关键词: 日间医疗, 交接班制度, 日间手术, 医疗质量, 核心制度

Abstract: Ambulatory medical care (AMC)， as stipuated in the newly promulgated “Interim Provisions on Quality Management of Ambulatory Medical Care in Medical Institutions”， refers to the medical service model that provides patients with the whole process of inpatient diagnosis and treatment within 24 h， and should ensure the medical quality and safety. As a new medical model， AMC includes ambulatory surgery and ambulatory chemotherapy， and has the potential advantages of clear diagnosis and treatment procedures， shortened hospital stay and reduced medical costs. However， compared with focusing on the management of AMC in the developed countries in Europe and the United States， the development of AMC in China is still in the promotion stage led by the government， and focus on the clinical practice of single disease under AMC model， and still lacks a mature and propagable management model. Moreover， the traditional shift handover system would led to unequal access to information， untimely communication and inefficient communication among surgeons and nurses， and is not fully applicable to the ambulatory medical care model. Our center has established a new shift handover system under the AMC model based on the previous clinical practice——“YTT” shift handover system， that is， in the daily morning meeting， the doctor on duty would hand over medical conditions of the previous day， the chief resident doctor would report the surgery arrangements and related arrangements of the current day， and the doctor-patient assistant would arrange the surgery schedules of the next day. The “YTT” shift system is a new shift hand over system gradually explored on the basis of clinical practice and adapted to the AMC model， which aiming at improving the safety and efficiency of AMC， ensuring the quality of ambulatory medical services， and providing reference for the clinical application and promotion of the new shift handover system under AMC model.

Key words: Ambulatory medical care, Shift handover system, Ambulatory surgery, Medical quality, Core system