Meet Dr Xiaoquan Liu
After graduating from his master’s degree in 2005, Dr Xiaoquan Liu from the Paediatric Intensive Care Unit (PICU) at Xianyang Rainbow Children’s Hospital in China, has devoted his time to PICU clinical work for the past 15 years. He has worked successively in three hospitals in China: Xi’an Children’s Hospital, University of Hong Kong-Shenzhen Hospital and now Xianyang Rainbow Children’s Hospital. In December 2019, he successfully finished his one-month international observership in the PICU at Great Ormond Street Hospital for Children (GOSH), London. Today, he is sharing his observership experience at GOSH.
Why did you choose GOSH for an international observership?
During my 15-year’s of clinical work in PICU, I am always looking for opportunities to study abroad to further improve and break through my boundaries. Luckily, I managed to participate in the international observership programme at GOSH in 2019 with the support of my hospital and the British Embassy. Knowing that GOSH is one of the UK’s best children’s hospital and I had the chance to observe within the PICU, I applied for this programme without any hesitation.
Furthermore, the work experience I gained at the University of Hong Kong-Shenzhen Hospital enabled me to acquire a lot of knowledge about Hong Kong’s medical system. Considering Hong Kong’s system was based on the UK’s, I developed a strong interest in exploring the UK’s medical system and hospital management. I believed this observership opportunity would allow me to deepen my understanding of my previous work.
What was your main job responsibility? Was it in line with your expectations?
The one-month observership was far beyond my expectations. The academic atmosphere is very strong here. Various types of academic activities are organised even more frequently than Hong Kong’s hospital for example symposiums and seminars. Using flexible locations, exchanges could take place anywhere including offices and staff rooms. I also found that every lecturer was dedicated and treated every event very seriously, no matter its size.
Usually, we participated in a hand-over meeting at 8:15am and then visited the wards with the team at 9:00am. Following a timetable, we could either attend academic events or case discussion meetings in the afternoon. Real patient cases were reviewed and discussed in the meeting. The types of meetings were various covering multi-disciplinary meetings, imaging meetings and neurology meetings.
Among these, what impressed me most was the experience in the Clinical Simulation Centre at GOSH. The equipment and facilities here can truly imitate human vital signs. The scenes are very real, making the simulation training interesting and realistic.
What did you learn during the observership? Were there any differences in healthcare between China and UK?
I would say I harvested a lot from different aspects. First is about the overall medical management system. UK’s hierarchical medical system can efficiently divert patients and reasonably allocate its medical resources. Patients with mild conditions can be managed in community hospitals. For the tertiary hospitals, the consultants at GOSH could focus on patients with rare and severe conditions. With an efficient appointment booking system, we don’t see any crowed queues at this big hospital.
Due to the different national conditions between China and the UK, the doctors in the tertiary hospitals in China spend most of the time treating general conditions. The work is stressful because of the high volume of patients. However, China has started to develop an appointment system even though there are certain challenges. Moreover, GOSH owns near 400 beds and over 4,000 staff. The patient/doctor ratio is different between the two countries, which leads to further differences in observation and emergency responses.
Secondly, how GOSH manages its hand-over and ward-visiting also left me with a deep impression. In the PICU and CICU, the doctors and nurses sit together in the hand-over meeting. The doctors share updates in detail and discuss with the nurses what to do next, afterwards the nurses visit the ward. In China, the ward-visiting work is mostly conducted by the doctors instead of nurses. However, in my opinion, nurses are doctors’ eyes and it is extremely important to improve the nurses’ degree of participation.
Moreover, I am amazed by how complete and advanced GOSH’s facilities for diagnosis are which allows the hospital to provide comprehensive diagnosis checks for the patients and reduces the risk of misdiagnosis. I also noticed that portable MRI scanners are widely used at GOSH. I think it's a really good idea to use a mobile device like this to increase the utilisation rate of MRIs at the hospital.
Last but not least, I would like to emphasise children-centric cultural value and humanistic care at GOSH. From the hospital environmental planning, to the organisation of patient activities, the design of facilities for children, the interaction between nursing staff and patients in the ward or the efforts of thousands of volunteers, we can feel GOSH’s love and care for each family at all times. During the observership, I also visited the beautiful chapel inside GOSH, which records GOSH’s profound history and its respect for different faiths.
What are your plans when you return to China?
I have started to prepare my presentation for learning-sharing. When I go back home, I will share what I have observed and learned at GOSH with my colleagues. Although some differences are caused by national conditions and the process of change might take time, I think that there are some good concepts and methods that worth working on. I hope my own hospital and teams can start to implement some of these actions, step by step. I believe that our efforts will gradually bring us up to international standards.
Furthermore, I would highly recommend GOSH’s International Observership Programme to my peers without a doubt. I wish more and more paediatricians could come to GOSH and study its history, culture, and work here in person. Even though I have completed my observership, I will keep in touch with my supervisor Dr Joe Brierly and other team members, and definitely invite him to China when the opportunity arises.