FTC2019 | Innovation, Affordability, and Public Welfare: How Gaozhou People's Hospital Built a Nationally Leading Cardiovascular Surgery Department

Located in the economically underdeveloped western Guangdong region, Gaozhou People's Hospital performs over 1,000 cardiac surgeries annually, effortlessly handling various complex and high-difficulty procedures. How has its Department of Cardiovascular Surgery achieved this?

On November 9, 2019, at the inaugural FTC 2019 China Forum on Frontier Technologies in Cardiac Surgery, Professor Cao Yong, Director of the Department of Cardiovascular Surgery at Gaozhou People’s Hospital, delivered a presentation titled “Staying True to Our Original Aspiration and Forging Ahead: Development Practices of the Department of Cardiovascular Surgery at Gaozhou People’s Hospital.” VCBeat has compiled and edited the highlights of his presentation.

Professor Cao Yong, Director of the Department of Cardiovascular Surgery, Gaozhou People's Hospital

Gaozhou People's Hospital, located in the mountainous region of western Guangdong Province, is a county-level public hospital. Its predecessors were Maoming County Public Hospital, established in 1927, and Guangnan Hospital, founded in 1947. It has since developed into a modernized Grade III Class A general hospital integrating medical care, scientific research, teaching, and disease prevention. The hospital has 2,600 authorized beds, 26 first-level disciplines, 45 second-level disciplines, and 52 clinical departments. It achieved the national healthcare reform goal of "treating serious illnesses within the county" four years ahead of schedule.

In the “2018 China Hospital Competitiveness · Top 100 County-Level Hospitals” ranking, Gaozhou People’s Hospital was ranked second. In December 2018, the hospital was designated as a pilot institution for establishing and improving modern hospital management systems, becoming the only county-level hospital in Guangdong Province included in the national pilot program.

The Department of Cardiovascular Surgery at Gaozhou People's Hospital, established in 1978, enjoys an outstanding reputation not only locally in Gaozhou but also throughout western Guangdong, where it is widely acclaimed that “seeking treatment for heart disease at Gaozhou People's Hospital is equivalent to receiving care in Beijing.” The department is also renowned nationwide, with 80% of its patients coming from outside Gaozhou.

The cardiovascular surgery system at Gaozhou People's Hospital has been progressively refined, comprising three surgical wards with its own operating rooms and Department of Anesthesiology. It has established specialized units including Vascular Surgery, the Extracorporeal Life Support Center, the Cardiopulmonary Bypass Department, and the Cardiovascular Surgery ICU. The volume of surgeries performed by the department ranks among the highest in Guangdong Province, with 1,812 procedures conducted in 2018.

In recent years, the department has performed a large number of highly complex surgeries, such as radical arterial switch operation, radical repair for pulmonary atresia, cone reconstruction of the tricuspid valve, rheumatic mitral valvuloplasty, MORROW procedure, off-pump sequential coronary artery bypass grafting, repair of ventricular septal rupture, and interventional closure of congenital heart defects. The oldest patient was 86 years old, while the youngest surgical patient was only 4 days old and weighed 1.3 kilograms.

Professor Cao Yong believes that there are several reasons supporting the continuous advancement of the Department of Cardiovascular Surgery at Gaozhou People's Hospital:

Powered by Technological Innovation.The Department of Cardiovascular Surgery at the hospital adheres to a flexible talent acquisition philosophy of “talent need not be exclusively employed by us, but should be utilized by us.” It regularly sends staff for external training and invites domestic and international experts to deliver lectures. The department has appointed Professor Meng Xu and Professor Chen Xinxin as distinguished experts, who visit monthly to conduct specialist outpatient clinics, provide clinical teaching, and offer surgical guidance. In recent years, the department has introduced more than 40 new techniques and procedures, significantly enhancing its overall capabilities.

Guided by the principle of affordability.In 1927, Mr. Chen Jitang founded Gaozhou People's Hospital with the original aspiration of “building a hospital for the common people.” Over the years, the Department of Cardiovascular Surgery has been committed to reducing costs and alleviating the financial burden on patients, thereby practicing the concept of an “affordable hospital.” The cost of major surgeries in the department is relatively low, approximately half that of hospitals in the provincial capital, with a clinical pathway implementation rate of 55%. Furthermore, the department adheres to rational drug use, prioritizes affordable medical supplies, and restricts the use of imported materials. In 2018, the average length of stay for patients in the department decreased by 1.7 days, resulting in reduced hospitalization costs.

"Taking public welfare as our responsibility."The Department of Cardiovascular Surgery at the hospital has consistently organized the "Summer Public Welfare Heart-Saving Month." From 2013 to the present, seven consecutive sessions have been held, cumulatively providing curative cardiac surgery to 2,102 children from impoverished families with congenital heart disease across China, and waiving medical fees totaling RMB 18.35 million. In addition, the department launched the "Guangdong-Tibet Heart-to-Heart" public welfare initiative in Gaozhou, performing cardiac surgeries for children with heart disease in Tibetan regions. Furthermore, the department has engaged in various other public welfare activities, including free clinical consultations in rural areas, postoperative follow-up visits for children with congenital heart disease in rural communities, physical examinations for children in welfare institutions, free postoperative re-examinations for patients with congenital heart disease, and health check-ups for the elderly in nursing homes.

Learn from the Spirit of Norman Bethune.The Bethune spirit embodies great internationalism and communism, characterized by enthusiasm for work and the pursuit of excellence. The Department of Cardiovascular Surgery has consistently upheld the Bethune spirit and established ties with the Canadian Bethune Medical Development Association. The department’s physicians created WeChat health groups to enhance public awareness and capabilities in disease prevention. Additionally, the department provides ECMO services for both adults and children, including mobile ECMO transport. Committed to mastering new technologies and continually tackling complex surgical challenges, the department performed the first cardiac surgery on an HIV-positive patient in a county-level hospital in China. It has also successfully carried out high-difficulty procedures such as the Arterial Switch Operation, radical correction of pulmonary atresia, Bentall procedure combined with Sun’s procedure, and ECMO.

Professor Cao Yong stated that he hopes the Department of Cardiovascular Surgery at Gaozhou People’s Hospital will establish valvuloplasty for rheumatic heart disease as a technical brand, become a regional center for the treatment of aortic dissection, perform more minimally invasive cardiac surgeries such as thoracoscopic surgery, robotic surgery, and TAVI, build a heart failure treatment center, and carry out procedures such as heart transplantation.