Objective To explore the short-term effects of reengineering for the first-surgery preparation process in day surgery management. Methods In July 2019, West China Hospital of Sichuan University began to reconstruct a standard process for the first-surgery preparation process in day surgery based on the theory of process reengineering. Patients who underwent the first general anesthesia operation on the day at the Day Surgery Center between February and June 2019 were selected as the pre-reengineering group, and those between July and November 2019 were selected as the post-reengineering group. The time intervals for each stage of the surgical process and the incidences of delays in each stage were compared between the two groups. Results A total of 633 patients were included, with 309 in the pre-reengineering group and 324 in the post-reengineering group. The time from arrival to admission for the first patient [(30.24±7.86) vs. (22.45±10.65) min, P<0.001], time from admission to doctor’s orders [(9.42±7.07) vs. (5.45±5.86) min, P<0.001], waiting time before entering the operating room after nursing preparation [(23.67±17.59) vs. (18.46±19.60) min, P=0.001], and total waiting time from admission to entering the operating room [(73.42±18.46) vs. (65.27±21.00) min, P<0.001] in the post-reengineering group were all shorter than those in the pre-reengineering group. The incidence of patients admitted after 07:50 (2.3% vs. 0.3%, P=0.034) and the incidence of nurses’ preparation completion time extending beyond 08:20 (6.1% vs. 2.5%, P=0.022) in the post-reengineering group were lower than those in the pre-reengineering group. Conclusion The reengineering of the first-surgery preparation process significantly improves the management of day surgery across multiple stages of the process, reducing patient waiting times and minimizing delays in admission, order processing, and nursing preparations that may affect patients’ punctual entry into the operating room.
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 explore the practical effects of action research on the management of preoperative fasting and fluid restriction in day surgery patients. MethodsA convenience sampling method was used to select day surgery patients who underwent day surgery at the Day Surgery Center of West China Hospital of Sichuan University between May 2022 and May 2024. According to the admission time, patients were divided into control group, first cycle group, and second cycle group. The effects of the preoperative fasting and fluid restriction management plan were observed based on the implementation of two rounds of action plans. Results A total of 567 patients were included. Among them, there were 186 cases in the control group, 190 cases in the first cycle group, and 191 cases in the second cycle group. There was no statistically significant difference in general information among the three groups of patients (P>0.05). After implementing the initiative to reduce preoperative fasting durations, the median preoperative fasting time for day surgery patients in the second cycle group was 4.41 (3.13, 6.12) hours, which represented a significant reduction compared to 13.72 (10.83, 16.40) hours in the control group and 6.42 (4.53, 9.60) hours in the first cycle group (P<0.05). Although the fasting duration did not significantly decrease among the three groups, the morning feeding rates for patients in the first and second cycle showed a slight increase compared to the control group. Conclusions Through the implementation of a preoperative fasting and fluid restriction management protocol, the preoperative fluid restriction duration for day surgery patients has been significantly reduced. This aligns with the principles of enhanced recovery after surgery. Moreover, the incidence of intraoperative aspiration and postoperative nausea and vomiting did not show a significant increase. Action research offers crucial theoretical and practical support for the efficient and scientific implementation of preoperative fasting and fluid restriction management.