Application of continuous quality improvement in reducing same-day cancellation rate of gynecological day surgery_West China Medical Journal

Authors：

YANG Yuqiong ^1,2 , LI Mingxuan ^1,2 ,  TAN Xin ^3,4

1. Department of Day Surgery Nursing, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610066, P. R. China;
2. Key Laboratory of Birth Defects and Related Diseases of Women and Children (Sichuan University), Ministry of Education, Chengdu, Sichuan 610041, P. R. China;
3. Department of Day Surgery, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610066, P. R. China;
4. Department of Day Surgery, Hi-Tech Zone Hospital for Women and Children, West China Second University Hospital, Sichuan University, Chengdu, Sichuan 610095, P. R. China;

Corresponding author：

TAN Xin, Email: 13398362780@163.com

Keywords：

Day surgery; gynecology; cancellation of surgery; factor analysis; continuous quality improvement

DOI：

10.7507/1002-0179.202411376

Video：

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Objective To explore strategies to reduce the same-day cancellation rate of gynecological day surgery. Methods The same-day cancellation status of gynecological surgery in the Department of Day Surgery, West China Second University Hospital, Sichuan University from January to December 2021 (before improvement) was investigated. The causes of cancellation were analyzed from three aspects: patient-related factors, medical factors, and examination factors. Subsequently, management countermeasures were formulated for the controllable factors and continuous quality improvement was implemented. After improvement, the same-day cancellation rate of gynecological day surgery from September 2022 to January 2023 was collected and compared with that before improvement. Results Continuous quality improvement was implemented targeting three factors in day surgery, namely the short interval between patient’s visit time and pre-scheduled time, the irrational sequence of preoperative examinations for patients, and the non-standardized treatment of patients with abnormal vaginal discharge by physicians. The same-day cancellation rates of gynecological day surgery before and after the continuous quality improvement were 3.70% (156/4211) and 2.13% (30/1411), respectively, and the difference was statistically significant (χ²=8.231, P=0.004). Conclusion Optimizing the preoperative examination and admission process, effective preoperative education and physician-patient communication, establishing unified standards for the approval of vaginal discharge tests and standardized treatment protocols, and clarifying the responsibilities of the preoperative comprehensive assessment outpatient clinic along with the supervision system are effective measures to reduce the same-day cancellation rate of gynecological day surgery.

Citation： YANG Yuqiong, LI Mingxuan, TAN Xin. Application of continuous quality improvement in reducing same-day cancellation rate of gynecological day surgery. West China Medical Journal, 2025, 40(2): 245-249. doi: 10.7507/1002-0179.202411376 Copy

1.	陈迎春, 李劲松. 实施日间手术治疗模式的探讨. 中国医院管理, 2009, 29(7): 24-25.
2.	张沁青, 谭耘. 降低日间手术当日取消率的品管圈实践. 护理学报, 2020, 27(9): 19-22.
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13.	刘亚萍, 嵇武, 叶向红. 应用术前预康复降低日间手术临时取消率的应用效果. 东南国防医药, 2022, 24(1): 80-82.
14.	冯文, 赵红, 陈威, 等. 我国日间诊疗服务模式的组织与制度创新. 中华医院管理杂志, 2019, 35(4): 307-310.
15.	陈亚玲, 莫洋, 谭亮, 等. 综合性医院日间手术中心的建设和运营管理. 华西医学, 2019, 34(2): 127-132.
16.	袁华娣, 洪萍花, 蒋立群, 等. 择期日间手术当日取消手术的原因分析及对策. 护理与康复, 2015, 14(10): 965-967.
17.	杨陈, 张学兵, 敖伟, 等. 儿童日间手术当日手术取消的原因分析及对策. 护理学杂志, 2018, 33(6): 74-76.
18.	Smith MM, Mauermann WJ, Cook DJ, et al. Same-day cancellation of cardiac surgery: a retrospective review at a large academic tertiary referral center. J Thorac Cardiovasc Surg, 2014, 148(2): 721-725.
19.	江美雅, 杨玉香, 黄玉仙. 妇科手术患者术前不同阴道准备方法的效果比较. 当代护士(中旬刊), 2015(10): 68-69.
20.	杨小晓, 马张芳, 刘敬花, 等. 回顾性调查眼科日间手术取消原因及改进措施. 河北医药, 2023, 45(8): 1254-1258.

1. 陈迎春, 李劲松. 实施日间手术治疗模式的探讨. 中国医院管理, 2009, 29(7): 24-25.
2. 张沁青, 谭耘. 降低日间手术当日取消率的品管圈实践. 护理学报, 2020, 27(9): 19-22.
3. 郭莉, 高兴莲, 柯稳, 等. 医疗机构日间手术开展及规范化管理现况调查. 中国护理管理, 2024, 24(4): 576-581.
4. 于丽华. 中国日间手术发展的历程与展望. 中国医院管理, 2016, 36(6): 16-18.
5. 嵇武, 刘亚萍, 戴玮. 我国日间手术开展现状与前景展望. 中国实用外科杂志, 2020, 40(2): 199-202.
6. Roxbury CR, Shah J, Tang D, et al. Analysis of 24-hour surgical cancellations in an academic rhinology and skull base surgery practice. Int Forum Allergy Rhinol, 2019, 9(3): 298-304.
7. Wong DJN, Harris SK, Moonesinghe SR, et al. Cancelled operations: a 7-day cohort study of planned adult inpatient surgery in 245 UK National Health Service hospitals. Br J Anaesth, 2018, 121(4): 730-738.
8. Macario A. Are your hospital operating rooms "efficient"? A scoring system with eight performance indicators. Anesthesiology, 2006, 105(2): 237-240.
9. Haana V, Sethuraman K, Stephens L, et al. Case cancellations on the day of surgery: an investigation in an Australian paediatric hospital. ANZ J Surg, 2009, 79(9): 636-640.
10. 奚春花, 施东婧, 李芸慧, 等. 非白内障眼科日间手术当日取消率及原因分析. 中华医学杂志, 2022, 102(21): 1608-1613.
11. 四川省护理学会. 日间手术中心护理质量安全管理: T/SCNA 0001-2022. 成都: 四川省护理学会, 2022.
12. 赖小琴, 王颖, 马洪升, 等. 品管圈在降低日间手术当日停台率中的应用研究. 华西医学, 2020, 35(2): 181-186.
13. 刘亚萍, 嵇武, 叶向红. 应用术前预康复降低日间手术临时取消率的应用效果. 东南国防医药, 2022, 24(1): 80-82.
14. 冯文, 赵红, 陈威, 等. 我国日间诊疗服务模式的组织与制度创新. 中华医院管理杂志, 2019, 35(4): 307-310.
15. 陈亚玲, 莫洋, 谭亮, 等. 综合性医院日间手术中心的建设和运营管理. 华西医学, 2019, 34(2): 127-132.
16. 袁华娣, 洪萍花, 蒋立群, 等. 择期日间手术当日取消手术的原因分析及对策. 护理与康复, 2015, 14(10): 965-967.
17. 杨陈, 张学兵, 敖伟, 等. 儿童日间手术当日手术取消的原因分析及对策. 护理学杂志, 2018, 33(6): 74-76.
18. Smith MM, Mauermann WJ, Cook DJ, et al. Same-day cancellation of cardiac surgery: a retrospective review at a large academic tertiary referral center. J Thorac Cardiovasc Surg, 2014, 148(2): 721-725.
19. 江美雅, 杨玉香, 黄玉仙. 妇科手术患者术前不同阴道准备方法的效果比较. 当代护士(中旬刊), 2015(10): 68-69.
20. 杨小晓, 马张芳, 刘敬花, 等. 回顾性调查眼科日间手术取消原因及改进措施. 河北医药, 2023, 45(8): 1254-1258.

West China Medical Journal

Application of continuous quality improvement in reducing same-day cancellation rate of gynecological day surgery

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