Construction and application of the "coordinate multidisciplinary care model" in elderly patients undergoing radical cystectomy based on QCC.

OBJECTIVE

This study aims to develop and evaluate a multidisciplinary care model utilizing Quality Control Circle (QCC) methodology for elderly patients undergoing radical cystectomy.

METHODS

This comparative study included patients who underwent radical cystectomy at Zhujiang Hospital between May 2022 and July 2023 (pre-improvement group, ​= ​65) and between August 2023 and July 2024 (post-improvement group, ​= ​41). The QCC team implemented four key interventions: a case manager-led collaborative team, a comprehensive care information platform, tiered holistic care management protocols, and an evidence-based referral system. Patient outcomes were assessed using the FACT-Bl scale, discharge readiness measurements, and hospitalization duration.

RESULTS

Post-implementation FACT-Bl scores demonstrated significant improvements across all dimensions ( ​< ​0.05), with the most notable gains in functional well-being (8.52%, ​< ​0.001), followed by emotional well-being (5.88%, ​= ​0.002), social/family well-being (5.26%, ​= ​0.002), and physical well-being (5.00%, ​= ​0.016). The bladder cancer-specific subscale improved by 3.73% ( ​= ​0.018), contributing to a 6.08% increase in total score ( ​< ​0.001). While hospitalization duration remained comparable between groups (17.00 vs. 19.00 days, ​= ​0.771), discharge readiness significantly improved by 7.95% ( ​= ​0.001).

CONCLUSIONS

Implementation of this QCC-based multidisciplinary care model significantly enhanced quality of life and discharge readiness in elderly bladder cancer patients undergoing radical cystectomy. This approach offers a transferable framework that could benefit various clinical settings focused on optimizing geriatric care.