• Quality Improvement in Health Care
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• v.8 no.1
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• pp.84-94
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• 2001

Background : in order to adapt to changes of the medical environm interests that is drawn in ambulatory surgery are increased as a method of approaching a patients' satisfaction and cost-effective management. The purpose of this study is to a assess the operation which is able to perform through ambulatory care unit, to identify the problem in ambulatory surgery, and to increased the opportunity of ambulatory surgery with safety. Methods : Between May 13th, 1998 and June 30th, 2000, we performed surgical treatment through ambulatory care unit, and evaluate the results of them. The sorts of operation, duration of stay in the hospital, total cost of treatment, satisfaction of patients and safety if anesthesia were assessed. Results : We performed ambulatory surgery without serve complications and the patients were satisfied with surgical treatment through ambulatory care unit. In comparison of ambulatory and admission surgery, there was a reduction of cost to 16.7~25.3% in ambulatory surgery. Also, the duration of admission was 2 days shorter than admission surgery. Conclusions : According to our results, the surgical treatment through ambulatory care unit is safe and useful method that increase the quality of medical service, satisfaction of patients and reduce the cost of treatments.

• Journal of The Korea Institute of Healthcare Architecture
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• v.16 no.1
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• pp.35-42
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• 2010

As a functionally complicated facility, it requires rational strategy to accommodate multi-functional needs to plan a hospital. Ambulatory surgery units located in large hospitals have problems such as longer waiting time and congestion for patients due to complicated planning and organization within limited area, which raise needs for independent ambulatory surgery centers to enable smoother medical treatment for patients. To design an independent ambulatory surgery center, understanding of zoning and layout of each unit needs is particularly required. This study focuses on research of efficient zoning/organization of day surgery unit and circulation arrangements of ambulatory surgery centers by analyzing various examples abroad, which will eventually help finding appropriate way of planning domestic ambulatory surgery centers. Specific area of research includes ambulatory surgery process, programmatic requirements, spatial organization of the facility, layout of surgery unit and circulation arrangements of ambulatory surgery centers.

• Journal of Korean Academy of Nursing Administration
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• v.9 no.1
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• pp.5-18
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• 2003

Purpose : For improvement of nursing services in ambulatory unit, ambulatory nursing activity was identified and the required time by nursing activity was measured. Method : The data were collected from 4 tertiary hospitals and 2 secondary hospitals. The method of data collection was used the self-reporting method. The 123 nurse-work days and 137 nurse-aid-work days in 6 hospitals were analyzed. Results : As a result, 11 ambulatory nursing domains and 79 ambulatory nursing activities were confirmed. Above 50% of subjects performed the general outpatient affair domain. The percentage of total time spent in each domain were as follows : general outpatient affair domain, 58.3%, patient education ${\cdot}$ counseling domain, 10.8%, therapeutic care domain, 8.6% and so on. And the average hours were measured by activity and domain. Conclusion : For the improvement of ambulatory nursing care, the strategies that keep the legal standard of number of ambulatory nurse and exchange the nursing-aid for the nurse is needed. And it is also needed to standardize the ambulatory nursing services.

• Journal of Korean Academy of Nursing Administration
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• v.23 no.1
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• pp.90-100
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• 2017

Purpose: The purpose of this study was to develop a tool to evaluate the nursing competency of ambulatory nurses and to verify the reliability and validity of the developed tool for use in general hospitals. Methods: The evaluation tool for ambulatory nursing competency was developed through a literature review and tests for validity and reliability. Results: Subsequent to a review of the literature on nursing performance of ambulatory nurses, a 12 item questionnaire was developed. Through factor analysis, 12 items in a 2 factor solution were derived. Cronbach's ${\alpha}$ coefficient of the final instrument was .86. Conclusion: The assessment tool developed in this study allows for objective assessments of nursing competencies in relation to the competencies expected of ambulatory care nurses. It is hoped that the assessment tool can be used for empirical verification and to provide basic data for establishing the necessary policies to secure outstanding human resources.

• Journal of the Ergonomics Society of Korea
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• v.31 no.2
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• pp.327-336
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• 2012

Objective: The purpose of this study is to find the problems of stability when people use the bassinet as an ambulatory aid for old people. Background: Many aged people use a bassinet as ambulatory aid. But the safety of using the bassinet as ambulatory aid has not been verified yet. Method: The 13 university-students who don't have musculoskeletal disorders volunteered to participate in this study. According to structural analysis of the both tools, we compared the structural stability of an outdoor rollator with the structural stability of a bassinet. And when the participants walked using both tools, the motions were captured and analysed. We measured the angle of shoulder joint and the angle of trunk from the ground when the participants were walking. And we found the distance from participants' pressure cone apex and greater trochanter. Results: Following the structural analysis, the bassinet has the lower structural stability than the outdoor rollator. When the people used the bassinet as ambulatory aid, the angle of the shoulder joint was bigger than to use the outdoor rollator. The angle of trunk wasn't different between the outdoor rollator and the bassinet. And distance from pressure cone apex to greater trochanter was far to use the bassinet than to use the outdoor rollator. Conclusion: Through the structure analysis and gait analysis of the bassinet and the outdoor rollator, we can be aware of that the bassinet has problem of stability. Therefore the people who use the bassinet as an ambulatory aid, especially supporting body weight, may be hurt due to the problems of stability. Application: This research can be used for developing a study of the ambulatory aid and preventing the accident when the aged people use the ambulatory aid.

• Journal of Korean Neurosurgical Society
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• v.50 no.3
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• pp.216-223
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• 2011

Objective : The purposes of this study are to estimate postoperative survival and ambulatory outcome and to identify prognostic factors thereafter of metastatic spinal tumors in a single institute. Methods : We reviewed the medical records of 182 patients who underwent surgery for a metastatic spinal tumor from January 1987 to January 2009 retrospectively. Twelve potential prognostic factors (age, gender, primary tumor, extent and location of spinal metastases, interval between primary tumor diagnosis and metastatic spinal cord compression, preoperative treatment, surgical approach and extent, preoperative Eastern Cooperative Oncology Group (ECOG) performance status, Nurick score, Tokuhashi and Tomita score) were investigated. Results : The median survival of the entire patients was 8 months. Of the 182 patients, 80 (44%) died within 6 months after surgery, 113 (62%) died within 1 year after surgery, 138 (76%) died within 2 years after surgery. Postoperatively 47 (26%) patients had improvement in ambulatory function, 126 (69%) had no change, and 9 (5%) had deterioration. On multivariate analysis, better ambulatory outcome was associated with being ambulatory before surgery (p=0.026) and lower preoperative ECOG score (p=0.016). Survival rate was affected by preoperative ECOG performance status (p<0.001) and Tomita score (p<0.001). Conclusion : Survival after metastatic spinal tumor surgery was dependent on preoperative ECOG performance status and Tomita score. The ambulatory functional outcomes after surgery were dependent on preoperative ambulatory status and preoperative ECOG performance status. Thus, prompt decompressive surgery may be warranted to improve patient's survival and gait, before general condition and ambulatory function of patient become worse.

• Quality Improvement in Health Care
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• v.12 no.1
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• pp.6-16
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• 2006

Objectives : The purpose of this study was to identify the characteristics influencing consultation and waiting time in ambulatory patients. Methods : This study was conducted in a tertiary teaching hospital. Subjects were a total of 10,383 ambulatory patients. Consultation time was measured by time spent for meeting with his/her physician per patient. Waiting time was defined as the time difference between each patient's reserved time and time to meet with his/her physician for ambulatory care. Multiple regression analyses were performed to determine the factors influencing consultation and waiting time. Results : Consultation time was different according to patient' age, previous experience of clinic visit, recent admission history, medical department, specialist care, type of reservation, and day of the week. Significant factors influencing waiting time were patient' age, residential area, previous experience of clinic visit, recent admission history, medical department, specialist care, time spent after ambulatory care begins, and day of the week. Conclusions : The medical department was the strongest factor affecting both consultation time and waiting time. The ambulatory reservation management systems should take into account patient characteristics as well as care-related features.

• Journal of The Korea Institute of Healthcare Architecture
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• v.1 no.1
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• pp.61-67
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• 1995

The purpose of this study is to define the problems associated with ambulatory care facilities, to classify the types of ambulatory care facilities, to examine significant architectural case studies, and to point the way toward enhanced architectural solutions for healthier ambulatory health care service environments for the patients. The case study will provide a brief introduction to the selected cases and examine planning concepts and design factors.

• The Journal of Internal Korean Medicine
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• v.30 no.2
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• pp.422-430
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• 2009

Background : Stroke is the second leading cause of death in Korea, following cancer. Stroke consists of ischemic and hemorrhagic stroke, and ischemic stroke can be largely classified as atherothrombotic stroke or embolic stroke. Carotid intima-media thickness (IMT) is an indicator of atherosclerosis used commonly as a screening test for abnormalities of the coronary artery. 24-hour ambulatory ECG is widely used to screen for underlying diseases that causes syncope, palpitation, arrhythmia, etc. Objectives : Since both carotid IMT and 24-hour ambulatory ECG are used to screen for cardiac problems, we endeavored to explore the correlation between carotid IMT and 24-hour ambulatory ECG of stroke patients. Methods : The records of ischemic stroke patients who were admitted to Kyunghee Medical Center Oriental Hospital ward from March 2006 to May 2009 were reviewed. 28 patients who had both carotid Doppler US and 24-hour ambulatory ECG test undertaken during their admission were analyzed. The relationship of abnormal ambulatory results and common carotid artery(CCA) IMT were statistically analyzed using Fisher's exact test and t-test. Results : The mean age of the abnormal ambulatory group was older than the normal group (74${\pm}$ 8.0 vs. 61${\pm}$12.1, p=0.0098). Although insignificant, the abnormal ambulatory group showed much thicker CCA-IMT than normal ambulatory group (2.l7${\pm}$ 1.16 vs. 1.51${\pm}$0.97. p=0.l389). Conclusion: No significant correlation was observed between abnormal ambulatory results and CCA-IMT. However, the difference in CCA-IMT between the two groups was too big to be ignored and further investigation with larger and better controlled trials are warranted.

• Journal of Preventive Medicine and Public Health
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• v.21 no.1 s.23
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• pp.47-60
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• 1988

The monthly ambulatory treatment days in newly detected hypertension group and known hypertension group were analyzed. The population was identified through the records of screening examination given by Korea Medical Insurance Corporation during the period from April to July, 1986. From the records of screening examination, 11,614 hypertensive patients were identified. By random sampling,959 patients were selected : among them, 544 fell under the category of known hypertension group and the other 415 fell under the newly detected hypertension group. The monthly ambulatory treatment days of these patients during the period from the April, 1985 to September, 1987 were analyzed in order to compare the exents of medical care utilization as well as to define and analyze the determinants responsible for the ambulatory treatment days between the two groups. The following results were obtained. 1) In the known hypertension group, no statistically significant changes in the ambulatory treatment days was observed after, in comparision to before, the screening examination. However, in the newly detected hypertension group the medical care utilization increased after the screening examination because of hypertension. 2) The ambulatory treatment days for hypertension of the known hypertension was statistically significant and higher than that of the newly detected hypertension group after screening examination. 3) There was no statistically significant change in the ambulatory treatment days in association with diseases other than hypertension in either group before and after the screening examination. 4) There was no statistically significant variable responsible for ambulatory treatment days in the known hypertension group. However, the income was a statistically significant variable in the newly detected hypertension group. 5) After the screening examination, the variables determining the ambulatory treatment days were the age of the patient and the diastolic blood pressure in the known hypertension group. These variables responsible for 2.02% of the total ambulatory treatment days. In the newly detected hypertension group, the income was a statistically significant variable which was responsible for 2.10% of total ambulatory treatment days. The above results satisfied the hypothesis that there would be no significant changes in the ambulatory treatment days before and after the screening examination in the known hypertension group. Also the hypothesis that there would be no significant change in the exents of medical care utilization for the diseases other than hypertension before and after the screening examination in either group was satisfied Also the medical care utilization was significantly higher in the known hypertension group than the newly detected hypertension group after the screening examination. This finding satisfied the hypothesis. This study was limited by the lack of considering fully the variables reponsible for the clinical symptoms of hypertension as well as for the individual characteristics. Thus, the result of this study are not fully adequate to define the determinants responsible for the exents of medical care utilization. In the future studies on medical rare utilization, additional variables should be considered.