Tian P R, Li M Y, Liu J L, Bai R X, Bi J T, Dong G L, Du Y M, Han J G, Han W, Jiang Y, Li Y X, Li Z F, Lin H W, Liu D G, Liu Y, Meng F Q, Ni R G, Song J H, Xu Q, Yan W M, Zhang N W, Zhong C H, Zhang P, Zhang Z T
Department of General Surgery,Beijing Friendship Hospital,Capital Medical University,National Clinical Research Center for Digestive Diseases,National Key Laboratory of Digestive Health,Beijing 100050,China.
Department of General Surgery,Beijing Luhe Hospital,Capital Medical University,Beijing 101149,China.
Zhonghua Wai Ke Za Zhi. 2025 Jul 1;63(7):624-629. doi: 10.3760/cma.j.cn112139-20250205-00052.
To establish and assess the quality control and improvement system for metabolic and bariatric surgery in Beijing. Based on relevant documents from the National Health Commission and the Beijing Municipal Health Commission,and referencing the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP) by the American Society for Metabolic and Bariatric Surgery,a quality control system was developed under the Beijing Quality Control and Improvement Center of Metabolic and Bariatric Surgery. The system incorporated on-site evaluations,data registration,and specialized training. From May to December 2023,on-site assessments were conducted at 21 hospitals in Beijing performing bariatric surgery,evaluating personnel qualifications,infrastructure,clinical workflows,and postoperative follow-up. A quality control database was created to collect real-time surgical data,and training was provided for data entry and professional skills. Assessment results were classified as excellent,qualified,or needing improvement,with rectification suggestions offered and follow-up visits conducted to track progress. All 21 hospitals achieved a 100% compliance rate for surgical indications, 16 (76.2%) met standardized surgical operation criteria,and 14 (66.7%) had standardized postoperative management. However,only 5 (23.8%) achieved a 12-month postoperative follow-up rate of ≥60%,and 4 (19.1%) had established specialized databases. Key challenges included insufficient specialized staffing (19.1%), lack of multidisciplinary collaboration (47.6%), inadequate equipment (57.1%), and low follow-up rates (57.1%). The database collected data from over 2 000 patients across 111 fields. After rectification, specialized database coverage rose to 61.9% (13 hospitals). Multi-level training programs developed backbone physicians and specialized nurses,significantly addressing the shortage of specialized personnel. The quality control system established in this study,through the integration of on-site evaluation,data registration,and specialized training,effectively enhances the standardization of surgical practices and data management capabilities.
建立并评估北京地区代谢与减重手术质量控制与改进体系。依据国家卫生健康委员会和北京市卫生健康委员会的相关文件，并参考美国代谢与减重外科学会的代谢与减重手术认证及质量改进项目（MBSAQIP），在北京代谢与减重手术质量控制与改进中心建立了质量控制体系。该体系包含现场评估、数据登记和专业培训。2023年5月至12月，对北京地区开展减重手术的21家医院进行了现场评估，评估内容包括人员资质、基础设施、临床工作流程和术后随访。建立了质量控制数据库以收集实时手术数据，并提供数据录入和专业技能培训。评估结果分为优秀、合格或需改进，并给出整改建议并进行随访以跟踪进展。21家医院手术适应证符合率均达到100%，16家（76.2%）符合标准化手术操作标准，14家（66.7%）术后管理规范。然而，只有5家（23.8%）术后12个月随访率≥60%，4家（19.1%）建立了专业数据库。主要挑战包括专业人员不足（19.1%）、缺乏多学科协作（47.6%）、设备不足（57.1%）和随访率低（57.1%）。该数据库收集了来自111个领域的2000多名患者的数据。整改后，专业数据库覆盖率提高到61.9%（13家医院）。多层次培训项目培养了骨干医师和专业护士，有效解决了专业人员短缺问题。本研究建立的质量控制体系通过整合现场评估、数据登记和专业培训，有效提高了手术操作的标准化水平和数据管理能力。
