Objective To analyze the causes of day surgery patients missing appointments, and discuss the countermeasures. Methods We selected the patients who had missed appointments for day surgery in the Second Affiliated Hospital Zhejiang University School of Medicine between January 2017 and June 2022. According to the implementation time of the measures, we divided the patients into two groups: pre-intervention (between January 2017 and June 2020) and post-intervention (between July 2020 and June 2022), to analyze the causes of patients’ cancellation, compare the change of patients’ cancellation rate before and after the implementation of measures, and explore the effectiveness of implementation measures. Results A total of 17 392 patients were included, and the total number of day surgery patients was 148 720 during the same period. The total cancellation rate was 11.69% (17 392/148 720). The cancellation rate in the post-intervention was lower than that in the pre-intervention [9.70% (7 935/81 775) vs. 14.13% (9 457/66 945), odds ratio was 0.695, 95% confidence interval (0.674, 0.717), P<0.001]. There were 13 common reasons for cancellation, of which “outpatient treatment, not hospitalization” was the most common reason. Conclusion Through the coordination of various departments, actively optimizing the preoperative evaluation of patients, updating the appointment process, strengthening effective communication and implementing the implementation of efficient medical treatment, the cancellation rate of day surgery can be reduced, which has certain reference significance to improving the management level of the hospital and the ability to serve patients.
Objective To assess the operational and quality management status of outpatient multi-disciplinarytreatment (MDT) services in tertiary hospitals nationwide, identify core quality indicators and key influencing factors for their development. Methods A multicenter cross-sectional survey was conducted from November to December 2024 among tertiary medical institutions nationwide that had implemented outpatient MDT services. The entropy weight method was employed to calculate the weights of outpatient MDT quality indicators, objectively determining their importance ranking. Meanwhile, a 10-point Likert scale was used to systematically evaluate internal and external factors influencing the development of outpatient MDT services. Results A total of 521 hospitals were surveyed. Among them, there were 458 tertiary hospitals (87.9%) and 63 tertiary hospitals (12.1%). Gaps remain in key aspects of outpatient MDT quality management: 295 institutions (56.6%) lacked clear inclusion criteria for MDT case discussions; 159 (30.5%) had not implemented an electronic medical record system for outpatient MDT; and 130 (25.0%) had not established an assessment mechanism for outpatient MDT. Objective weighting via the entropy weight method revealed the top three indicators by weight: “whether outpatient MDT regulations have been formulated” (27.287%), “whether a standard approval process exists for establishing an MDT” (19.079%), and “whether a team secretary is assigned” (15.433%). Analysis of influencing factors showed that among external factors, “medical insurance policies” had the most significant impact, while among internal factors, “departmental emphasis/physician awareness” was most prominent. Conclusions The core indicators of outpatient MDT quality management were screened by entropy weighting method and the key influencing factors were explored using Liszt scoring method. This provides an objective basis for healthcare administration to standardize outpatient MDT services and enhance operational quality and efficiency.
