Objective To explore the content and scientific evidence of every element of the fast-track programmes in colorectal surgery. Methods The literatures about the applied status and opinion of the modality applied in the surgical treatment of the colorectal cancer and fundament investigation in recent years were collected and reviewed. Results The feasibility of the every fast-track’s element was based on the clinical and fundamental investigaton. Conclusion The advantage of the fast-track programmes in colorectal surgery is confirmed.
ObjectiveBased on recently update Database from Colorectal Cancer (DACCA), we aimed to analyze the characteristics of in-hospital process management from reginal medical center’s colorectal cancer patients.MethodsWe used Version January 29th, 2019 of DACAA being the analyzing source. The items were included date of first out-patient meeting, admitted date, operative date, discharged date, waiting-time, preoperative staying days, postoperative staying days, hospital staying days, and manage protocol, whose characteristics would be analyzed.ResultsWe left 8 913 lines to be analyzed by filtering DACCA. Useful data lines of first out-patient meeting had 3 915, admitted date had 8 144, operative date had 8 049, and discharged date had 7 958. The average of waiting-time were (9.41±0.43) days, and based on timeline trend for line prediction analyzing, which showed R2=0.101 257, P<0.001. The average of preoperative staying days were (5.41±0.04) days, and based on timeline trend for line prediction analyzing, which showed R2=0.023 671, P<0.001. The average of postoperative staying days were (8.99±0.07) days, and based on timeline trend for line prediction analyzing, which showed R2=0.086 177, P<0.001. The average of hospital staying days were (14.43±0.08) days, and based one timeline trend of line prediction analyzing, which showed R2=0.098 44, P<0.001. Analyzable ERAS data were 2 368 lines in DACCA. Total EARS data in 2 368 lines, there were 108 lines (5%) completed and 2 260 lines (95%) incomplete. Pre/post ERAS data in 2 260 lines, there were 150 lines (7%) completed and 2 110 lines (93%) incomplete. Post ERAS data in 2 110 lines, there were 170 lines (8%) completed and 1 940 lines (92%) incomplete.ConclusionsIn recent 20 years, the regional medical center served in-hospital colorectal cancer patients with decreased preoperative staying days, postoperative staying days, and in-hospital staying days from DACCA analyzing, which could prove the service ability had been in improved. Utilization rate of EARS was increased, and also being the main in-hospital process management.
【摘要】 目的 探讨如何通过流程优化应对体检高峰期。 方法 通过体检高峰期流程优化前后（2008年与2010年）的管理成效对比，评估高峰期流程控制的有效性。 结果 体检高峰期流程优化后，平均候检人数由8人下降至3人、平均侯检时间由11.9 min下降至4.2 min，平均体检时间由175 min下降至130 min。体检者对体检环境、服务态度和服务质量的满意度均高于优化前，差异有统计学意义（Plt;0.05）。 结论 通过流程优化与控制有效地缓解了高峰期体检人员等候时间过长现象，极大地提高了体检者满意度，保障了健康体检工作质量。【Abstract】 Objective To explore how to cope with the peak flow of physical examination through the process optimization. Methods Evaluate the utility of the process control at physical examination peak flow, by contrasting the management effect before and after the physical examination peak flow optimization (2008 and 2010). Results After the process optimization in peak flow, the average number of people waiting to be checked is down to 3 from 8, the consumers′ satisfaction with the medical environment, service attitude and the service quality is higher than before optimization, the difference was significant (Plt;0.05). Conclusion Through the process optimization and control effectively relieve the time for waiting to be examined, greatly enhance the satisfaction of people who take physical examinations and ensure the quality of physical examination.
The technical combination of artificial intelligence (AI) and thoracic surgery is increasingly close, especially in the field of image recognition and pathology diagnosis. Additionally, robotic surgery, as a representative of high-end technology in minimally invasive surgery is flourishing. What progress has been or will be made in robotic surgery in the era of AI? This article aims to summarize the application status of AI in thoracic surgery and progress in robotic surgery, and looks ahead the future.
ObjectiveTo analyze the limitations and challenges for the use of real-world data in the decision making of drug reimbursement through literature review and provide standard process and guideline for the real-world study supporting drug reimbursement. MethodsBy summarizing the relevant policies, regulations, and guiding principles of major drug regulatory agencies worldwide, the study analyzed the applicable conditions, framework, and reimbursement mode for using real-world evidence in the decision making of drug reimbursement. ResultsThe study found that the health technology assessment departments of major developed countries and Asian countries have used real -world evidence to evaluate the drug efficacy and safety. The application scope of real-world data for reimbursement decision included describing the treatment process of the disease, assessing economic burden, verifying economic models, and evaluating the efficacy and safety of drugs. Some developed countries including the United Kingdom and the United States had released guidelines or frameworks of the real-world study for reimbursement decision. The process and framework of using real-world data in reimbursement decision could be divided into three models: coverage with evidence development, outcome-based contract, and re-assessment. ConclusionReal-world data has been widely used in the process of health technology assessment. To adapt to the development of the pharmaceutical industry and to meet the needs of clinical patients, it is urgent to standardize the process of collecting real-world data and formulate the scope and process of using real-world data in the reimbursement process.