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.
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.
Due to optimizing medical service resources and improving service efficiency, day surgery has attracted the attention of medical and management experts worldwide. In 2019, day surgery was included as one of the performance assessment indicators of tertiary public hospitals. In recent years, hospital-based day surgery centers have begun to plan and build. Although the basic facilities have been perfectly improved, but how to efficiently and safely operate and manage the centralized day surgery has become the primary problem to clinicians and managers. The purpose of this paper is to introduce how the Day Surgery Center of West China Hospital of Sichuan University uses scientific management tools and establishes a professional multidisciplinary team, so as to carry out efficient operation management and control of medical quality and safety risks of the Day Surgery Center. And then provide practical experience guidance and suggestions with strong feasibility and operability for peers.
Day surgery has been developed in China for over 30 years. However, the admission decisions for day surgery patients are still mainly based on expert experience, brainstorming, and institutional recommendation, and lack scientific admission criteria and universality. West China Hospital of Sichuan University has implemented methods such as semi-supervised learning based on heterogeneous data, to construct a more objective and accurate patient admission model based on large amounts of diagnosis and treatment data. This initiative aims to assist the country and hospital in reducing medical costs and alleviating the acute problem of the current contradiction between supply and demand of medical resources. It also seeks to optimize the utilization and allocation of bed resources, reduce the cost of patient management, enhance the theoretical research on patient admission methods in day surgery in China, and provide reference and inspiration for other hospitals in the day surgery industry in China.
The vigorous development of day surgery is crucial to alleviating the contradiction between supply and demand of medical and health care and improving the efficiency of medical and health resources in China. The current path dependence, policy inertia, and lack of coordination in the development of day surgery have brought a more severe test to the healthy and orderly development of day surgery in China, and the vulnerability in the development of day surgery has also emerged gradually. By examining the positive and negative experiences and lessons learned in the current development of day surgery, from the perspective of “structure-resource-information- society” subsystems, and based on the identification of key competencies in the collaborative development system for day surgery, this article indicates that the day surgery resilience is a composite system composed of spatial resilience, digital resilience, resource oriented resilience, institutional resilience and management resilience, and analyzes the implementation path of day surgery collaborative development system, providing a theoretical basis for the healthy and orderly development of day surgery in China.
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.