The Department of Chest Medicine at Far Eastern Memorial Hospital has established a patient-centered, interdisciplinary respiratory care model. Guided by the core values of precision medicine, team collaboration, sustainable carbon reduction, process optimization, quality improvement, innovative development, and pursuit of excellence, the department has developed and implemented an integrated care system involving physicians, nurses, pharmacists, and dietitians. This model is deeply embedded in disease-specific medical strategies and continues to shape a high-quality Center of Excellence for pulmonary care.

      Under the philosophy and culture of Total Quality Management (TQM), all medical services, care delivery, and strategic execution are centered on the patient. The department emphasizes innovation, continuous improvement, analysis and review, standardization, and implementation to establish a robust quality culture in pulmonary medicine. Strategies and work plans are formulated based on clinical needs, team missions, and annual objectives, driving various initiatives. In alignment with hospital-wide quality frameworks, the department has assigned dedicated personnel for patient safety, quality improvement (indicator liaisons), and ISO compliance. Regular monthly departmental meetings are held to report on quality-related matters.

    Monthly team meetings are conducted to analyze and review performance indicators. For abnormal indicators, improvement plans are proposed and tracked using the PDCA (Plan-Do-Check-Act) cycle. Below are key aspects and tangible results of our TQM culture:

1. Culture of Innovation and R&D

   The department fosters innovation as a central pillar of medical care. It focuses on new ideas, technologies, developments, and services to build novel healthcare models. Examples include:

 Precision medicine using exhaled nitric oxide for asthma management

    Development of a 5G AI-based voiceprint monitoring system for asthma care

     Big data-driven predictive modeling for extubation outcomes and ARDS risk assessment in respiratory therapy

2. System Optimization and Innovation

   The majority of patients in the department are inpatients. For high-risk patients, real-time system alerts enable the care team to take timely actions, reducing intubation and emergency incidents. Additional innovations include:

   Alert systems for COPD patients overusing oral steroids

   SABA (short-acting beta-agonist) overuse warnings in asthma patients

Optimized electronic respiratory therapy systems

   These digital innovations enhance care quality through improved system integration.

3. Culture of Continuous Quality Improvement

   All clinical quality indicators are regularly monitored, analyzed, and reviewed. Immediate adjustments are made as needed, and PDCA cycles are implemented to strategize and execute improvements. Examples include:

 Reducing average length of stay for pulmonary inpatients

Increasing smoking cessation success rates in COPD patients

Expanding telemedicine services and remote health consultations

4. Standardized Process Implementation

   Medical procedures are documented into standardized operating procedures to ensure consistent and accurate care. For instance:

   RCC (Respiratory Care Center) developed standardized weaning protocols, leading to one of the highest weaning success rates nationwide

   Standardized protocols for pulmonary rehabilitation, with top execution rates across the country

5. Indicator-Based Quality Monitoring

    Quality indicators are set based on clinical needs. Indicator definitions are clearly outlined, with data collected via automated systems. Tableau dashboards assist teams with clinical analysis, review, and improvement. Since 2018, indicator audits have ensured that designated staff understand data definitions and address abnormalities effectively.

 Tangible Achievements

   The department’s commitment to team-based care, innovation, and continuous quality improvement has led to the following achievements:

   Joint Commission of Taiwan Disease-Specific Care Certification: Certified for both "COPD Care Quality" and "Asthma Care Quality"

SNQ National Quality Mark: Awarded five SNQ National Quality Certifications

   Asthma Care: Patented (Certificate No. M670227, Taiwan Intellectual Property Office) use of exhaled nitric oxide and 5G voiceprint technology, achieving 94% asthma control rate; reduced oral steroid usage from 11.07% in 2019 to 2.89% in 2024; implemented ESG initiatives to reduce high-carbon medications and devices, cutting usage by 44.83% and carbon emissions by 3,250 kgCO?e over three years

   COPD Care: With optimized team-based care, achieved a 94.29% six-month smoking cessation success rate in 2024, highest nationwide; awarded top national quality incentive funding from the Health Promotion Administration for six consecutive years

Respiratory Therapy: Innovative use of Electrical Impedance Tomography (EIT) has enhanced critical care quality, with a 74% weaning success rate at the Respiratory Care Center

Looking Forward

   To meet future trends in smart and technological healthcare, the Department of Chest Medicine remains committed to delivering high-quality respiratory care through integrated team collaboration. Emphasizing precision medicine, team-based care, system management, process optimization, innovation, and quality enhancement, we aim to continuously improve care for respiratory patients. We also integrate ESG principles into clinical practice to fulfill our social responsibility in healthcare. With relentless pursuit of innovation, strategic quality monitoring, and process improvement, we strive for excellence—continually raising the standard of respiratory care without pause.

SNQ National Quality Mark: Awarded five SNQ National Quality Certifications

The quality of thoracic medicine has been published in various medical associations, with outstanding results.