Target Population

Target: Stable ER patients in triage categories 3–5. Conditions: Vertigo, chest distress/palpitation, ileus, stroke, soft tissue/migraine/bone pain.

Description

Taiwan launched the National Health Insurance Chinese Medicine Emergency Treatment Plan in May 2017, which provides Chinese medicine treatment for nine major indications, aiming to reduce emergency congestion and reduce patients' repeated entry and exit or stay in the emergency room. The Mackay Department of Traditional Chinese Medicine launched this plan in January 2018. It first sent resident doctors to the emergency department for external training to build communication bridges and promote cooperation. Different from other hospitals’ model of waiting for emergency consultation with TCM doctors, the Mackay Department of Traditional Chinese Medicine takes the initiative to screen patients and discuss treatment adaptability with emergency western doctors to avoid misdiagnosis by western doctors due to lack of understanding of TCM. In addition, the Mackay Department of Traditional Chinese Medicine took the lead in 2022 to provide traditional Chinese medicine consultation and prescription of traditional Chinese medicine to patients diagnosed with COVID-19 during the emergency period to avoid delaying the golden treatment period.

Key Highlights

Treatment technology: Acupuncture, traumatology and traditional Chinese medicine intervention methods are used to improve the discomfort of patients in the emergency observation area.

Key technology: the first to establish a team to handle emergency TCM interventional procedures.

It is the first of its kind in Taiwan to clearly define the disease types suitable for intervention and establish a process for communicating with emergency departments.

Service Data

Our hospital’s TCM emergency treatment plan admitted a total of 119 patients in 2018, while a total of 176 patients were admitted in 2010, a total of 883 patients were admitted in 2010, a total of 337 patients were admitted in 2011, and a total of 337 patients were admitted in 2011. A total of 375 people. (Details are shown in the attachment_attached table)

Featured Outcomes

Total Volume: 1,274 sessions (2019–2021).
2021 Share: 99.2% in Taipei, 54% nationwide (Ranked 1st).
Consultation: 97.6% (Taipei), 99.6% (Tamsui).
Completion & Intensity: 100% completion; 2.6 treatments/stay.
Satisfaction: Over 90% satisfied.
Pain Relief (Mean NRS -2.4): Migraine -3.5, Chest pain -2.6, Vertigo -2.6, Acute abdomen -2.0, Soft tissue -2.3, Bone pain -1.7.
ER Stay: Cut to 170 mins (Chest pain with intervention <2h).
Safety (0% Incidence): Pneumothorax, retained needles, fainting, and medication errors.

Safety Outcomes

Quality and Safety Data
Pneumothorax Rate: Kept at 0% from 2019 to 2024.
Retained Needle Rate: Kept at 0% from 2021 to 2024.
Patient Fall Rate: Kept at 0% from 2021 to 2024.
Acupuncture Injury Rate: Kept at 0% from 2020 to 2024.
Needle-Fainting Rate: Kept at 0% from 2022 to 2024.
Severe Bleeding Events: 0 cases recorded in ER interventions.
Permanent Nerve Damage: 0 cases recorded in ER interventions.
ER Intervention Shocks: 0 cases recorded during treatment.
Broken Needle Incidents: 0 cases recorded during ER stays.
Program Completion Rate: 100% completion via dual-screening.
ER Infection Rate: 0 infection cases due to strict control.
Prescription Error Rate: 0% error rate via automated system alerts.
TCM Powder Pouch Indicator: Sealed film leakage rate at a low 0.08%.
Prescription Quality Level: Drug safety quality achieved 6 Sigma level.
Hospital QCC Competition: Safe care model won 5th place hospital-wide.
Taipei Consultation Rate: ER consultation rate reached 97.6%.
Tamsui Consultation Rate: ER consultation rate reached 99.6%.
Dual-Verification System: Strict needle counts mapped to body zones.

Satisfaction

Satisfaction and Feedback Data
Overall Treatment Freq: Over 90% rated satisfied or very satisfied.
Pre-treatment Explanation: 92.2% rated satisfied or very satisfied.
ER Waiting Time Comfort: 95.3% rated satisfied or very satisfied.
Medical Professionalism: 95.3% rated satisfied or very satisfied.
Symptom Improvement Rate: 81.2% rated satisfied or very satisfied.
Doctor Respect & Listening: 95.3% rated satisfied or very satisfied.
Patient Privacy Protection: 93.8% rated satisfied or very satisfied.
Discharge Health Education: 100% provided with info before leaving.
TCM Outpatient Referral: 100% referred for follow-up if needed.
Inpatient Consultation Rate: 100% continuous care for ward transfer.
National Peer Recognition: Selected as model hospital by CMA ROC

International Achievements

International Achievements
International Journal Pub: Published ER acupuncture consultation study.
Global Literature Comparison: Vertigo relief outcomes beat prior research.
World Pain Relief Benchmarking: Soft tissue pain relief exceeded legacy data.
Global Protocol Benchmarking: More comprehensive than US/Aus setups.
Pioneering Quality Indicators: Monitored safety metrics overlooked in US/Aus.
World-Leading Fainting Protocol: Advanced fainting workflows beat US/Aus standards.
Unique Needle Retention Rules: Retained needle protocol is a global first.
Cross-Strait Forum Invitation: Invited to speak at Cross-Strait Youth Forum.
Suzhou Expert Lecture Invited: Shared ER workflows at Suzhou symposium.

Benefits and Impacts

Positive Impact
Improving Quality of Care: Pioneered sending TCM residents to the ER for a 6-month hands-on specialist training , bridging the communication gap between departments. By building the region's strongest joint emergency team , the department achieved the highest case volume in Taiwan in 2021 , significantly advancing the scale and clinical visibility of emergency integrative medicine.
Standardization of Protocols: Successfully built standard workflows for ER consultations , and led globally by crafting strict safety guidelines for needle retention and fainting management. This rigorous safety framework was selected as a national benchmark model by the CMA ROC for all major hospitals to follow.
Patient Care Benefits: Quantitative data showed significant pain relief, with mean NRS scores dropping by 2.4 points, led by chest distress and migraine. Enrolled cases of ileus, bone pain, and migraine saw 3-day ER re-visit rates drop to 0%. Early intervention within 2 hours also significantly shortened ER observation times for chest pain.
Healthcare Sustainability: Launched a pioneering sync-consultation model for emergency COVID-19 cases to prescribe NRICM101 instantly , easing ER crowding and optimizing triage. Backed by automated drug-safety order checks , the program successfully fulfills the long-term goal of safe, holistic, and sustainable green healthcare.