Title: Enhancing Patient Safety and Satisfaction: Show Chwan's Journey to TÜV Rheinland SQS Healthcare Standard 2019 Certification and Beyond

 

Introduction：

In order to enhance the quality of medical services, the Show Chwan Healthcare System (Show Chwan), encompassing both the Show Chwan Memorial Hospital (CS. Hospital) and Chang Bing Show Chwan Memorial Hospital (CB. Hospital), participated in the certification process of the TÜV Rheinland SQS Healthcare Standard 2019 (SQS Healthcare). TÜV Rheinland, a symbol of safety and quality in virtually all areas of life, was founded over 150 years ago. The purpose of this study is to examine the efforts and outcomes of Show Chwan's engagement in the SQS Healthcare certification process, with a focus on evaluating the tangible impact of achieving this certification on the quality of medical services, as well as patient and employee satisfaction.

Methods：

Since March 2021, the Show Chwan in Changhua's two hospital areas has initiated preparations for SQS Healthcare certification. Initially, a task force was established to develop an annual work plan, which is executed, tracked, reviewed, and continuously improved each month. In terms of risk reduction, Hazard Vulnerability Analysis (HVA) was applied to select, analyze, and prioritize disasters. Emergency drills were conducted on-site for the top five high-risk disasters. Regarding patient safety, environmental safety, and service processes, quality monitoring and satisfaction surveys are regularly conducted. For issues or items with lower satisfaction, problem analysis and proactive improvements are made. The hospital system made systematic improvements to both its hardware and software infrastructure and optimized various work processes to achieve standardization and documentation. Cross-departmental audits are conducted annually to ensure the implementation and consistency of standards in theory, writing, and practice. The Director's office organizes annual management review meetings to examine hospital safety, quality, and risk control management, ensuring that overall results meet organizational operational needs and ensuring effectiveness, appropriateness, and adequacy.

Results：

In January 2023 and December 2023, CS. Hospital and CB. Hospital successfully passed the TÜV SQS Healthcare certification for two consecutive years, becoming the first hospitals in Taiwan to pass the 2019 version of the certification. To provide 'patient-centered' high-quality services, the Show Chwan invested in numerous hardware upgrades to offer one-stop integrated medical services. Recognizing the importance of specialized care, CS. Hospital established a Craniofacial Center in April 2023 and an Integrated Traditional Chinese and Western Medicine Center in July 2023. CB. Hospital set up an International Thyroid Center offering one-stop outpatient services, enabling same-day appointments, examinations, and diagnoses, thereby reducing patients' anxiety of traveling back and forth for medical treatment. These initiatives earned recognition through the award of the Taiwan’s SNQ National Quality Mark Certification, providing a safe, convenient, and comfortable medical environment for the public. Additionally, the Show Chwan established a regional joint defense team in the central hospital area, including CS. Hospital, CB. Hospital, and Zhushan Hospital. This team, comprising seven medical departments, collaborates with physicians supporting each other in joint scheduling, providing services where 'patients stay put, and doctors move,' ensuring the fastest possible golden standard treatment, and focusing on patient-centered care for the most comprehensive health care.

In the realm of mitigating risks, the HVA pinpointed 'fire' as a critical area of concern. To address this, the SQS Healthcare committee's audit uncovered flaws in the system for recalling emergency response personnel. Subsequent enhancements led to the implementation of an efficient one-touch mobile voice paging system, significantly speeding up response times. Additionally, to streamline patient services, twelve new self-service payment kiosks were introduced in the outpatient departments this year, noticeably reducing waiting times for patients making payments. This improvement is reflected in patient satisfaction scores, which rose modestly but notably: CS. Hospital saw an increase from 86.5% in 2020 to 87% in 2023, and CB. Hospital from 85.8% to 86.4% in the same period(Figure 1). The patient count also grew substantially between 2020 and 2023, by 4.8-9.1%(Figure 2), a testament to the growing trust and recognition of Show Chwan’s medical services in the local community. On the employee front, satisfaction levels at CS. Hospital and CB. Hospital improved from 82% and 69% in 2020 to an average increase of 2.3%-3.3% by 2023 (Figure 3), following the adoption of SQS Healthcare in 2021.

In the logistics and support management sector, Show Chwan took a significant step in 2018 by introducing the 'Smart Logistics Mobile Inspection System.' This system utilizes mobile devices to scan and upload inspection results directly to a database, fostering a paperless work environment, enhancing administrative efficiency, and cutting down operational costs. In 2023, the focus shifted to waste management with the launch of a lean improvement project. Despite ongoing enhancements in medical services, the hospitals successfully reduced their infectious waste output by an average of 4500 kg per month, aligning with ESG corporate sustainability goals and promoting a lifestyle of reduced carbon footprint and waste.

Conclusion：

'To cure sometimes, to relieve often, to comfort always.' The Show Chwan has been serving the community for 50 years, adhering to the service philosophy of 'Heartfelt, Innovative, and Treating Patients as Family.' Bearing the responsibility of a guardian in local healthcare, it is committed to providing patient-centered, safe, and friendly services, fulfilling the vision of 'becoming the Mayo Clinic of Asia and establishing excellent rural hospitals.' Therefore, a new audit system was introduced to mobilize knowledge, raise awareness, prompt change, and put knowledge into action. This enhances management and service quality. The recent successful passage of the SQS Healthcare certification, with gradual improvements in patient and staff satisfaction data, demonstrates that the Show Chwan has adapted well. This success illustrates the replicability of Show Chwan's certification approach. The improvements in patient and employee satisfaction, along with enhanced risk management and service processes, suggest that this model could effectively be adopted by other healthcare institutions seeking similar advancements in care quality and operational efficiency.

Reference：

1.        TÜV Rheinland SQS Healthcare Standard 2019