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.	陳迎春, 李勁松. 實施日間手術治療模式的探討. 中國醫院管理, 2009, 29(7): 24-25.
2.	張沁青, 譚耘. 降低日間手術當日取消率的品管圈實踐. 護理學報, 2020, 27(9): 19-22.
3.	郭莉, 高興蓮, 柯穩, 等. 醫療機構日間手術開展及規范化管理現況調查. 中國護理管理, 2024, 24(4): 576-581.
4.	于麗華. 中國日間手術發展的歷程與展望. 中國醫院管理, 2016, 36(6): 16-18.
5.	嵇武, 劉亞萍, 戴瑋. 我國日間手術開展現狀與前景展望. 中國實用外科雜志, 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, 施東婧, 李蕓慧, 等. 非白內障眼科日間手術當日取消率及原因分析. 中華醫學雜志, 2022, 102(21): 1608-1613.
11.	四川省護理學會. 日間手術中心護理質量安全管理: T/SCNA 0001-2022. 成都: 四川省護理學會, 2022.
12.	賴小琴, 王穎, 馬洪升, 等. 品管圈在降低日間手術當日停臺率中的應用研究. 華西醫學, 2020, 35(2): 181-186.
13.	劉亞萍, 嵇武, 葉向紅. 應用術前預康復降低日間手術臨時取消率的應用效果. 東南國防醫藥, 2022, 24(1): 80-82.
14.	馮文, 趙紅, 陳威, 等. 我國日間診療服務模式的組織與制度創新. 中華醫院管理雜志, 2019, 35(4): 307-310.
15.	陳亞玲, 莫洋, 譚亮, 等. 綜合性醫院日間手術中心的建設和運營管理. 華西醫學, 2019, 34(2): 127-132.
16.	袁華娣, 洪萍花, 蔣立群, 等. 擇期日間手術當日取消手術的原因分析及對策. 護理與康復, 2015, 14(10): 965-967.
17.	楊陳, 張學兵, 敖偉, 等. 兒童日間手術當日手術取消的原因分析及對策. 護理學雜志, 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, 楊玉香, 黃玉仙. 婦科手術患者術前不同陰道準備方法的效果比較. 當代護士(中旬刊), 2015(10): 68-69.
20.	楊小曉, 馬張芳, 劉敬花, 等. 回顧性調查眼科日間手術取消原因及改進措施. 河北醫藥, 2023, 45(8): 1254-1258.

1. 陳迎春, 李勁松. 實施日間手術治療模式的探討. 中國醫院管理, 2009, 29(7): 24-25.
2. 張沁青, 譚耘. 降低日間手術當日取消率的品管圈實踐. 護理學報, 2020, 27(9): 19-22.
3. 郭莉, 高興蓮, 柯穩, 等. 醫療機構日間手術開展及規范化管理現況調查. 中國護理管理, 2024, 24(4): 576-581.
4. 于麗華. 中國日間手術發展的歷程與展望. 中國醫院管理, 2016, 36(6): 16-18.
5. 嵇武, 劉亞萍, 戴瑋. 我國日間手術開展現狀與前景展望. 中國實用外科雜志, 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, 施東婧, 李蕓慧, 等. 非白內障眼科日間手術當日取消率及原因分析. 中華醫學雜志, 2022, 102(21): 1608-1613.
11. 四川省護理學會. 日間手術中心護理質量安全管理: T/SCNA 0001-2022. 成都: 四川省護理學會, 2022.
12. 賴小琴, 王穎, 馬洪升, 等. 品管圈在降低日間手術當日停臺率中的應用研究. 華西醫學, 2020, 35(2): 181-186.
13. 劉亞萍, 嵇武, 葉向紅. 應用術前預康復降低日間手術臨時取消率的應用效果. 東南國防醫藥, 2022, 24(1): 80-82.
14. 馮文, 趙紅, 陳威, 等. 我國日間診療服務模式的組織與制度創新. 中華醫院管理雜志, 2019, 35(4): 307-310.
15. 陳亞玲, 莫洋, 譚亮, 等. 綜合性醫院日間手術中心的建設和運營管理. 華西醫學, 2019, 34(2): 127-132.
16. 袁華娣, 洪萍花, 蔣立群, 等. 擇期日間手術當日取消手術的原因分析及對策. 護理與康復, 2015, 14(10): 965-967.
17. 楊陳, 張學兵, 敖偉, 等. 兒童日間手術當日手術取消的原因分析及對策. 護理學雜志, 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, 楊玉香, 黃玉仙. 婦科手術患者術前不同陰道準備方法的效果比較. 當代護士(中旬刊), 2015(10): 68-69.
20. 楊小曉, 馬張芳, 劉敬花, 等. 回顧性調查眼科日間手術取消原因及改進措施. 河北醫藥, 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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