Hemodialysis patients

At the Hualien Armed Forces General Hospital, our multidisciplinary team—comprising doctors, nurses, social workers, and long-term care specialists—has pioneered a "Precision Care and Smart Upgrading Program" to serve our community. By integrating real-time physiological data with a digital prescription platform, we have optimized clinical workflows and achieved a 98% documentation accuracy rate.

Our commitment to clinical safety is reflected in our transition to ultrasound-guided cannulation. This initiative has empowered less-experienced staff, raising successful cannulation rates from 43% to 89%, while maintaining a flawless three-year record of zero needlestick injuries and bloodstream infections. Beyond the clinic, we are meeting broader public health goals, completing the national Hepatitis C elimination target six months ahead of schedule. By tripling Advance Care Planning (ACP) consent rates (from 20% to 60%) through our specialized dialysis palliative care model, we have successfully integrated military medicine with community resources to protect and honor our most vulnerable patients.

• Precision Vascular Access Management: By integrating ultrasound-guided cannulation with dilution-based flow monitoring and a fast-track angioplasty protocol, our team has significantly reduced the risks of vascular access immaturation and occlusion.

• Smart Digital Platform Integration: We successfully synchronized electronic prescriptions with real-time physiological data uploading. This digital transformation has streamlined clinical workflows and eliminated manual errors, resulting in a 98% accuracy rate for nursing documentation.

• Innovative Holistic & Palliative Care: Our multidisciplinary approach leverages Shared Decision-Making (SDM) to honor patient autonomy. This initiative increased Advance Care Planning (ACP) consent rates from 20% to 60% . We achieved the national Hepatitis C elimination ahead of the deadline.

• Healthcare Resilience & Crisis Adaptability: The team demonstrated high-level resilience by maintaining uninterrupted emergency dialysis services throughout the COVID-19 pandemic. Our ability to rapidly adapt clinical protocols under pressure ensured the safety and continuity of care for our vulnerable patient population.

• 89% successful cannulation rate for new shunts among less-experienced staff.

• Hemodialysis nursing documentation accuracy rate: 98%.

• The ACP consent rate increased to 60%.

• The cure rate of hepatitis C: 100%.

• Re-cannulation rates plummeted from 15.3% to 3.8%.

• Surgical revisions for vascular access were reduced from 7 to 4 cases per quarter.

• We reduced the weight of non-recyclable contagious waste by 30%.

• Monthly average dialysis volume grew from 445 to 724 sessions

• New AVF cannulation success rate improved from 43% to 89%

• Repeat cannulation rate reduced from 15.3% to 3.8%

• Fistula occlusion rate declined from 0.158% to 0.026%

• AVF infection rate: 0% for three consecutive years

• Hepatitis C cases eliminated by 2025; cure rate 100%

• Infectious waste volume reduced by 30%

• Advance directive signing rate increased from 20% to 60%

• Documentation time reduced to 7–10 min; accuracy rate 98%

• Overall patient satisfaction score: 95.8/100

• 0% Needlestick injury for three consecutive years.

• 0% Vascular access infection for three consecutive years.

• Dialysis-related hepatitis C infection rate: Officially eliminated in 2025.

• Vascular access re-cannulation rate decreased from 15.3% to 3.8%.

• 98% of nursing documentation is accurate

• Public health and epidemic prevention: Zero staff infections during the pandemic.

• overall patient satisfaction rating of 95.8 out of 100.

• Satisfaction regarding professional explanations and clinical management reached 96%.

• 95% of patients reported that our advanced monitoring protocols significantly increased their confidence in the safety and efficacy of their treatment.

• 92% of patients agreed that flow measurements were performed without discomfort.

• Patients' feedback confirmed that ultrasound-guided cannulation and online monitoring helped reduce clinical risks.

• The overall satisfaction score for the medical team’s explanations and management was 95.4 points.

Currently, we are working on extending our approach and writing a medical education study, entitled "From Palpation to Visualization: Impact of a Structured Ultrasound-Guided Training Program on Cannulation Competency and Safety Among Novice Hemodialysis Nurses."

Innovative Care Leadership: Surpassed national hepatitis C elimination targets, pioneered a premier dialysis palliative care model, and deployed a smart digital platform.

Enhanced Patient Outcomes: Reduced complications and pain through precision vascular management while improving quality of life via holistic, fast-track services.

Sustainability & Resilience: Cut medical waste by 30% and ensured uninterrupted service in remote regions and during disaster scenarios.