Objective To explore the feasibility and the security of one-day stay ward in stripping surgery of saphenous vein varicosity. Methods Two hundred and eighty two patients treated in our hospital in 2011 were enrolled in this study， according to the operation mode， these patients were divided into 2 groups， ninety patients in one-day stay ward group and one hundred and ninety two patients in in-patient group. Their clinical features and medical operation indexs（included preoperative waiting time， duration of hospital stay， and medical cost）were retrospectively analyzed. Results There was no statistical differences on clinical features between the two groups. But compared with in-patient group， the preoperative waiting time， duration of hospital stay， and medical cost were shorter or lower in one-day stay ward group （P＜0.05）. Conclusions The one-day stay ward operation mode can decrease preoperative waiting time， duration of hospital stay and medical cost significantly， and it also can ensure the safety of clinical treatment. So it’s worthy in the clinical promotion.
ObjectiveTo investigate the medical quality of rehabilitation departments in medical institutions at all levels in Shenzhen and analyze the problems, so as to promote the continuous improvement of rehabilitation care quality in this city.MethodsFrom September to November 2019, a field investigation was carried out in 53 rehabilitation departments in Shenzhen. Five dimensions were scored by experts, including professional capacity, rules and regulations, knowledge and skills, supervision and feedback, and hospital infection control. Descriptive statistical analysis was used to characterize the data, and one-way analysis of variance was used to analyze the difference among different level hospitals.ResultsThe average score of rehabilitation medical care quality in Shenzhen was 83.98±8.28. The average score of tertiary, secondary, and primary hospitals were 85.61±7.02, 84.54±7.83, and 77.55±10.60, respectively, and the difference among different level hospitals was statistically significant (P<0.05). According to the standard score, the highest score was in the dimension of supervision feedback (95.75±6.50), and the lowest score was in the dimension of knowledge and skills (77.27±14.64).ConclusionThe overall quality of rehabilitation care in Shenzhen needs to be improved, and the management and professional training systems need to be established.
ObjectiveTo evaluate the safety and quality of patients in day surgery. MethodsThe clinical data of patients in day surgery from March to December 2014 in this hospital were collected. The incidence of complications, delayed discharge rate, rate of readmission to hospital, satisfaction, and so on, were analyzed. ResultsOf 5 520 patients were in day surgery, including laporoscopic cholecystectomy, hernia repair surgery, vocal cord polyps resection, breast minimally invasive surgery, varicose vein of lower limb, choledochoscopy, gastrointestinal polyposis, and so on. No patient was loss of follow-up, unplanned reoperation or death after day surgery. There were 39.95%(2 205/5 520) of wound pain and 0.51%(28/5 520) of postoperative nausea and vomiting in the complications. The delayed discharge rate was 0.62%(34/5 520), the rate of unplanned readmission to hospital was 0.49%(27/5 520), and the satisfaction rate was 98.99%(5 464/5 520). ConclusionFor the above surgery types in this study, the day surgery mode is safe and effective.
Objective To explore the effect of lean management on patients’ safety, medical quality, and satisfaction in day surgery ward. Methods The patients underwent day surgery between May 4th, 2017 and April 30th, 2018 were selected as the subjects (the lean management of day surgery ward implemented on November 1st, 2017). The patients underwent day surgery between May 4th and October 31st, 2017 were taken as the control group (n=2 864), and the ones between November 1st, 2017 to April 30th, 2018 were taken as the observation group (n=2 705). The following data between the two groups were compared: the cancellation rate of day surgery, the 24-hour delayed discharge rate, the rate of 12-hour median or severe pain after surgery, the rate of 12-hour postoperative nausea and vomiting, the awareness rate of health education, the patients’ satisfaction, and the incidence of adverse events.Results Compared with those in the control group, the cancellation rate of surgery (4.81% vs. 6.25%), the 24-hour delayed discharge rate (2.76% vs. 4.28%), the 12-hour median or severe pain after surgery (5.55% vs. 8.31%), the rate of 12-hour postoperative nausea and vomiting (5.86% vs. 7.71%) decreased in the observation group, and the differences were statistically significant (P<0.05). The awareness rate of health education increased from 92.18% to 98.02% after the implementation of lean management, the patients’ satisfaction increased from 92.48±2.58 to 96.53±1.64 after the implementation of lean management, and the differences were statistically significant (P<0.05). The incidences of adverse events in the two groups were not statistically different (0.16% vs. 0.41%, P>0.05). Conclusion The implementation of lean management model can insure the medical safety and quality of day surgery, and improve overall work efficiency and the patients’ medical service experience in day surgery ward.
Venous thromboembolism (VTE) is a high-risk complication in hospitalized patients, especially in patients with orthopedic surgery, neurosurgery, thoracic surgery, cardiac surgery and tumor surgery. It is also a significant cause of patients’ unexpected death and perioperative death. Through establishment of norms of VTE management system and organizational structure, formulation of perfect VTE risk assessment system and prevention and treatment scheme for hospitalized patients, training of all the medical staff for related knowledge, and test operation of the system in key departments, we established a hospital standardized system of venous thromboembolism prevention and management. Our VTE prevention and treatment work achieved good results through multidisciplinary collaboration.
Objective To analyze the research hotspots and trends of Chinese literature on medical quality evaluation indicators in China in recent years. Methods We searched for relevant Chinese literature on medical quality evaluation indicators on China National Knowledge Infrastructure from January 2000 to December 2024, and analyzed the annual publication volume, authors and institutions, research hotspots and frontiers. Results Finally, 177 articles were included in the literature. From 2000 to 2024, the number of Chinese literature on medical quality evaluation indicators in China showed a fluctuating upward trend, reaching 15 articles per year in both 2015 and 2024. The issuing units mainly included the National Institute of Hospital Administration, the School of Public Health of Peking University, Huazhong University of Science and Technology, etc. The publishing team mainly included author teams such as MA Xiemin, LIANG Minghui, XIA Ping, etc. The high frequency keywords and top 10 keywords for centrality ranking included medical quality, evaluation indicators, indicator system, Delphi method, evaluation, evaluation system, quality evaluation, indicators, clinical pathways, and hospital management. “Case classification” was the earliest emerging term in the study of medical quality evaluation indicators. In terms of burst intensity, the top 5 keywords for burst intensity included Delphi method, case classification, problem, data quality, and evidence-based evaluation. Conclusion The publishing institutions and research teams of Chinese literature on medical quality evaluation indicators in China are relatively loose, and there are still problems such as insufficient practical application of medical quality evaluation indicators and single research tools and methods.
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.
Objective To enhance medical quality evaluation by conducting a systematic review and evidence-based synthesis of relevant research. Methods Such databases as CBM (1978 to 2009), VIP (1989 to 2009), CNKI (1990 to 2009), WanFang Dissertation database (1997 to 2009), and relevant websites were searched to identify relevant Chinese studies for the synthetical evaluation on methods evaluating medical quality. Results A total of 216 articles including 184 observational studies, 29 traditional reviews, and 3 experts’ opinions were identified. Twenty-one synthetical evaluation methods were used among 216 articles, and the top three methods which had been quoted more than 30 times were: RSR (19.72%), TOPSIS method (19.03%), and comprehensive index (12.80%). Among the 184 observational research papers, the documents using one kind of comprehensive evaluation took up 89.13% (164/184), the ones using two kinds of evaluation methods accounted for 9.78% (18/184), and those using three kinds of methods accounted for 1.09% (2/184). Conclusion a) The joint use of two or more than two methods is not common. The majority of studies using single comprehensive evaluation method focus on RSR, TOPSIS and comprehensive index method; b) The comprehensive evaluation method is considered non-uniform, some not even standardized; c) Most of the medical literatures do not correct the value of quality assessment; and d) Considerably most studies perform retrospective evaluation with historical data.
ObjectiveTo assess the efficacy and safety of pediatric day surgery (PDS) program. MethodsWe retrospectively analyzed 148 pediatric surgeries between June 2012 and June 2013, including 31 for cryptorchidism, 53 for concealed penis, and 64 for hernia. According to the operation mode, these children were divided into PDS group and in-patient group. Analysis of the postoperative complications and hospital stay, and hospitalization expenses was carried out. ResultsThere was no statistical differences on success rate of operation, re-admission rate, postoperative fever, and postoperation nausea and vomiting between the two groups (P>0.05). But compared with the in-patient group, hospitalization expenses, medical cost, therapeutic treatment fee and hospital stay were significantly lower or shorter in the PDS group (P<0.05). ConclusionPDS is a safe and cost-effective program that reduces the average hospitalization days, reduces the per capita hospitalization cost, increases the turnover of beds, and benefits the child and the family.