Community hospital builds itself up into credible option

CHANGSHA -- The city of Liuyang in China's Hunan province is well known for its delicious steamed dishes that have high fat and salt.

Although tasty, their popularity among locals has led to a high incidence of strokes.

While the large hospitals in big cities are well equipped to treat patients requiring intensive care, the community hospitals in small cities sometimes have to refer patients to the big hospitals as they lack the resources to treat complications. To better serve its community, a hospital along the Hunan-Jiangxi border is trying to fill the gap.

In 2011, Jili Hospital, which has made a name for itself in the region for treating strokes and other neurological disorders, added a 15-bed intensive care unit (ICU) for neurological patients.

"In our work, it's a race against time," said Huang Pujia, a 36-year-old neurologist and neurosurgeon who has been with the hospital for 11 years. "When you are treating brain diseases, time is of the essence."

To speed up treatment, when a patient's family contacts the hospital, physicians collect basic information -- such as age and symptoms -- over the phone. Admitting physicians then wait for the patient at the arrival hall so medical tests can start immediately.

"The waiting time from the patient's arrival until he or she is placed in surgery is minimal," Huang said.

The ICU has advanced treatment methods like intravenous thrombolysis -- using medication to break down the clots formed in blood vessels, which could lead to strokes. The procedure can be done in less than 40 minutes. Huang said the fastest application was done in only 18 minutes.

A team of 10 doctors and 21 nurses work round the clock. Last year, the ICU treated over 900 patients, an impressive number for a community hospital.

A large number of patients are farmers from the surrounding areas. Huang said the staff takes pains to ensure they are not confused or even scared off by complicated medical jargon.

"I always take time to address their concerns and explain the illness using language they understand, for example, using farming metaphors," he said.

Liu Jialiang, a farmer from Jiangxi province, had a sudden brain hemorrhage at midnight. The local hospital did not have the means to perform a craniotomy, surgery that would require opening the skull, and sent him to Jili Hospital.

"Doctor Huang clearly explained the potential risks and benefits of the operation and we decided to have faith in him," Liu's son Liu Shenggao told Xinhua. "He saved my father's life."

Today, the community hospital also boasts a national-level stroke center recognized by China's state health authorities.

"We send our physicians to large hospitals for further education and training," said Chen Xiaoling, president of the hospital. "Huang Pujia has been sent twice to the most famous hospital in our province and taught our staff how to perform a craniotomy."

However, not everything has been easy. The growth has come at the expense of the staff having to shoulder severe work pressure, with little time for family life.

Huang, for instance, is often woken up at midnight when there is an emergency and his skills are needed.

His wife Wu Xiaohui, a nurse at the hospital, said: "Due to the high pressure and erratic hours, my husband has serious insomnia. As a wife, I feel really bad but as a colleague, I understand. We are engaged in a profession which is closely tied to people's lives."

One way of ensuring the community's health is by stressing the merits of prevention and a healthy lifestyle. The hospital works with the locals to teach them basic knowledge that can go a long way in preventing strokes and other diseases.

"We also teach locals how to identify and prevent illnesses in their villages," Chen said.