1背景早在1987年英国爱丁堡皇家医院就开始着手研究快速的治疗流程分类系统给心肌梗塞的患者所带来的时间经济效益，就此对快速流程的研究正式拉开了序幕。到了20世纪90年代初，欧洲部分医院的急诊科首先从科室角度开始迅速推广快速流程； 同时涉及麻醉方面的流程效率改革和创新逐步兴起。20世纪90年代末麻醉专业从门诊麻醉模式、手术及麻醉前干预上，开始逐步提升快速流程的综合管理能力。正是在20世纪90年代末，快速流程的理念被正式提出，在当时它还有一个名称叫做多模式康复流程。这种理念随之在欧美国家流行起来，大量的临床实践不断在进行。1994年，美国Engelman等就提出了冠状动脉旁路“fast-track recovery”的概念，并建立了一套相应的快速康复程序，通过实践发现其的确能够加快患者的术后康复、缩短住院时间。至此快速流程作为一项高效的临床运作模式被正式纳入临床具体病种的应用中。从2001年至今，心脏外科及结直肠外科的快速流程已趋于成熟，并已成功地渗透到外科领域的多个环节……
３ 整体流程图……
As one of the crucial measures in the action plan for improving health services, day surgery is committed to efficiently integrating medical resources and improving the quality of medical services. Nowadays, public hospitals in China are vigorously promoting the day surgery cases. The normalization of day surgery is also one of the major goals for the Department of Gastroenterology to meet the current medical needs and explore sub-professional development in line with the discipline’s advantages. Taking the current status of day surgery in the Department of Gastroenterology of West China Hospital of Sichuan University as an example, this paper explores and constructs the “Huaxi Model of Day Surgery in the Department of Gastroenterology”, focusing on the management mode, operation process, operation implementation, quality and safety assurance of day surgery, so as to facilitate the exchange of experiences.
As the reform of medical insurance payment methods is implemented, it is necessary for the medical institutions to further improve cost control and standardize the rational use of medical supplies. Over the years, West China Hospital of Sichuan University has made the assessment of the access of supplies by using the existing external evidence and the internal evidence created through real world data analysis methods. In this thesis, the difficulties faced by the access of medical supplies are deeply analyzed. The supplies access management system of West China Hospital of Sichuan University and its achievements in average waiting time of new supplies, rationality of purchase application, scientificity of demonstration results, support for the implementation of fourth-level surgery, and cost control are taken as examples. From this, a set of new paths can be provided for other hospitals to learn from at the time of carrying out medical supplies access management.