In order to promote the effective development of hospital day surgery mode, a construction method of information management platform that meets the characteristics of day surgery mode is presented. By analyzing the business process of the day surgery mode, the system architecture of the information platform is given; according to the difficulty of the surgical scheduling, the two-stage surgical scheduling algorithm based on the ranking theory is given; by analyzing the day surgery data statistically, a multi-angle surgical index analysis module is provided. The information management of the day surgery mode has been realized, and the work efficiency has been improved. A reasonable day surgery information platform construction can help to optimize the daytime surgical procedure and promote the smooth development of day surgery.
With the rapid development of day surgery mode in China, day surgery management has shifted from extensive to refined, but there are still many problems in the information system of day surgery in Chinese hospitals. The Second Affiliated Hospital Zhejiang University School of Medicine has developed a day surgery information management system since 2018, established a pre-hospital and in-hospital day surgery ecological management, and integrated daily management concepts and management rules into the system through the whole-process information management. It realized the whole process, full data, closed-loop and path-based information management of day surgery. This paper introduces the day surgery information management system of the Second Affiliated Hospital Zhejiang University School of Medicine, and aims to share the experience of building the day surgery information management function module.
In the context of the burgeoning development of day surgery, the shortened hospital stay has led to a relative reduction in the professional care that patients receive. As a result, more stringent requirements for nursing quality management have emerged. Scientific and objective sensitive indicators can provide quantitative standards for monitoring and evaluating nursing quality. This article comprehensively reviews the definition, classification, construction steps, and methods of nursing quality sensitive indicators. Additionally, it delves into the current status of the construction and application of such indicators for day surgery both at home and abroad. Those insights can offer a scientific foundation for the management of nursing quality in day surgery settings.
Objective To explore the feasibility and safety of tension-free vaginal tape-obturator for female stress urinary incontinence under the daytime surgical mode based on the concept of enhanced recovery after surgery. Methods The clinical data of female patients with stress urinary incontinence at the First Affiliated Hospital of Kunming Medical University between June 2019 and June 2023 were retrospectively analyzed. According to the perioperative management mode of patients, they were divided into daytime surgery group and routine surgery group. The basic, intraoperative, and postoperative conditions of two groups of patients were compared. Results Finally, 183 patients were included, including 91 in the routine surgery group and 92 in the daytime surgery group. All patients successfully completed the surgery. There was no statistically significant difference in age, preoperative comorbidities, surgeon in chief, or operation duration between the two groups of patients (P>0.05). The preoperative waiting time after hospitalization [(0.00±0.00) vs. (2.42±0.58) d], hospitalization expenses [(13815.10±2906.01) vs. (18095.21±3586.67) yuan], total surgical expenses [(3961.36±707.35) vs. (4440.19±1016.31) yuan], anesthesia expenses [(718.53±61.06) vs. (755.30±74.65) yuan], western medicine expenses [(818.07±259.30) vs. (1282.14±460.75) yuan], total hospitalization duration [(1.11±0.31) vs. (5.77±1.30) d], and postoperative hospitalization duration [(1.11±0.31) vs. (3.35±1.42) d] in the daytime surgery group were lower than those in the routine surgery group (P<0.05). There was no significant difference between the two groups in postoperative complications (respiratory complications, fever, nausea and vomiting, vaginal bleeding, urinary retention, peritonitis), satisfaction, postoperative pain or self perception of symptom improvement (P>0.05). Conclusion The daytime surgery for female stress urinary incontinence based on the concept of enhanced recovery after surgery is safe and feasible, which can shorten hospitalization duration and reduce hospitalization costs.
ObjectiveTo explore the safety of day surgery program of video-assisted thoracoscopy surgery in the treatment of pulmonary nodules.MethodsWe retrospectively analyzed the clinical features of the patients who received video-assisted thoracoscopy surgery between June and November 2019 in Day Surgery Center of West China Hospital, Sichuan University. The basic conditions, surgery duration, intraoperative blood loss, placement time of thoracic drainage, postoperative pain score, hospitalization expenses, and postoperative complications were observed. Postoperative telephone follow-up was conducted on the 2nd, 3rd, and 30th day after operation. The 1st day after operation means the next day after operation.ResultsA total of 29 patients were included with 5 males and 24 females. Surgeries were successfully performed on these 29 patients and they were all discharged as planned. The mean surgery duration was (78.14±16.37) min, the mean intraoperative blood loss was (38.15±23.04) mL, and the mean placement time of thoracic drainage was (577.45±233.70) min. Intraoperative open chest surgery and massive hemorrhage were not occurred. The Pain Numerical Rating Scale score at the 6th hour after surgery was 2.10±0.56, and the average hospitalization expense was (33 600±4 611) yuan. In the 29 patients, the postoperative complications included pneumothorax in 2, urinary retention in 1, tachycardia in 1, and persistent cough in 9. No recurrence of the listed complications was reported on the 30th day of telephone follow-up. No severe complications or postoperative death occurred.ConclusionDay surgery program of video-assisted thoracoscopy surgery is safe and effective in the treatment of pulmonary nodules.
ObjectiveTo explore the management experience of day surgery in children specialized hospitals.MethodsWuhan Children’s Hospital began one-day pediatric surgery in 1981. In 2001, one-day surgery center was formally established to centralize treatment and management. In the past three years, the mixed management of centralized and decentralized treatment was increased. At the same time, the one-day surgery management process was optimized, the relevant access and evaluation system was strictly implemented, to ensure the medical quality and medical safety.ResultsSince 2001, more than 120 000 cases of day surgery had been performed in the hospital, without death or other serious complications. The incidence of common postoperative complications was less than 0.8%, and the time of occurrence of complications was mainly within 12 hours after surgery. By 2018, the number of day surgeries in the hospital accounted for 29.57% of the annual elective surgeries, and the overall incidence of complications was lower than the traditional hospitalization mode of the same disease.ConclusionsThe concept of patient-centered service is truly embodied in day surgery. Specialized hospitals, especially children’s hospitals, have a large number of single diseases, a large demand for patients’ surgeries, a high degree of homogeneity of surgeries, good surgical results, and urgent needs and advantages to carry out day surgery. Day surgery is suitable to start in developed departments, and be promoted in other specialties of the hospital when experience has been accumulated, so as to increase the proportion of day surgery in elective surgery gradually.
Objective To investigate the safety and feasibility of day surgery for patients with palmar hyperhidrosis based on the principles of enhanced recovery after surgery (ERAS). Methods We retrospectively reviewed the medical records of consecutive patients who underwent endoscopic thoracic sympathicotomy (ETS) in the First Affiliated Hospital of Xi'an Jiaotong University from March 2020 to December 2021. Patients were divided into a day surgery group and a conventional group according to their perioperative management methods. The patients in the day surgery group underwent an optimized perioperative procedure under the guidance of ERAS, and were ventilated with a laryngeal or face mask during the operation. The patients in the conventional group completed the preoperative examination, operation and postoperative observation according to the conventional procedures, and were intubated with a single-lumen endotracheal tube. The demographic characteristics, operation time, hospital stay, postoperative complications, and hospitalization cost were compared between the two groups. Results Finally 172 patients were collected, including 90 males and 82 females, with an average age of 25.97±7.43 years. There were 86 patients in each group. All patients ceased suffering from palmar sweating after surgery. No patient experienced massive bleeding or conversion to thoracotomy. There was no statistical difference in operation time between the two groups (P=0.534). Patients in the day surgery group were discharged within 24 hours. The average hospital stay in the conventional group was 2.09±0.41 days. Incidence of postoperative respiratory complications, and the hospitalization cost of the day surgery group were significantly lower than those of the conventional group (P＜0.001). The satisfaction rate in both groups was greater than 95%. Conclusion Day surgery for patients with palmar hyperhidrosis based on the principles of ERAS is safe and feasible, which can reduce postoperative complications, shorten the length of hospital stay and save the cost of hospitalization.
Objective To understand the incidence and severity of postoperative acute pain in patients undergoing day surgery, and to explore the influencing factors of moderate to severe pain after surgery, so as to provide a reference for pain management in day surgery. Methods Convenience sampling method was used to select patients undergoing day surgery under multi-modal pain management in West China Hospital of Sichuan University between April and August 2020, and the general conditions, surgical conditions, and postoperative pain of the patients were investigated. According to the degree of postoperative pain, patients were divided into mild pain group and moderate to severe pain group. Logistic regression analysis was used to explore the influencing factors of postoperative pain in the two groups. Results A total of 509 patients were finally included, of which 69 patients presented with moderate to severe pain. Logistic regression analysis showed that patient age [odds ratio (OR)=0.970, 95% confidence interval (CI) (0.946, 0.993), P=0.012], pain threshold [OR=1.348, 95%CI (1.048, 1.734), P=0.020] and postoperative drainage tube [OR=2.752, 95%CI (1.090, 6.938), P=0.017] were the influencing factors of moderate to severe pain after surgery. Conclusion Under multimodal pain management, the incidence of moderate to severe pain in day surgery patients is low, and medical staff should further strengthen pain management from the factors affecting pain to reduce the incidence of moderate to severe pain after surgery.
ObjectiveTo investigate the effect of quality control circle (QCC) activity in reducing the temporarily stopping rate of day surgery.MethodsThe QCC activity was carried out from December 2018 to October 2019. By determining the theme of the activity and drawing up the plan, a retrospective analysis of pre-hospital day surgery stoppage status and reasons was performed based on 2 696 patients who had reserved surgery in the day surgery center from December 2018 to February 2019. Based on the data, the goal was determined, and measures were developed and confirmed from May to August 2019. Then the measures were standardized and implemented continuously from September to October 2019. The rate of surgical cessation before the implementation of the measures (from December 2018 to February 2019) was compared with that after the implementation of the measures (from September to October 2019).ResultsAfter the QCC activity, the temporarily stopping rate decreased from 2.89% to 1.34%, and the difference was statistically significant (P<0.001).ConclusionThe QCC activity can effectively reduce the temporarily stopping rate of day surgery, and lay the foundation for continuously promoting the optimization of day surgery resources and quality improvement.