基于临床路径进行的肺癌外科质量监测与持续改进：单一手术组经验总结

BACKGROUND AND OBJECTIVE: Standard operation procedure (SOP) could standardize treatment procedure and reduce medical expenses, but SOP drawn by the government may not suit all medical institutions, so individual adjustment made by surgical team is necessary. METHODS: We recorded the information of patients undergoing lung resection, including postoperative hospital stay, medical expenses and ratio of video-assisted thoracoscopic surgery (VATS) rate to evaluate surgical quality sustaining improvement in terms of structure indicator, process indicator and outcome indicator, aiming at exploring the ideal postoperative hospital stay and the best indicators to evaluate surgical quality improvement. RESULTS: The average postoperative hospital stay reduced significantly between 2016 and 2013 [(4.08±1.8) d vs (6.13±3.6) d, P < 0.001)]. VATS rate increased from 2013-2016 (17%→48%→68%→73%), as well as single port VATS rate (0%→2%→52%→66%). CONCLUSION: Surgical quality surveillance and sustaining improvement by surgical team could further reduce postoperative hospital stay and perioperative complications.