Editor's note: On October 8, 2021, the ninth batch of Hunan Chenzhou Medical Aid Xinjiang Mid-term Rotation Expert Group went to the Toxun County People's Hospital in Xinjiang thousands of miles away to carry out a one-and-a-half-year medical aid work in Xinjiang. Among the members of the expert group for aiding Xinjiang, Kang Jingyuan, a communist party member from the Affiliated Hospital of Shonan University, recorded in writing the bits and pieces of his life in aiding Xinjiang...
The construction of stroke center is a key microcosm of the comprehensive strength of a hospital, and it has an irreplaceable role in the development of a hospital. The Toksun County People's Hospital is located in the central and eastern part of the Xinjiang Uygur Autonomous Region, with a remote geographical location, relatively backward economic development, and relatively lagging behind in the development of medical technology. I am very saddened to see that many patients with stroke diseases in the local area are seriously threatened by the inability to receive treatment nearby, resulting in serious threats to their lives and health. Promoting the construction of the hospital stroke center in the shortest possible time is the first thing I want to do after I entered Xinjiang.
Setting up a stroke center in a local hospital is not a simple ceremony, even if it is completed by hanging a sign, the establishment of a stroke center needs real medical treatment strength. The existing conditions of Toxon County People's Hospital are not optimistic, there is no independent neurology department, and there is no neurologist with specialized training. Stroke center construction as one of the key points of hospital development, time is tight, the task is heavy, and involves all aspects of the hospital, if you do not quickly formulate a detailed stroke center construction plan and fully promote it, the stroke center of Toxon County People's Hospital is impossible to build in the short term.
How to find problems in problems and how to solve problems in problems is a difficult problem in front of me. Formulation of plans, personnel training, concept promotion, operation and implementation... Many, many things need to be done by me one by one, and no matter which link goes wrong, the final suffering is the people of Toxon County.
After many investigations and detailed understanding in the early stage, I found that the biggest problem in the construction of the hospital stroke center is that there are not many cases of intravenous thrombolysis, and the reason for the small number of intravenous thrombolytic cases is that doctors and patients do not have a clear understanding of the advantages and disadvantages of emergency thrombolysis, and the specialist doctors themselves do not have a deep understanding of the importance and necessity of emergency thrombolysis, coupled with weak theoretical foundation and insufficient publicity, resulting in many emergency patients, but there are very few who can get the best treatment. Many emergency patients do not receive the best treatment within a limited time window.
In response to this problem, I immersed myself in my thoughts, repeatedly grinded, and formulated the outline of the construction of the stroke center of the Toxon County People's Hospital and a series of plans for the construction of the stroke center and the training program for department personnel.
The first is to strengthen the study of theoretical knowledge. Rich theoretical knowledge is the wealth of a doctor's life. Using my own advantages, I developed a detailed theoretical knowledge learning plan for the department doctors, from the general theory of the neurological system, to the individual theory, and finally to the specific disease, the theoretical content is rich and rich, including both on-site lectures and video audio materials, pictures and texts so that the department doctors will not feel bored and boring, but also easier to understand and accept.
Then there is the professional skills training. Professional skills are one of the most necessary for a doctor to practice, and accurate judgment of the disease can make the later treatment play a multiplier effect with half the effort. Through the department rounds and the department doctor's conversation, I found that the department doctor was relatively unfamiliar with the specialty examination, did not have a systematic idea, sometimes could not remember how to check the body, and sometimes even if I remembered the technique, it was very stiff. In this regard, I prepared detailed nervous system examination materials for the doctors in the department to learn by myself, and demonstrated the operation through on-site teaching methods, and used the opportunity of the usual rounds to repeatedly train to deepen everyone's impression. In order to test the learning effect, I arranged a skill assessment for each doctor in the department, and I was very happy to see that their physical examination methods were continuously improved.
Practice is the only criterion for testing the truth, the key to the construction of stroke centers is that the treatment process is not smooth and standard, how to let the members of the stroke center construction find their own deficiencies, that must be known in practice. Repeated drills and then checking for omissions and filling in the gaps are things that I often emphasize to the doctors in the department. Everyone's participation, everyone's passing, and problem-oriented continuous improvement are the meaning of the drill. After continuous intensive drills and skill training, the medical staff of the Stroke Center of Toxon County People's Hospital has now changed from the previous "one person is the main force, others participate" to the current "everyone is the main force of thrombolysis" model. The rescue and treatment capacity of stroke centers has been significantly enhanced.
Karma is good at diligence and absurdity, and success is in thinking and destroying in laziness. No matter how tired and busy I usually am at work, I still insist on going to the countryside every month for free clinics. In the past six months, I have traveled to almost all the township health centers in Toxon, sent the medical services of the tertiary first-class general hospital to the villagers, and sent the health science and emergency medicine knowledge of stroke to the homes of the local people. The wind in Xinjiang had roughened my skin, and the shoes under my feet had worn out two pairs. But I often think that even if only one of the masses can benefit from my popular science and free clinics, then the hard work of this road will be worth it.
The construction of the stroke center of the Toksun County People's Hospital in Xinjiang must not only meet the unified standards of the state, but at the same time, it must also be in line with the actual situation of local development in Xinjiang. After sorting out the whole process of the hospital's construction process in the stroke center, I actively communicated with leaders and colleagues, found out the problem step by step, and put forward corresponding handling opinions. Through methodical improvement and common efforts, in 2022, the Department of Neurology of Toxon County People's Hospital has exceeded the total number of thrombolytics in the time window in less than three months, and there are no obvious complications, which fully meets the requirements of stroke center construction, and the rapid treatment rate and benefits of patients have been greatly improved. This makes my heart feel very excited and happy.
Recently, the Toxon County People's Hospital has docked with the main committee unit of the Xinjiang Stroke Alliance, and intends to invite experts to guide and review the construction of the hospital's stroke center. I sincerely hope that stroke patients in Toxon County can get timely and effective treatment, and I hope that the hospital stroke center can pass the national acceptance with its own hard strength and become a stroke center alliance unit.