Referral to Surgery in Under 7 Hours: How Bidirectional Referral Wins the Golden Treatment Window

On the morning of June 15, 11-year-old Xiao Jin, suffering from persistent abdominal pain, visited the joint outpatient clinic of Shanghai Children's Hospital and Zhujiajiao People's Hospital accompanied by his family. Li Tingjun, associate chief physician in pediatrics and director of pediatrics at Zhujiajiao People's Hospital, conducted a careful examination and strongly suspected acute appendicitis, immediately activating the referral green channel and contacting Chen Feng, the on-duty attending physician in general surgery at Shanghai Children's Hospital. Because the two hospitals share medical records, repeated test requests and examinations were avoided; after arrival the child was confirmed to have acute appendicitis (pelvic position), and surgery was successfully completed at 3 p.m.

that day. From the initial visit and activation of the point-to-point green referral channel to admission and completion of surgery, the whole process took less than seven hours. Shanghai Children's Hospital now stations one associate chief physician at its Zhujiajiao outpatient department, with more than 10 specialists rotating through; in addition to general pediatrics it runs seven specialty clinics — TCM, child health care, gastroenterology, cardiology, otolaryngology, dermatology and surgery — so that children in surrounding areas can receive tertiary Grade A pediatric care close to home.