Unplanned surgery cancellation (USC) was an important quality management issue in the course of medical care for surgical patients, which caused inappropriate use of hospital resources and had negative impacts on quality and safety. This study used Lean Six Sigma to reduce the incidence of USC. Following the Lean Six Sigma DMAIC (Define, Measure, Analyze, Improve, and Control) process, the main factors influencing the USC were identified, such as the time of informing patient admission, the time of submitting operation notice, and the management of test report follow-up. A series of measures were implemented including improving the health education content of virtual bed patients, standardizing the way of communication between the Admission Management Center and the patients, improving the timing of anesthesia evaluation, optimizing the process of operation notice with an information system, and implementing the regulations of virtual bed management. The incidence of USC reduced from 10.21% in Jan. 2016 to 3.8% in Dec. 2016, and the Z-score increased from 1.25 to 1.68, which improved patient safety and demonstrated that Lean Six Sigma was an effective method to solve cross-department issues in hospital.

Long-term indwelling catheters are utilised in people who are unable to use another bladder management method, for example the elderly and those with disability and/or severely restricted mobility that cannot use the bathroom or perform intermittent selfcatheterisation (Cottenden et al., 2009). Most users of long-term indwelling catheters have a disability such as spinal cord injury or

Purpose The purpose of this study was to evaluate how the “COVID-19 prevention and control measures” changed nosocomial infections in neurosurgery. Methods To explore changes in nosocomial infections in neurosurgery during the COVID-19 pandemic, the clinical data of inpatients of neurosurgery from January 1, 2020, to April 30, 2020 (COVID-19 era) were first analyzed and then compared with the same period in 2019 (pre-COVID-19 era). We also analyzed data from May 1, 2020, and December 31, 2020 (post-COVID-19 era) at the same time in 2019 (second pre-COVID-19 era). Results The nosocomial infection rate was 7.85% (54/688) in the pre-COVID-19 era and 4.30% (26/605) in the COVID-19 era (P = 0.011). Between the pre-COVID-19 and COVID-19 eras, the respiratory system infection rate was 6.1% vs. 2.0% (P < 0.001) and the urinary system was 1.7% vs. 2.0% (P = 0.837). Between the pre-COVID-19 and COVID-19 eras, the proportion of respiratory system and urinary infections in total nosocomial infections was 77.78% (42/54) vs. 46.15% (12/26) and 22.22% (12/54) vs. 46.15% (12/26), respectively, (P = 0.006). Between the second pre-COVID-19( ) and post-COVID-19 eras, the proportion of respiratory system and urinary infections in total nosocomial infections was 53.7% (44/82) vs. 40.6% (39/96) and 24.4% (20/82) vs. 40.6% (39/96), respectively, (P = 0.022). Conclusions The COVID-19 pandemic reduced the incidence of nosocomial infection in neurosurgery, and the main reduction was in respiratory infection, while the proportion of urinary infections in total nosocomial infections increased significantly.

Objectives: Toevaluate the cost of home care for patients with moderate-to-severe dependency. Methods: This study retrospectively collected 123 cases of home nursing patients in Taizhou city, a city in southeast China, from January to November 2021 and compared the actual total cost and actual expenditure of home nursing with in-hospital nursing. Results: Thecost of home nursing was higher than that of hospital nursing(vsYuan).Compared to home-based nursing and in-hospital nursing, the reimbursement amount of government-borne medical insurance reimbursement is higher (vsYuan).The actual cost of the patient’s expenses is less than that of home care(vsYuan). There were significant differences between the two groups in the actual total cost and expense reimbursement(vs,p< 0.05; vs,p< 0.05). There was no significant difference between the two groups regardingtotal self-care expenses(p =0.327). Conclusion: The cost of home nursing is high, but the government and the hospital absorb the corresponding expenditure cost, so the actual expenditure of patients is low.Home care saves time and avoids the risk of accidents caused by moving.Home care reflects the medical policy to provide services and cost support through cost analysis. Further, the continuous care of moderate and severe living dependent discharged patients getscomplete nursing care.

No abstract