The National Clinical Key Specialty Construction Project in 2022 of the Emergency and Critical Care Department of Shanghai General Hospital Gets Approval

Link of the original article:https://mp.weixin.qq.com/s/NLOvAf-WIDVYV4-owKDzcg

Recently, the National Health Commission and the Ministry of Finance of the People’s Republic of China issued the Implementation Plan of the Medical Service and Guarantee Capacity Improvement (Capacity Building of Medical and Health Organizations) Project. The Emergency and Critical Care Department of our hospital successfully passed the review and its National Clinical Key Specialty Construction Project in 2022 successfully got approval.

The Emergency and Critical Care Department of Shanghai General Hospital is one of the few units integrating emergency and comprehensive ICU in Shanghai. The department effectively integrates superior resources and talent teams, breaks the bottleneck of treatment of critically ill patients, improves their treatment efficiency, and deeply practices a series of advanced concepts including early intervention of the critical care team, organ function protection in the whole life chain and early rehabilitation, and family care. Under the leadership of Professor Wang Ruilan, Director of the department, after construction and development of more than a decade, the department became a key discipline of the hospital (plateau discipline), an important weak discipline of the health and family planning system in Shanghai, and a key discipline of public health construction in Shanghai. It won a series of honors including “Women’s Civilized Position of All-China Women's Federation”, “Shanghai Advanced Collective Fighting against COVID-19”, and “National March 8th Red Flag Collective”. This time, it won the title of National Clinical Key Specialty again and gradually became leading in the discipline in Shanghai.

Currently, the department is the post-doctoral scientific research workstation of Shanghai Jiao Tong University School of Medicine, the doctor/master station of Shanghai Jiao Tong University School of Medicine and Nanjing Medical University, the Standardized Training Base for Resident Doctors of Emergency Nationwide and in Shanghai, the Standardized Training Base for Specialized Physicians, the National Standardized Training Base for Specialized Physician of Critical Care Medicine of Internal Medicine Department/Surgery Department, Clinical Practice Base of Emergency Medicine of University of Toledo, Clinical Teaching Demonstration Base of Shanghai Jiao Tong University, Excellent Teaching Team of Shanghai Jiao Tong University, and “National Key Professional Base” of the National Standardized Training for Resident Doctors.

The key diseases of the discipline mainly include difficult and critical diseases including multiple organ dysfunction syndrome, severe pneumonia, sepsis, severe multiple injuries, severe pancreatitis, and high-risk pregnant and lying-in women. The emergency department receives 460,000 person-times per year and the comprehensive ICU receives more than 2,000 critically ill patients (person-times) per year, including about 200 patients of severe pneumonia, about 250 patients of sepsis, and about 80 high-risk pregnant and lying-in women per year. It has become a regional critical care center, diagnosis and treatment center of difficult and complicated diseases, and precision medicine center in the south and northwest of Shanghai. It led the establishment of the Emergency Alliance of the Area around Tai Lake and the Emergency and Severe Disease Treatment Alliance of the Yangtze River Delta, promoting the overall raising of the level of treatment of emergency and severe diseases in the Yangtze River Delta. In the area of treatment of severe viral pneumonia, the department has significantly increased the success rate of treatment through early identification, precise intervention, and innovative bundle management. It has been widely promoted in the Yangtze River Delta and nationwide. It won the first prize of the Shanghai Medical Science and Technology Award in 2022. The department has significantly decreased the treatment time and increased the success rate of rescue for special and dangerous people with the difficult disease of “upper gastrointestinal hemorrhage” by leading the new mode of integrated emergency ICU and MDT. It won the title of the National Dangerous Gastrointestinal Hemorrhage Treatment Demonstration Center (5-star). The number of ECMOs performed in the department is leading in Shanghai. ECPR is a routine program. It has become the Southwest Organ Function Support Center in Shanghai. The department also developed the integrated trauma treatment model led by the Emergency and Critical Care Department, became the first to create the 5G ambulance and chief coordinator system, and vigorously developed air rescue. Currently, it is the Shanghai Acute Trauma Emergency Center, one of the first batch of National Joint Pilot Hospitals of Medical Rescue of Aviation, and Shanghai Critically Ill Pregnant and Lying-in Woman Emergency Center. It created an excellent result of a success rate of 100% in the treatment of high-risk pregnant and lying-in women for five consecutive years.

The department focuses on the development and training of key core technologies. It won the titles of Bedside Ultrasound Monitoring Center of the Shanghai Emergency ICU Quality Control Center, the Mechanical Ventilation Training Center of the Critical Care Branch of Shanghai Medical Association, and the Core Skill Training Base of Emergency and Severe Disease in Shanghai. Since 2009, the department has organized the national continuing education programs for 13 consecutive years, including Study Class for Basic Life Support of Critical Illness, Training Class for Practical Skills of Ultrasound of Severe Illness, and Training Class for New Technologies of Extracorporeal Membrane Oxygenation. It held “First Aid Forum of Trauma in the Area around Tai Lake”, “Alliance Forum of Critical Illness in Yangtze River Delta”, “Gongji Summit Forum of Critical Illness”, etc. It has a good reputation in the Yangtze River Delta Area.

At the beginning of its establishment, the Emergency and Critical Care Department paid attention to emergency capacity building and successfully handled multiple major emergency events. In 2009, the department successfully treated the first severe case of Influenza A H1N1 in Shanghai; in 2014, it established the hierarchical emergency disposal model in the hospital; and from 2022 to 2023, the department worked together to protect Shanghai. At the same time, as the Expert Group of the National Joint Defense and Control Mechanism and the COVID-19 Treatment Expert Group in Shanghai, it sent people to support the anti-epidemic work in different places and won the title of "Advanced Collective Fighting against COVID-19 in Shanghai".In the last 5 years, the department obtained 17 national projects including Key/Major Projects of the Ministry of Science and Technology of the People’s Republic of China and the National Natural Science Foundation of China, and more than 60 department-level and bureau-level projects. It has published more than 100 SCI papers. It has been accumulatively cited for about 1,200 times in the most influential journal Circulation (IF 23.602). It obtained 6 domestic invention patents, 7 utility model patents, and 3 software copyrights. It has edited and co-edited 10 monographs and 11 expert consensuses. The department has established the clinical drug trial base and evaluation center of emergency and critical care, specialized disease cohort database and biological sample bank (severe pneumonia and sepsis), and the critical care information system. It has led 7 multicenter clinical researches and participated in more than 40 international and domestic multicenter clinical researches. It obtained multiple talent programs including Shanghai Leading Talent and Sailing Program.

Correspondent/Emergency Critical Care Department Lu Jian