Patients with stage 5 chronic kidney disease undergoing hemodialysis, including those with high-risk comorbidities.

Long-term hemodialysis patients with arteriovenous fistulas or arteriovenous grafts.

Since its establishment, the Hemodialysis Unit of our hospital has been committed to providing safe, professional, and patient-centered kidney care services, with particular emphasis on the quality management of vascular access in hemodialysis patients. Arteriovenous fistulas serve as the lifeline for patients undergoing hemodialysis, and their patency directly affects dialysis efficiency, complication rates, and overall quality of life.

This project adopts a dual-track strategy that integrates innovation and quality management as its core approach. Through interdisciplinary collaboration, process standardization, the implementation of smart technologies, and enhancement of patients’ self-care capabilities, a comprehensive vascular access care model has been established. The care team integrates professional resources from nephrology, cardiology, vascular surgery, nursing, nutrition, and rehabilitation services. In addition, an AI-powered smart platform, innovative patient education materials, and a daily vascular access care checklist were introduced to enable early detection and timely intervention.

Following implementation, the rate of vascular access occlusion was significantly reduced, while patency rates and patient satisfaction were substantially improved, demonstrating care outcomes that are both innovative and supported by empirical evidence.

• Established a dual-track model integrating innovation and quality management by forming an interdisciplinary vascular access care team and developing standardized vascular access assessment and care processes.

• Implemented an AI-enabled smart patient engagement platform, integrating a daily vascular access care checklist and multimedia education to strengthen early abnormality detection, real-time feedback, and patient self-care execution.

• Designed a mobile vascular access exercise cart to provide real-time hand exercise guidance during dialysis sessions, enhancing patient engagement and adherence while supporting long-term vascular access function.

• Approximately 18,000 hemodialysis service visits annually, providing stable and high-capacity professional care.

• Innovative multimedia patient education videos accumulated a total of 1,495 views, with the vascular access hand exercise video receiving the highest number of views (597 views).

• The official smart patient engagement platform reached 1,725 interactions, accumulated 108 registered users, and achieved a 100% message response rate.

• One-year vascular access patency rate reached 97.9%, outperforming national and international benchmarks.

• The vascular access intervention rate decreased from 15.15% to 2.73%.

• The vascular access care knowledge error rate decreased to 2.4%, with a 75.6% improvement.

• Dialysis water microbiological testing consistently demonstrated zero colony counts, meeting dialysis safety standards.

• Comprehensive IGRA screening for tuberculosis was implemented to strengthen infection risk management.

• Regular disaster preparedness drills and an emergency self-rescue kit system were conducted to enhance patient safety.

• Overall patient satisfaction among hemodialysis patients reached 98.54%, representing an increase of 1.16% compared with the previous period.

• Patient feedback primarily focused on “care and timely responsiveness,” accounting for 80% of all feedback.

• The AI-enabled smart patient engagement platform achieved an 80% utilization rate, with 86 patients continuing active use, demonstrating high acceptance and adherence.

• Developed an integrated vascular access care model in accordance with international nephrology clinical guidelines.

• Research outcomes were documented in academic manuscripts and benchmarked against international literature, with comparative analysis of vascular access patency indicators across multiple countries.

• Care outcomes and process designs demonstrate cross-national comparability, facilitating international knowledge exchange and application.

• Enhanced the quality of hemodialysis vascular access care, reduced the need for invasive interventions, and improved overall patient health outcomes.

• Through data-driven analysis, the number of PTA procedures was reduced by 52 cases compared with the previous period, resulting in cost savings of NT$1,542,512 in medical equipment, supplies, and personnel expenses.

• Established a replicable integrated vascular access care model for regional hospitals, improving healthcare effectiveness and demonstrating potential for national health insurance cost savings.