CMUH Bulletin Board

Tobacco Hazard Prevention

According to the Taiwan Tobacco Control Annual Report 2015 released by the Executive Yuan Ministry of Health and Welfare Health Promotion Administration, approximately 3.27 million adults aged over 18 years old are smoking; the smoking rate in adult male is 29.2% and the smoking rate for female is 3.5%. Tobacco hazard has resulted in at least 20,000 deaths in Taiwan each year and while the problems with exposure to family second-hand smoking are the most serious among children, young people and women.

To encourage the public with smoke cessation, the Executive Yuan Ministry of Health and Welfare launched the “Second-Generation Smoke Cessation Therapy Pilot Program” in 2012 for the public to receive smoke cessation services in medical institutions designated by the Health Promotion Administration. The public participating in smoke cessation program may enjoy funding for some drug expenses and there will be professionals to help them quit smoking.

Health and Weight Loss

Obesity is one of the most important roots cause for chronicle disease. The Executive Yuan Ministry of Health and Welfare Health Promotion Administration launched the national weight loss policy, “Taiwan 101, Top Health,” in 2012 to create a healthy lifestyle and build a health supporting environment for smart food and smart exercise.

To help the public with difficulty in weight control, CMUH offers a “special weight control outpatient” for physicians specialized in obesity medicine, nutritionists specialized in weight control and sports therapist to jointly offer general weight control and control the health for the public.

AIDS Prevention

AIDS (Acquired Immune Deficiency Syndrome) occurs when the virus destroys the immune system of the human body through sexual intercourse, blood transfusion or mother-to-child vertical transmission and other paths, resulting in the lower body resistance and the invasion by bacteria and virus. In some serious cases, patients could die. The incubation period for human immunodeficiency virus (HIV) is 5 to 15 years. Currently there is no effective vaccine for prevention and the disease could not be cured. Therefore it is necessary to practice safe sex, use disposable needle and syringe as well as avoid unnecessary blood transfusion. Pregnant women are also advised to take HIV pre-test.

It is essential to protect the health of other people and yours to avoid becoming the target of HIV invasion. The Ministry of Health and Welfare started offering free drugs since April 1997 and nearly 70 hospitals have been designated to offer special medical services for each patient with HIV infection. CMUH is an AIDS medical institution designated by the Ministry of Health and Welfare Center for Disease Control, providing anonymous test.

Cancer Prevention

Cancer has led in the top 10 causes of death for Taiwanese people since 1982. The incidence rate and mortality show upward increasing trend year by year with substantial impact on the people’s health. The Executive Yuan Ministry of Health and Welfare Health Promotion Administration launched the “early cancer screening” to focus on the screening of four common cancers, including breast cancer, cervical cancer, colorectal cancer, and oral cavity cancer. These four types are cancers proven for lowered mortality through early screening detection, early discovery and early treatment.

Currently the government subsidizes the following policy and target for four cancer screenings：

• 1. Mammography: 45-69 year-old women or 40-44 year-old women with family history in second kinship of breast cancer; one examination in every two years.

• 2. Pap smear: female over 30 years old shall take one examine a year or at least one examination in every three years.

• 3. Oral mucosa examination: Those over 30 years old and are currently chewing betel nuts (including those who have quitted) or public with smoking habits, or indigenous people who are 18-29 years old and chew betel nut (including those who have quitted) shall take one examination every 2 years.

• 4. Colorectal examination: 50-69 years old shall take one every two years.

• Note: Mammography is reservation based. Please reserve for examination via phone.

Bilingual Environment

To provide convenience for foreigners seeking medical care and assist the government promote the policy on “building international living environment and improving national English proficiency,” CMUH has been establishing a bilingual environment since 2002. Apart from providing bilingual version of indicators, publication and medical forms (hospital profile, diagnosis certificate, and health education leaflet), CMUH also instructs frontline personnel in basic communication skills in order to guide foreigners to their destination and process relevant administrative process without language barrier.

After years of dedication, CMUCH constantly receives external recognition for the establishment of quality English living environment, including: selected by the Ministry of Health and Welfare as the friendly hospital in building English living environment in 2003, distinguished hospital in hospital building English medical operation environment program for foreigners visit and performance follow-up activities, promoted by Taiwan College of Healthcare Executives and granted by Executive Yuan Ministry of Health and Welfare in 2006, and the gold level in 2010-2011 English service mark from Research, Development and Evaluation Commission, Executive Yuan. Moreover, to conform CMUH’s medical quality with international standards, CMUH further passed the accreditation of JCI international hospitals with high passing standards in 2010 and 2014 to make progress toward internationalization.

Community Health Building

World Health Organization stressed “Concepts of Community Health Building and Promotion” in Alma-Ata Declaration to implement fundamental health medical care for public health promotion and accomplishment of national health. The “healthy city plan” promoted by World Health Organization in community health plan completes the actions in community health promotion through community development. In other words, the process of public involvement allows professionals and the general public to jointly discover the issues related to community health in addition to integrating community resources and to solve the health issues of the community together.

The Executive Yuan Ministry of Health and Welfare launched the “community health building” program since 1999 and established 199 community health building units in 2006. The involvement of community resources allows the public to voluntarily discover the health issue of community, reaching consensus and establishing community autonomous care and health building mechanism. Health is introduced to daily life, where the residents jointly establish a healthy life supporting environment to support each other and lead a healthy life.

CMUH has been participating in the Health Promotion Administration’s Health Building Program since 2000. The current project launched by CMUH is the Taichung City “Ankan Community Health Building Work,” where 42 cooperative community group resources in Taichung area are integrated with six community health stations set up as the key operations for promoting integrated screening, community health promotion and cancer and chronicle disease prevention. Moreover, CMUH target at the high-risk groups or illness cases in the community by holding regular weight loss class, health walking class, smoke cessation class, health drinks class, and other health promotional courses and activities to improve the health of community public. CMUH was rated by the Health Promotion Administration as the distinguished organization in community health building

Baby-Friendly Hospital

Breastmilk is the best food for babies. The Executive Yuan Ministry of Health and Welfare initiated the launch of baby-friendly hospital certification since 2001 to boost the breastfeeding rate among Taiwanese people. The pure breastfeeding rate after one month of delivering the baby has increased from the 24.32% in 2001 to the 44.72% in 2010, indicating that the promotion of baby-friendly hospital certification has significant positive influence on the increase in breastfeeding rate.

CMUH fully supports breastfeeding and is the benchmark learning hospital for national baby-friendly hospitals. In 2010, CMUH joined the pilot program for “Prenatal and Postnatal Care Quality Assurance and Consultation Services,” providing pregnant women and postnatal women with 24 hours of uninterrupted premium medical care and consultation services.

National Health Policy

The National Health Insurance has not stopped actions of reforms since the first launch in March, 1995. CMUH has been fully cooperating with National Health Insurance in terms of the implementation of global budget system, pay for the performance system, family physician integrated care system, patient oriented integrated care program, inpatient Diagnosis Related Groups (DRGs) payment system, Post-acute Care (PAC) -Cerebrovascular Diseases, My Health Bank promotion, health insurance medical information cloud query system, and electronic transfer platform system…etc.

To provide services of medical care to rural areas and cooperate with the National Health Insurance Project of Integrated Delivery System in the mountains and outlaying islands (IDS), CMUH proceeded to Xinyi County of Nantou County to offer Dili Village with 24-hour emergency and outpatient services as well as home medical rehabilitation, cultivation of health insurance volunteers and devotion in community prevention medicine. CMUH fulfills its social responsibility in promoting medical care in rural areas over the long run and has been awarded with GlobalVision Charity Promotion Exemplary Award.

Moreover, CMUH cooperates with National Health Insurance to take actions in promoting My Health Book with added-value application. In 2016, CMUH participated in the health book added-value application APP creative competition and was awarded with the third place in Theme Category (silver gray health gold bank) and excellence in disease topic category (small data scientist). The public can check on their personal health data with convenience at any time, control their health affairs, manage self-health, and promote medical care safety and quality with wide recognition.

Organ Donation

The “Human Organ Transplant Act” was promulgated in 1987 for implementation. The efforts exerted by the domestic medical industry in Taiwan have eventually driven the organ transplant technology to advance while the safety and effectiveness of surgery have substantially improved with remarkable performance. Taiwan Organ Registry and Sharing Center upholds to the concept of “organ donation and extension of life” in attempt to work for the continuation of human life. Apart from optimizing the philosophy of love, the center cooperates with “Human Organ Transplant Act” with good intention and other relevant laws and regulations to promote organ donation and transplant, establish organ transplant data, advocate for organ donation and effective use, and thereby enhance the national health.

In 2002, Superintendent Jeng, Long-Bin led the transplant team and completed the first successful case in liver transplant surgery for Chine Medical University Hospital, which also opened a new chapter for the organ transplant of CMUH. Due to the full tacit understanding in cooperation, the transplant team has accomplished distinguished performance and extended countless number of lives, improving the future living quality of patients.

Hospice Palliative Care

Life is precious and deserves the right to protecting dignity even at the end of the course. The Executive Yuan Ministry of Health and Welfare National Health Administration launched the “Hospice Joint Care Program” since 2005. The public can reserve hospice palliative care in advance and voluntarily remark on the health insurance IC card through rigorously processing mechanism, which effect is equal to a statement of intent in writing. Hospice palliative care combines the cooperation between the medical teams of all department and the hospice care team to provide terminal cancer patient with hospice services, assisting terminal patients with pain relief, providing holistic care for the body, mind and soul, and helping patients and families cope with the adjustment as one faces with life and approaches the end.

CMUH participates in the “Hospice Joint Care Program” from the Ministry of Health and Welfare and serves as the contracting hospital for Hospice Foundation of Taiwan, providing hospice palliative ward, hospice joint care and home hospice nursing services.

The number of people marking hospice on health insurance IC card increases annually and CMUH was awarded with the excellent group award in “Advocacy for Advance Hospice Palliative Care and Palliative Care Choice with Voluntary Remark on Health Insurance Card” presented by the Ministry of Health and Welfare in 2014, 2015 and 2016.

Innovative Hospice Home Service – Service Hours Monday to Friday 08:00-20:30 and holidays (Saturday, Sunday). The customized hospice care can meet holiday patients with their medical care requirement.

Hospital-Acquired Infection (HAI)

Executive Yuan Ministry of Health and Welfare Center for Disease Control has launched the “Antibiotics Stewardship Program (ASP) to upgrade the quality and efficiency of medical institution in antibiotics management, urge hospitals and communities to devote in the safety culture of reasonable antibiotics use, and reduce antibiotics resistance and occurrence of medical care related infection. Professionals from all disciplines are gathered, including the physicians of infection department, pharmacists, medical technologist, infection control nurses, and information personnel, to collaborate and jointly develop guidelines for antibiotics use, building information management process, and monitoring the trends of bacterial strains with anti-resistance, so that the use of antibiotics will be improved to avoid anti-resistant bacteria.

CMUH served as the central region demonstration center for “Antibiotics Stewardship Program” between 2013 and 2015, cooperating with project execution on existing foundation and effectively conducting antibiotics management with counseling provided to other hospitals. In 2015, the demonstration center led the central region team with award granted in “third place for group excellence award.”

Medication Safety

Starting from 2012, the Ministry of Health and Welfare has advocated for the objectives and key points in the five core competencies of correct medication. Competency 1. Clearly express one’s physical conditions. Competency 2. Clearly see drug labels. Competency 3. Apply correct and clear medication and time. Competency 4. Love one-self and be the owner of his/her body. Competency 5. Make friends and make friends with physicians and pharmacists.

CMUH is a patient-oriented hospital and specializes in outpatient pharmaceutical affairs process, inpatient pharmaceutical affairs process, cloud medicine resume, outpatient integrated care and discharge health education, which not only effectively integrates the department and medicine of patients with chronic diseases but also informs the complete medicine information and status instantly. CMUH offers more personalized medicine application assessment and health education services, the comprehensive pharmaceutical process service of medical center and protects public health.

Moreover, CMUH has established the “Central Region Correct Medication Education Resource Center” to continue launching the policy of correct medication education, intensify the advocacy for correct and reasonable medication concept ot the public, improve self-health care capacity, avoid redundant medication, educate correct medical seeking behavior, and assure medication safety and reduce wastes of medical resoruces. The resource center has been promoting the concept of correct medication since its foundation. In the example of 2016, the resource center has held 41 sessions of promotional campaigns in and outside of CMUH by counseling Beigang Branch into the seedling correct medication resource center, exposing to press, receiving interview from the radio station and news channel, and thereby carrying out the propaganda on correct medication.

Apart from the aforementioned “Central Region Correct Medication Education Resource Center,” CMUH still needs to assist the Ministry of Health and Welfare with establishing the “Chinese Medicine Safety and Health Education Resource Center,” “Taiwan Rare Disease Special Nutritious Food and Emergency Drug Logistics Center,”　“Central Region Anti-Drug Education Resource Center,” “Central Region Drug Adverse Reaction Reporting Center” Central Region Drug Shortage Processing Center” and other units. CMUH also cooperates with medication policy to cooperate with different sectors in the society by holding or participating in various activities, exchanging with government officials, experts and medicine students from other countries. Over the years, CMUH has acquired “SNQ National Quality Mark,” “Medical Quality Award” and “Taiwan Society of Health-System Pharmacists” and Taiwan Society of Health-System Pharmacists Academic Wall Paper as well as multiple marks and awards with recognition from different sectors.

Outpatient Integrated Care

The annual increase of elderly population and patients with chronic diseases require the patients to make multiple appointments, diagnosis and medicine acquisition under existing medical environment. To avoid the inconvenience in seeking medical treatment and waste in medical resources, the National Health Insurance Administration has launched the “Multi-Chronic Disease Outpatient Integrated Care Program” in 2009 to provide the public with greater protection in medical quality and medication safety.

CMUH integrated care team includes physicians specializing in elderly, physicians of all department, pharmacists, registered nurses, social workers, and nutritionists. Integrated department allows patients to seek medical treatment on the same day, saving time traveling to and from hospital. The number of medicines is integrated to avoid redundant medication, thereby upgrading the medical care quality of patients with chronic diseases. Professionals will arrange personalized integrated medical treatment according to personal requirement and disease conditions.

Vaccination

In the 2016-2019 interim policy objectives and guidelines on “Establishing Excellent Disease Prevention and Contingency System and Moving Towards the New Century of Disease Prevention” of Ministry of Health and Welfare, the section regarding vaccination aims to assure the stable and adequate financing for vaccination, sustainability in promoting vaccination process, application of various preventions and vaccination, and improvement of national immunity. The national vaccine funds planning and prevention vaccination plan offers vaccination for enterovirus, influenza, tuberculosis, and hepatitis B. In 2016, the comprehensive vaccination against influenza helped children, elderly and those with relatively weaker immunity to produce antibiotics against contagious diseases to avoid the invasion from virus, thereby meeting the objectives for “An ounce of prevention is worth a pound of cure.”

The Ministry of Health and Welfare Center for Disease Control (CDC) convened experts and researchers to form the Advisory Committee on Immunization Practices and regularly develop the targets and schedule suggested for vaccination in sum of empirical medicine and local Taiwan data according to the statistics on the epidemic severity and the ration of post-infection result in life jeopardy. The public can consult with the pediatric department or department of family medicine for vaccination related requirement and questions. The public is required to notify the physician before vaccination if the patient suffers from major disease, fever or cold, drug allergy or is taking medication. The physician will determine after the consultation. Additionally, CMUH tourism medical outpatient includes personalized tourism health risk assessment and infectious disease prevention (vaccination consultation). The physician specializes in controlling the health of people during tourism by providing comprehensive medical consultation for tourism.

The human health is substantially affected by the environment. Apart from facing the threat from virus, the hazardous substance in the environment often directly or indirectly jeopardizes the human health due to industrial environment and food additives, as well as triggering certain specific diseases such as PM2.5 in air pollution, new Type A influenza, plasticizer, leakage of nuclear radiation in Japan, melamine with Chinese milk scandal and public health incidents in recent years. To resolve the psychological panic and concerns in the public, the Ministry of Health and Welfare not only announces relevant information via the press and website but also sets up special clinic at the medical institutions in response to specific incidents, thereby providing the public with immediate consultation and diagnosis services.

Energy Conservation and Carbon Emission Reduction

Rapid resource depletion is the major challenged human encounter in the 21st century. Being earth friendly and protective of the environment requires the self-consciousness, awareness and joint solution by human around the world. To cooperate with government policies and in response to the rising energy expenses year by year, CMUH has launched the energy saving and carbon emission reduction campaign since 2009, taking improvement actions from the management and equipment. CMUH also participates in national material energy saving carbon emission reduction solutions by signing the participation in “voluntary energy saving” institute. In 2012, CMUH was received project funding from the “Energy Performance Guarantee Project” of Ministry of Economic Affairs Energy Bureau and “Smart Building” of Ministry of the Interior. CMUH intends to expand the performance in energy conservation and carbon emission reduction through the implementation of these two projects, so that CMUH not only heal physically and psychologically but also care for and cherish the earth.

In 2013, CMUH was awarded by the Ministry of Health and Welfare Health Promotion Administration with “International Environment-Friendly Hospital.” In 2016, the Ministry of Health and Welfare Health Promotion Administration awarded CMUH with health promotion hospital paradigm and creative project select/health promotion and creativity project in category of “Ecology Sustainability” environmental education – Green Smart Hospital 4.0 “Excellence Award.”

Classification of Emergency Medical Capacity

To accomplish patient orientation and provide Taiwanese people with safe, applicable, efficiency, and fair medical services, the Ministry of Health and Welfare promulgated the “Standards for Classification of Hospital Emergency Medical Capacity” in July 2009 and classified hospital capacity into “severe,” “intermediate” and “general” classes. Meanwhile the six acute and critical disease care for emergency, acute cerebral stroke, acute coronary syndrome, major trauma, high-risk pregnancy and newborn, ICU, are included in the rating for hospital emergency medical capacity in order to establish a national emergency medical care network.

CMUH has been assessed by the Ministry of Health and Welfare in accordance with “Standards for Classification of Hospital Emergency Medical Capacity” and rated as a severe emergency responsible hospital for 2009 and 2013. CMUH appeals in the collaboration of medical teams and efficiency in medical process in order to assure the quality of emergency medical care. According to the five levels of triage classification released by the Ministry of Health and Welfare, the emergency department will assist patients with higher severity in priority treatment. The personnel at the triage zone will advocate the public with minor syndromes to seek for medical treatment at the general outpatient while encourage the patients with minor syndromes to seek for medication from non-medical center so that the medical center will place more efforts in handling patient with acute and critical conditions.

Domestic Violence and Sexual Assault Prevention Services

To implement the State’s reporting and prevention on children and youth protection from domestic violence and sexual assault cases, provide women and children with full safety protection, actively promote the improvement on the situations of high-risk families and caregiving capacity of family members, and reducing incidents of children and youth abuse, CMUH has linked the internal and external resource networks to provide legal aids, psychological consultation, emergency relief, safety and protection, life reconstruction, and medical assistance according to the victim’s requirement.

If the public or your families/relatives (including minors) have suffered from the illegitimate invasion, through physical or psychological conducts, from family members, or have been sexually assaulted by acquaintances or strangers, the victims are suggested for reporting to the police immediately and escaping from the scene in addition to receiving proper treatment, injury diagnosis, evidence collection, and interview at the Emergency Department of CMUH. CMUH is a “Domestic Violence and Sexual Assault Prevention Responsible Hospital” and forms a “Violence and Abuse Victim Medical Team” from medical staff and social workers. The team offers victims with 24 hours of professional services based on principles of confidentiality and protection to assure the subsequent safety programs.

Suicide Prevention

Taiwanese Society of Suicidology President Ming-Been Lee addressed in the “東亞自殺防治學術研討會” on December 4, 2011 that suicide topped the 9th place for cause of mortality among Taiwanese people for 13 consecutive years. Under the enthusiastic efforts between the government and private sectors, suicide has withdrawn from the top 10 causes of mortality in 2010 but topped the 11th. Suicide is a worldwide public health issue and there are approximately 1,3 million people worldwide who die of suicide. In particular, 70% of the suicides take place in Asia. In view of this, in response to the Ministry of Health and Welfare intensification in the promotion of psychological health in elderly and suicide prevention work pilot operation program in 2012, CMUH integrated CMUH department of family medicine, psychological medicine and social work service through interdepartmental collaboration to become the only hospital among the 5 pilot hospitals in central Taiwan. After the end of the program, CMUH has expanded this prevention program to all inpatients of CMUH to assess the suicide risk and subsequent intervention through the measurement of emotional meter, thereby attaining the prevention performance.

Electronic Medical Record

The Ministry of Health and Welfare has been promoting electronic medical record related program with much enthusiasm, from the promotion of medical information standard, pilot-program of electronic medical records in medical institutions, establishment of medical certificate management center, to medical information security and the revision of Privacy Protection Act, with distinguished performance and effectively establishing the environment and infrastructure for promoting electronic medical records.

To promote the implementation of interoperability for electronic medical records between hospitals, CMUH has eventually promoted the practice and application of electronic medical records in terms of regulation, safety, standards, and promotion.

CMUH targets at implementing electronic medical records through “holistic health care.” By establishing a complete electronic information system, CMUH clearly records and conveys the patients’ information, physician evaluation and diagnosis opinions with accuracy, thereby to upgrade medical care quality. IN response to policies on national health insurance of Taiwan and electronic medical records, Taiwan Medical Cloud has transformed the electronic medical records into the foundation of medical cloud form under the guidance of the government. Consequently CMUCH has met the policy objectives of holistic health care and gained access to broader scope of health care market.

CMUH upholds to innovation and leadership by simplifying the process and content of cloud medical application with the optimal contribution. CMUH has implemented electronic medical record with success and has been awarded by the Ministry of Health and Welfare for the “Third Place in the Total Number of 2014 Hospital Announced Electronic Medical Record Sheets for Implementation,” Gold Award in 2015 Award for Hospitals Implementing Electronic Medical Record and Interoperable Application with Excellence –Innovation and Application Service Promotion, and Silver Award in paperless promotion.

銜接長照2.0服務

本院通過衛生福利部「銜接長照2.0出院準備友善醫院」認證

我國隨著生育率與死亡率雙雙出現下降的趨勢，整體人口結構快速趨向高齡化，使得長期照顧需求人數也同步增加。又因家庭的照顧功能逐漸式微，使得個人與家庭的照顧壓力日益加重，進而連帶產生社會與經濟問題，因此，為建立完善的長照體制，行政院 105年12月19日核定長期照顧十年計畫 2.0，期藉由發展以服務使用者為中心之多元連續性服務模式，回應不同族群需求，以滿足當前社會照顧服務的多元需求。

期藉由縣市政府照管中心連結醫院出院準備服務的專業醫療團隊共同評估病人身體、經濟、心理或情緒上的照護需求，如有長照需求的服務對象，出院前即完成評估並取得長照服務，評估結果無縫接軌，協助民眾及時獲得所需服務資源，使病人及其家屬獲得完整性及持續性的長照服務。

出院準備銜接長照服務流程：(1)於住院病人出院至少3天前完成長照服務評估。(2)與照管中心合作，確認個案意願並填寫同意書後，將長照評估結果與所在地照管中心完成接洽，擬定長照2.0之17項服務項目之銜接流程及銜接方式，銜接服務項目中包含居家服務、居家護理、居家復健、喘息及簡易生活輔具等五項長照服務。(3)照管中心並應於個案出院後1個月內完成個案複評。