between. Therefore, although the crowd is crowded, it is orderly and will not be trapped in a chaotic flow of people.
Across the emergency building, it is a tall building under construction. In the past ten years, there have been no surrounding residential areas for large buildings, and this high-rise building under construction is somewhat awkward. People passing by, look up from time to time to look at the green protective net. This is the translational medicine complex being built by Huaxi Hospital. Previously, this open space has been empty for ten years.
Beside the building, there is a large green tiled red wall with antique buildings and quiet surroundings. Here is the administrative building of Huaxi Hospital and Huaxi Medical College.
One of the offices on the third floor is still empty. This is the office of Shi Yingkang, the former president of Huaxi Hospital.
△Huaxi Hospital Administration Building. Photo by Tan Zhuo.
Say Huaxi, can’t get around Shi Yingkang
One day around 2010, Shi Yingkang, the dean of Huaxi Hospital and nearly 60 years old, pointed to the open space outside his window at his office on the third floor. He excitedly said to his colleagues: “This land can be covered later. Building, we Huaxi (hospital) 50 years later, there is still building space.”
Then, he pointed to another slightly dilapidated building in the distance, doing the gesture of moving backwards. “I will dig it later and move it (New) Go here.”
In that year, he was the dean of Huaxi Hospital for nearly 17 years. When he left office three years later, he was the longest-serving public hospital in China.
In that year, he may have predicted that Huaxi Hospital 50Meetings, mobilizing everyone to participate, can quickly implement decision-making.
It is rare that the combination of Shi Yingkang and Zheng Shangwei is not a directive, and the other is unconditionally obeyed. Both have an equal “complementary”.
When the educated youth, there is a fear of the world, not afraid of the ground, breaking the rules, the courage to try, this point is reflected in Shi Yingkang. He loves to learn, can widely absorb the knowledge of the outside world, and also requires subordinates to report external information and make suggestions.
A management team member of Huaxi Hospital who has been with Shi Yingkang for more than a decade recalled that on several occasions, Shi Yingkang came downstairs and drank: “How do you not work in this section?!” He replied “Shi Dean, Don’t talk about it, why don’t I work, I work every day.” Shi Yingkang replied: “Why don’t you give me the latest information?”
When any decision is discussed, Shi Yingkang is sometimes easy. Whenever he pulled away, Zheng Shangwei would “snap” back and forth ingeniously and quietly.
The above management recalled that in 2006, Huaxi Hospital was preparing to start performance reform. At that time, the performance system of public hospitals was backward. The wages of doctors and nursing staff, medical staff and administrative logistics personnel were quite equal, and they were completely unable to mobilize the enthusiasm of employees. However, because this reform is extremely complicated, involving the interests of dozens of departments and thousands of employees, it is the most complicated and dangerous beach in the deep water area.
The entire reform requires a series of complex processes that go through repeated calculations, formulation, piloting, adjustment, and then promotion, at least for a few years. When discussing the meeting, Shi Yingkang said, “We are carrying out performance reform this year…” Zheng Shangwei immediately added that Shi Dean meant “starting” performance reform. The change of a word reveals the complexity of performance reform and the characteristics that need to be step by step. In the end, the performance reform of Huaxi Hospital was completed from the start to the completion of the entire six years.
△ The open space that Shi Yingkang refers to, is building a translational medicine complexUnder the parking lot. Otherwise, the current Huaxi Hospital will be blocked.
After ten years in 2007, the plan was finally completed. Huaxi Hospital, which has expanded its scale in advance, has already harvested the dividends of public hospital development. When other hospitals realize this, it is too late to catch up. Fortunately, in the rising period of hospital development, Huaxi Hospital completed the performance reform and drug consumables procurement reform.
An expert who participated in the performance reform of Huaxi Hospital was very grateful. In that year, public hospitals were eating large pots of rice, and the salary of administrative staff and the salary of medical staff were almost the same; the salary of a department head and the head nurse was exactly the same. To open the income gap, it is bound to cause fierce contradictions. Fortunately, in the incremental period of reform, the income of employees will not decrease. On this basis, the income gap will be widened and the situation will be much milder.
Strong as Shi Yingkang, but does not advocate the rule of the people, but vigorously promote the system construction. In the preparation, the employees are divided into the internal and external staff, and the conditions stipulated by the system are not met. It is completely useless to find someone else; the same is true for performance reform.
The most difficult reform was in 2006, when the right to purchase consumables was collected, and it was decided by doctors and departments to be managed by the hospital. A director of the department who carried out the reform recalled that at that time, a consumable was supplied by a number of manufacturers. The big experts often used some kind of consumables that had been used for many years. If they were replaced with other consumables, even if they would save the whole hospital, they would save costs. There will be fierce opposition from the big experts. They are groups in hospital reform that are more difficult to manage than ordinary doctors. Even if the director of the department repeats his work, some experts are not reluctant. Finally, it was not until Shi Yingkang and Zheng Shangwei came out together that the reforms were completed with the help of rigid and soft, carrots and sticks.
The logistics manager recalled that the biggest feature of Shi Yingkang and Zheng Shangwei was “not selfish.” He has worked in logistics for many years and has never received these two people to say hello to any supplier. After working for more than 20 years, Shi Yingkang never brought him to see his daughter working in West China. “It’s clean, you have the confidence to speak, and the reform can be thorough.”
In 2007, the reconstruction of the main hospital area of Huaxi Hospital was completed. As the bed expanded to 4,300 sheets, it became the world’s largest single-point hospital. It was once placed at the cusp of the wind, and Shi Yingkang was also named as the “brick chief.” Some employees who felt that their interests were damaged during the reform were resentful and reported that Shi Yingkang continued. Some employees who have worked hard in the reforms are puzzled by the strategy of making a small amount of money for Huaxi Hospital. They feel that they have not paid the corresponding return, and their income has not been improved. I feel that I have become the ideal process of Shi Yingkang. Cannon fodder.
In 2009, the new medical reform startedmove. The previous medical reform was directly defined by the State Council’s research institute as “basic unsuccessful”, and the scale expansion of public hospitals was seriously criticized. The top management no longer emphasizes the marketization of hospitals. Some hospitals that want to continue to expand will be slowed down more or less unless they are supported by superiors like the Zhengda First Affiliated Hospital.
Even if the expansion of Huaxi Hospital came to an abrupt end in 2007, other reforms that support its subsequent development have already been laid out in advance. In 2000, the hospital’s informatization construction was carried out; in 2008, the regional first- and second-level hospitals were linked, and became the “medical community” pushed by the nation in 2019. At the time, the skeptics said that Huaxi Hospital had taken the lead in siphoning grassroots patients into Huaxi Hospital.
A person who went to Huaxi Hospital on February 1st, 2019.
Innovation: Discipline Construction and Operations Management Center
Since 2007, the scale of Huaxi Hospital’s expansion has stopped for 12 years. Even if it is still difficult to find a bed, 6,000-10,000 bed admission certificates per day, only one-fifth of the people can be screened and admitted to the hospital. The rest wait for half a month or even longer, and Huaxi does not continue to expand.
Even without any outside doubts, in the planning of Huaxi management, the scale expansion has reached the end of the time. In 2000, Shi Yingkang felt that the development of Huaxi Hospital has reached the point where it is necessary to continue to increase investment in scientific research. It requires the ranks of academicians and national key laboratories. It is not a long-term way to rely on clinical treatment of patients and earn some money.
The people of the Huaxi Hospital Reform Team recalled that they reached a consensus at the time: building a hospital is not like real estate, it can make money without building a house. To build a new department, you need to be equipped with doctors and nurses. You also need the support of the anesthesiology department and the laboratory, as well as administrative and logistics personnel. The cultivation of medical personnel is an extremely slow process. Blind expansion, without follow-up resources to keep up, medical quality is bound to decline.
In addition, Shi Yingkang has always insisted that hospital development should be condensed in discipline construction. When Huaxi Hospital started reforms in the late 1990s, in the predicament of limited resources, is it clinical or scientific research? Shi Yingkang is in charge of the public and insists on walking with two legs.
In 2000, he began to plan and build a scientific research building, recruiting doctoral students who specialize in scientific research, and leading the same salary as clinical medical staff. If he does not treat patients, he will conduct scientific research in the laboratory and have caused dislike of the special medical staff. .
In addition, Shi Yingkang has introduced medical talents from overseas. A professor who returned from the United States around 2008 recalled that Shi Yingkang strongly invited him back to Huaxi Hospital. Unlike other domestic hospitals that throw olive branches, Shi Yingkang’s 3.9 million yuan talent introduction fee was only 300,000 yuan. Residential, the other 3.6 million yuan is supported by research funding, used to establish laboratories and recruit laboratories. The professor was immediately impressed and quickly returned to China to establish a research laboratory.
He still remembers the scene of talking with Shi Yingkang: “People are extremely crisp and neat, only talk about the key points, not to mention the details. Because the details have already set a set of system standards for the introduction of talents in the first, second and third levels, I was then In line with the conditions of the first-level talents, the administrative department will implement various policies immediately.”
Although for a variety of reasons, this professor has only worked in Huaxi Hospital for three years, but the memory of the administrative department of Huaxi Hospital is completely new in scientific research and clinical practice.
Huaxi Hospital’s ability to treat incurable diseases was well known around 2010. The indicators are comparable to those of Peking Union Medical College Hospital. At that time, Shi Yingkang’s consideration was very simple. The people of Sichuan were very troublesome to go to Shanghai and Beijing. The cost was extremely high. Huaxi was the last hurdle of the entire western incurable disease.
Huaxi Hospital has long encouraged doctors to treat patients with intractable diseases and patients who are good for the development of the discipline. In the distribution of doctors’ performance, 80 gallbladder operations are similar to those for a liver transplant. In 2019, the number of incurable diseases in the third and fourth grades of Huaxi Hospital has reached 89%.
Huaxi Hospital has an innovation in the history of hospital management in China, which is to establish a hospital operation management team. The president of a public hospital in a southern province recalled the first visit to Huaxi Hospital ten years ago and was “very surprised” when he heard the concept of departmental management. In the process of managing public hospitals in the following years, he said: “The Operations Management Division of Huaxi Hospital is the secret weapon in the administrative management of Huaxi Hospital.”
The earliest experience came from Chang Gung Memorial Hospital in Taiwan.
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