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.
ObjectiveTo explore the effect of perioperative fine management on patients undergoing video-assisted thoracoscopic surgery (VATS) for pulmonary nodule in day surgery mode.MethodsWe retrospectively analyzed the data of patients undergoing VATS for pulmonary nodule in Day Surgery Center of West China Hospital, Sichuan University between June 2019 and October 2020. The number of VATS procedures and general data of patients were collected. The effects of fine management on postoperative intrathoracic drain management, pain management, and diet management, as well as the postoperative follow-up and satisfaction survey were analyzed.ResultsA total of 162 patients were enrolled. The duration of postoperative chest drainage of 150 VATS patients who discharged from the hospital with normal extubation lasted for 5 to 22 h with an average of (10.88±3.54) h. Univariate analyses and multivariate logistic regression analysis showed that gender, age, method of surgery, and immediate postoperative pain score were not associated with delayed removal of thoracic drainage tube (>10 h) (P>0.05). The lowest score of numerical rating scale for pain intensity was 0 (painless) and the highest was 4 (moderate pain). After surgery, 12 patients (7.4%) were transferred out of the day surgery department, 2 patients (1.2%) were indwelled postoperative urinary catheter, 11 patients (6.8%) had unplanned revisit, and 6 patients (3.7%) had unplanned readmission. Patient satisfaction surveys were all satisfactory.ConclusionsThe implementation of fine management in VATS for pulmonary nodule in day surgery mode is beneficial for ensuring that patients can remove the drainage tube before discharge from the hospital, without severe pain after the operation and with good follow-up satisfaction.