Objective To analyze the progress of evaluation indexes for enhanced recovery after surgery (ERAS) model at home and abroad, and to propose suggestions for constructing systematic evaluation model of ERAS. Methods Atfirst checked the Chinese and English databases, including Medline, Embase, Sciencedirect, ACP Journal Club, BioMed Central, the Cochrane Central Register of Controlled Trials (CENTRAL), Science Citation Index Expanded, Cochrane Library, NHS Economic Evaluation Database, CNKI, VIP, and Wanfang databases (retrieval time was from January 1997 to December 2017), and then filtered the literatures, excluded duplicate documents, a total of 1 020 English literatures and 786 Chinese literatures were enrolled eventually to make an review. Results The literatures showed that, at present, there was no comprehensive and systematic evaluation index system about ERAS at home and abroad. The existing evaluation indexes mainly included the following deficiencies: localization and fragmentation of evaluation indicators, lack of evaluation indicators of ERAS organizational framework and process management, as well as lack of standardized operational definition of evaluation indicators. Conclusions The evaluation indexes of ERAS at home and abroad do not constitute a systematic evaluation index system according to scientific principles, which will restrict the standardization of accelerated surgical rehabilitation in our country. To establish a multidimensional and comprehensive quality evaluation index system based on multi-evaluation of hospital, patient, social, and medical management institutions, which covers ERAS organizational structure, process management, and clinical outcomes, is a necessary condition for the development of ERAS model.
Since 2015, when the day surgery mode was officially reckoned and supported by the National Health Commission, the day surgery model has entered the new period of rapid development. But at the same time, challenges in the vacancy of the evaluation indexes of the medical quality and safety of day surgery still pose obstacles to its growth. At present, there is no nationally unified evaluating index or appraising system for the day surgery-related medical quality and safety. In this paper, based on structure-process-outcome theory, the day surgery practice and involved researching literature were retrieved, reviewed, and analyzed. Also, the practice model at West China Hospital of Sichuan University (a pioneer day surgery hospital in China) was comprehensively compared with the National Clinical Improvement System. From the aspect of day surgery medical quality and safety evaluation indicators, it is hoped to provide an evidence-based method and evaluation of day surgery, and a theoretical basis for establishing policies and data reference.
Objective To analyze the research hotspots and trends of Chinese literature on medical quality evaluation indicators in China in recent years. Methods We searched for relevant Chinese literature on medical quality evaluation indicators on China National Knowledge Infrastructure from January 2000 to December 2024, and analyzed the annual publication volume, authors and institutions, research hotspots and frontiers. Results Finally, 177 articles were included in the literature. From 2000 to 2024, the number of Chinese literature on medical quality evaluation indicators in China showed a fluctuating upward trend, reaching 15 articles per year in both 2015 and 2024. The issuing units mainly included the National Institute of Hospital Administration, the School of Public Health of Peking University, Huazhong University of Science and Technology, etc. The publishing team mainly included author teams such as MA Xiemin, LIANG Minghui, XIA Ping, etc. The high frequency keywords and top 10 keywords for centrality ranking included medical quality, evaluation indicators, indicator system, Delphi method, evaluation, evaluation system, quality evaluation, indicators, clinical pathways, and hospital management. “Case classification” was the earliest emerging term in the study of medical quality evaluation indicators. In terms of burst intensity, the top 5 keywords for burst intensity included Delphi method, case classification, problem, data quality, and evidence-based evaluation. Conclusion The publishing institutions and research teams of Chinese literature on medical quality evaluation indicators in China are relatively loose, and there are still problems such as insufficient practical application of medical quality evaluation indicators and single research tools and methods.
Day surgery is a new medical service model, which has developed rapidly in China because of its advantages of safety, efficiency and resource conservation. However, along with the rapid development in quantity, it also presents contradictions such as the mismatch with the previous surgical quality and safety management model, the urgent need for the unification of the new system of quality and safety evaluation indicators at the national level, and the imbalance in the construction of information technology of medical institutions in China, leading to the new problem of uneven quality control of day surgery. This article constructs a “five-in-one” new system for the quality and safety management of day surgery from the perspective of high-quality development, aiming to provide a theoretical basis for the formulation of relevant policies in China and to promote the safe, efficient, and orderly development of day surgeries.
As an important practice of collaborative medicine, multi-disciplinary team (MDT) plays a key role in improving the level of diagnosis and treatment of difficult and complex diseases. MDT quality evaluation is an important research content to promote the development of MDT model, which directly affects the effectiveness of diagnosis and treatment and patient experience. This paper systematically summarizes the relevant literature at home and abroad, focuses on MDT quality evaluation methods and tools, combs the dimensions and indicators of quality evaluation in different scenarios, and summarizes the common quality control laws in MDT practice. On this basis, combined with the characteristics and practical bottlenecks of China’s MDT model, this paper puts forward the key directions that should be paid attention to in the future MDT quality evaluation research, in order to provide theoretical references for the construction of MDT quality evaluation framework and promote the standardized development of MDT model.
Objective To systematically analyze the relevant research on quality management evaluation indicators for day surgery at home and abroad, and provide a basis and reference for constructing a more scientific, systematic, and comprehensive quality management evaluation indicator system for day surgery. Methods PubMed, Cochrane Library, Embase, Web of Science, Medline, OVID, SinoMed, China National Knowledge Infrastructure, VIP, and Wanfang were systematically searched. The retrieval time limit was from databases establishment to April 1, 2025. The data related to the evaluation indicators of quality management in day surgery were extracted and integrated for analysis. Results Finally, 73 articles were included, including 49 Chinese articles and 24 English articles. Based on the 3-dimensional quality structure model, the indicators were divided into 3 primary indicators (structure, process, and result), 15 secondary indicators, and 49 tertiary indicators. There were 4 secondary indicators and 16 tertiary indicators related to structure. The top 3 tertiary indicators with the highest number of related studies were establishing admission criteria for day surgery patients, establishing admission criteria for day surgery specialists, establishing clinical pathways for day surgery, and establishing emergency protocols for day surgery. There were 7 secondary indicators and 22 tertiary indicators related to the process. The top 3 tertiary indicators with the highest number of related studies were the implementation rate of discharge follow-up, completion rate of patient satisfaction survey, and completion rate of preoperative condition assessment. There were 4 secondary indicators and 11 tertiary indicators related to the results. The top 3 tertiary indicators with the highest number of related studies were rate of postoperative complication, rate of reaching the standard for patient satisfaction scores, and rate of unplanned readmission. Conclusion The current quality management evaluation indicator system for day surgery in China is still in the exploration and development stage, and lacks a complete, unified, and standardized indicator system.
Objective To construct a core competency evaluation indicator system for health managers. Methods Literature review, research group discussion, and Delphi method were used to establish the core competency indicators for health managers. Results A total of 8 experts completed 2 rounds of inquiries, and 8 questionnaires were distributed in both rounds, all of which were effectively collected. The judgment coefficient of the first round of inquiry was 0.936, the familiarity level was 0.933, the coefficient of expert authority was 0.935, and the Kendall harmony coefficient was 0.216 (P<0.05). The judgment coefficient of the second round of inquiry was 0.925, the familiarity level was 0.950, the coefficient of expert authority was 0.938, and the Kendall harmony coefficient was 0.438 (P<0.05). The final determination of the core competency evaluation indicators for health managers included 4 primary evaluation indicators (ranked in descending order of score as full process health management skills, organizational management ability, professional ethics, and comprehensive knowledge of health management) and 55 secondary indicators. Conclusion The core competency evaluation indicator system for health managers has good scientificity, systematicity, and completeness, which can provide references for defining, evaluating, and training the responsibilities of health managers.