• Acute Myocardial Infarction

• Acute Coronary Syndrome, ACS

Yuan’s General Hospital is a mid-level emergency responsibility hospital. In 2022, key indicators for acute myocardial infarction (AMI) care—including in-hospital mortality rate(13.0%) and 14-day unplanned readmission rate(3.3%)—were higher than peer benchmarks. In addition, the prescription rates of beta-blockers at discharge (85.2%) and ACEI/ARB during hospitalization (34.4%) were below peer averages.

To address these gaps, we implemented a problem-oriented integrated care strategy linking the emergency department, catheterization laboratory, intensive care unit, and general wards. The model focuses on three core domains: optimizing reperfusion timeliness, improving adherence to guideline-directed medical therapy (GDMT), and strengthening post-discharge follow-up through case management.

Through interdisciplinary collaboration and workflow redesign, a structured and replicable AMI integrated care model was established to enhance overall care quality and clinical outcomes. In terms of outcomes, in 2025, the hospital achieved a 100% rate for both beta-blocker prescriptions at discharge and inpatient ACEI/ARB utilization. Furthermore, the 14-day unplanned readmission rate dropped to 0%, and the inpatient mortality rate decreased to 11.4%, demonstrating the clear effectiveness of these improvements.

• Enhanced Acute Care Efficiency: Implemented a dedicated primary nursing system in the emergency department, introduced STEMI-specific LINE communication tools, developed an ACS emergency catheterization checklist, and pioneered the national “AMI Medication Kit” to significantly reduce treatment delays.

• Integrated Interdisciplinary Care: Established an integrated handover communication platform and standardized order sets, with continuous monitoring and improvement of GDMT quality and adherence.

• Innovative Post-Discharge Management: Appointed dedicated AMI case managers, created patient support groups and AMI education toolkits, and led nationwide implementation of “In-Care” wearable devices for post-discharge health monitoring.

• Over 200 AMI patients have been managed and assisted over the past three years.

• More than 100 emergency primary PCI (percutaneous coronary intervention) procedures for STEMI patients have been performed in three years.

• AMI case managers have successfully enrolled and managed more than 200 patients.

• The 14-day unplanned readmission rate for AMI patients in our hospital decreased from 3.25% to 0%.

• The in-hospital mortality rate for STEMI patients in our hospital decreased from 13.0% to 11.4%.

• Significantly shortened the average time to administer Dual Anti-platelet Therapy (DAPT) in the ER from 181.0±14.5seconds to 28.8±2.5seconds.

• Achieved 100% adherence to GDMT (Guideline-Directed Medical Therapy) for STEMI patients, up from 34.4%.

• Implemented the Acute Coronary Syndrome (ACS) Emergency Catheterization Checklist, with usage rate increasing from 0% to 100%.

• Fully integrated the informatics system for emergency cardiac catheterization procedure timing, reaching 100% utilization.

• Reached a 100% enrollment rate for AMI patients by case managers.

• Achieved a 100% follow-up rate by case managers for discharged AMI patients.

• Increased the smoking cessation referral rate for AMI patients (via case managers) from 0% to 92.6%.

• Launched the use of "In-Care" wearable devices for discharged patients, increasing usage from 0% to 50%.

• The 14-day unplanned readmission rate for AMI patients in our hospital decreased from 3.25% to 0%, which is lower than the national average of 1.95%.

• The in-hospital mortality rate for STEMI patients in our hospital decreased from 13.0% to 11.4%.

• Outpatient overall satisfaction with physicians averaged over 90%.

• Inpatient overall satisfaction with physicians averaged over 85%.

A clinical study titled "Comparison between using wearable six-lead electrocardiogram and 12-lead electrocardiogram" is currently being conducted to evaluate the "In-Care" wearable device.

• Promoting the overall quality of AMI care and optimizing patient outcomes in Taiwan.

• Showcasing the tangible impact of integrated care and digital-aided tools on chronic disease management.