrics, public health or prevention and health care, and other departments directly engaged in disease prevention and control; In some department resource allocation indicators, the proportion of pediatricians and psychiatrists should be increased. Third grade comprehensive hospitals, traditional Chinese medicine hospitals, and integrated Chinese and Western medicine hospitals should set up general practice departments to promote balanced development of various specialties. The fourth is to strengthen medical management and the construction of medical ethics and style. In the Standard, medical quality control indicators such as oncology, infectious diseases and radiology issued in recent years have been added to the quality control indicators of key specialties, and some general terms and codes have been updated. The 'Standards' further strengthen the implementation of the' Nine Guidelines for Clean and Honest Conduct of Medical Institution Staff ', requiring strict adherence to public welfare responsibilities and ethical conduct. The fifth is to optimize and improve the evaluation method through information technology. The Standard places greater emphasis on online evaluation and daily data monitoring, improving the objectivity of evaluation, reducing on-site inspections, and alleviating the burden on grassroots. It explicitly states that overly detailed and unrealistic evaluation methods such as the "thousand point system" should not be used or used in disguise.