DAISY nurse March -- Wu Jia-Yun

Nurse Wu Jai-Yun worked on the ventilator care unit for 6 years. The patients are all long term chronic respiratory dependent patients. Most of these patients are unresponsive and they stare blindly in the white ceiling every day and that may be the only thing they see day in and day out. Typically the nurse's duty can also be mundane and repetitious. But to nurse Wu, she sees her job is to not only take good care of the patients physically with compassion and enthusiasm but also provide emotional and spiritual support to the patients and their family.

She once had to attend to a 70 years old female patient who was ventilator dependent, and bed ridden after a severe stroke. Her condition wasn’t stable and the outlook was not too optimistic. The patient relied on machines to maintain her vital signs, and her primary caregiver was her daughter. When the physician discussed the DNR option for her mother, her daughter refused and insisted on aggressive resuscitation instead.

While interacting with the patient’s daughter, Nurse Wu Jia-Yun realized that there was a strong bond between the daughter and her mother. The daughter was not married and her mother was her life’s only focus. Losing her mother would mean lose her motivation for other things. Understanding the situation, Nurse Wu Jia-Yun made exception to the visiting-hours limitation, hence increasing the time available to the daughter to care for the patient. Ms. Wu also made efforts to improve the comfort level of the patient, by relieving her pain and providing spiritual support. Through interaction, she soon developed a very good relationship with the patient’s daughter. Ms. Wu helped the daughter cope and grieve. The patient’s daughter began to understand that since nothing could be done that would improve her mother’s condition, letting go may be the best way to relieve her mother from suffering. She eventually accepted the DNR option for her mother, and the patient passed away surrounded by her family in peace and dignity.

For Nurse Wu Jia-Yun, the core of good patient care is to maintain the patient’s dignity and improve his or her comfort during illness. The scope of care is also extended to the patient’s relatives. She demonstrated the core values of Min-Sheng Healthcare Network in:

■ Honesty：
1. Complete duties within timeframe.
2. Follow hospital and department policies and procedures.
■ Originality：
1.Involved in quality indicator monitoring, and in various quality improvement projects.
2. Involve in developing nursing continuous education.
■ Progression：
1. Pursued further academic degree while working at the same time.
2. Voluntarily attended nursing administration training course and was promoted as the deputy head nurse of the respiratory care center in 2010.
■ Excellence：
1. Proactively identifies patient and family needs/difficulties and provides recourses and support.
2. Patient and family satisfaction.
■ Sharing：
1. Is a clinical mentor and teaches new staff and nursing students; she is viewed by others as enthusiastic and a patient mentor.
2. Willing to cover extra shifts and support other units when there’s a staffing shortage.

Daisy nurse Feb. -- Wu Show-Mei

Ms. Wu Show-Mei has been working as a nurse ever since she graduated from school 13 years ago. Her passion for this career grew as her experience increased. Nurse Wu Show-Mei is now assistant nurse manager on the “VIP ward” (the unit that receives private-pay patients) where she has served for several years. From her daily clinical service, she has come to realize that sincerity and compassion are essential for good patient care. She also clearly understands that “Money is not everything” and that “Health is the greatest wealth.”
Here is an example from a real story:

Mr. Tzu was a senior executive at a company. He was admitted to the hospital with end-stage cancer, and because the disease had spread throughout his body he couldn’t undergo surgery. Although he has accepted his fate and try to face positively in the impending death, his primary nurse Ms. Wu soon realized that Mr. Tzu’s was consumed with worries on the future of his wife and young son. Nurse Wu built a good and trustful nurse-patient relationship with Mr. Tzu and his family. She facilitated a pastor upon patient's request to provide spiritual support to the patient and his family, and encouraged him to reflect on his life honestly. Thanks to her efforts, the patient was not afraid of death anymore, he felt at peace with himself and was able to express his feeling toward his family openly. After Mr. Tzu passed away, Nurse Wu assured the patient had proper wrapping of his body and accompanied Mr. Tzu and his family in the final journey of his life.
Nurse Wu meets Nightingale’s spirit of helping people with passion, patience, caring, attentiveness, and respect. She also reflects the core values of Min-Sheng’s Network through:

■ Honesty：
1. Has worked in this hospital for 9.5 years, therefore expressing her loyalty.
2. Pays attention to cost and expenses and never charges the patient wrongly.
3. Documents care in nursing notes accurately and thoroughly.

■ Innovation：
1. In 2009, her quality improvement project of “enhancing inter-shift communication” won the 2nd prize in the hospital-wide competition.
2. In 2010, her patient education poster won the 2nd prize in the nursing department competition.

■ Progression：
1. Actively attends ongoing educational programs, such as specialty trainings of OB/GYN and Pediatrics, mentor program, infection control and quality improvement.
2. Completed nursing administration training and was promoted to assistant nurse manager in 2010.

■ Excellence：
1. Selected as the “best nurse of the month” by patients in May, July, August, September, October, November, and December of 2010.
2. Received 52 compliment letters from patients after discharge in 2010.

■ Sharing：
1. As a clinical teacher, she provided instruction to new staff and nursing students, she is loved and trusted by her trainees.
2. She is willing to cover extra shifts and support other units when there’s a staffing shortage.
3. Proactively increased level of cleanliness and safety in the care environment and won the 2nd price in the hospital wide competition.

Min-Sheng Hospital is very fortunate to have such a fine nurse providing direct care to the patients at the hospital.

Dr. Yang Min-Sheng reflects on his life journey in an interview with the National Taiwan University Alumni Magazine -Part II

A father and son’s big dream

Upon his retirement thirty years later, his son, Dr. Fred Yang came back from the United States with the ambition of not just carry on with his father’s business, but to expand it and make it more sustainable.

After receiving his M.D from NTU and completing his residency at the Chang Gung Memorial Hospital, Dr. Fred Yang went on to study public health at Harvard and business management under Peter Drucker. As he was about to launch his own career in the U.S, he received a letter from his father urging him to come back to Taiwan.

Dr. Yang Min-Sheng recalls: “When we were at our old san-Min Campus we used to encounter operation bottlenecks. We hardly had any competitive advantage, and couldn’t deliver sustainable financial results and medical quality. Therefore I wrote to my son and asked him to come back”. Within two weeks Fred Yang had brought his entire family back to Taiwan. “I was surprised and deeply moved. My son had heard my plea.”


Turning a crisis into an opportunity

What Dr. Fred Yang saw was an opportunity. In order to establish a healthy financial structure, he appointed an American finance expert as Vice President. A project to build a new hospital got underway in 2001, but construction costs overrun, the SARS epidemic outbreak of 2003 and a reduction in reimbursements from the National Health Insurance led the hospital to face new financial challenges.

In 2007, Dr. Yang stunned everyone by entering a “sell and lease back” agreement for the hospital’s ground and building with Insurance giant ING. This move relieved the hospital from financial stress, and provided Dr. Fred Yang with the leverage to expand his healthcare business and to work towards fulfilling his dream of managing 100 facilities within 10 years through mergers and acquisitions.
In order to manage his growing healthcare business efficiently and effectively Dr. Fred Yang formed a management company, Health Care Corporation of Asia (HCCA) which he put in charge of HR, strategic planning, and finance for all the facilities of the Min-Sheng group. He invited Dr. Steve Chan, the former Minister for Health, as board chairman of HCCA.

Meanwhile, Dr. Yang formed another healthcare logistics company, ShareHope, to integrate purchases of medications and other medical supplies, as well as laundry service for all Min-Sheng facilities. Thanks to this centralized management, operations and logistics costs have been greatly reduced. Both ShareHope and HCCA are expected to be eventually listed on the stock market.

To keep improvements in quality in pace with the facilities expansion, Dr. Yang started recruiting doctors and professors from National Taiwan University such as Prof. Lee Yuan-The and Prof. Chang Yang-Chyuan. Today, nearly 80% of the doctors at Min-Sheng served at NTUH, and the improvement in quality was recognized through Joint Commission International hospital accreditation in 2006.

Dr. Fred Yang has successfully transformed and elevated Min-Sheng from simply operating hospitals to running a healthcare business. He is now ready venture in the Greater China market, and embrace opportunities in the biotechnology field.


Life after retirement

With his son firmly in charge, Dr. Yang Min-Sheng has been able to enjoy happy and carefree retirement. “He -Fred Yang- is accountable for the future of Min-Sheng. I am glad to see that he performs beyond my expectations.” What accompany Dr. Yang Min-Sheng these days are not scalpels and syringes, but books, poems, music, chess, golf, friends, and his wife.

轉自台大雙月刊第73期http://www.alum.ntu.edu.tw/wordpress/?p=10328

Dr. Yang Min-Sheng reflects on his life journey in an interview with the National Taiwan University Alumni Magazine -Part I

Founder and chairman of Min-Sheng Healthcare Network, Dr। Yang Min-Sheng started his business as a one-man surgical clinic 35 years ago। He shared his clinic space with other physicians, so that patients would benefit from doctors of different specialties. Thirty-five years later, Min-Sheng Healthcare Network has become a healthcare enterprise operating 1200 beds. In this article we will learn about the history, growth and evolution of the Min-Sheng Healthcare Network. Its expansion strategies of “sell and lease back” and “merge and acquisition” completely broke the norms of the healthcare industry in Taiwan.

Inspired by Professor Dr. Yang Si-Biao

In 1959, Dr। Yang Min-Sheng graduated from Taipei Municipal Jianguo High School, and although he ranked in the top 5 in academic performance, it wasn’t enough to enter the medical school of National Taiwan University (NTU). Fortunately he was admitted to NTU medical school because a prospective student gave up on the opportunity. However back then, Dr. Yang’s real interest was not in medicine but in civil engineering. He didn’t concentrate on his studies and wasted plenty of valuable time outside school. One thing worth mentioning is that he began to learn Japanese which he was able to use later in life while participating in Rotary Club activities.

In his 3rd year in medical school, academic requirements began to be very tough, and he was forced to commit himself to studying in order to survive in the highly competitive medical student group। Not until he began his internship at the National Taiwan University Hospital (NTUH) in his 5th year, did he find his passion and enthusiasm toward medicine. Finally in the 7th year, he was top of his class in academic performance and he started to build the confidence required to be a good doctor.

When he started his clinical residency at NTUH, his mentor was Professor Dr। Yang Si-Biao। Professor Yang was a specialist in TB treatment. Back in those days, the technology was not very advanced, and diagnosis was mostly based on physical exams that require experience and expertise from the physician. Professor Yang was a very good role model for Dr. Yang Min-Sheng in terms of medical practice and caring for patients. Dr. Yang Min-Sheng decided to be a good physician like Professor Yang.

Choosing GI surgery as his specialty

For most medical students, surgery is the top choice of specialty, and Dr. Yang Min-Sheng was no exception. He recalls: “A surgeon looks very confident. When patients come to the hospital they look very sick, but they become energetic 2-3 days after surgery… this is so amazing.”

This was a time of constant surgical innovations, such as “finger fracture” for liver surgery created by the famous surgeon Professor Dr. Lin Tien-Yo, or open heart surgery and lung surgery. There were also many opportunities for young surgeons to further study overseas. For all these reasons and the fact that his other mentor, Professor Dr. Hsu Shu-Chien (the one who introduced him to the lady who would later become his wife) specialized in GI surgery, Dr. Yang Min-Sheng chose GI surgery as specialty.

There are many other teachers that Dr. Yang Min-Sheng also appreciated, such as Professor Lin Huai-Shan who taught histology, Professor Yeh Shu who taught pathology, and Professor Yeh Chia-Ying who taught Chinese. Dr. Yang Min-Sheng learned how to be a good physician from these talented and compassionate mentors.

However, the memory of medical school is not all pleasant. Studying biochemistry was a nightmare. He was one of three students who failed in that subject, and Professor Chang Yu-Cheng (also the Chief Officer for Academics) didn’t give him a chance to appeal. “That was the only makeup exam I had in my entire life. The summer of my 2nd year made for the darkest days in my academic life” says Dr. Yang Min-Sheng.

Building confidence from being the leading actor in a stage-play


Dr. Yang Min-Sheng never participated in university extracurricular activities during his 7 years at NTU because of the heavy academic workload and his shy personality. The only exception was that he was accidentally chosen to be the leading actor in a stage-play called “The Ding-Sher Family (meaning: a rich family).” Dr. Yang Min-Sheng played the part of the father in the family and his natural and hilarious acting was loved by the audience. It also gave him the chance to interact with female classmates who had so far seemed to be “inaccessible.” This experience helped Dr. Yang regain his confidence.

Being tired of commuting between Taipei and Taoyuan everyday, he started staying at his classmates’ or private-tutoring students’ places. In his 5th year, he even lived at the medical school’s old library located next to the morgue. Says Dr. Yang: “I didn’t mind it at all. It was a very quiet and a good place for me to study at night.”


TB infection motivated him to open his own hospital

In his 2nd year at NTUH, Dr। Yang contracted tuberculosis (TB) and underwent surgery as an inpatient। Without that experience, he wouldn’t have comprehended the pain and hardship of being a patient. “This happened a day when Professor Chen Kai-Mu (AKA: The Thunder God) told me to insert a patient with a Foley catheter. I was too busy and forgot about it. When Professor Chen visited the patient in her room later after surgery and the patient complained, he yelled at me for being forgetful. At that moment I began to vomit blood and was sent to the operation room immediately by my colleagues.” There he was tied to the surgery table and was inserted a bronchoscope rudely by an ENT doctor. I suffered during the entire examination process. I told myself, I wouldn’t do this to my patients in the future.” said Dr. Yang. Thanks to the operation by Professor Lin Tien-Yo, his disease was cured, however difficulty urinating and emptying his bowels after surgery made Dr. Yang experience the sufferings of being a patient again. He says “I was so bored staying in a hospital. The only things I was looking forward to were the visits by my primary nurse everyday.”

At first his goal was to be a successful plastic surgeon, but he didn’t receive a recommendation from Professor Hsu to study plastic surgery overseas. As a part-time physician at NTUH his income was limited, meanwhile he didn’t receive financial supports from his in-laws anymore. Furthermore, because his history of TB he had to alter his plans of being a physician overseas. Instead, he decided to open his own clinic in his hometown of Taoyuan City.

With his reputation from training at NTUH, Dr. Yang’s surgical clinic attracted many patients and its business did very well. In order to better serve his patients, he opened his clinic space to other specialists. If patients needed a surgery that Dr. Yang couldn’t perform himself, he would invite other specialist to the clinic to operate on them. Thanks to this service, patients no longer needed to travel to Taipei for specialty surgeries and treatments. He also opened several branch hospitals and nursing homes in rural areas of Taoyuan. “When I earned 10 thousand dollars, I dreamed of contributing 50 thousand dollars to society. When I got 100 thousand dollars, I dreamed of contributing more. My goal is to continuously realize dreams.”

Dr. Yang Min-Sheng retired from clinical service two years ago. Over his career he has helped relieve the pains from disease of countless patients, but what always brought Dr. Yang the greatest feeling of accomplishment was to help patients solve their financial difficulties. “In those days physicians had more autonomy and freedom. We could freely decide how to charge a patient. Take an Appendectomy for example; we would charge wealthy patient $30,000. But for a poor patient, a chicken was good enough to pay for the surgery. We robbed the rich and helped the poor. Like a gentleman thief. We often solved the patients’ physical and emotional problems, and won their respects and friendship.” This good patient-physician relationship motivated Dr. Yang Min-Sheng to keep moving.

轉自台大雙月刊第73期http://www.alum.ntu.edu.tw/wordpress/?p=10328