Under the background of promoting day surgery nationwide and ensure the medical quality, fine management is crucial and in trend. As one of the earliest central health organizations that started day surgery service in China, West China Hospital of Sichuan University has conducted approximate 140 000 day surgery cases in the past nearly 10 years. Based on the experience of practice, West China Hospital of Sichuan University has summarized 26 clinical indicators from 5 aspects to evaluate and monitor the economic efficacy and medical quality and safety of day surgery, including the input and output, the efficiency, the patient experience, the medical quality and safety, and the difficulty evaluation of surgery. The aim is to explore and establish an appraisal and monitoring system for day surgery, promote the stable development of day surgery, improve the work efficiency, and take the government plan of implementation day surgery to improve medical services into action.
After nearly 30 years of localized development of day surgery in China, in order to enable more patients to enjoy high-quality and affordable day surgery medical services, some medical institutions have begun to try same-day surgery, which means the patient can be operated and discharged within the same workday. With the help of the national three-level diagnosis and treatment service model, it provides continuous medical services and guarantees for day surgery patients through the integration of “hospital-community”. This article first introduces the development history of day surgery, summarizes the definitions and requirements of day surgery in different countries or academic associations, and finally focuses on same-day surgery in China, aims to provide some ideas for the future development of day surgery in China.
Under the background of promoting the high-quality development of public hospitals, day surgery in China has also entered a stage of refined and high-quality continuous development. The high-quality connotation of day surgery includes high quality of medical treatment, high quality of nursing, high quality of management and high quality of service, which is also a difficulty and challenge faced by current medical management. Among them, medical treatment is the core, nursing and service are the key, and management is the essence of day surgery.
ObjectiveTo estimate the radiation dose (RD) to the general public and nuclear medicine technicians from patients undergoing 99mTc-methoxy isobutyl isonitrile (MIBI) myocardial perfusion imaging. MethodsFrom January to June 2015, 55 patients including 30 males and 25 females aged between 25 and 87 years[averaging (63.6±15.1)years] ready to undergo myocardial perfusion scintigraphy with 99mTc-MIBI were prospectively recruited in this study. Approximately at hour 1.5 after injection of 99mTc-MIBI, whole-body dose-equivalent rate was measured with a radiation-survey meter at 0.3 meter and 1.0 meter from the patients. On the basis of human 99mTc-MIBI metabolic rate proposed by the International Commission of Radiological Protection and human social contact model proposed by the National Council on Radiation Protection and Measurements, the RDs to the general public from patients who had completed 99mTc-MIBI myocardial perfusion imaging and left nuclear medicine department were calculated. On the assumption that a nuclear medicine technician typically spent 5 minutes at a distance of 0.3 meter for positioning the patient, the technician's RD was also estimated. ResultsThe RD to a family member sleeping with the patient at night was predicted to be 42.88-160.55 μSv, to a family member contacting the patient at daytime 7.50-29.38 μSv, to a colleague 9.89-38.78 μSv and to a nearby passenger 124.48-466.06 μSv. The RD to a technician per 99mTc-MIBI myocardial perfusion imaging procedure was predicted to be 1.72-6.44 μSv. ConclusionThe predicted RDs to the general public and technicians from exposure of patients undergoing 99mTc-MIBI myocardial perfusion imaging are significantly lower than the regulatory dose limits.
Post-traumatic stress disorder (PTSD) is one of the common chronic diseases in psychiatry. It has a long course of disease which seriously affects patient’s life and work, and has a serious impact on social function. So far, the diagnosis of PTSD is limited to clinical symptom manifestations and physician experience, and no exact pathological substance basis is found, while the pathological substance basis is crucial for accurate diagnosis, selection of effective treatment methods, evaluation of treatment results, and assessment of disability. Head MRI is currently one of the most promising techniques to solve this problem. This paper reviews the progress in MRI research on brain structure changes in PTSD patients, in order to explore the possible future development directions.
By learning the nearly ten years’ experience and summaries in day surgery, West China Hospital of Sichuan University drafts a series of standards for day surgery management. This article mainly introduces the pre-administration management standards of West China Hospital of Sichuan University, involving: standards for the management of surgeons, nurses, patients, and the type of operation; standards for pre-administration work procedure; standards for pre-administration health education; standards for appointment, scheduling, and coordination for day surgery; and standards for surgery notification. This paper aims to share experience with peer professionals, and provide theoretical basis and practical guidance for the standardization and development of day surgery, as well as the establishment of a safe day surgery management system.
Although day surgery started late in China, its development momentum is strong. Due to the advantages of day surgery, the requirements of new medical reform and the promotion of national policies, thousands of hospitals have tried this innovative operation management mode in the past decade, presenting a picture of blooming flowers in full bloom. However, due to the lack of unified management standards for day surgery in China, there are still many practical problems in China, such as inconsistent definitions, inconsistent connotations and diversified management modes. It is believed that the day surgery will develop healthily and sustainably in China after the relevant management standards are formulated at the national level. Based on the development of day surgery at home and abroad, this paper discusses the expectation and prospect of day surgery in China.