Day surgery mode is a challenge for surgeons, anesthesiologists, nurses, and managers. Standardized management should be implemented in each management model, no matter centralized management or decentralized management model, by utilizing the theory of enhanced recovery after surgery and information management to establish a system to ensure patient’s safety and medical quality. Only in this way the development of day surgery will be healthy and sustainable.
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.
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.
Driven by the national policy of “improving quality and efficiency, and serving the people”, day surgery has become a crucial breakthrough in the high-quality development of China’s public hospitals. As an efficient and cost-effective medical service model, day surgery in China has evolved systematically—from initial spontaneous exploration to structured, government-led guidance. Drawing on the experience of West China Hospital of Sichuan University, this article provides a comprehensive overview of day surgery model innovation under China’s unique management framework, covering the evolution of definitions, policy-driven factors, innovative development, distinctive quality control, and expansion of surgical procedures. Chinese day surgery is advancing toward a “five-dimensional” model—characterized by consistent definitions, standardized processes, objective evaluation, information-based management, and regular case selection—reflecting strong national adaptability and institutional innovation.
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.
In 2022, the General Office of the National Health Commission issued Interim Regulations on Quality Management of Day Care in Medical Institutions, which strictly regulated the requirements for medical institutions to carry out day surgery, reflecting that medical quality and safety management is the core principle of day surgery management. Medical quality and safety management is the core foundation of the sustainable development of day surgery, which directly determines the life cycle and continuous vitality of day surgery in the future development of our country. The remarkable achievements of day surgery at West China Hospital of Sichuan University are attributed to a set of scientific and standardized quality and safety management measures based on clinical pathways. These measures not only provide fine management for every link in the surgical process, but also effectively guarantee the medical safety and treatment effect of patients by optimizing the operation norms before, during and after the operation. This article shares the quality and safety management concept of West China Hospital of Sichuan University, which is “proficient in pre-hospital care, cautious in hospital care, skilled in post-hospital care”, for the peers to learn from and share.
As an advanced mode of diagnosis and treatment, day surgery is widely carried out in foreign countries. Although it started late in China, it has been gradually valued and vigorously promoted in medical and health field in recent years. The effective implementation of day surgery in hospital cannot be separated from the strong support of performance management system. Through introducing the performance management experiences in promoting day surgery mode in West China Hospital of Sichuan University, this article discusses how to construct an effective whole-course performance management system for day surgery combined with operation management through three mechanisms: the management committee mechanism, the operation management mechanism and the performance assessment mechanism, which are based on the structure-process-outcome dimensions of quality management system, at the three levels of hospital, department and position, so as to provide a reference for developing day surgery in China.
目的：探討國產自膨式鎳鈦記憶合金食管支架在食管、賁門良惡性狹窄及食管瘺中的臨床應用并觀察療效。方法:收集我院2005年11月～2008年8月采用胃鏡輔助置入鎳鈦記憶合金食管支架的患者108例，其中男90例，女18例，年齡37~88歲；包括食管癌性狹窄41例，賁門癌性狹窄5例，放療后狹窄1例，肺癌壓迫致食管狹窄1例，食管、賁門癌術后吻合口頑固性狹窄21例，食管癌術后復發致狹窄6例，食管瘺33例。結果：108例患者共置入食管支架116枚，一次性置入成功率100%，置入后患者吞咽梗阻的癥狀有不同程度的改善，嗆咳的癥狀基本消失。結論：食管支架置入操作簡單、安全，成功率高，是治療食管良惡性狹窄及封堵瘺口的有效方法。
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.
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.