diff --git a/openhis-ui-vue3/src/views/doctorstation/components/prescription/prescriptionlist.vue b/openhis-ui-vue3/src/views/doctorstation/components/prescription/prescriptionlist.vue
index 2c4cabc2..a7bf93c3 100755
--- a/openhis-ui-vue3/src/views/doctorstation/components/prescription/prescriptionlist.vue
+++ b/openhis-ui-vue3/src/views/doctorstation/components/prescription/prescriptionlist.vue
@@ -3346,7 +3346,7 @@ function syncGroupFields(row) {
   }
 }
 
-function setValue(row) {
+async function setValue(row) {
   unitCodeList.value = [];
   unitCodeList.value.push({ value: row.unitCode, label: row.unitCode_dictText, type: 'unit' });
   
@@ -3398,8 +3398,8 @@ function setValue(row) {
     showPopover: false, // 确保查询框关闭
   };
   console.log('[BugFix] setValue - prescriptionList[rowIndex].adviceType_dictText:', prescriptionList.value[rowIndex.value].adviceType_dictText);
-  // 🔧 修复执行科室逻辑：优先使用项目维护的所属科室(row.orgId)，其次使用positionId，最后回退到患者科室
-  prescriptionList.value[rowIndex.value].orgId = row.orgId || row.positionId || props.patientInfo?.orgId;
+  // 🔧 Bug #455: 执行科室默认逻辑：使用positionId(诊疗执行科室配置) → 患者就诊科室，不再使用row.orgId(项目所属科室)
+  prescriptionList.value[rowIndex.value].orgId = row.positionId || props.patientInfo?.orgId;
   prescriptionList.value[rowIndex.value].dose = row.dose || row.doseQuantity;
   prescriptionList.value[rowIndex.value].quantity = row.quantity || 1;
   prescriptionList.value[rowIndex.value].unitCodeList = unitCodeList.value;
@@ -3518,7 +3518,7 @@ function setValue(row) {
       prescriptionList.value[rowIndex.value].positionId = finalLocationId;
     }
   } else {
-      getOrgList();
+      await getOrgList();
       // 会诊类型（adviceType == 5）和诊疗类型（adviceType == 3）的处理
       if (row.adviceType == 5) {
         // 会诊类型：设置默认值