ArticleFrontiers in oncology2026
A structured, indicator-driven quality improvement cycle is associated with improved adherence and outcomes after liver resection for hepatocellular carcinoma.
Article in Frontiers in oncology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Purpose: Despite established perioperative guidelines for hepatocellular carcinoma (HCC) resection, inconsistent implementation hinders optimal recovery. This study evaluated clinical outcomes associated with a structured, Nursing-Sensitive Indicator (NSI)-driven quality improvement program designed to ensure reliable execution of evidence-based practices. Patients and methods: We leveraged a cohort of 172 patients undergoing curative liver resection at The Third Affiliated Hospital of Chongqing Medical University from May 2019 to June 2024. An NSI-driven program featuring systematic monitoring, alert-triggered care bundles, and weekly audit/feedback was implemented. Program patients (Intervention, n=86) were compared to a historical usual-care cohort (Control, n=86) after 1:1 propensity score matching. Primary outcomes included perioperative process compliance and short-term recovery metrics (complications, length of stay). Secondary outcomes included 1-year recurrence-free survival (RFS) and patient-reported outcomes. Results: The intervention was significantly associated with improved process metric adherence, notably correlating with reduced time to first ambulation (17.8 ± 8.5 Conclusion: Implementing a structured NSI-driven quality management program was significantly associated with higher perioperative care fidelity, faster functional recovery, and better recurrence-free survival after HCC resection. This framework provides an effective mechanism for translating evidence-based guidelines into reliable routine practice, potentially correlating with favorable long-term oncological outcomes.
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