• Community residents

• Long-term care facility residents

• Vulnerable groups: low-income, disabled, rare disease patients

• Homeless, hearing/visually impaired

• Corporate employees and civil servants

This initiative promotes the Patient Autonomy Act through community outreach with a two-stage model (education lecture → ACP consultation), integrating the Hospice and Palliative Care Center and Tamsui Community Medicine Center.

From 2019 to September 2024, 4,052 persons participated in ACP and 3,949 completed Advance Decisions (AD). In 2023, the hospital ranked first nationally in ACP volume; AD signings accounted for 41.90% of New Taipei City and 9.11% nationwide. The hospital received the Ministry of Health and Welfare's ACP Promotion Excellence Award for three consecutive years (2022–2024).

• Innovative two-stage community outreach: lecture → formal ACP

• Dedicated hemodialysis unit ACP clinic

• Home-based ACP

• Institution-based ACP

• Full subsidy for vulnerable groups

• Training of 56 ACP volunteer promoters

• Corporate fundraising to protect healthcare equity

• 208 outreach sessions, 18,507 participants

• ACP: 4,052 persons; AD: 3,949 persons (2019–Sep 2024)

• 177 outreach events: 128 health stations, 27 institutions, 12 social welfare, 10 home visits

• Reached New Taipei, Taipei, Keelung, Taoyuan

• 2023 target: 450 persons; achievement rate 559%

• 2024 target: 1,000; Jan–Sep 2024 achievement 79.2% (792 persons)

• Tamsui MacKay AD signings account for 29.5% of New Taipei and 4.0% nationally

• Community outreach AD conversion rate 78.77% (health stations)

• Community outreach satisfaction average 98.5% over five years

• 9 certified ACP core instructors

• Standardized two-stage process ensures consultation quality

• ACP service volume tracked quarterly via BSC balanced scorecard

• 21 AD implementation cases activated, all eligible for hospice care

• Community outreach satisfaction: 98.1%, 98.0%, 98.8%, 99.0%, 98.6% (2019–2023)

• Post-outreach Patient Autonomy Act knowledge score rose from 54.8 to 95.7 (n=1,012)

• High public trust and satisfaction ratings

• Consecutive international health-promoting hospital presentations 2021–2024 (4 papers)

• 5 journal publications (hospice care, renal nursing, counseling)

• Jan 2024: invited lecture at HKU Faculty of Social Sciences on Taiwan's ACP model

• Invited benchmark sharing at national organ transplant and patient autonomy center

• Patient: reduced cost burden, improved accessibility, more family dialogue

• Clinical: streamlined processes, standardized quality

• Policy: upholds health rights; advised NHI to expand free consultation eligibility

• Social: cross-sector corporate collaboration; multi-media death literacy promotion