The National Health Commission issued the "Opinions on Strengthening the Capacity Building of Critical Care Medical Services"

Opinions on Strengthening the Capacity Building of Critical Care Medical Services

Strengthening the capacity building of critical care medical services is an important part of the construction of a healthy China and the high-quality development of health care, and an important measure to build a high-quality and efficient medical and health service system and a major emergency treatment system, which is of great significance for safeguarding people's lives and health. The following opinions are hereby put forward so as to implement the decisions and deployments of the Party Central Committee and the State Council, to promote the continuous improvement of the capacity of critical care medical services, and to make up for the shortcomings of critical care medical resources.    

1. General requirements and main objectives

(1) General requirements. Thoroughly implement the spirit of General Secretary Xi Jinping's series of important instructions on health work and epidemic prevention and control, promote the capacity building of critical medical services as a key part of the construction of the medical and health service system in the 14th Five-Year Plan, and improve the critical medical service system with "matching energy levels, reasonable layout, excellent services, and combination of emergency and emergency". Effectively expand critical care medical resources, optimize the structure and layout of medical resources, focus on making up for the shortcomings of critical care medical resources in the western region and counties, and realize the balanced development of regional critical care medical resources. Strengthen the construction of critical care medicine specialties, strengthen the training and team building of critical care medicine professionals, improve the ability of specialty services, and realize the high-quality development of intensive care medicine specialties.    

(2) Main objectives. By the end of 2025, the number of intensive care beds (including comprehensive ICU beds and specialized ICU beds, the same below) will reach 15 per 100,000 people, the number of convertible intensive care beds (hereinafter referred to as "convertible ICU beds") will reach 10 per 100,000 people, and the ratio of comprehensive ICU beds to doctors in relevant medical institutions will reach 1:0.8 and the bed-to-nurse ratio will reach 1:3. By the end of 2027, the number of intensive care beds nationwide will reach 18 per 100,000 people, and the number of convertible intensive care beds will reach 12 per 100,000 people.    

2. Continue to improve the network of critical care medical services

(3) Establish and strengthen the construction of national medical centers and national regional medical centers specializing in critical care medicine. Relying on high-level hospitals, the National Intensive Care Medical Center and the National Regional Intensive Care Center have been set up to give full play to their leading role in "medical treatment, teaching, research, and prevention". Combined with the joint construction of national regional medical centers by the government and the province, the construction of national regional medical centers, and the construction of provincial-level regional medical centers, the expansion and sinking of high-quality medical resources will be promoted through trusteeship, cooperation and co-construction. Establish a mechanism for the overall planning, coordination and dispatch of regional resources, and improve the ability of centralized treatment and regional coordination of critically ill injured and sick personnel in major emergencies. By the end of 2025, we will strive to have at least one general hospital in each province that is at or near the capacity and level of the National Regional Medical Center for Critical Care.    

(4) Strengthen the construction of urban critical care medical service networks. The construction of critical care medical service network will be included in the construction of medical alliances such as urban medical groups, and the integration and coordination mechanism of medical resources within the grid will be improved. Focusing on the western region, we will strengthen the construction of intensive care departments in leading tertiary hospitals, and improve the ability to treat critically ill patients. Strengthen the service capacity building of primary medical institutions, and improve the ability to identify, handle, and refer acute and critical cases. In the national emergency medical rescue team, intensive medical personnel should be arranged, and equipped with ventilators, ECMO (extracorporeal membrane oxygenation), monitors and other equipment, as well as necessary portable equipment, to adapt to the implementation of rescue tasks of different scales, and form a rapid response, mobile and flexible treatment force that can be dispatched within or across regions. Strengthen the construction of intensive care medicine specialty alliances and telemedicine collaboration networks, and guide the sinking of high-quality medical resources.    

(5) Improve the capacity of critical medical services in the county. Promote the "Thousand Counties Project" to improve the comprehensive capacity of county-level hospitals, and carry out in-depth counterpart assistance to county-level hospitals and "group" assistance for medical talents, so as to make up for the shortcomings of county-level critical medical service capabilities. We will continue to promote the construction of county-level medical communities, improve the mechanism of linkage and division of labor, enhance the ability of grassroots medical institutions to deal with severe cases and standardize referrals, and comprehensively improve the medical treatment capacity of major emergencies in the county. By the end of 2025, we will strive to reach the level of second-level general hospitals in at least one hospital in each county, and promote the capacity level of intensive care medicine departments of a number of county-level hospitals to reach the level of third-level general hospitals.    

3. Efforts should be made to strengthen the capacity building of critical care medical specialties

(6) Reasonably increase the number of beds for critical care medicine. Coordinate the planning and layout of critical care medical resources, general hospitals at level 2 or above and traditional Chinese medicine hospitals with capacity (including hospitals integrating traditional Chinese and Western medicine and ethnic medicine hospitals, the same below) shall independently set up intensive care departments, and infectious diseases and children's specialized hospitals at level 2 or above shall build intensive care units, and add a new batch of intensive care beds according to standards to meet the needs of large-scale emergency treatment. Qualified specialized hospitals at or above the second level may set up intensive care medicine departments and apply for additional diagnosis and treatment subjects. The ICU beds of various specialties in medical institutions are equipped with monitoring and treatment equipment to meet the needs of comprehensive critical care, and can be quickly put into the treatment of severe patients in the face of major emergencies. Hospitals shall, in accordance with the principle of combining emergency and peacetime, reserve a batch of convertible ICU beds, select appropriate independent hospital areas and ward buildings, and rebuild their internal wards in accordance with the requirements for infection prevention and control, and equip them with oxygen supply and power supply facilities that meet the needs of critical care equipment, as well as respiratory support, rescue, and monitoring equipment, to ensure that they can be converted into specialized intensive care beds within 24 hours. By the end of 2025, the proportion of general ICU beds, specialized ICU beds and convertible ICU beds in tertiary general hospitals, traditional Chinese medicine hospitals, infectious diseases and children's specialized hospitals will not be less than 4%, 2% and 4% respectively, and by the end of 2027, the above indicators will not be less than 4.5%, 2.5% and 4.5% respectively. By the end of 2025, the proportion of general ICU beds, specialized ICU beds and convertible ICU beds in secondary general hospitals, infectious diseases and children's specialized hospitals will not be less than 2%, 1% and 2% respectively, and by the end of 2027, the above indicators will not be less than 2.4%, 1.2% and 2.4% respectively.    

(7) Promote the building of clinical specialty capacity in critical care medicine. Implement the "14th Five-Year Plan" for National Clinical Specialty Capacity Building, accelerate the "Millions and Millions" project of key clinical specialties, take critical care medicine as a priority support direction for clinical specialty capacity building, promote appropriate medical technology projects, actively introduce advanced treatment technologies, enrich treatment methods, and make up for the shortcomings of critical care medicine professional technology. At the national, provincial, and municipal (county) levels, a certain number of key clinical specialty construction projects related to critical care medicine are supported. Guide medical institutions to take critical care medicine as an important support for improving the capacity of clinical specialties, give priority support in terms of beds, equipment, staffing, etc., and improve the ability to monitor the functions of important systems such as respiration and circulation, and support life support treatment.    

(8) Improve the medical quality management and control system of the intensive care medicine department. Strengthen the construction of the national-provincial-municipal (county) three-level medical quality management and control (hereinafter referred to as quality control) system of the Department of Critical Care Medicine, and strive to achieve "full coverage" of the quality control center of critical care medicine at the prefecture and city level by the end of 2025. Continuously improve the quality control index system, research and formulate key technologies and quality control indicators or quality monitoring items for key diseases in critical care medicine, and incorporate relevant quality control indicators in critical care medicine into the evaluation of tertiary hospitals and the evaluation of clinical specialty capabilities, so as to effectively guide medical institutions to improve the level of medical quality management in intensive care medicine.    

(9) Improve the service model of the intensive care department. On the basis of consolidating critical care medicine, we should strengthen the prevention, early warning and identification of diseases that are prone to occur or transition to severe diseases, pay attention to early rehabilitation, and improve the prognosis of diseases. Encourage the Department of Critical Care Medicine to innovate multidisciplinary diagnosis and treatment models, absorb the participation of teams such as infection, traditional Chinese medicine, rehabilitation, pharmacy, and nutrition, and establish a multidisciplinary joint diagnosis and treatment and ward round system. Accelerate the promotion of "Internet +", telemedicine and other information service models, and use information technology to guide the sinking of high-quality medical resources. Carry out social work and volunteer services, strengthen doctor-patient communication, and build a harmonious doctor-patient relationship.    

Fourth, effectively expand the team of critical care medicine professionals

(10) Strengthen the training of physicians specializing in critical care medicine. Strengthen the education of critical care medicine in colleges and universities, and strengthen the cultivation of knowledge and ability related to critical care medicine in the undergraduate education of clinical medicine. Reasonably determine the enrollment scale of graduate students in critical care medicine, strengthen the construction of graduate courses in critical care medicine, and improve clinical diagnosis and treatment and scientific research capabilities. Implement demand-based recruitment, strengthen the standardized training of residents in critical care medicine, and strengthen the cultivation of clinical diagnosis and treatment capabilities.    

(11) Increase the proportion of physicians specializing in critical care medicine. Strengthen the construction of a team of critical care medical professionals, and medical establishments should be equipped with critical care medicine professionals in accordance with standards. Encourage medical establishments to give full consideration to the work characteristics of intensive care medicine and the value of technical labor, appropriately favor critical care medical personnel, and establish a stable team of physicians.    

(12) Strengthen professional training in critical care medicine. Establish a rotation training system for critical care medical specialties. Physicians in the intensive care units of tertiary general hospitals other than the intensive care department shall conduct at least half a year of continuous and systematic rotation training and assessment in the intensive care medicine department, be able to master the concept of intensive care medical treatment, be proficient in the use of ventilators, continuous renal replacement therapy (CRRT), etc., to carry out important organ function support, encourage the development of traditional Chinese medicine professional knowledge training, give full play to the role of traditional Chinese medicine in the treatment of critical care, so that a group of other specialist physicians have the clinical technical ability of critical care medicine, and become a reserve of critical care medicine professionals.    

(13) Strengthen the construction of a team of critical care professionals. Implement the "14th Five-Year Plan" for the development of nursing, regard intensive care nurses as urgently needed talents, and further promote the expansion of intensive care nurses. Establish and improve mechanisms for performance appraisal and reward evaluation based on nursing positions, and give appropriate preference to clinical front-line nursing positions such as intensive care nurses. Gradually establish a salary system that mainly reflects job responsibilities, implement post-based responsibility, post-based salary, appropriate responsibility and salary, and assessment cash. Intensify the training and training of intensive care nurses, and by the end of 2025, the proportion of intensive care nurses participating in special training will not be less than 90%, and by the end of 2027, the special training will basically be "fully covered".   

5. Continue to promote the reform of the field of critical care medical services

(14) Reasonably adjust the price of critical medical services. Include the price of critical medical services in the dynamic adjustment mechanism for overall consideration, and where the conditions for initiation are met, priority is given to medical service items that reflect the characteristics and value of critical medical technology and labor services, such as those with high technical difficulty, high risk, and high resource consumption, into the scope of price adjustment, and reasonable price adjustments are to be formulated. We should do a good job in the convergence of policies such as price adjustment, medical insurance payment and medical fee control, so as to ensure that the burden of basic medical expenses on patients does not increase overall.    

(15) Enhance the attractiveness of the critical care medicine profession. Improve the internal distribution mechanism with medical quality, efficiency, and patient satisfaction as the core, reflect the value of knowledge, technology, management and other elements, achieve excellent performance and equal pay for equal work, and reasonably ensure the remuneration and benefits of medical personnel in the intensive care department. Fully consider the work characteristics of the intensive care medicine department and the value of technical labor services, and give appropriate preference to the medical staff of the intensive care medicine department in the promotion of professional titles, job hiring, and evaluation of excellence. Provide good learning and working conditions for medical staff in the intensive care department, relieve the pressure of medical staff, and fully mobilize their enthusiasm.    

6. Organization and implementation

(16) Strengthen organizational leadership. Relevant local departments at all levels should attach great importance to the capacity building of critical medical medical services, and include them in the construction of a healthy China, the high-quality development of public hospitals, and other key work to promote the overall advancement. Local health administrative departments at all levels and departments in charge of traditional Chinese medicine should strengthen departmental communication and coordination, and formulate specific implementation plans for their respective regions based on the current situation of regional critical care medical resources. Local health administrative departments at all levels should include the construction of intensive care departments in the requirements for hospital grade evaluation, to ensure that all policies and measures achieve practical results.    

(17) Strengthen departmental coordination. The health department, in conjunction with the competent department of traditional Chinese medicine, should make overall plans and rational distribution of regional critical care medical resources, guide qualified medical institutions to strengthen the construction of critical care medicine departments, and improve the capacity of critical care medical services. The development and reform and financial departments should implement various support policies for the development of intensive care medicine in accordance with regulations. The education department should strengthen the training of medical students specializing in intensive care medicine. The human resources and social security departments shall, in conjunction with relevant departments, accelerate the reform of the personnel and salary system of public hospitals, and implement the relevant policies that favor the intensive care department.    

(18) Strengthen supervision and guidance. All levels of local administrative departments for health shall, in conjunction with relevant departments, strengthen guidance on efforts to build capacity for critical care medical services within their jurisdictions, conduct regular scheduling in accordance with major indicators, promptly grasp the progress of work, report results, excavate typical examples, and summarize experience.

Interpretation of the "Notice on Printing and Distributing Opinions on Strengthening the Capacity Building of Critical Care Medical Services".

1. Background

In his report to the 20th National Congress of the Communist Party of China, General Secretary Xi Jinping stressed the need to strengthen the prevention and control system and emergency response capacity building for major epidemics. The experience of the new crown epidemic has proved that strengthening the capacity building of critical medical services is an important measure to improve the capacity of major public health emergencies. In order to effectively expand critical care medical resources, optimize the structure and layout of medical resources, and achieve balanced development of regional critical care medical services, the National Health Commission, the National Development and Reform Commission, the Ministry of Education, the Ministry of Finance, the Ministry of Human Resources and Social Security, the National Health Insurance Administration, the State Administration of Traditional Chinese Medicine, and the National Bureau of Disease Control and Prevention jointly issued the Notice on Printing and Distributing Opinions on Strengthening the Capacity Building of Critical Care Medical Services.

Second, the main content

The "Opinions on Strengthening the Capacity Building of Critical Care Medical Services" is divided into six parts: the first part, the overall requirements and main objectives. The overall requirements of "energy level matching, reasonable layout, excellent service, and combination of peace and emergency" are proposed, and the expected goals by the end of 2025 and the end of 2027 are clarified. The second part is to continue to improve the network of critical care medical services. It is proposed to rely on the construction of "dual centers", urban medical groups and county-level medical communities to build a hierarchical and hierarchical critical care medical service network. The third part focuses on strengthening the capacity building of critical care medicine specialties. It is clear that the capacity building of intensive care medicine specialties should be strengthened through four ways: reasonably increasing the number of beds, promoting the construction of key clinical specialties, improving the medical quality management and control system, and improving the service model. The fourth part is to effectively expand the team of critical care medicine professionals. It is emphasized to strengthen college education and continuing education, and strengthen the construction of critical care medical professionals. Medical institutions are required to increase the proportion of physicians specializing in intensive care medicine according to standards. The fifth part is to continuously promote the reform of the field of critical care medical services. Coordinate with relevant departments to reasonably adjust the price of critical care medical services, reasonably ensure the remuneration of medical personnel in the intensive care department, and enhance the attractiveness of the critical care medicine profession. Part VI: Organization and implementation. Emphasize the "three strengthenings", that is, strengthen organizational leadership, strengthen departmental coordination, and strengthen supervision and guidance.

Annex 2

"On Printing and Distributing Strengthening Critical Care Medical Services." 

    Expert Interpretation of the Opinions on Capacity Building (1)

Qiu Haibo, Zhongda Hospital, Southeast University

Recently, in order to further strengthen the capacity of critical care medical services, the National Health Commission and other eight departments jointly formulated the "Opinions on Strengthening the Capacity Building of Critical Care Medical Services". Focusing on the capacity building of critical care medical services, we will comprehensively promote the high-quality development of critical care medical service capabilities from five aspects: improving the critical care medical service network, strengthening the capacity of critical care medicine specialties, expanding the team of critical care medical professionals, and promoting the reform of the field of critical care medical services.

The capacity of critical care medical services is the basic and strategic support for the high-quality development of medical institutions, and the bottom line and red line to ensure the life and health of the people. Aiming at the key nodes that must focus on and continue to "exert force" to improve the capacity of critical care medical services, it has strong pertinence, scientificity and urgency.

1. Capacity building of critical care medical services is the foundation for the high-quality development of medical and health services

The key to the level of treatment of critically ill patients in medical institutions depends on the intensive care unit (ICU). Intensive care medicine is a clinical discipline that competes with the "Grim Reaper" for time and life, and is the last line of defense for the lives of all critically ill patients. The level of critical care medicine is the embodiment of the comprehensive medical capacity of the whole hospital. As the focus of the construction of the medical service system in the 14th Five-Year Plan, the capacity building of critical medical services has been promoted, reflecting the country's continuous efforts in the key links and areas of high-quality development of medical and health care, making every effort to make up for shortcomings, strengthen weak links, and achieve high-quality development of critical medical service capacity.

On the basis of the full coverage of the national key clinical specialties of critical care medicine in all provinces and autonomous regions across the country, during the "14th Five-Year Plan" period, we will promote the expansion and sinking of high-quality medical resources for critical care medicine, and strive to have at least one general hospital in each province reach or approach the capacity and level of the national critical care regional medical center. At the same time, by strengthening the construction of the urban critical care medical service network and the county-level critical care medical service network, a hierarchical and hierarchical critical care medical service network can be built, and critical care services can be obtained at the doorstep, which fully demonstrates the core value orientation of the high-quality development of the national medical service system.

2. Improving the capacity of critical care medicine is the key to the high-quality development of medical and health undertakings

The ability of critical care medicine determines the discipline level of critical care medicine and the ability to treat severe patients, which is the concrete embodiment of the ability of medical institutions to treat severe patients. The capacity building of critical care medicine includes intensive care medical resources marked by the number of beds, critical care treatment capacity represented by key clinical specialties, quality assurance marked by medical quality and control system, and full-chain management of severe patients represented by improved medical models, that is, the pericritical care medicine management system.

(1) Adequate critical care resources are the basic conditions for the treatment of seriously ill patients in medical institutions. Coordinate the planning and layout of critical care medical resources, and general hospitals above the second level and qualified traditional Chinese medicine hospitals are required to independently set up intensive care medicine departments. At the same time, critical care bed resources must be scalable. In addition to the intensive care beds in the intensive care medicine department, the specialized intensive care units should also be equipped with monitoring and treatment equipment for comprehensive critical treatment, so that they can be quickly put into the treatment of severe patients in the face of major emergencies. At the same time, in accordance with the principle of "combination of normal and emergency" and in accordance with the requirements of infection prevention and control, a batch of "convertible ICU beds" with basic critical treatment equipment is stored, so that the critical medical resources of medical institutions can be extensible enough to meet the emergency needs of major emergencies.

(2) Accelerate the construction of key clinical specialties and vigorously improve the capacity for the treatment of severe cases. During the 14th Five-Year Plan period, we will accelerate the construction of clinical specialties under the "Millions of Thousands Project", take critical care medicine as a priority support direction for the construction of clinical specialties, and further improve the coverage of national key clinical specialties of critical care medicine. At the same time, we will actively promote the construction of key specialties of critical care medicine at the provincial, municipal (county) level, guide medical institutions to take critical care medicine as the focus of discipline construction, and give priority to policy and finance. Effectively expand the high-quality resources of critical care medicine, optimize the structure and layout of medical resources, realize the balanced development of critical care medicine, continuously improve the capacity of critical care medical treatment, and realize the high-quality development of intensive care medical specialty capabilities.

(3) Strengthen medical quality management, and maintain the bottom line of medical quality and safety in critical care medicine. Grasp every element of the quality and safety of critical care medicine, establish and improve the quality control system of critical care medicine, and make the treatment of critical care more standardized and effective. The medical quality of critical care medicine is not only closely related to the allocation of critical care resources, but also pays more attention to the whole process of diagnosis and treatment of critical patients, and takes the final outcome (incidence of nosocomial infection, standardized case fatality rate, etc.) as the key quality control indicators of critical care care. Focus not only on short-term outcomes, but also on long-term rehabilitation.

(4) Actively innovating the model of critical care services is the only way for the high-quality development of medical and health care. On the basis of actively strengthening and consolidating critical care medicine, we should further improve the pericritical care medicine management system of prevention, standardized treatment, and early rehabilitation, and strengthen the care of pericritical patients throughout their life cycle. Promoting early warning and identification of severe patients, especially early prevention of severe disease, can significantly reduce the incidence of severe disease, significantly improve patient outcomes, and significantly reduce the consumption of medical resources.

3. Improving the attractiveness of critical care medicine is the core of the high-quality development of medical and health undertakings

Strengthening the people-oriented discipline and strengthening the attractiveness of the discipline can unite and attract more excellent intensive care doctors is the core element of improving the ability of the specialty. First, the sense of responsibility and honor of intensive care doctors strengthens the attractiveness of the discipline. Critical care medicine is a discipline full of vitality and challenges, and critical care doctors are facing critically ill patients walking on the edge of life and death, with awe and rock-solid hearts, full of a sense of responsibility, and full of honor in the face of successful patients. Second, the urgency of the development of critical care medicine requires more and better intensive care physicians. Critical care medical resources are the basic conditions for the treatment of critically ill patients in medical institutions, and the social demand for critical care medical resources determines the huge shortage of critical care physicians, and more excellent physicians are urgently needed to join the critical care medicine team. Third, the increasing attractiveness of disciplines is the core link to enhance the ability of specialties. Let doctors have career prospects and promotion space, provide more training mechanisms for high-level talents, improve the salary system, continuously enhance the attractiveness of the discipline, ensure that more high-quality medical talents join the team of intensive care medicine, and ensure the high-quality development of the discipline.

Annex 3

Notice on Printing and Distributing Opinions on Strengthening the Capacity Building of Critical Care Medical Services

Expert Interpretation (2)

-- Improving the construction of a team of critical care medical personnel 

Contribute to the high-quality development of critical care medicine

Du Bin, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences

In order to meet the growing health needs of the people, since the 18th National Congress of the Communist Party of China, the CPC Central Committee with Comrade Xi Jinping at the core has adhered to the people-centered development philosophy, put people's health in a strategic position of priority development, and comprehensively promoted the construction of a healthy China. In the construction of a healthy China and the high-quality development of health care, the construction of an intensive medical service system is undoubtedly one of the important contents.

On June 4, 2021, the General Office of the State Council issued the "Opinions of the General Office of the State Council on Promoting the High-quality Development of Public Hospitals", pointing out that in order to build a new system for the high-quality development of public hospitals, it is necessary to focus on the technical research on the diagnosis and treatment of difficult and critical diseases, so as to promote the progress of national medicine. In addition, the construction of clinical specialties should be guided to meet the clinical needs of major diseases, focusing on the development of clinical specialties including intensive care medicine, and leading the new trend of high-quality development of public hospitals.

Recently, the National Health Commission and other eight departments jointly formulated the "Opinions on Strengthening the Capacity Building of Critical Care Medical Services" (hereinafter referred to as the "Opinions"), focusing on continuously improving the critical care medical service network, focusing on strengthening the capacity building of critical care medicine specialties, and effectively expanding the team of critical care medical professionals. Specific requirements have been put forward for continuously promoting the reform of the field of critical care medical services, in order to effectively expand critical care medical resources, strengthen the training and team building of critical care medical professionals, and achieve the goal of high-quality development of critical care medicine.

1. Promote the homogeneity of standardized training for intensive care medicine residents through the construction of systems and systems

According to a survey by the Critical Care Medicine Branch of the Chinese Medical Association, in just four years from 2011 to 2015, the number of beds in the intensive care department increased by 36%, and the number of doctors and nurses increased by 35% and 55%, respectively. According to the data released by the National Health Commission, in the past three years, the above data has shown a rapid growth momentum. While the medical resources of critical care medicine have increased significantly, the quality of medical services has been effectively improved.

In recent years, the National Health Commission has accelerated the establishment of a standardized system for resident doctors, and integrated intensive care medicine into the overall promotion. Experts were organized to formulate the detailed rules for the recognition of the professional base of the intensive care medicine department and the detailed rules for the training content of the standardized training of intensive care medicine residents. During the three-year residency programme, trainees are required to complete specialist rotations in Internal Medicine (15 months in total, including 3 months each in Cardiovascular, Respiratory Medicine, Gastroenterology, Nephrology and Neurology), General Surgery and Emergency Surgery (4 months), Anesthesiology (2 months) and Intensive Care Medicine (12 months). Through the rotation of basic specialties (internal medicine, surgery and anesthesiology), taking into account the diagnosis and treatment of etiology and organ support, and at the same time, through the systematic training of comprehensive ICU, the comprehensive professional knowledge and skills related to critical care medicine are emphasized. Through the construction of institutions and systems, the homogeneous development of standardized training for intensive care medicine residents should be promoted.

2. Promote the homogeneity of the construction and management of the intensive care medical team within the hospital through the cultivation of reserve talents

The "Opinions" require that medical institutions at all levels should reserve a batch of "convertible ICU beds" in accordance with the principle of "combining ordinary and emergency", so as to meet the needs of large-scale emergency treatment in the face of major emergencies. At this time, in addition to the medical staff of the intensive care department, the medical staff of other specialized care units should also participate in the medical work as the treatment force of intensive care medicine. We can plan the knowledge and skills training of young doctors in the intensive care department and various specialized care units as a whole, so as to achieve the homogeneity of personnel training and team building. Specifically, doctors in the specialized care units of tertiary general hospitals can be required to receive systematic training in the intensive care department for no less than six months in a row to make up for the shortcomings in their knowledge structure, and young doctors in the specialized care units can also be considered to receive regular training in the intensive care department to understand the latest progress in critical care medicine, and after completing the training, they can be used as a reserve of critical care medicine professionals in the hospital. In the face of major emergencies, a mixed team of medical staff from the intensive care department and the intensive care unit of each specialty can be formed to ensure medical safety to the greatest extent while giving full play to the role of critical care medical reserve talents.

Whether in daily work or in major emergencies, critical care medical personnel play an active role in the treatment of critically ill patients. However, the team of critical care medicine professionals needs to be strengthened. The General Office of the Central Committee of the Communist Party of China and the General Office of the State Council issued the "Opinions on Further Improving the Medical and Health Service System", and the National Health Commission issued the "14th Five-Year Plan for the Development of Health Talents", both emphasizing the strengthening of the training of urgently needed professionals in critical care medicine and other fields. The "Opinions" put forward specific requirements for the construction of critical care medical talents. Medical establishments shall, in light of their own actual conditions, improve the construction of their own critical care medical personnel training system in accordance with requirements, and lay a solid foundation for the high-quality development of critical care medical disciplines.

Source: Official website of the National Health Commission