문제: 병원에서는 잘못 사용하는 신체 관련 언어, 문법적으로 틀린 말, 비속어, 지나친 겸양어, 잘못 사용하는 존칭어, 격에 안 맞는 준말 등으로 내부 및 외부 고객과의 의사전달이 정확하지 않은 경우가 흔히 있다. 병원 직원의 부적절한 언어 사용은 외부 고객 유치 및 유지를 방해하며, 병원의 이미지 실추와도 관련이 있다. 목적: 바른 언어 표현법 매뉴얼과 동영상 구축 및 활용으로 내부 및 외부 고객의 만족도를 향상시키고자 한다. 의료기관: 서울시 종로구에 소재한 대학병원 질 향상 활동: 바른 언어 표현법 매뉴얼 구축 후 동영상을 완성하여 병원의 모든 직원들이 학습하여 활용할 수 있도록 하였다. 개선효과: 바른 언어 표현법을 잘 학습하면 바른 언어를 사용하는 습관을 가지게 되어 의사전달이 명확해지고 표현이 풍부해지며 상호간 이해하는 폭이 넓어져 내부 고객 및 외부 고객의 만족도가 향상될 것이다. 또한 병원직원 전체 언어생활의 품격이 높아질 뿐만 아니라 병원의 위상도 높아질 것이다.

Objectives : The purpose of this study was to determine whether the published AMI report card could reduce in-patient mortality, 7-day after discharge mortality, and length of stay (LOS). Methods : Interrupted time-series intervention analysis was used to evaluate the impact of the report card for AMI care quality in November 2005 in terms of risk-adjusted in-patient mortality, risk-adjusted 7-day after discharge mortality, and DRGs case-mix LOS using the claim data of Health Insurance Review and Assessment Service. Results : Public disclosure of AMI care quality decreased risk-adjusted in-patient mortality and DRGs case-mix LOS by 0.00050% per month and 0.042 days per month respectively, however there was no effect on risk-adjusted 7-day after discharge mortality. Patterns of effect of public disclosure on AMI outcomes were a fluctuating pattern on risk-adjusted mortalities and a pulse impact for 1 month on DRGs case-mix LOS. Conclusions : We found the public disclosure of AMI care quality had decreasing effects on risk-adjusted in-patient mortality and DRGs case-mix LOS, but the size of the effect was marginal.

Background : Evidence-based guidelines are now used for enteral nutrition(EN) in neurosurgical intensive care unit patients who mostly depend on EN. This study compared and analyzed the nutritive conditions of patients before and after they underwent guideline based nutritional interventions in order to determine whether using these guidelines improved their calorie supply. Methods : Data on the patients' nutritional requirements, maximum calorie supply through EN, serum albumin level, and total lymphocyte count were collected and analyzed using SAS version 9.1.3. All the statistical analyses were performed at a significance level of P<0.05. Result : The maximum calorie supply through EN was $923.1{\pm}359.7$ kcal before the intervention and $1254.4{\pm}196.3$ kcal after the intervention; this difference was statistically significant(P<0.05). The ratio of nutritional requirements to maximum calorie supply through EN was $55.5{\pm}22.4%$ and $74.2{\pm}13.9%$ before and after the intervention, respectively; this difference was statistically significant(P<0.05). This indicates a 19% increase in the ratio after the nutritional intervention. The serum albumin level also significantly increased from $2.7{\pm}0.6g/dL$ before the intervention to $3.2{\pm}0.4g/dL$ after the intervention(P<0.05). The total lymphocyte count slightly increased from $1267.7{\pm}728.2cells/mm^3$ before the intervention to $1801.9{\pm}1211.5cells/mm^3$ after the intervention; this difference was not statistically significant. Conclusion : The results showed that using the evidence-based feeding guidelines for interventions increased the calorie supply and improved the patients' nutritive conditions from moderate malnutrition to mild malnutrition.

Background : The purpose of study in to grasp the level of perception of hospital workers on the patient safety culture, consider the difference in perception of patients safety culture according to medical service and finally find out a way to establish patient safety culture in hospital. Methods : As for the data, the analysis on frequency, t-test, ANOVA and tukey test were carried out by using SPSS 12.0. Result : The results of comparison among the positive response ratios on the patients culture of hospital workers showed that the subjects had perceived the teamwork within units most positively(74.1%), and perceived most negatively on the non-punitive response to error(16.2%)and the staffing(26.2%). 68.6% of subjects answered that the medical error were mostly of always reported. when daytime working hours are longer, perception of patient safety culture ranked low. In general, departments for direct medical service than departments for indirect medical service assessed patient safety culture high. Conclusion : Organizational learning and teamwork within units, communication openness, active support of hospital management for patient safety, and cooperation across the units would be crucial to promote the overall perceptions of patients safety of hospital workers and the level of patients safety in the units and to improve the quality of the event reporting system.