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.
ObjectiveTo explore the standardized index system of quality control for single disease of day surgery in Shanghai municipal hospitals.MethodsFrom April to November 2020, through literature research and comprehensive analysis of research results, the framework of quality control index system for single disease of day surgery focusing on obstructive sleep apnea hypopnea syndrome surgery and laparoscopic cholecystectomy was constructed; Delphi method was used to evaluate the quality of day surgery in terms of results, objectivity, statistics, sensitivity, accessibility, quantifiability, importance, and guidance. Finally, the final indicators were screened out.ResultsAfter three rounds of Delphi investigation, 18 experts finally formed 14 general indexes and 14 personalized indexes (6 for obstructive sleep apnea hypopnea syndrome and 8 for laparoscopic cholecystectomy) in the single disease of day surgery quality control index system.ConclusionsThe general indexes and personalized indexes quantifying the quality control index for single disease of day surgery are conducive to the standardization and standardized management of day surgery, and can provide a reference for improving the medical quality and safety, and sustainable development of day surgery.
This paper expounds the experiences and thinking of enclosed emergency management under emergency coronavirus disease 2019 (COVID-19) epidemic in a Grade A tertiary hospital in Shanghai. The main emergency prevention and control measures included accurately controlling information of all people in the hospital, implementing strict hospitality prevention and control programs, providing strongly logistics support services, ensuring the safety of medical services, stabilizing mood of all people in the hospital, and guiding the correct public opinion. During the enclosed management period, the hospital worked smoothly and orderly, and no infection or transmission ocurred. Practice shows that the use of enclosed emergency management model is an effective way to respond to emergency COVID-19 epidemic, which can provide scientific reference for the hospital facing public health emergencies.