Kaohsiung Veterans General Hospital

The Artificial Intelligence Severe Sepsis Early Warning System： Kaohsiung Veterans General Hospital has introduced the nation's first AI system utilizing a machine learning model to predict patients' risk of developing severe sepsis, providing timely alerts and decision support to medical professionals.

Regarding its effectiveness, since its implementation in 2017, this system has led to remarkable improvements in various care indicators for severe sepsis patients. The execution rate of lactate measurement within one hour of admission increased substantially from 45.4% to 50.6%. The rate of measuring the second lactate level within six hours of admission rose from 67% to 86.6%. The rate of blood culture before antibiotic administration increased from 54.8% to 63.7%. The antibiotic administration rate within three hours improved from 47.3% to 49.8%. Additionally, the execution rates of rapid fluid resuscitation and vasopressor administration within one hour of the first hypotensive event increased by 4% and 79.2%, respectively, ensuring timely and appropriate treatment for patients.

This system has not only enhanced the quality of medical care but also yielded significant economic benefits. The average length of hospital stay decreased by 1.6 days, resulting in an annual cost savings of NT$107 million for the hospital. Furthermore, the patient mortality rate declined from 24.8% to 23.3%, potentially saving 27 precious lives each year. Kaohsiung Veterans General Hospital's innovative efforts have received widespread recognition from the domestic and international medical communities, garnering multiple awards in medical quality competitions and media coverage.

Innovative smart early warning system：This system is the first in Taiwan to feature continuous real-time light alert reminders in both the physician information management system and medical record writing system. Additionally, it is the pioneering system to incorporate continuous real-time color-coded name alerts for high-risk patients in the nursing bedside information system. Furthermore, the system utilizes an artificial intelligence model to predict the risk of in-hospital cardiac arrest (IHCA) for admitted patients, providing decision support.

In terms of effectiveness, since its launch in 2015, the system has successfully reduced the incidence rate and density of IHCA within the hospital. Data from 2013 to October 2021 shows a significant 32% decrease in the IHCA incidence rate and a 40% reduction in IHCA density across the entire hospital, excluding the ICU. Moreover, the system adopts a simplified indicator concept, allows for a lucid representation of key metrics such as mortality rates, facilitating continuous monitoring and improvement efforts.

In conclusion, Kaohsiung Veterans General Hospital's Smart Early Warning System has spearheaded medical technology innovation. Through the integration of artificial intelligence and continuous alert mechanisms, front-line medical professionals can promptly detect changes in patient conditions, significantly reducing medical risks and safeguarding patient safety. This achievement underscores Kaohsiung Veterans General Hospital's leading position in the digital transformation of healthcare.

Personalized medication recommendations and dosages：Our hospital has implemented several innovative measures to enhance patient medication safety and efficacy by providing personalized medication recommendations and dosages.

The following are some noteworthy initiatives:

Firstly, we have launched an "Intelligent Medication Evaluation System" that comprehensively assesses physicians' prescriptions based on individual patient profiles such as renal function, body weight, and concurrent medications. The system automatically provides personalized medication recommendations and dosage adjustment suggestions. This system processes approximately 6,000-7,000 prescriptions monthly, with an average physician acceptance rate exceeding 92%.

Furthermore, for high-risk medications like antibiotics and chemotherapeutic agents, we have established multiple protective mechanisms, including automatic dosage input, pharmacist review platforms, and medication monitoring. Take antibiotics for example ,our hospital's innovative intelligent antibiotic system has significantly enhanced the appropriateness and efficiency of antibiotic use. Research data show implementation of the system nearly halved the time to appropriate antimicrobial therapy, especially during off-hours, in medical wards, and for gram-negative bacteremia cases. Furthermore, it has significantly lessened the workload of infection control personnel, saving them around 30 minutes per day. Review turnaround times also vastly improved, ensuring that patients receive effective antibiotics in a timely manner. Moreover, the system's streamlined multi-drug resistant organism reporting is projected to save the hospital over NT$76,000 annually in isolation gown costs alone. This pioneering system has not only garnered multiple prestigious national healthcare quality awards but also secured patented status, underscoring its outstanding contributions.

Furthermore, for high-risk medications like antibiotics and chemotherapeutic agents, we have established multiple safeguards, including automatic dosage input, pharmacist review platforms, and medication monitoring. Take antibiotics for example - the system incorporates patient renal function, weight, and indications to recommend optimal dosages to physicians, effectively reducing the risk of inappropriate medication usage.

We have implemented a comprehensive "Pharmaceutical Service Integration Platform" that covers the entire process from medication evaluation and prescription review to medication monitoring. The intelligent system evaluates medication safety based on patients' physical conditions and concomitant medications, providing personalized dosage recommendations and monitoring plans for physicians. This has significantly reduced the risk of inappropriate prescribing, such as decreasing the rate of inappropriate medication usage for patients with multiple chronic conditions by 11.1%.

Furthermore, we strive to enhance patient medication adherence. We have developed a "Medication Reminder App" that connects patients' smartphones to medication QR Codes, sending timely reminders and tracking medication intake and therapeutic effects. We also provide multilingual medication instructions to assist patients from diverse cultural backgrounds in properly taking their medications.

In summary, leveraging innovative technologies, we tailor medication regimens for every patient, comprehensively monitoring and optimizing their medication therapies to maximize safety and improve the quality of care. We are committed to continual improvement, contributing our to the establishment in building a smart healthcare system.

Intelligent Controlled Substance Management Platform：Upholding an innovative mindset, we have developed the "Intelligent Controlled Substance Management Platform" that integrates advanced information systems with automated processes to safeguard patient medication use. It strictly controls drug dispensing, effectively reducing risks and ensuring that the public receives safe and high-quality medical services.

Since its implementation in 2019, the "Intelligent Controlled Substance Management Platform" has demonstrated outstanding performance. Through automated system operations, it maintains full control over the inventory and distribution of controlled substances, preventing human errors. After regular inspections by health authorities, our hospital's actual inventory and theoretical inventory of controlled substances have consistently maintained zero discrepancies, fully exhibiting the effectiveness of our rigorous management. This system also won the Gold Award at the 2019 Kaohsiung International Invention & Design Expo.

Our medical team adheres to the highest medical practice, remaining vigilant and continually evolving by embracing innovation to improve healthcare quality. We aspire for the "Intelligent Controlled Substance Management Platform" to become a robust guardian of patient medication safety, allowing the public to seek medical treatment with peace of mind, and establishing our hospital's leadership position as a truly smart hospital. We will continue to serve the public wholeheartedly and uphold the patient-centric philosophy in medical care.

CT-DVT(Deep Vein Thrombosis)：As a modern healthcare institution, we are dedicated to harnessing cutting-edge technologies to enhance the accuracy of disease diagnosis, thereby delivering superior treatment outcomes and quality of life for our patients. Tackling the critical issue of deep vein thrombosis (DVT), we have successfully implemented an advanced " CT-DVT(Deep Vein Thrombosis)" decision support system, significantly elevating diagnostic precision and efficiency.

DVT is a highly insidious condition that, if left undetected and untreated, can lead to severe complications such as life-threatening pulmonary embolism, posing grave health risks to patients. Traditional diagnostic methods, including clinical symptom observation, laboratory testing, and ultrasound examination have their limitations, making it difficult to accurately pinpoint the location and extent of clots, resulting in missed or delayed treatment in some cases.

To overcome these challenges, we have introduced state-of-the-art multi-detector computed tomography (CT) scanning technology for DVT diagnosis. This state-of-the-art imaging diagnostic tool offers numerous advantages: high-resolution CT images clearly depict minute clots; rapid scanning reduces examination time and improves efficiency; non-invasive testing mitigates risks, comprehensive scanning helps detect occult thrombi; 3D reconstruction provides an intuitive visualization of clot location. Collectively, these features inform sound clinical decision-making.

The implementation of the CT Venography for Deep Vein Thrombosis system marks a significant stride forward in our DVT diagnostic capabilities. By utilizing this advanced imaging decision-support tool, we can promptly and effectively identify potential DVT risks, tailor more precise treatment plans for patients, significantly improve treatment outcomes, reduce complication risks, and empower patients to regain their health and well-being.

We remain committed to continuously introducing advanced and applicable innovative medical technologies, elevating our clinical standards to deliver superior, patient-centric healthcare experiences. As technology progresses, we eagerly anticipate the advent of even more groundbreaking innovations that will benefit our patients, and we will tirelessly strive toward this better future.

Comprehensive Disaster Reporting System：Kaohsiung Veterans General Hospital upholds the core values of medical care, prioritizing patient safety above all else. To provide a reassuring medical environment for the public, the hospital has established a comprehensive disaster reporting system to monitor disaster situations in real-time. Through rigorous disaster prevention mechanisms and response processes, resources are swiftly mobilized to address emergencies, fully safeguarding patient rights and interests.

In 2023, the hospital was awarded the National Sustainable Development Award, a testament to the remarkable effectiveness of its disaster reporting system. Last year, the hospital executed typhoon response measures three times, efficiently handling 32 reports during Typhoon Doksuri, 49 reports during Typhoon Haikui, and 22 reports during Typhoon Koinu through the system. All response and recovery efforts were completed according to standard procedures, effectively protecting patient safety. During the preparation phase, units can report situations in advance through the system, highlighting potential risks. The hospital then promptly allocates resources to reinforce protective facilities. When disasters occur, personnel are immediately dispatched to handle reported incidents.

The staff of Kaohsiung Veterans General Hospital work wholeheartedly to serve the public. We will continue to improve and enhance our smart healthcare capabilities, strengthening the disaster reporting and response mechanisms. Our goal is to create a truly intelligent and caring medical center, providing the public with the highest quality and most attentive medical care, thus realizing the vision of becoming a premier smart hospital.

Holistic Smart Healthcare System：Kaohsiung Veterans General Hospital strives to provide holistic, patient-centered medical care through interdisciplinary collaboration and the utilization of smart technology systems to deliver personalized, comprehensive healthcare services. We have developed the "Holistic Smart Healthcare System" to integrate medical resources, gather insights from experts across various fields, and devise the most appropriate treatment plans based on patients' conditions. This approach comprehensively improves medical quality and effectively safeguards patient rights.

Since its implementation, the "Holistic Smart Healthcare System" has yielded remarkable results. To date, 1,496 holistic case conferences have been initiated, averaging approximately 18 per month, spanning 25 departments. These conferences bring together four or more different healthcare professionals, including physicians, nurses, pharmacists, and nutritionists, accounting for 90% of the participants. Through an interdisciplinary collaborative model, comprehensive assessments and discussions are conducted for each case, leading to the development of integrated treatment solutions.

Concurrently, the system emphasizes communication and interaction with patients and their families by actively inviting them to participate in the conferences and share in medical decision-making. The participation rate has reached 61%, with a satisfaction rate of 93%, demonstrating a positive and trusting relationship between healthcare providers and patients. Through these holistic case conferences, various challenges faced by patients and their families, such as medical (28.4%), nutritional (17.7%), post-discharge care/placement (17.4%), and medication (11%) issues, can be effectively addressed, leading to reduced hospital stays and the prevention of medical disputes.

Utilizing smart systems and interdisciplinary collaboration, we provide holistic patient care, enhancing mutual trust and satisfaction between healthcare providers and patients. Continuously innovating to develop a warm, safe, high-quality smart healthcare hub.

Intelligent Nursing System：Our hospital has implemented the Intelligent Nursing System, integrating electronic systems and restructures workflows to achieve a paperless operation goal. This provides seamless and high-quality nursing services for patients. On one hand, it ensures patient safety and enhances the quality of clinical care; on the other hand, it simplifies nursing workflows, reduces workloads, improves the nursing practice environment, and promoting the health and well-being of both patients and nursing staff.

From 2020 to 2023, our hospital successfully maintained zero instances of physical restraints and kept the pressure injury rate below 0.06%. Additionally, our pain control achievement rate for cancer patients exceeded 90%, and the nursing guidance rate for "low white blood cell count" for first-time chemotherapy patients reached over 99%, exhibiting exceptional nursing quality. Simultaneously, the inpatient satisfaction rate with nursing care reached 98%, and the nursing record audit pass rate was 100%, a testament to the platform's success in ensuring patient and nursing safety and quality.

The Kaohsiung Veterans General Hospital medical team will continue to refine and optimize the Intelligent Nursing System through smart technologies and process re-engineering to provide safer, more humanized, and higher-quality medical services to the public. We prioritize a patient-centric approach and implement lean management principles.

Patient-safety Reporting system：Patient safety is a core value that is indispensable for healthcare institutions. To ensure medical quality and prevent potential risks, our hospital has established a comprehensive "Patient-safety Reporting system" to comprehensively monitor and actively improve various abnormal incidents that may affect patient safety.

The system features automated functions, capable of proactively recording various abnormalities and color-coded classification based on their severity. It tracks the progress of abnormality handling through a systematic management process. Simultaneously, the system categorizes abnormalities for enhanced efficiency in management. Medical staff can easily complete abnormality reporting and tracking with simple operations, significantly improving the timeliness and convenience of abnormality management.

Since its implementation, this system has played a significant role in maintaining patient safety. The reporting rate of abnormal incidents has increased notably, allowing for comprehensive analysis of the root causes of abnormalities and promptly improvements, effectively preventing the recurrence of similar abnormalities. Furthermore, the rich data generated by the system provides crucial insights for management to grasp the safety status and identify high-risk areas within the hospital, facilitating the formulation of practical safety policies and measures, and comprehensively enhancing the hospital's medical quality and patient safety.

Patient safety is the highest standard for our hospital's work. Upholding this steadfast belief, we continue to refine the " Patient-safety Reporting system" in collaboration with all employees to create the safest and most reliable medical environment for patients.

Enhancing Improvement Rates of Frailty Risk in Elderly Inpatients：Patient safety has always been our top priority, and extra caution is required when caring for elderly patients. To ensure that hospitalized patients receive appropriate and high-quality care, we have introduced an innovative electronic assessment form system aimed at improving the frailty risk reduction rate for elderly inpatients.

The new electronic form system integrates assessments for frailty and delirium, automatically initiating the assessment process for patients aged 65 and above upon admission. Each newly admitted elderly patient undergoes not only an initial screening but also a daily delirium assessment , with frailty assessments conducted every 7 days or before discharge. The assessment results are logged directly into the nursing records, facilitating care planning and streamlining the workflow for nursing staff.

Since the system's implementation, coupled with ongoing educational training and information system development, the completion rates for frailty and delirium assessments have risen from 85% and 87% to 100%, respectively. Most importantly, the system's introduction significantly improved the frailty risk reduction rate for elderly patients. Between 2020 and 2022, the frailty reduction rate for elderly inpatients remained between 67% and 70%, but in 2023, it rose substantially to 87.8%. Additionally, the incidence of delirium decreased from 11.6% to 9.4%.

Our efforts in improving the quality of care for elderly patients have been widely recognized. Since 2020, we have received numerous awards in various quality competitions, including the Silver Award in the Thematic Category of the Taiwan Healthcare Quality Management Competition, the Bronze Tower Award in the Self-Improvement Category of the National United Ring Taiwan Continuous Improvement Competition, the Silver Award in the Elementary Category of the Quality Improvement Outcome Presentation Competition, and the Silver Award in the Thematic Improvement Elite Category of the National Healthcare Quality Award.

We will continue to dedicate ourselves to enhancing patient safety and optimizing healthcare quality, especially in providing more attentive and humanized care for elderly patients. We strive to become a trusted healthcare partner for patients and their families through continuous innovation and improvement.