sovbooks Chapter 1468 - 588: A Death in Digestive Internal Medicine, Joining the Investigation
Chapter 1468 - 588: A Death in Digestive Internal Medicine, Joining the Investigation
"To understand the scope of work in the Quality Control Office, you must first know what we do. The hospital has two departments responsible for the control of medical quality: the Medical Department and the Quality Control Office. The Medical Department acts like a coach for medical staff and clinical departments. It provides guidance to clinical departments on how to perform specific diagnostic tasks and improve service quality."This kind of perspective was something Zhou Can heard for the first time.
However, on closer thought, the Medical Department does act somewhat like a coach. It not only helps clinical departments handle disputes between doctors and patients but also sets specific requirements in clinical operations, guiding medical staff to operate in compliance.
"Our Quality Control Office acts like a referee. We can evaluate and score the diagnostic situations of clinical departments, even down to individual patients. Whether the diagnostic tests ordered are comprehensive, the medication is reasonable, the surgical operations are compliant, and the quality of surgery and treatment meets standards—all these can be judged. Our first group comprises core members from various departments, including medical management, nursing, hospital infection control, medical engineering, information, logistics, medical technology, and pharmacy."
Previously, I only knew that the Quality Control Office was impressive, managing affairs extensively like a king.
Moreover, whenever clinical departments are penalized, they always obey submissively.
Now knowing that the first group of the Quality Control Office is a coalition of core members from many departments, Zhou Can finally understood why the Quality Control Office is so powerful.
In terms of rank, there is no question of who’s stronger between the Medical Department and the Quality Control Office.
However, in actual operations, the authority of the Quality Control Office is clearly far greater than the Medical Department.
Now I understand, its authority surpasses the Medical Department not because the office itself is higher-ranked, but because the members of the Quality Control Office are outstanding.
The head of the Medical Department is the Medical Director.
Looking at the members of the Quality Control Office, the director and leader of the first group is Qin Yuan’s Assistant.
If Dean Zhu weren’t too busy, the director might even be held by Dean Zhu himself.
Even so, Qin Yuan’s Assistant’s rank is a level higher than Director Xin of the Medical Department.
In the Quality Control Office, there are figures like Vice Dean Bai and Vice Director Ye—leaders at the hospital level. Any one of them could crush the Medical Department decisively.
It is not difficult to discern from Qin Yuan’s Assistant’s words that each member of the first group in the Quality Control Office is a significant figure.
Zhou Can has managed to join this first group, which allows him, in future work, the opportunity to meet other group members and expand his network. And since he gets to know figures within the hospital, these connections will prove extremely useful.
"Remember, the Quality Control Office isn’t a no-nonsense overseer. We must conduct our work appropriately. Clinical departments naturally view us with hostility; too frequent checks can easily lead to rebellion. Therefore, our approach must be balanced."
After formally inducting Zhou Can into the Quality Control Office, Qin Yuan’s Assistant began teaching him important work considerations.
"We focus our checks on several categories: patient death during treatment, post-surgical patient death within a short period, multiple patients complaining about the same doctor within a short time..."
"Understood."
Zhou Can nodded in agreement.
"The Quality Control Office generally conducts decentralized operations. Problems arise anywhere, and we fight wherever they occur. You are a doctor in the clinical department, usually not tasked to work alone, except when preliminary identification of medical responsibility or for examining key patients, you may be called for support. I know that your usual workload is already very heavy. Have you truly considered not taking on administrative duties for a few more years?"
Towards the end of the conversation, Qin Yuan’s Assistant persistently inquired again with a caring tone.
"I won’t reconsider. With your trust, I certainly cannot let you down. I am still young, and I can continue enduring by gritting my teeth a bit more."
With significant support from two vice deans, Zhou Can finally secured this position, so he naturally wouldn’t want to give it up.
"Very well, go ahead and focus on your work. You will be notified via phone when there’s a task."
Qin Yuan’s Assistant ceased further persuasion.
...
Upon returning to the Emergency Department, the hospital had already issued a notice about his new appointment.
Director Lou, Deputy Director Han, and others were quick to congratulate Zhou Can.
Having someone in the Quality Control Office is indeed beneficial for the Emergency Department.
It’s easier to conduct business with someone in authority in the administration.
Although Dr. Xu didn’t say anything, it was clear he was equally pleased.
Colleagues in the operating room clamored for Zhou Can to host a banquet; such a grand occasion naturally calls for celebration.
Zhou Can couldn’t refuse.
It’s also a chance to foster good relations with everybody.
He arranged two tables at the hotel, inviting all the medical and nursing staff from the operating room for a meal. For those on duty unable to come, Zhou Can ordered abundant takeaways for them.
That night, upon returning home, Su Qianqian was thrilled to learn of his promotion.
In the middle of the night, when he was sleeping peacefully, Zhou Can was woken up by a ringing phone.
Groggy, he answered.
"Hello!"
"Dr. Zhou, please come to the Digestive Internal Medicine as quickly as possible; a patient has unexpectedly died, and you are needed to see to it."
The voice belonged to Qin Yuan’s Assistant.
Zhou Can jolted awake, quickly got dressed, and rushed to the hospital.
This was his first involvement in handling a death incident after becoming a member of the Quality Control Office.
No matter what the cause, any in-hospital patient death must be promptly reported to the Medical Department.
Life is paramount, especially in hospitals.
The Medical Department acts as the coach for clinical departments. Upon receiving a notification of patient death, they promptly send personnel to secure various materials and evidence and conduct preliminary investigation of the event’s cause.
However, the Medical Department’s words aren’t final; the Quality Control Office must be involved in assessments too.
The absence of a referee makes the process incomplete.
Zhou Can shares a profound connection with the Digestive Internal Medicine, having spent a lengthy training period there in the past.
Unexpectedly, his first involvement in a death cause review after joining the Quality Control Office happens in the Digestive Internal Medicine.
When he arrived at the Digestive Internal Medicine department, the atmosphere was very solemn.
The family members were grief-stricken, and the faces of two male relatives were full of anger.
After a patient’s death, most family members rarely have a pleasant expression.
Understanding family members will follow the hospital’s requirements to have a hearse transport the body to the funeral home.
More troublesome family members might cause quite a commotion.
It may even lead to destruction at the hospital and assaults on medical staff.
Late at night, there are few medical staff on duty, making handling post-mortem procedures more difficult.
The Medical Department sent only one deputy director, which is already considered quite a high rank.
From Quality Control, four people in total arrived: Assistant Qin, along with two unrecognized people, a man and a woman.
"Let me introduce you; this is Director Ju Shiman from the Nursing Department, and this is Director Liu Shiqiu from the Infection Control Office. Director Liu used to work in Internal Medicine and has rich clinical experience in Internal Medicine." After introducing their identities, Assistant Qin looked at Zhou Can. "This is Zhou Can from the Emergency Department, the deputy team leader of the operating room."
Currently, Zhou Can’s notable clinical position seems to be only the deputy team leader of the operating room.
"The patient suddenly vomited a large amount of blood half an hour ago, convulsed, and died despite resuscitation efforts. We asked you to come because the family has doubts about the hospital’s quality. The three of you are to investigate the patient’s care and treatment during hospitalization. As for the specific cause of death, if the family is unsatisfied, they can apply for forensic identification."
Assistant Qin briefly explained the situation.
Human death is significant, and generally, few family members want to proceed with forensic identification since it requires dissecting the body.
Moreover, large hospitals like Tu Ya generally have intricate connections with identification agencies.
Unless there’s an obvious major mistake, the identification results are generally more favorable to the hospital.
Whether to maintain the stability of the current medical environment or for other interests, identification agencies are usually quite friendly to hospitals.
The deceased’s body has not been dressed yet because it was an unexpected death at midnight; caregivers and mortuary workers were resting.
It will probably take some time for them to come over and handle the situation.
Zhou Can noticed the patient had a urinary catheter, indicating special treatment was done shortly before death.
At this moment, Director Shang of Digestive Internal Medicine also arrived at the scene.
The patient’s attending doctor should have also arrived, but considering the family’s strong emotions, they chose not to appear.
This is understandable.
To protect the involved doctors, the hospital wouldn’t easily let doctors meet with the family. Even if negotiations are needed, the Medical Department will lead negotiations with the family.
The patient’s abdomen was visibly swollen, but the body was extremely thin.
Firstly, the patient is male, so pregnancy is basically ruled out.
If the abdomen is swollen, it might be gas, or it could be constipation.
"Once you three have understood the situation, proceed to the meeting room to participate in the discussion," Assistant Qin signaled.
"Understood."
The other two were veterans, experienced, and quickly grasped Assistant Qin’s instructions.
Zhou Can was a newcomer but not foolish.
Many things can’t be discussed in front of family members. Doctors close the door to discuss, arrive at conclusions, and then the leaders provide treatment opinions. Finally, the Medical Department, specializing in resolving doctor-patient disputes, communicates with the family to resolve the issue.
Morgue workers soon arrived, someone persuaded the family away and began placing the body in a bag.
Due to the dispute, appearance tidying was generally not done.
The family watched nearby, not allowing the body to be moved.
The deceased patient was young, probably not over forty years old. It’s uncertain whether he had a wife and children; in any case, there was no middle-aged woman crying very sorrowfully at the scene.
Only one elderly lady with white hair was crying profusely.
An old man was beside her, supporting her.
They are likely a couple.
Their looks have some similarities to the deceased’s, likely to be the deceased’s parents.
Seeing a white-haired person sending off a black-haired person, the scene inevitably felt distressing.
Zhou Can took off his gloves, tossed them into the trash, then headed to the meeting room.
Assistant Qin was the most senior in the meeting room, sitting at the head position, with the vice head of the Medical Department sitting beside him.
Director Shang from Digestive Internal Medicine, along with three doctors and two nurses, sat separately on the other side.
Basically, now these people accepted the investigation from the administrative department, informing the Medical Department and Quality Control to clarify the patient’s cause of death and define responsibility.
"Have you three finished investigating?"
Assistant Qin invited Zhou Can and the others to sit.
"Pretty much done."
The three sat in the vacant seats to Assistant Qin’s left side.
This was also Zhou Can’s first time facing Director Shang and others from an administrative leadership perspective.
"Director Ju, does the patient’s care have issues?"
Assistant Qin inquired of Director Ju Shiman from the Nursing Department.
"Hmm... there are basically no major issues with medication, but the urinary catheter might not have been handled properly."
Her words caused the faces of Director Shang and others across the room to change slightly.