Current situation and development strategy of the construction of the medical quality control system for thoracic surgery at the municipal level in Chengdu_Chinese Journal of Clinical Thoracic and Cardiovascular Surgery

Authors：

WANG Yifan ^1,2 , HU Jingguo ^1,2 , SUN Yu ^1,2 , ZHANG Kaixin ^1,2 , GAO Ke ^1,3 , YAO Xiaojun ^1,4

1. Chengdu Municipal Thoracic Surgery Medical Quality Control Center, Chengdu, 610081, P. R. China;
2. Department of Thoracic Surgery, The Affiliated Hospital of Chengdu University, Chengdu, 610081, P. R. China;
3. Department of Cardiothoracic Surgery, Chengdu Second People's Hospital, Chengdu, 610017, P. R. China;
4. Department of Thoracic Surgery, Public Health Clinical Center of Chengdu, Chengdu, 610061, P. R. China;

Corresponding?author：

Keywords：

Thoracic Surgery; quality control; Donabedian model; third level network; multidisciplinary team; patient-reported outcomes

DOI：

10.7507/1007-4848.202507017

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In recent years, the Chengdu Municipal Thoracic Surgery Quality Control Center has preliminarily established a regional quality control system for thoracic surgery through the development of standards, data reporting, and on-site supervision, achieving phased improvements. This review summarizes the current development of Chengdu’s thoracic surgery quality control system, including its organizational structure and scoring methodology, quality indicators based on structure–process–outcome, information technology infrastructure, and multicenter collaboration experiences, and outlines trends in surgical volume, minimally invasive procedure rates, human resources, and care quality metrics. It also analyzes existing challenges such as inter-hospital quality disparities and insufficient interoperability among information platforms. Drawing on domestic and international best practices, we propose development strategies to further enhance the homogenization and continuous improvement of thoracic surgery quality in the region. The Chengdu experience could offer a valuable model for building regional thoracic surgery quality control systems nationwide and for integration with the national quality control platform.

1.	Farjah F, Detterbeck FC. What is quality, and can we define it in lung cancer?-the case for quality improvement. Transl Lung Cancer Res, 2015, 4(4): 365-372.
2.	趙育, 孫建文. 基層公立醫院微創外科發展現狀分析. 中國衛生產業, 2017, 14(35): 189-190.Zhao Y, Sun JW. Analysis on the development status of minimally invasive surgery in primary public hospitals. China Health Ind, 2017, 14(35): 189-190.
3.	孫振國, 岳韋名, 高存, 等. 胸腔鏡肺癌手術的質量控制. 中華腔鏡外科雜志(電子版), 2020, 13(6): 332-336.Sun ZG, Yue WM, Gao C, et al. Quality control of thoracoscopic surgery for lung cancer. Chin J Endosc Surg (Electron Ed), 2020, 13(6): 332-336.
4.	傅俊惠, 鄭浩勝, 杜澤森, 等. 食管系膜切除在胸、腹腔鏡食管癌手術質量控制中的應用. 中國微創外科雜志, 2017, 17(10): 868-872.Fu JH, Zheng HS, Du ZS, et al. Application of mesoesophagus excision in quality control of thoraco-laparoscopic esophagectomy for esophageal cancer. Chin J Minim Invasive Surg, 2017, 17(10): 868-872.
5.	莊偉濤, 高枕, 曾偉生, 等. 胸部巨大腫瘤外科治療的基本原則與質量控制. 中國胸心血管外科臨床雜志, 2020, 27(9): 996-1000.Zhuang WT, Gao Z, Zeng WS, et al. Basic principles and quality control of surgical treatment for large thoracic tumors. Chin J Clin Thorac Cardiovasc Surg, 2020, 27(9): 996-1000.
6.	涂遠榮, 劉彥國, 陳劍鋒, 等. 手汗癥ETS微創技術優化與日間手術質量控制中國專家共識. 中國胸心血管外科臨床雜志, 2025, 32(1): 8-13.Tu YR, Liu YG, Chen JF, et al. Chinese expert consensus on optimization of ETS minimally invasive technique and quality control of day surgery for palmar hyperhidrosis. Chin J Clin Thorac Cardiovasc Surg, 2025, 32(1): 8-13.
7.	Ren Y, Zhang G, Hu X, et al. Quality control and evaluation system for general thoracic surgery. Curr Chall Thorac Surg, 2024, 6: 24.
8.	Jacobs JP, Shahian DM, Prager RL, et al. Introduction to the STS National Database Series: outcomes analysis, quality improvement, and patient safety. Ann Thorac Surg, 2015, 100(6): 1992-2000.
9.	Moore L, Lavoie A, Bourgeois G, et al. Donabedian’s structure-process-outcome quality of care model: validation in an integrated trauma system. J Trauma Acute Care Surg, 2015, 78(6): 1168-1175.
10.	Seder CW, Salati M, Kozower BD, et al. Variation in pulmonary resection practices between The Society of Thoracic Surgeons and the European Society of Thoracic Surgeons General Thoracic Surgery Databases. Ann Thorac Surg, 2016, 101(6): 2077-2084.
11.	謝冬, 陳昶, 姜格寧. 普胸外科手術質量控制與評估體系. 中國胸心血管外科臨床雜志, 2019, 26(1): 8-15.Xie D, Chen C, Jiang GN. Quality control and evaluation system of general thoracic surgery. Chin J Clin Thorac Cardiovasc Surg, 2019, 26(1): 8-15.
12.	朱甬倩, 陳倩, 孫洲, 等. 省級質控中心信息化管理平臺構建與應用. 中國衛生質量管理, 2023, 30(5): 81-84.Zhu YQ, Chen Q, Sun Z, et al. Construction and application of a provincial-level quality control center information management platform. Chin Health Qual Manag, 2023, 30(5): 81-84.
13.	謝麗娜·伊力, 何萍. 醫院精細化醫療質量控制與管理實踐. 中國衛生信息管理雜志, 2021, 18(4): 505-508,525.Xielina YL, He P. Practice of refined hospital medical quality control and management. Chin J Health Inf Manag, 2021, 18(4): 505-508,525.
14.	國家心血管系統疾病醫療質量控制中心. 2023年中國心血管病醫療質量概述. 中國循環雜志, 2024, 39(9): 833-852.National Center for Cardiovascular Quality Improvement. Overview of cardiovascular disease medical quality in China in 2023. Chin Circ J, 2024, 39(9): 833-852.
15.	National Health Service. National thoracic surgery audit annual report 2022. UK NHS, 2023.
16.	邱越, 尹薇, 孔天驕, 等. 國家醫療質控中心將達47個. 健康時報, 2023-11-10(003).Qiu Y, Yin W, Kong TJ, et al. The number of national medical quality control centers will reach 47. Health Times, 2023-11-10(003).
17.	Churruca K, Pomare C, Ellis LA, et al. Patient-reported outcome measures (PROMs): a review of generic and condition-specific measures and a discussion of trends and issues. Health Expect, 2021, 24(4): 1015-1024.
18.	Dai W, Feng W, Zhang Y, et al. Patient-reported outcome-based symptom management versus usual care after lung cancer surgery: a multicenter randomized controlled trial. J Clin Oncol, 2022, 40(9): 988-996.
19.	Heiden BT, Eaton DB Jr, Engelhardt KE, et al. Routine collection of patient-reported outcomes in thoracic surgery: a quality improvement study. Ann Thorac Surg, 2022, 113(6): 1845-1852.
20.	Ost DE, Niu J, Zhao H, et al. Quality gaps and comparative effectiveness in lung cancer staging and diagnosis. Chest, 2020, 157(5): 1322-1345.
21.	Batchelor TJP, Rasburn NJ, Abdelnour-Berchtold E, et al. Guidelines for enhanced recovery after lung surgery: recommendations of the Enhanced Recovery After Surgery (ERAS?) Society and the European Society of Thoracic Surgeons (ESTS). Eur J Cardiothorac Surg, 2019, 55(1): 91-115.
22.	張勇. 三級質控目標管理模式在ICU病房管理中的應用. 中醫藥管理雜志, 2020, 28(20): 131-132.Zhang Y. Application of tertiary quality control target management model in ICU ward management. J Tradit Chin Med Manag, 2020, 28(20): 131-132.
23.	丁峰明. 三級質控管理在外科手術中的應用. 中醫藥管理雜志, 2019, 27(15): 193-194.Ding FM. Application of tertiary quality control management in surgical operations. J Tradit Chin Med Manag, 2019, 27(15): 193-194.
24.	Farjah F, Flum DR, Varghese TK Jr, et al. Failure-to-rescue and pulmonary resection for lung cancer. J Thorac Cardiovasc Surg, 2015, 149(5): 1365-1373.
25.	Portuondo JI, Shahian DM, Cooke DT, et al. Failure to rescue as a surgical quality indicator: current concepts and future directions. Anesthesiology, 2019, 131(2): 426-437.
26.	冷雪峰, 金健, 叢偉, 等. 成都市胸外科醫療質量控制中心體系建設實踐與討論. 中國胸心血管外科臨床雜志, 2018, 25(6): 453-457.Leng XF, Jin J, Cong W, et al. Practice and discussion on the construction of thoracic surgery medical quality control system in Chengdu. Chin J Clin Thorac Cardiovasc Surg, 2018, 25(6): 453-457.

1. Farjah F, Detterbeck FC. What is quality, and can we define it in lung cancer?-the case for quality improvement. Transl Lung Cancer Res, 2015, 4(4): 365-372.
2. 趙育, 孫建文. 基層公立醫院微創外科發展現狀分析. 中國衛生產業, 2017, 14(35): 189-190.Zhao Y, Sun JW. Analysis on the development status of minimally invasive surgery in primary public hospitals. China Health Ind, 2017, 14(35): 189-190.
3. 孫振國, 岳韋名, 高存, 等. 胸腔鏡肺癌手術的質量控制. 中華腔鏡外科雜志(電子版), 2020, 13(6): 332-336.Sun ZG, Yue WM, Gao C, et al. Quality control of thoracoscopic surgery for lung cancer. Chin J Endosc Surg (Electron Ed), 2020, 13(6): 332-336.
4. 傅俊惠, 鄭浩勝, 杜澤森, 等. 食管系膜切除在胸、腹腔鏡食管癌手術質量控制中的應用. 中國微創外科雜志, 2017, 17(10): 868-872.Fu JH, Zheng HS, Du ZS, et al. Application of mesoesophagus excision in quality control of thoraco-laparoscopic esophagectomy for esophageal cancer. Chin J Minim Invasive Surg, 2017, 17(10): 868-872.
5. 莊偉濤, 高枕, 曾偉生, 等. 胸部巨大腫瘤外科治療的基本原則與質量控制. 中國胸心血管外科臨床雜志, 2020, 27(9): 996-1000.Zhuang WT, Gao Z, Zeng WS, et al. Basic principles and quality control of surgical treatment for large thoracic tumors. Chin J Clin Thorac Cardiovasc Surg, 2020, 27(9): 996-1000.
6. 涂遠榮, 劉彥國, 陳劍鋒, 等. 手汗癥ETS微創技術優化與日間手術質量控制中國專家共識. 中國胸心血管外科臨床雜志, 2025, 32(1): 8-13.Tu YR, Liu YG, Chen JF, et al. Chinese expert consensus on optimization of ETS minimally invasive technique and quality control of day surgery for palmar hyperhidrosis. Chin J Clin Thorac Cardiovasc Surg, 2025, 32(1): 8-13.
7. Ren Y, Zhang G, Hu X, et al. Quality control and evaluation system for general thoracic surgery. Curr Chall Thorac Surg, 2024, 6: 24.
8. Jacobs JP, Shahian DM, Prager RL, et al. Introduction to the STS National Database Series: outcomes analysis, quality improvement, and patient safety. Ann Thorac Surg, 2015, 100(6): 1992-2000.
9. Moore L, Lavoie A, Bourgeois G, et al. Donabedian’s structure-process-outcome quality of care model: validation in an integrated trauma system. J Trauma Acute Care Surg, 2015, 78(6): 1168-1175.
10. Seder CW, Salati M, Kozower BD, et al. Variation in pulmonary resection practices between The Society of Thoracic Surgeons and the European Society of Thoracic Surgeons General Thoracic Surgery Databases. Ann Thorac Surg, 2016, 101(6): 2077-2084.
11. 謝冬, 陳昶, 姜格寧. 普胸外科手術質量控制與評估體系. 中國胸心血管外科臨床雜志, 2019, 26(1): 8-15.Xie D, Chen C, Jiang GN. Quality control and evaluation system of general thoracic surgery. Chin J Clin Thorac Cardiovasc Surg, 2019, 26(1): 8-15.
12. 朱甬倩, 陳倩, 孫洲, 等. 省級質控中心信息化管理平臺構建與應用. 中國衛生質量管理, 2023, 30(5): 81-84.Zhu YQ, Chen Q, Sun Z, et al. Construction and application of a provincial-level quality control center information management platform. Chin Health Qual Manag, 2023, 30(5): 81-84.
13. 謝麗娜·伊力, 何萍. 醫院精細化醫療質量控制與管理實踐. 中國衛生信息管理雜志, 2021, 18(4): 505-508,525.Xielina YL, He P. Practice of refined hospital medical quality control and management. Chin J Health Inf Manag, 2021, 18(4): 505-508,525.
14. 國家心血管系統疾病醫療質量控制中心. 2023年中國心血管病醫療質量概述. 中國循環雜志, 2024, 39(9): 833-852.National Center for Cardiovascular Quality Improvement. Overview of cardiovascular disease medical quality in China in 2023. Chin Circ J, 2024, 39(9): 833-852.
15. National Health Service. National thoracic surgery audit annual report 2022. UK NHS, 2023.
16. 邱越, 尹薇, 孔天驕, 等. 國家醫療質控中心將達47個. 健康時報, 2023-11-10(003).Qiu Y, Yin W, Kong TJ, et al. The number of national medical quality control centers will reach 47. Health Times, 2023-11-10(003).
17. Churruca K, Pomare C, Ellis LA, et al. Patient-reported outcome measures (PROMs): a review of generic and condition-specific measures and a discussion of trends and issues. Health Expect, 2021, 24(4): 1015-1024.
18. Dai W, Feng W, Zhang Y, et al. Patient-reported outcome-based symptom management versus usual care after lung cancer surgery: a multicenter randomized controlled trial. J Clin Oncol, 2022, 40(9): 988-996.
19. Heiden BT, Eaton DB Jr, Engelhardt KE, et al. Routine collection of patient-reported outcomes in thoracic surgery: a quality improvement study. Ann Thorac Surg, 2022, 113(6): 1845-1852.
20. Ost DE, Niu J, Zhao H, et al. Quality gaps and comparative effectiveness in lung cancer staging and diagnosis. Chest, 2020, 157(5): 1322-1345.
21. Batchelor TJP, Rasburn NJ, Abdelnour-Berchtold E, et al. Guidelines for enhanced recovery after lung surgery: recommendations of the Enhanced Recovery After Surgery (ERAS?) Society and the European Society of Thoracic Surgeons (ESTS). Eur J Cardiothorac Surg, 2019, 55(1): 91-115.
22. 張勇. 三級質控目標管理模式在ICU病房管理中的應用. 中醫藥管理雜志, 2020, 28(20): 131-132.Zhang Y. Application of tertiary quality control target management model in ICU ward management. J Tradit Chin Med Manag, 2020, 28(20): 131-132.
23. 丁峰明. 三級質控管理在外科手術中的應用. 中醫藥管理雜志, 2019, 27(15): 193-194.Ding FM. Application of tertiary quality control management in surgical operations. J Tradit Chin Med Manag, 2019, 27(15): 193-194.
24. Farjah F, Flum DR, Varghese TK Jr, et al. Failure-to-rescue and pulmonary resection for lung cancer. J Thorac Cardiovasc Surg, 2015, 149(5): 1365-1373.
25. Portuondo JI, Shahian DM, Cooke DT, et al. Failure to rescue as a surgical quality indicator: current concepts and future directions. Anesthesiology, 2019, 131(2): 426-437.
26. 冷雪峰, 金健, 叢偉, 等. 成都市胸外科醫療質量控制中心體系建設實踐與討論. 中國胸心血管外科臨床雜志, 2018, 25(6): 453-457.Leng XF, Jin J, Cong W, et al. Practice and discussion on the construction of thoracic surgery medical quality control system in Chengdu. Chin J Clin Thorac Cardiovasc Surg, 2018, 25(6): 453-457.

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