At 17:00 on January 16, the Xi'an Municipal Health Commission announced that it will further improve the medical services of patients in the two hospitals in the high-tech zone and patients with long-term filing.
It specifically mentions that special personnel such as long-term hemodialysis, tumor radiotherapy and chemotherapy, and pregnant women who are documented in the hospital are guaranteed to ensure the continuity of their medical services.
The last time these two hospitals appeared in the official announcement was 3 days ago: at 10 o'clock on January 13, the "Notice on the Handling of Xi'an High-tech Hospital and Xi'an International Medical Center Hospital" (hereinafter referred to as the "Notice") pointed out that there are 4 opinions on the treatment of these two hospitals, except for the difference in the responsibility of the hospital responsible for the dismissal and suspension of personnel, the other 3 are consistent:
1. Suspend business for rectification for 3 months, and reopen the clinic after passing the rectification period;
2. Give a warning;
3. The city circulates criticism, interviews the main responsible person of the hospital, and instructs the hospital to do a good job of comforting the family.
In addition, the Xi'an Municipal Health Commission issued the "Work Plan for Ensuring Normal Medical Treatment for the Masses During the Closure of Two Hospitals in the High-tech Zone" (hereinafter referred to as the "Plan") during the same period.
It should be known that in the Xi'an High-tech Zone, which has a population of 960,000, although these two hospitals are private, they are the only two third-class hospitals. Seven years after its opening in 2002, Gaoxin Hospital became the first social tertiary hospital in China. With a planned bed of 5,037 beds, Xi'an International Medical Center Hospital once became the world's first in terms of total beds, and was called "the world's largest single private hospital".
In the 72 hours after the hospital received the news of the official suspension, the patient network asked for help, the doctor was "banned", and the social media voice of 117 patients was heard; the hospital quickly set up a suspension and rectification office, and the hospital leaders continued to report the latest situation of patients, communicate, modify and implement rectification suggestions with the Health Commission.
As Zhang Xiaoming, director of a department at Xi'an International Medical Center Hospital, said to the health community on January 15, "After the hospital was shut down, some patients' medical services were interrupted, which is not anyone's original intention."
The good thing is that the problem is solved quickly.
According to a number of doctors and the health community, there are currently more than 1,000 inpatients in the two hospitals who need to continue to receive treatment until they are discharged smoothly.
Received the message of the suspension
Doctor: How is that possible?
On the morning of January 13, as soon as Zhang Xiaoming arrived at the office, he heard colleagues talking about the imminent closure of the hospital for three months.
Colleagues asked Zhang Xiaoming if it was true? He said, "How could it be that a three-month suspension would be unprecedented for any hospital."
What Zhang Xiaoming did not expect was that this was not a rumor.
"Helpless, but can only accept, since the wood has become a boat, it can only face." Three months is not long, and it is not short to say short." According to Xu Ran, another doctor at Xi'an International Medical Center Hospital, at the summary meeting of all hospital staff held on the afternoon of January 12, the suspension was roughly mentioned, and the theme of the meeting was to make everyone "obey the arrangement and not complain".
But the official announcement has not yet been released, which has led doctors to talk about it, "everyone's mood is still stable, we have no overreaction."
The reason for the suspension of these two hospitals should also start from two public opinions in recent days.
One is # Xi'an woman said that her father died after being rejected for angina,The second is #Xi'an eight-month pregnant woman miscarriage incident#, two topics are frequently searched, so that public opinion is tilted to pregnant women and patients' families, and in the eye of the storm, it is Xi'an High-tech Hospital and Xi'an International Medical Center Hospital.
Yang Zhanfeng, deputy director of the Plastic Surgery Hospital of Xi'an International Medical Center, posted on Weibo on January 10: "The head nurse of our medical beauty center returned to the department after completing the nucleic acid sampling task of 10 urban villages, but her phone and circle of friends were full of injustice and insults, and her nurse's uniform, which was already thin, hung loosely on her body, her face was black and red and very haggard, and she had not taken a hot bath for more than twenty days. Received the task in the early morning, immediately set off into the village is 8.9 hours! Don't make them sweat and cry..."
In this epidemic in Xi'an, the two hospitals that have been suspended have participated a lot. According to the data as of January 10, since the outbreak of the epidemic, the hospitals under Xi'an International Medical Group have selected 9 batches of medical teams and 511 medical staff to participate in the diagnosis and treatment of designated hospitals for new crown pneumonia; 107 batches of nucleic acid sampling teams and 6918 medical staff have been selected, and more than four million (4200420) nucleic acid samples have been completed.
Previously, during the epidemic in Wuhan, Xi'an International Medical Group assisted a total of 330 medical staff, of which the fourth batch of medical teams in Shaanxi Province to support Hubei was led by Ma Qingjiu, then president of Xi'an International Medical High-tech Hospital.
Figure: From 0:00 on December 23, 2021, xi'an residential areas will be closed and managed. At 6:00 a.m. on December 23, 437 medical staff of the hospital gathered and rushed to 175 nucleic acid collection stations in Xi'an.
In this tug-of-war of public opinion, there is no winner.
In the face of the news that the hospital was suspended for three months, it was not only the doctors who were surprised, but also the netizens who had been active in the "crusade" against the two hospitals.
Netizen apologized: "I feel very sorry for the words I scolded you and hoped that you would stop business." I felt very angry when that happened, but I didn't expect so much."
Patients admitted on the last train before the suspension
"If there is a problem in the transfer process, who is responsible?"
The "Notice" was issued, and the hospital did not immediately stop the treatment, but had a short buffer period. Both the hospital and the patient said that on the morning of January 13, the hospital was still receiving normal treatment.
After the official announcement of the suspension, the doctor began to communicate with the patient and give explanation and reassurance. "On the morning of the 13th, a doctor came to my ward and informed me and two other patients that the hospital had been asked to close for rectification and that patients might have to be transferred to other hospitals." Patient Xu Ting told the health community.
For patients with occult breast cancer like Xu Ting, who require multiple chemotherapy treatments, the continuity of treatment is crucial.
This is a rare and difficult to diagnose breast cancer. Since her diagnosis, she has been receiving treatment at the Department of Nail And breast surgery at Xi'an International Medical Center.
On January 12, the day she was ready for her sixth chemotherapy, she was told on the second day of her hospitalization that the hospital was closed and she might face a transfer.
However, "not wanting to be transferred" is the unanimous idea of Xu Ting and her patients. On the one hand, because she was allergic to drugs, she needed to do anti-allergic treatment, and the chemotherapy that could have ended in 3 days was extended, on the other hand, Xu Ting was worried that this time she was discharged from the hospital, and it would not be so easy to come back next time.
Chemotherapy must be done every 21 days, Xu Ting still has two chemotherapy to do, and the hospital is closed for up to 3 months, what should she do next treatment?
"The head of the department personally went to each ward to comfort the patient, told us not to worry, left our phone to each of our patients, and when it came to the next treatment time, call him, and the hospital will try to help us solve the problem of follow-up transfer treatment." Xu Ting said.
"Through some of our personal relationships, we help patients contact other hospitals for referral, and many patients cannot be delayed, especially patients with tumors and medium-term radiotherapy and chemotherapy, they can't wait." Dr. Xu Ran said to the health community.
Xu Ting believes that the hospital needs to admit that what is wrong needs to be admitted, but such a suspension of business and rectification will bring inconvenience to many patients: "Do you say that it is really so easy for our patients to transfer?" Do other hospitals know about all the check-up procedures? If there is a problem in the transfer process, who can be responsible?"
Many cancer patients will be required to use a PICC catheter, which, from the appearance, is a small infusion tube protruding from the skin, and the drug can be placed directly through this infusion tube and directly into the central vein from the peripheral vein. But exposed infusion tubes are required to be kept clean and subject to regular maintenance by healthcare professionals.
Before the notice of suspension and rectification was issued, Xu Ting had to go to the hospital every week to receive maintenance. The hospital is closed, what about the maintenance of PICC catheterization and follow-up chemotherapy?
The doctor of breast nail surgery told Xu Ting that if he needed to come to the hospital after discharge, he would go to the emergency department to call him, and then he would go to the first floor to pick up Xu Ting for treatment or PIC catheter maintenance. In addition, when patients are discharged from the hospital, the hospital will arrange for an ambulance to safely take them home.
Fortunately, on January 14, a doctor gave her and all her patients in breast nail surgery one-on-one of the good news: they could continue to stay in the hospital for treatment.
On January 14, a document for the xi'an International Medical Center's closed office was circulated in the patient population, which said that in order to ensure the continuous diagnosis and treatment needs of some patients and special diagnosis and treatment, the patients who were admitted or received in the later stage were being counted. Eligible patients include: hemodialysis patients (only for patients with fixed hemodialysis in our hospital), tumor radiotherapy and chemotherapy patients (limited to patients who have received treatment in our hospital and still need follow-up treatment), and it is strictly forbidden to admit new patients.
It also said that patients with acute and critical illness (if they do not carry out first aid behavior, there will be life-threatening or disabling or teratogenic) can be admitted normally, but it is strictly forbidden to make an appointment for such patients by telephone.
These patients are called "old patients" by Xu Ting: patients like her who have a medical record in the two hospitals before the suspension.
From the hospital's internal documents on January 14 to the January 16 update of the Health Commission's policy, the opening of the policy has become more and more open to "old patients", allowing these special personnel in need to restore continuous medical services.
On January 16, Lu Yongpeng, deputy director of the Xi'an Municipal Health Commission, introduced at the press conference that he will further do a good job in the medical services of patients in hospitals and long-term archived patients in 2 hospitals in the high-tech zone:
First, patients in the hospital will continue to do a good job in follow-up diagnosis and treatment services in accordance with the treatment plan that has been formulated;
The second is to ensure the continuity of medical services for special personnel such as long-term hemodialysis, tumor radiotherapy and chemotherapy, and pregnant women who are documented in hospitals;
The third is to quickly implement on-site rescue in case of emergency patients. The Xi'an Health Commission has sent a special class to the hospital to coordinate and guide, and make every effort to ensure that the medical services of the above personnel are continuously filed.
Patients who contact the hospital everywhere
With the doctor who was "forbidden knife" Big V
In the 72 hours after the suspension, many patients waited outside the hospital.
On January 13, 2 hours after the announcement of the suspension of the two hospitals, the official website of the Xi'an Municipal Health Commission released the "Work Plan for Ensuring normal medical treatment for the masses during the suspension of two hospitals in the High-tech Zone", and the purpose of the "Plan" was to actively respond to the shortage of medical resources in the high-tech zone after the suspension of Xi'an High-tech Hospital and Xi'an International Medical Center Hospital, and effectively alleviate the inconvenience of the masses to see a doctor.
In the "Plan", 9 tertiary hospitals under the municipality are designated to support 9 community health service centers (or township health centers) in the high-tech zone.
Designated hospitals under the epidemic situation are under considerable pressure. Xu Ran analyzed to the health community: "Originally, these hospitals had greater pressure to accommodate under the epidemic; coupled with the fact that there were patients who needed continuous treatment, the department suddenly accepted new patients, and the pressure of diagnosis and treatment was even greater, and the previous files were not in their own hospitals, and they may sometimes be unwilling to take such risks."
The "Plan" stipulates: Do a good job of explaining the special patients such as infants, pregnant women, hemodialysis, and tumors who have been fixed in Xi'an High-tech Hospital and Xi'an International Medical Center Hospital for a long time, reasonably divert them to other hospitals for treatment, and determine the first affiliated hospital of Xi'an Medical College as a tertiary first-class comprehensive guarantee hospital for the masses in the high-tech zone.
The health community called the obstetrics department of the first affiliated hospital of Xi'an Medical College on January 15, and said that it could directly make an appointment to queue up, and there were already some pregnant women who took the pregnancy test report filed in Xi'an High-tech Hospital to their hospital.
In addition to the problem of pregnant women facing medical treatment, at 20:51 on January 13, Professor Guo Shuzhong, director of the Plastic Surgery Department of Xi'an International Medical Center, posted on Weibo that "it is rare to be as anxious as today", and 117 patients with microtia are in urgent need of second-stage surgery, otherwise the risk will increase, but they have been "banned".
At 11:01 on the 14th, Guo Shuzhong posted on Weibo: "Just received a notice, the superior agreed that I can operate on these children at Xi'an International Medical Center Hospital." It is reported that yesterday, the leaders of the Xi'an Municipal Health Commission and the Xi'an International Medical Center Hospital had an in-depth communication on this matter, and in the spirit of saving lives and helping the injured, they agreed to let me operate on these children. As the attending physician of these children, I am sincerely happy for them and their parents, and I am grateful to the superior leaders for being able to understand the children's suffering! 」
The reason for this change, according to Zhang Xiaoming, who is also at Xi'an International Medical Center Hospital, "The hospital has actually been consulting with the leaders of the Health Commission or constantly reporting for instructions, not only involving the second stage of microtia surgery, but also radiotherapy and chemotherapy patients."
Continue treatment + training
"Normal Salary"
A hospital leader of Xi'an High-tech Hospital told the health community that the hospital has been busy with the rectification and reform office of the Health Commission recently, in addition to rectification, more real-time reporting of patients' medical treatment.
The suspension does not mean that the workload of clinicians has plummeted, and there are still more than 1,000 patients waiting to continue treatment in both hospitals. Xu Ran's department has two wards and a intensive care unit, about 100 patients, need to treat them to a stable discharge, the treatment cycle is relatively long, and some patients cannot be discharged in a short period of time.
Zhang Xiaoming's department has nearly 100 patients, he said, the vast majority of patients should be able to be discharged before the Spring Festival, but there are a few serious conditions, may not be able to be discharged for three months.
After the release of the suspension notice, Xu Ran recalled that on the afternoon of January 13, there was no special change in his team's work, and he was still preparing for the next day's surgery; on the morning of the 14th, he rounded the room and did surgery, and the department carried out about 5 operations throughout the day.
"After three months of suspension, the work content has changed." Xu Ran sighed.
The experts have received work arrangements from the hospital to give lectures at the hospital. Not only experts, but also the daily life of other medical staff, in addition to continuing to treat patients in the hospital, they must also carry out training on the knowledge of suspension and rectification, and the learning and training of system, business, and clinical knowledge and skills is indispensable.
Xu Ran revealed that at present, the preliminary plan includes 2 to 3 times a week, each time 1 to 2 hours of system training; the president of the specialized hospital, well-known professors to make special reports to the whole hospital; the study of the core medical system and the epidemic prevention and control system.
"There are many contents of the training, including summarizing the previous reflections, summarizing the shortcomings, and making up for the shortcomings. In terms of training, the hospital has unified requirements, but the department should combine its own characteristics to do it." Zhang Xiaoming said.
Xi'an International Medical Center includes a total of 11 specialist hospitals. Specific to the department, there will be corresponding special lectures, including case review, review of previous special cases and death cases, clinical skills training for micro-operation, etc., and for the operating department, it is necessary to operate in the morning and carry out scientific research activities in the afternoon.
Pictured: The Department of Cardiac Surgery at Xi'an International Medical Center Hospital operates on a 50-year-old patient with aortic dissection in Baoji City on January 4.
Medical staff must arrange specific study time according to the work of the department. Not only the leaders and department directors of specialized hospitals need to do the above things, but all doctors must prepare their own topics, special lectures, and reviews of special cases.
In addition, due to the particularity of the department, Xu Ran's department is divided into multiple sub-professional groups, each group has its own team leader, suspended for three months, so that they have more time to invest in scientific research.
"This is a difficult time for us, but opportunities and difficulties coexist. Although we have been out of business for three months to study and train, through this short stop and study, in order to go higher and farther in the future, I don't think we can treat and waste these three months negatively." Zhang Xiaoming said.
According to the 2020 annual report of International Medicine, even under the influence of the epidemic, the combined annual emergency volume of the two hospitals has exceeded 1.2 million, and nearly 70,000 inpatients have been hospitalized.
Dr. Xu Ran said that since the opening of Xi'an International Medical Center Hospital in September 2019 for two years, because the number of patients has expanded particularly rapidly, many jobs have been very hasty, including many new doctors and nurses, eager to enter clinical work, lack of particularly adequate training, so you can take this opportunity to let everyone precipitate and reflect.
But on the other hand, he admits that the suspension has a greater impact on both the hospital and their personal career development: because of this suspension, the source of the hospital's previously established sources, mutual cooperation units, and the reputation accumulated within two years of the hospital's opening will be affected.
Zhang Xiaoming, the head of the department, is much more optimistic, "that is, start over." Having experienced the whole process from the preparation, opening and development of Xi'an International Medical Center Hospital, he believes that the current situation is much better than the initial stage, with strong medical technology strength, service attitude, service awareness, and the accumulation of a large number of old patients, they are not afraid to start a business again.
"The salaries of medical staff are paid normally." The head of a specialized hospital in Xi'an International Medical Center Hospital told the health community.
Alleviate the "difficulty of medical treatment", the contradiction point is not in the "suspension of medical treatment"
Concerted efforts should be made to restore patient intake in hospitals
Public information shows that although the two hospitals suspended are private, they are the only two third-class hospitals in the high-tech zone. According to the official website data, the beds in the high-tech hospital are 1500, and the beds in the Xi'an International Medical Center Hospital are more than 5000 beds.
Just in October 2021, International Medicine, a listed company affiliated to the two hospitals, also said in response to investors that recently, the number of daily inpatient beds in Xi'an International Medical Center Hospital reached a record high of 2,000 beds, and the number of daily inpatient beds in high-tech hospitals exceeded 1,400 beds. The overall use of medical beds in both hospitals is in a phase of rapid increase.
"During the epidemic period, Xi'an International Medical Center basically maintained about 1700-1800 patients in the hospital, plus more than 1,000 patients in high-tech hospitals, if these patients disperse to other hospitals, it will be stressful to other hospitals, which is an objective fact." Zhang Xiaoming, director of the department, said.
Will the suspension disrupt the original order of medical treatment in other designated hospitals and cause stress?
The health community called the First Affiliated Hospital of Xi'an Medical College and the First Affiliated Hospital of Xi'an Jiaotong University, which are close to the two hospitals, and the hospital said that the number of patients was the same as usual and had not yet caused pressure.
According to the information Xu Ran learned, due to the impact of the epidemic, there are fewer reception hospitals in Xi'an that have completely resumed normal operation, including several affiliated hospitals of the Fourth Military Medical University and Xi'an Jiaotong University, "According to my understanding, they have not returned to the normal state of containment, and now they are all in a low-level operating state, and the current number of income patients is 20% to 30% of the normal income, and may not reach 50%, so the feedback they are currently receiving is difficult to refer to."
However, with the improvement of the epidemic situation in Xi'an, Xu Ran said that in the next 1 to 2 weeks, the capacity of many hospitals should go up, which will alleviate some of the "pressure of medical treatment".
From the current point of view, the pressure of medical treatment caused by the suspension of medical treatment is a secondary contradiction, the main contradiction is "epidemic control", the recovery of patient intake in other hospitals, and the entry into a medium or high operating state.
(Note: At the request of the interviewee, Zhang Xiaoming, Xu Ran, and Xu Ting are pseudonyms)
Author: Luo Chunhao Guhui Yan Lao Zhao Wenqing
Producer: Zhang Beihai
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