华西医学

华西医学

日间手术评价与监控指标初探

查看全文

在国家助力日间手术发展和确保患者医疗质量安全的背景和前提下,精细化管理是日间手术发展的重要趋势。四川大学华西医院作为国内最早开展日间手术的医疗机构之一,迄今已开展日间手术近 10 年,累计服务近 14 万名患者。在此实践经验基础之上,四川大学华西医院总结出 5 个维度共 26 个评价与监控日间手术经济学效益和质量安全的指标,包括投入产出指标、效率效能指标、患者体验指标、医疗质量安全指标和手术难易程度评估指标,旨在探索与构建我国日间手术评价与监控体系,促进日间手术稳步发展,提高工作效能,践行国家提出的将日间手术作为改善医疗服务行动计划。

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.

关键词: 日间手术; 精细化管理; 医疗质量; 评价指标

Key words: Day surgery; Fine management; Medical quality; Clinical indicators

引用本文: 蒋丽莎, 马洪升. 日间手术评价与监控指标初探. 华西医学, 2019, 34(2): 202-205. doi: 10.7507/1002-0179.201901131 复制

登录后 ,请手动点击刷新查看全文内容。 没有账号,
1. Cullen KA, Hall MJ, Golosinskiy A. Ambulatory surgery in the United States, 2006. Natl Health Stat Report, 2009, 28(11): 1-25.
2. 刘秋秋, 刘小玲. 湘雅医院日间手术室的构建与患者安全管理. 中国医院建筑与装备, 2016(7): 41-42.
3. 胡彬. 国家卫生计生委印发《2016年改善医疗服务行动计划重点工作方案通知》. 中医药管理杂志, 2016, 24(9): 24.
4. 柴双. 《进一步改善医疗服务行动计划(2018-2020年)》解析. 中国社会工作, 2018(18): 4-6.
5. Wright AJ. Charles Thomas Jackson: " the head behind the hands”: applying science to implement discovery and invention in early nineteenth century America. J Hist Med Allied Sci, 2010, 65(3): 429-431.
6. Nicoll JH. The surgery of infancy. BMJ, 1909, 2(2542): 753-754.
7. Heberer G. Introduction to advantages, risks, and disadvantages of ambulatory surgery for patients and surgeons. Langenbecks Archiv Für Chirurgie, 1982, 358(1): 411-412.
8. International Association for Ambulatory Surgery. Ambulatory surgery handbook: 2nd edition, 2014. (2015-02-02)[2019-01-20]. http://www.iaas-med.com/files/2014/Day_Surgery_Manual2.pdf.
9. 马洪升. 日间手术的管理. 华西医学, 2017, 32(4): 481-482.
10. Lemos P, Jarrett P, Philip BK. Day surgery: development and practice. Portugal: International Association for Ambulatory Surgery, 2006: 258-275.
11. Yuan H, Chung F, Wong D, et al. Current preoperative testing practices in ambulatory surgery are widely disparate: a survey of CAS members. Can J Anaesth, 2005, 52(7): 675-679.
12. McIsaac DI, Bryson GL, van Walraven C. Impact of ambulatory surgery day of the week on postoperative outcomes: a population-based cohort study. Can J Anaesth, 2015, 62(8): 857-865.
13. Marsden J, Lipp A, Kumar V. Day surgery: implications for general practice. Br J Gen Pract, 2016, 66(646): 232-233.
14. Sarkiss CA, Papin JA, Yao A, et al. Day of surgery impacts outcome: rehabilitation utilization on hospital length of stay in patients undergoing elective meningioma resection. World Neurosurg, 2016, 93: 127-132.
15. Sjövall S, Kokki M, Kokki H. Laparoscopic surgery: a narrative review of pharmacotherapy in pain management. Drugs, 2015, 75(16): 1867-1889.
16. Aspinen S, Harju J, Juvonen P, et al. A prospective, randomized study comparing minilaparotomy and laparoscopic cholecystectomy as a day-surgery procedure: 5-year outcome. Surg Endosc, 2014, 28(3): 827-832.
17. 李志超, 庄磊雪, 马洪升, 等. 日间手术患者出院管理. 重庆医学, 2015, 44(27): 3858-3860.
18. Coley KC, Williams BA, Dapos SV, et al. Retrospective evaluation of unanticipated admissions and readmissions after same day surgery and associated costs. J Clin Anesth, 2002, 14(5): 349-353.
19. Rosero EB, Joshi GP. Nationwide use and outcomes of ambulatory surgery in morbidly obese patients in the United States. J Clin Anesth, 2014, 26(3): 191-198.
20. Vilar-Compte D, Roldán R, Sandoval S, et al. Surgical site infections in ambulatory surgery: a 5-year experience. Am J Infect Control, 2001, 29(2): 99-103.
21. Owens PL, Barrett ML, Raetzman S, et al. Surgical site infections following ambulatory surgery procedures. JAMA, 2014, 311(7): 709-716.
22. 尹欢, 陈昌驹, 肖毅. 改善医疗服务实现医患双赢--遵义医学院附属医院建立新型诊疗模式纪实. 中国卫生, 2017(3): 101-102.
23. 孙泽勇, 马洪升, 戴燕, 等. 日间手术费用和感知调查与分析. 华西医学, 2015, 30(10): 1933-1935.