• Residents of Miaoli County

• Acute coronary syndrome patients

• Patients requiring emergency cardiac catheterization

Miao-Li Hospital is the only public hospital in Miaoli County, located in an emergency medical resource-deficient area. The Cardiovascular Center was established in September 2013, received accreditation for severe acute coronary syndrome emergency medical care in 2019, and acquired German high-resolution cardiac catheterization equipment in 2020. A comprehensive 24/7 emergency cardiac catheterization system has been established through collaboration with fire departments and allied hospitals, featuring physician support from outside institutions and green channel protocols to ensure timely treatment for patients.

• 24/7 emergency cardiac catheterization support year-round

• Innovative image card rapid transmission and instant messaging communication system

• Seamless coordination between outside physicians and in-house physicians, with external physician response rate of 51.1%

• Optimized green channel protocol achieving D2W time less than 60 minutes, exceeding international standards

• Regular meetings with fire departments and allied hospitals to strengthen regional medical networks

• Comprehensive radiation safety protection with advanced equipment

• Multi-disciplinary team collaboration in patient care

• Total emergency cases during off-hours and holidays: 47 cases

• External physician response rate: 51.1% (24 out of 47 cases)

• D2W time (Door-to-Wire time) in recent two years: Less than 60 minutes

• No significant difference in D2W time between in-house and external physicians (t=-1.844, p>0.05)

• Green channel protocol significantly reduces D2W time compared to standard pathway (t=-7.920, p<0.001)

• Pre-hospital ECG transmission significantly reduces vessel opening time

• Recent D2W time performance exceeds international standards (<60 minutes)

• Comprehensive radiation safety testing records

• Complete radiation protection equipment in catheterization laboratory

• Well-organized on-call schedule for 24/7 emergency cardiac catheterization

• Patient satisfaction surveys conducted for all outpatient, emergency, and inpatient cases

• Systematic quantitative satisfaction data collection

• D2W time less than 60 minutes, exceeding international standards

• Integration of international recommendations into clinical protocols

• Reduced emergency preparation time for acute coronary syndrome patients

• Shortened post-arrival emergency care pathways for acute myocardial infarction patients

• Significant thrombolytic efficacy in patients with complete hemodialysis fistula occlusion

• Successful catheter intervention for complete fistula occlusion in end-stage renal disease patients

• Effective targeted temperature management in post-resuscitation patients

• Continuous improvement in ST-elevation myocardial infarction treatment quality

• Clinical value of red blood cell distribution width as auxiliary diagnostic marker for myocardial infarction

• Optimized cardiac tumor care quality for cancer patients