Objective To discuss the running effect of the modified hospital-community integrated two-way-referral service mode in day surgery. Methods The hospital-community integrated two-way-referral service mode in day surgery was built in May 2014 by our center, and applied in the communities’ health service network in Chenghua District, Wuhou District, and Jinjiang District. From March 2017 some improvements of the mode were made, such as assigning specific person for the management of two-way-referral, conducting lectures in communities to train the community medical staff, and carrying out gratuitous treatment. The community acceptance rate and patients satisfaction were retrospectively analyzed between March of 2016 and March of 2017, and the number of upward referral (from community to hospital) was retrospectively analyzed between March to June of 2016 and March to June of 2017. Results The community acceptance rate was elevated from 81.3% to 99.1% and the patients satisfaction was improved from 95.4% to 100.0%, and the differences between the two periods were statistically significant (P<0.05). The number of upward referral increased from 0 to 23. Conclusions The modified hospital-community integrated service mode could optimize the course of surgery appointment, and make it convenient for patients. Furthermore, it also adjusts the reasonable allocation of medical resource effectively and promotes the implementation of national hierarchical medical system.
ObjectiveTo investigate the effect of quality control circle (QCC) activity in reducing the temporarily stopping rate of day surgery.MethodsThe QCC activity was carried out from December 2018 to October 2019. By determining the theme of the activity and drawing up the plan, a retrospective analysis of pre-hospital day surgery stoppage status and reasons was performed based on 2 696 patients who had reserved surgery in the day surgery center from December 2018 to February 2019. Based on the data, the goal was determined, and measures were developed and confirmed from May to August 2019. Then the measures were standardized and implemented continuously from September to October 2019. The rate of surgical cessation before the implementation of the measures (from December 2018 to February 2019) was compared with that after the implementation of the measures (from September to October 2019).ResultsAfter the QCC activity, the temporarily stopping rate decreased from 2.89% to 1.34%, and the difference was statistically significant (P<0.001).ConclusionThe QCC activity can effectively reduce the temporarily stopping rate of day surgery, and lay the foundation for continuously promoting the optimization of day surgery resources and quality improvement.
Objective To analyze the causes of unplanned overnight recovery of patients after same-day surgery and put forward countermeasures. Methods The data of same-day surgery patients in the Day Surgery Center of West China Tianfu Hospital of Sichuan University between February 2022 and May 2023 were selected. Patients who recovered overnight were defined as the unplanned overnight recovery group, and patients discharged on the same day after surgery were defined as the normal same-day group. The factors of unplanned overnight recovery after same-day surgery were analyzed. Results A total of 4 259 patients were enrolled, of whom 107 patients had unplanned overnight recovery, 4 152 patients were discharged on the same day after surgery, unplanned overnight recovery group accounted for 2.51% (107/4 259). Except for gender and age (P>0.05), there were significant differences between the two groups in the following six aspects: late starting time of surgery, longer distance from home, medical insurance settlement restrictions, pain, postoperative complications, and patient’s own factors (P<0.05). The results of logistic regression analysis showed that the late starting time of surgery [odds ratio (OR)=9.386, 95% confidence interval (CI) (2.993, 29.432), P<0.001], long distance from address [OR=4.828, 95%CI (2.015, 11.568), P<0.001], medical insurance settlement restrictions [OR=10.667, 95%CI (3.712, 30.658), P<0.001], pain [OR=30.514, 95%CI (7.688, 121.115), P<0.001], postoperative complications [OR=9.642, 95%CI (2.425, 38.342), P=0.001], and patient’s own factors [OR=16.087, 95%CI (10.358, 24.985), P<0.001] were risk factors for unplanned overnight recovery in same-day surgery patients. Conclusions The unplanned overnight recovery of same-day surgery patients in West China Tianfu Hospital of Sichuan University is related to six factors: late starting time of surgery, long distance from home, medical insurance settlement restrictions, pain, postoperative complications, and patient’s own factors. Medical staff can take corresponding measures to reduce the unplanned overnight recovery rate of same-day surgery by strict access standards, optimizing surgical scheduling, formulating individualized enhanced recovery after surgery programs, improving support for patient after discharge, and strengthening perioperative health education.