Taichung Veterans General Hospital achieves new milestones for holistic medical care — Novel utilization of knowledge management system for greater medical quality in Taiwan

Over the past years, the headquarters of Taichung Veterans General Hospital (TVGH) has actively introduced various types of information systems such that the hospital has become a benchmark in the digitization of medical hospitals in Taiwan. Particularly, since 2008, TVGH has introduced the KM system in such a way that it has not only created benefits in the hospital accreditation but also achieved the medical care and management process improvement mechanism with the diverse innovation of KM. Consequently, it is able to create holistic medical care services covering all aspects and to establish a solid foundation. ​
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The medical quality and care system in Taiwan are well-known in the world. This is a result achieved through the research and development of the entire medical system as well as the efforts of professionals. The medical hospitals in Taiwan are able to utilize ICT technology to improve medical service standards, which is the key to improve medical quality. Particularly, for TVGH constantly focusing on the holistic medical care, the hospital has continuously introduced various types of ICT technologies in recent years in order to create various innovative medical care services. The President of TVGH, Hui-Heng Hsu, indicates that under the complete ICT system infrastructure of TVGH, the introduction of the knowledge management system (KM) allows the extension of knowledge, constant improvement of processes and continuous innovation of services in order to establish a foundation for the holistic medical care and to allow TVGH to become the benchmarking hospital in the domestic medical industry. 

KM integrated with hospital accreditation to achieve efficiency, environmental protection and manpower savings

The professions involved in a medical system can be extremely complicated and broad. In addition, since the operating processes and standards of the various materials are different along with the rapid development of medical knowledge, the volume of knowledge accumulated by the hospital is enormous. President Hsu states that to integrate the cross-unit knowledge power of the hospital, TVGH has already introduced Knowledge Management (hereinafter referred to as “KM”) system in 2008. Through the establishment of knowledge management launch committee, each unit forms the seed teachers and for various types of clinical teaching discussion records, project execution outcomes, medical treatment processes and standards, overall audits and management are performed gradually in order to integrate all of the knowledge content that is originally scattered in different units into one system such that various types of medical knowledge and operational standards can be realized in paperless operations.

A few years after the introduction of KM, TVGH started utilized multi-dimension classification links of KM to greatly improve the daily management and supervision of the hospital. Accordingly, in 2014, when the Taiwan Society of Emergency Medicine performed the emergency medical physician training hospital survey, it applied the KM system in the accreditation for the first time. President Hsu expressed that the accreditation operation was relatively complicated, and that in the past, the hospital was often required to deploy a large number of manpower in sorting complicated articles and to print out great quantities of documents for use of the surveyors. Therefore, when TVGH used the KM system as the accreditation outcome demonstrative platform during the survey at that time, the review surveyors were impressed by such system.

Subsequently, TVGH further developed complete functions for the hospital accreditation management system, including the function for allowing supervisors to add follow-up assignments at any time and allowing staff to use the discussion function for various conditions. The system is able to remind staff about relevant matters through e-mail in order to allow the internal communication, interaction, overall accreditation operations in the hospital to be performed smoothly.
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President Hsu said that currently, TVGH utilizes KM not only at the hospital and in teaching hospital accreditation but also at various accreditations for a total of 36 items, including evaluation supervision of MOHW, hospital approval of various physician trainings and cancer diagnosis quality certification. In addition, TVGH is able to demonstrate outstanding performance in each accreditation. For example, in the2014 hospital accreditation and teaching hospital accreditation trial evaluation, through the precise search function of the KM system, during the auditing of medical care personnel operations by the review surveyors, the cooperating personnel was able to use a portable iPAD to obtain information directly from the system in order to verify whether or not the operations of the operating personnel complied with the SOP. After the accreditation, online continuous follow-up can also be used. Consequently, with numerous benefits of the system, TVGH has received great recognition. 

KM innovation with unlimited optimization processes for greater medial quality improvement  

“In fact, integration with accreditation is only a small part of KM application. Through the KM system, the values that can be created by a hospital are exceptionally great. “President Hsu also explained various examples of the benefits of KM applied in the hospital, including the case management of clinical teaching, teaching historical record management, teaching outcome statistical analysis, document asset repetitive application and so on, providing tremendous help to the achievement of holistic medical quality and care service for TVGH.

President Hsu provided the example that KM can be applied to the maintenance management of the standard operating procedures such that more than 2,700 copies of the ISO standard operation procedures (SOP) documents in TVGH can be managed completely, and medical personnel can log onto the system to search SOP. In addition, the content viewed can be ensured to be the latest version such that the hassle of misuse of numerous versions can be prevented. During the internal audit and verification, the historical operating documents and improvement project records can be searched. Therefore, it provides a great helps to the improvement of the hospital operating process and increase of medical quality as well as patient safety.

Even for the medical treatment aspect, KM can also be helpful. President Hsu said that in the field of endocrine and metabolic disorders for the treatment of diabetes, the glucose and glucose-target-rate of patients are mostly used as the indicators. Accordingly, the hospital can use the KM system to understand the target-rate of patients treated by each physician, and then the data accumulated over the years can be used as the trend indicator in order to perform peer comparison and subsequent improvement and follow-up; therefore, the medical treatment benefits of the hospital on chronic patients can be increased. 

Internal/external resources with accelerated KM innovation  

The reason that TVGH is able to apply KM to such an extent is related to the promoter’s understanding on the utilization of internal and external innovation resources. For the internal system of the hospital, TVGH has continuously promoted the “knowledge management expansion application contest activities” over the past years in order to seek employee creativity and to develop greater KM applications. President Hsu indicated that for the contest held annually, the KM promotion team would request the teams from different departments to participate in the accreditation and management team KM creativity application contest and the winner would receive the prize issued by the hospital as an encouragement thereof. As a result, best creations can be encouraged from the staff, and the sharing and learning effects can also be achieved through such method.

For the external system of the hospital, TVGH has maintained close interaction with the KM system solution provider, Galaxy Software Services (GSS), continuously. Through constant feedbacks on the information of medical service field knowledge from TVGH to GSS, GSS information is able to make adjustments on the system based on its IT professionals and both parties are able to discover greater KM development. Consequently, KM application can be deeply rooted in TVGH thoroughly, and GSS can also further improve the functions of the KM system, creating a win-win situation for both parties.

President Hsu said that the extensive KM application in TVGH has attracted numerous other domestic medical centers to visit TVGH, and TVGH has also received the honors of “2014 EPBA international project management benchmark enterprise award” and the ‘2015 PMI Taiwan project management benchmark enterprise award.”

In view of the overall KM application in TVGH, knowledge management is certainly not referring to the mere digitization of paper documents, but it also involves further thinking on how to discover new values from the vast amount of knowledge after the systematization of knowledge, in order to further improve the operational management medical quality of the hospital. It can even further achieve a cohesive corporate culture and improve team communication as well as cooperation mechanism, thereby creating a more prospective medical service path for the hospital.  
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