Objective To explore the influence of applying the fast-track surgery (FTS) to optimize the process in the perioperative period of cardiac intervention on the rehabilitation of patients with radial artery stenting surgery. Methods A total of 190 patients with radial artery stenting surgery in the Department of Cardiology, West China Hospital from June 2017 to May 2018 were enrolled. They were randomized into a control group (n=95) and a FTS group (n=95) by random umber table. There were 60 males and 35 females aged 35-88 (65.2±9.6) years in the control group as well as 62 males and 33 females aged 34-86 (61.5±11.3) years in the FTS group. Patients in the control group received routine perioperative care, but patients in the FTS group received individual precision interventions by applying the FTS concept to optimize the process of perioperative care, including individual care management before being admitted into hospital, during hospital, and after discharge from hospital. Duration of hospital stay, satisfaction scores, number of comorbidities after surgery, disease self-management ability, and readmission rates were compared between the two groups. Results Compared to the control group, the FTS group had significantly shorter duration of hospital stay, less comorbidities, higher satisfaction scores and disease self-management ability, and lower readmission rate to hospital (P<0.05). Conclusion Applying FTS into the perioperative period of cardiac interventions to optimize its process can help patients recover from radial artery stenting surgery, increase patients’ self-management abilities, shorten duration of hospital stay and decrease comorbidities and cardiac adverse events.
Objective To explore the process of using failure mode and effect analysis (FMEA) to optimize the management of specimens from relatives of patients and analyze its effects. Methods The data of the specimens tested by the family members of hospital patients between October 2019 and June 2020 in the Children’s Hospital of Fudan University were collected. The data between October 2019 and March 2020 were taken as the pre-FMEA group, and the data between April 2020 and June 2020 were taken as the FMEA group. We used FMEA method to evaluate the risk points in the management of specimens from relatives of patients, analyzed the reasons to propose improvement measures, and compared the effect of optimizing the management of specimens from relatives of patients before and after the implementation of FMEA. Results A total of 12 117 specimens from relatives of patients were included, including 6 132 cases in the pre-FMEA group and 5 985 cases in the FMEA group. A total of 13 potential failure modes were found, including 3 high risk, 3 medium risk and 7 low risk. After the implementation of FMEA, the 3 high risk failure modes, 1 medium risk failure modes “inspection type application error” and 1 low risk failure modes “diagnosis error” were lower than that pre-FMEA (P<0.05). The interview results showed that the job satisfaction and work risk awareness of relevant medical staff were improved after the implementation of FMEA. Conclusions The use of FMEA to optimize the management process of patient family specimens accurately captures the risk points. After the implementation of the improvement, the potential risk of the process is reduced, possible errors are prevented, work efficiency and job satisfaction are improved, and it can be used as a reference for hospital managers.
Objective To evaluate the effect of optimizing the management measures of cataract ambulatory surgery. Methods The patients who underwent cataract phacoemulsification combined with intraocular lens implantation in the Ambulatory Surgery Center of East District of Beijing Tongren Hospital affiliated to Capital Medical University were selected. Patients between January and December 2021 (after the optimization of ambulatory surgery process) were included, and patients between January and December 2020 (before the optimization of ambulatory surgery process) were included as control. The three factors of age, gender and surgical eye type were used as predictive variables for propensity score matching. The proportion of patients who completed the surgery according to the scheduled time, the proportion of eye drops used according to the doctor’s instructions and the number of hospital visits before and after the optimization of the ambulatory surgery process were compared with the patients who successfully matched. Results A total of 28306 patients were included, including 13284 before and 15022 after process optimization. There were 13467 males and 14839 females, with a median age of 70 (60, 78) years. There was no statistically significant difference in the age of patients before the process optimization (P>0.05), but there was statistically significant difference in gender and surgical eye (P<0.05). After the propensity score matching, a total of 12932 pairs of patients were matched successfully. After the propensity score matching, there was no statistically significant difference between the two groups in age, gender and surgical eye (P>0.05). After the process optimization, the proportion of patients who completed surgery on schedule (98.8% vs. 93.3%) and used eyedrops according to the doctor’s instructions (97.4% vs. 93.0%) were higher than that before the process optimization, and the proportion of patients who came to hospital more than 3 times (0.7% vs. 1.9%) was lower than that before the process optimization (P<0.05). Conclusion The optimized ambulatory surgery process can help patients complete the surgery according to the scheduled time and use eye medication according to the doctor’s instructions, and can reduce the number of patients coming to the hospital.