３ 整體流程圖……
As one of the crucial measures in the action plan for improving health services, day surgery is committed to efficiently integrating medical resources and improving the quality of medical services. Nowadays, public hospitals in China are vigorously promoting the day surgery cases. The normalization of day surgery is also one of the major goals for the Department of Gastroenterology to meet the current medical needs and explore sub-professional development in line with the discipline’s advantages. Taking the current status of day surgery in the Department of Gastroenterology of West China Hospital of Sichuan University as an example, this paper explores and constructs the “Huaxi Model of Day Surgery in the Department of Gastroenterology”, focusing on the management mode, operation process, operation implementation, quality and safety assurance of day surgery, so as to facilitate the exchange of experiences.
1背景早在1987年英國愛丁堡皇家醫院就開始著手研究快速的治療流程分類系統給心肌梗塞的患者所帶來的時間經濟效益，就此對快速流程的研究正式拉開了序幕。到了20世紀90年代初，歐洲部分醫院的急診科首先從科室角度開始迅速推廣快速流程； 同時涉及麻醉方面的流程效率改革和創新逐步興起。20世紀90年代末麻醉專業從門診麻醉模式、手術及麻醉前干預上，開始逐步提升快速流程的綜合管理能力。正是在20世紀90年代末，快速流程的理念被正式提出，在當時它還有一個名稱叫做多模式康復流程。這種理念隨之在歐美國家流行起來，大量的臨床實踐不斷在進行。1994年，美國Engelman等就提出了冠狀動脈旁路“fast-track recovery”的概念，并建立了一套相應的快速康復程序，通過實踐發現其的確能夠加快患者的術后康復、縮短住院時間。至此快速流程作為一項高效的臨床運作模式被正式納入臨床具體病種的應用中。從2001年至今，心臟外科及結直腸外科的快速流程已趨于成熟，并已成功地滲透到外科領域的多個環節……
As the reform of medical insurance payment methods is implemented, it is necessary for the medical institutions to further improve cost control and standardize the rational use of medical supplies. Over the years, West China Hospital of Sichuan University has made the assessment of the access of supplies by using the existing external evidence and the internal evidence created through real world data analysis methods. In this thesis, the difficulties faced by the access of medical supplies are deeply analyzed. The supplies access management system of West China Hospital of Sichuan University and its achievements in average waiting time of new supplies, rationality of purchase application, scientificity of demonstration results, support for the implementation of fourth-level surgery, and cost control are taken as examples. From this, a set of new paths can be provided for other hospitals to learn from at the time of carrying out medical supplies access management.