Kaohsiung Armed Forces General Hospital

Dialysis center innovations:

1. Service innovation：

• Customized scheduling：
  Adjust the working hours of medical staff to cooperate with patients to achieve one-on-one customized services and implement “patient-centered” medical services. In addition, it can also effectively reduce working hours, shorten the number of hours medical staff work, reduce operating costs, and achieve a win-win situation for operators and medical staff.
• Strengthen health education work, prevention is better than cure：
  In line with national policies, the Diabetes Care Network and the Chronic Kidney Disease (CKD) Care Network health education clinic have been established to promote diabetes health education and kidney disease prevention and treatment through full-time diabetes health teachers, chronic kidney disease health teachers, nutritionists and other care teams. We hope to reduce the incidence of end-stage renal disease through daily health education (note: uremia caused by diabetes has reached more than 1/3 of all kidney dialysis patients). We also cooperate with the National Health Bureau of the county and city government and the Renal Medicine Association to go to grassroots communities from time to time to promote kidney health care.
• Pay attention to quality control and strive for excellence：
  In order to improve the safety of dialysis patients’ pipelines, we produced a fixed version (patent pending) and innovatively used the double U fixation method to reduce patients’ fear and pain during dialysis. We also participated in the 1998 Medical Quality Control Circle Competition and performed well.

2.Technological innovation：

• Peritoneal dialysis：
  • In line with national policies, we have established peritoneal dialysis treatment rooms and resting and waiting areas for patients’ families, making our hospital’s ratio of hemodialysis to peritoneal dialysis better than that of its peers.
  • This center uses fully automated peritoneal dialysis (APD) for the first time.

3.Results：

• Peritoneal dialysis can reduce the number of daily connections for patients and reduce the infection rate.
• Less restrictions and greater flexibility in daily life can improve patients’ quality of life.
• Provide patients with comprehensive renal replacement therapy options.

4. Pre-peritoneal catheter implantation (SMAP)The first case was performed by the attending physician – Director Cai Mingkai and the attending physician – Director Xu Jingwen. The patient received HD treatment in February 1996. However, the patient himself was the breadwinner of the family. Due to work demands, he wanted to switch to peritoneal dialysis treatment. However, patients with traditional tube implantation needed to be hospitalized for a longer period of observation. He wanted to shorten the length of hospitalization and allow the patient to return as soon as possible. Because of his lack of employment, he underwent implantation on August 7, 1996, becoming the first “pre-implantation” case in our hospital.

5. Results：

• Preliminary tube implantation can avoid emergency dialysis intubation and dangerous complications; it can also shorten the length of hospitalization. Moreover, when peritoneal dialysis is started, the full dose of dialysis can be given and PD can be performed immediately.
• Allow patients to enter regular dialysis treatment smoothly and safely after fully understanding, learning and preparing.

6. Hemodialysis：
In addition to traditional hemodialysis (HD), our center also provides:

• Hemodialysis treatment (HDF).
• Continuous renal replacement therapy (CRRT), including CVVHD, CVVH and CVVHDF.
• Plasma exchange treatment.
• Hemoperfusion and other comprehensive services to benefit patients.