Annan Hospital treats diabetic feet via cross-dept care, tackling internal causes and wounds. Serving 348 patients since 2018 with SNQ recognition, it curbs ulcers and major amputations.

Positioning: Reducing the Incidence of Diabetic Foot Ulcers and Subsequent Amputations

A wound is essentially an external manifestation of a patient's internal health condition. Patients with diabetic foot often suffer from complications such as poor blood sugar control, kidney dysfunction, peripheral arterial occlusive disease, coronary artery disease, and malnutrition. Without addressing these internal issues, external wounds cannot heal effectively.

The Foot Wound Center at Annan Hospital focuses on treating wounds, educating patients and their families, and preventing recurrence or major amputations (defined as below-knee or above-knee amputations).

Key Features of the Center:

Establishing Multidisciplinary Collaboration:

Annan Hospital integrates multiple specialties to collaborate on patient care, holding regular discussions on complex cases to reduce amputation rates and preserve patients' limbs.

Utilizing Advanced Wound Care Technologies:

The center employs Negative Pressure Wound Therapy (NPWT, Vacuum-assisted closure (VAC®) systems) and the latest Dehydrated Amniotic Membrane Allograft (Amniogen®), along with various wound dressings. These approaches promote tissue growth, accelerate wound healing, reduce pain, minimize caregiving efforts, and further preserve limbs, thereby improving the quality of life for patients and their families.

Long-term Telephone Follow-up:

Annan Hospital is equipped with dedicated wound care case managers who monitor patients' progress and maintain clear communication channels between patients and the hospital. This enables timely feedback on wound conditions and facilitates early return visits and treatment if issues arise. Most importantly, it fosters a long-term, trusting doctor-patient relationship.

from 2018 to June 2024, Annan Hospital has served 295 patients with diabetic foot. Since receiving the National Quality Certification, this number has continued to grow.

1.Since March 2023, Annan Hospital has participated in the wound care enhancement program for the Yunlin, Chiayi, and Tainan regions initiated by the National Health Insurance Administration. The hospital provides wound care outpatient services and outreach medical care. As of June 2024, the Wound Care Center has served 23 patient visits.

2.As of June 2023, a total of 295 cases had been managed (262 inpatient cases and 33 outpatient cases). From July 2023 to June 2024, an additional 73 cases were managed (68 inpatient cases and 5 outpatient cases). A total of 266 inpatients underwent 713 surgeries, averaging 2.72 surgeries per patient.

Collaboration with the Cardiovascular Surgery Department accounted for 120 cases (39.3%).

Collaboration with the Endocrinology Department accounted for 77 cases (26.1%).

Collaboration with the Nephrology Department accounted for 96 cases (32.5%).

Collaboration with the Infectious Diseases Department accounted for 50 cases (16.9%).

Collaboration with the Hyperbaric Oxygen Therapy Department accounted for 23 cases (7.7%).

There were 38 cases of above-knee/below-knee amputations, accounting for 12.8% of all cases.

Inpatient Fall Rate: A total of 12 falls occurred over 9,943 cumulative inpatient days across all years, representing an incidence rate of 0.12%. Surgical Complication Rate: A total of 6 complications occurred out of 827 cumulative surgeries across all years, representing a rate of 0.7%. Limb Salvage Rate: The overall limb salvage rate reached 86.2% (with a total of 300 cases successfully discharging with limb preservation, excluding major amputations and inpatient deaths). Minor Amputation Rate: 144 cases, accounting for 41.3%. Major Amputation Rate: 43 cases, accounting for 12.3%.

Overall Satisfaction: Increased from 85.4% in 2024 (113Y) to 88.1% in 2025 (114Y). Medical Services: Rose to 89.8% (v.s. 86.0% previously). Nursing Services: Rose to 90.8% (v.s. 89.9% previously). Laboratory & Radiology: Significantly improved to 86.9% (v.s. 80.4% previously). Pharmacy Services: Rose to 88.3% (v.s. 84.8% previously). Other Services: Increased to 85.8% (v.s. 83.5% previously). Root Cause Analysis & Corrective Actions Identified Bottlenecks (2024): A temporary decline in satisfaction was driven by prolonged waiting times for medication dispensing (due to pharmacist shortages) and outpatient plastic surgery dressing changes. Implemented Quality Improvement (QI) Measures: Manpower Optimization: Recruited additional pharmacists to streamline dispensing workflows and reduce waiting times. Patient Flow Diversion: Established a dedicated Wound Care Center Clinic on Tuesday and Thursday mornings to divert patients requiring routine dressing changes, successfully mitigating outpatient bottlenecks. Outcomes & Qualitative Feedback: These targeted interventions effectively enhanced the patient experience, as reflected in the 2025 satisfaction recovery. Qualitative data from patient handwritten feedback further validated these efforts, with commendations noting that healthcare staff were "exceptionally patient."

On April 3, 2024, Annan Hospital received an official notification from the Ministry of Health and Welfare, selecting it as a "Training Base for Holistic Nursing and Evidence-Based Care in Effective Institutional Nursing."

Additionally, Annan Hospital has joined the wound care enhancement program for the Yunlin, Chiayi, and Tainan regions, initiated by the National Health Insurance Administration. The hospital provides wound care outpatient services and outreach medical services, catering to the wound care needs of nearby long-term care facilities.

• Inpatient Mortality Rate: 0% (0/29)

• Fall Incident Rate: 0% (0/850)

• Surgical Complication Rate: 0% (0/101)