{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T12:36:49Z","timestamp":1786538209687,"version":"build-2736575974"},"reference-count":31,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T00:00:00Z","timestamp":1786492800000},"content-version":"vor","delay-in-days":223,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100007937","name":"Peking University","doi-asserted-by":"publisher","award":["BMU2025YXXLHAIYX002"],"award-info":[{"award-number":["BMU2025YXXLHAIYX002"]}],"id":[{"id":"10.13039\/501100007937","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100015083","name":"Peking University People's Hospital","doi-asserted-by":"publisher","award":["RDM2023-06"],"award-info":[{"award-number":["RDM2023-06"]}],"id":[{"id":"10.13039\/501100015083","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100015083","name":"Peking University People's Hospital","doi-asserted-by":"publisher","award":["RDM2024-02"],"award-info":[{"award-number":["RDM2024-02"]}],"id":[{"id":"10.13039\/501100015083","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100015083","name":"Peking University People's Hospital","doi-asserted-by":"publisher","award":["RDX2024-07"],"award-info":[{"award-number":["RDX2024-07"]}],"id":[{"id":"10.13039\/501100015083","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Nursing Management"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Perioperative care is inherently complex, requiring seamless coordination among multidisciplinary teams. Traditional, fragmented workflows often lead to delays, inefficiencies, and increased risk, compromising both patient safety and operational performance.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>This study aimed to evaluate the impact of a patient\u2010centered, digitally enabled closed\u2010loop perioperative management system, implemented within the overall every control (OEC) framework, on operating room efficiency.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We developed and implemented a patient\u2010centered perioperative care continuum digital closed\u2010loop system that integrated real\u2010time data from the surgical anesthesia system to orchestrate a standardized workflow across the preoperative, intraoperative, and postoperative continuum. The study employed a mixed\u2010methods design. Quantitative data on the on\u2010time start rate of the first surgery, turnover time, and operating room utilization were collected from the preintervention baseline period (2022,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200918,076 cases) through the postintervention period (2023\u20132024,\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u200954,684 cases). Qualitative data from semistructured interviews with surgeons, nurses, and patients provided insights into the user experience.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Quantitative data revealed a significant and sustained improvement, with the on\u2010time start rate increasing from 74.6% to 89.5% (\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001), and operating room utilization also rose significantly (\n                      <jats:italic>p<\/jats:italic>\n                      &lt; 0.001), despite a 51% rise in surgical volume and a higher\u2010acuity patient caseload. Importantly, no system\u2010related adverse events were detected throughout the study period. Qualitatively, healthcare providers reported better teamwork, reduced cognitive load, and greater professional fulfillment, while patients experienced substantially shorter waiting times and less preoperative anxiety. The mixed\u2010methods approach suggested that these efficiency improvements were not only procedural but also associated with a fundamental enhancement of the work environment and care experience.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The OEC\u2010guided closed\u2010loop management system was associated with enhanced perioperative efficiency and sustained patient safety under conditions of increased demand. This model demonstrates that integrating real\u2010time digital feedback with a standardized management framework may create a virtuous cycle of continuous improvement, yielding favorable outcomes for both healthcare providers and patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Implications for Nursing Management<\/jats:title>\n                    <jats:p>Nursing leadership is pivotal in implementing digital closed\u2010loop perioperative systems, which may enhance efficiency and patient safety by streamlining workflows, reducing cognitive load, and improving staff well\u2010being, thereby demonstrating the potential of digitally augmented, nurse\u2010led management models.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1155\/jonm\/8337477","type":"journal-article","created":{"date-parts":[[2026,8,12]],"date-time":"2026-08-12T11:59:50Z","timestamp":1786535990000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Integrating Patient\u2010Centered Perioperative Care Continuum Digital Closed\u2010Loop Management With Overall Every Control to Improve Perioperative Efficiency: A Mixed\u2010Methods Study"],"prefix":"10.1155","volume":"2026","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3695-6835","authenticated-orcid":false,"given":"Yan Shu","family":"Wei","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0482-3891","authenticated-orcid":false,"given":"Xiao Li","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin","family":"Pei","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xue Jing","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Zhao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2823-2730","authenticated-orcid":false,"given":"Jing","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xin","family":"Xia","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wen Ping","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yue","family":"Ren","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Miao","family":"He","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yi","family":"Feng","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hai Yan","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1568-8974","authenticated-orcid":false,"given":"Jie","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2489-5983","authenticated-orcid":false,"given":"Xiu Yuan","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,12]]},"reference":[{"key":"e_1_2_13_1_2","doi-asserted-by":"publisher","DOI":"10.1016\/s0020-7489(00)00057-2"},{"key":"e_1_2_13_2_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.aco.0000192795.64678.e7"},{"key":"e_1_2_13_3_2","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2023.1118072"},{"key":"e_1_2_13_4_2","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.47731"},{"key":"e_1_2_13_5_2","doi-asserted-by":"publisher","DOI":"10.1053\/j.sempedsurg.2018.02.004"},{"key":"e_1_2_13_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/JHQ.0000000000000018"},{"key":"e_1_2_13_7_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjoq-2022-001957"},{"key":"e_1_2_13_8_2","doi-asserted-by":"publisher","DOI":"10.1017\/cts.2025.6"},{"key":"e_1_2_13_9_2","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2022.1060473"},{"key":"e_1_2_13_10_2","doi-asserted-by":"publisher","DOI":"10.1007\/s10916-023-01945-0"},{"key":"e_1_2_13_11_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13037-023-00388-3"},{"key":"e_1_2_13_12_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41746-024-01371-7"},{"key":"e_1_2_13_13_2","doi-asserted-by":"publisher","DOI":"10.1097\/ALN.0000000000003014"},{"key":"e_1_2_13_14_2","doi-asserted-by":"publisher","DOI":"10.1213\/ANE.0000000000006849"},{"key":"e_1_2_13_15_2","article-title":"OEC Management-Control System Helps China Haier Group Achieve Competitive Advantage","volume":"6","author":"Lin T. 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