Some complex surgical procedures allow for day surgery benefited from the advancement of the concept of enhanced recovery after surgery and minimally invasive surgical techniques. Shanghai Chest Hospital has set up thoracic day surgery ward incorporating some lung tumor surgeries into day surgery. Through process innovation, model innovation and management innovation, relying on the full-process closed-loop day surgery management system, the day surgery ward runs efficiently. It can help effectively alleviate the difficulty of admission and operation, and improve hospital operation efficiency as well as reduce the economic burden of disease. At the same time, we hope to explore an innovative development path for the possibility of day surgery in complex thoracic surgery, and create a new mode of day surgery that can be replicated and promoted.
Objective To establish a set of structure-process-outcome (SPO) indicators associating with the enhanced recovery after surgery (ERAS) process in day surgeries, based on the current data from Shanghai municipal hospitals. Methods The data on the first page of medical records of patients undergoing short-course surgery in 36 municipal hospitals in Shanghai between 2019 and 2021 were selected. The development of day surgery was analyzed, and the appropriate diseases and surgical catalogue for standardized management of day surgery were determined. Based on ERAS, the three-dimensional integrated indicators combined SPO process were designed. Results According to the national recommended day surgery directory, there were 87 kinds of day surgeries caried out by Shanghai municipal hospitals during 2019-2021. Another 81 kinds of day surgeries recommend had less than 100 cases. Under the circumstances, a set of SPO indicators were established, including 34 process indicators and 20 outcome indicators. They covered all process of day surgery. Conclusions An increase of day surgery is observed from 2019 to 2021 among Shanghai municipal hospitals. But the surgical ability still needs improving. The application of SPO indicators would provide evidence to enhance evaluation on how multi-disciplinary treatment and ERAS are conducted among day surgeries, therefore estimating if the surgical process is standard and methodical.