• 약학회지
• /
• 제52권2호
• /
• pp.151-159
• /
• 2008

Consultation program for pharmaceutical development is a new system in which pharmaceutical companies meet and discuss scientific and/or regulatory issues with drug regulatory authority in the research process and before submitting new drug applications. This program helps pharmaceutical companies reduce uncertainties in the research and development and increase the possibilities of getting drug marketing approval. Developed countries such as US, EU, and Japan have implemented various forms of pre-submission meetings or consultation programs since the mid-1990s. The rapid development of technology in pharmaceutical R&D increases the importance of communication between drug development companies and drug regulatory authority in Korea, too. In designing the consultation program, it is desirable to focus on the stages of clinical trials which take the longest period of time and the biggest amount of money in the pharmaceutical R&D process. We suggested that results or recommendations by drug regulatory authorities in pre-submission meetings or consultations be formally documented and considered in review process. Explicit scientific reasons are required for changing the results from consultations.

• 한국의료질향상학회지
• /
• 제8권1호
• /
• pp.56-72
• /
• 2001

Background : To shorten processing time for variety of medical affairs of the patient at the outpatient clinic of a big hospital is very important to qualify medical care of the patient. Therefore, patient's waiting time for medical examination is often utilized as a strong tool to evaluate patient satisfaction with a medical care provided. We performed this study to investigate factors delaying related with waiting time for medical examination. Methods : The data were collected from June 26 to July 30, 1999. A total 275 case of medical treatment and 5,634 patients who visited outpatient clinics of a tertiary hospital were subjected to evaluate the waiting time. The data were analyzed using frequency, t-test, ANOVA, $X^2$-test by SPSS Windows 7.5 program. Results : The mean patient's waiting time objectively evaluated ($30.9{\pm}33.9$ min) was longer than that subjectively by patient evaluated ($25.1{\pm}26.2$ min). Patient waiting time objectively evaluated was influenced by the starting time of medical examination, consultation hours, patients arriving time etc, as expected. The time discrepancy between two evaluations was influenced by several causative factors. Regarding the degree of patients accepted waiting time with the medical examination is 20 min. Conclusion : The results show that, besides the starting time of medical examination, consultation hours and patients arriving time, influence the patient's subjective evaluation of waiting time for medical examination and his satisfaction related with the service in the big hospital. In order to improve patient satisfaction related with waiting time for medical examination, it will be effective examination rather than to shorten the real processing time within the consultation room.

• 대한감각통합치료학회지
• /
• 제19권2호
• /
• pp.46-59
• /
• 2021

목적 : 아동작업치료사의 부모상담에 관한 경험을 현상학적으로 탐색하여 추후 부모상담 기술 향상을 위한 프로그램 마련의 근거로 활용하고자 하였다. 연구방법 : 연구 방법은 Colaizzi의 현상학적 연구 방법을 적용하였다. 임상경력 8년 이상으로 사설센터에서 근무하는 아동작업치료사 6명을 대상으로 전화 인터뷰를 실시하였다. 인터뷰 내용은 연구참여자의 동의하에 녹음하였으며, 추가적인 내용 확인은 이메일로 받았다. 녹음된 내용은 전사 뒤 분석하여, 아동작업치료사의 부모상담 경험의 의미와 본질을 기술하였다. 결과 : 면담 내용을 분석한 결과 2개의 범주화, 4개 주제모음, 21개의 주제가 도출되었다. 2개의 범주화에는 부모상담의 중요성과 부모상담에 영향을 미치는 요소가 있었고, 4개의 주제모음에는 부모상담의 의미, 부모-아동-치료사 간의 상호성, 치료사의 노력, 필요한 역량이 있었다. 결론 : 본 연구의 결과는 초임 아동작업치료사에 의미있는 자료로 활용될 수 있으며 앞으로 아동작업치료사의 부모상담 기술 향상을 위한 교육 프로그램이나 자료 개발의 기초자료로 활용될 수 있을 것이다.

• 한국의료질향상학회지
• /
• 제19권2호
• /
• pp.80-88
• /
• 2013

Objectives: With the increase in the number of people who are marginalized in receiving medical services, the role of Seoul National University Hospital as a public hospital is being emphasized. However, many patients are either experiencing delays in receiving medical services or simply being left out as a result of the inaccessibility to the department of social work on part of both the patients and the medical staff. Methods: In order to increase consultation from other departments and the accessibility to the department of social work for the socially marginalized group through early consultation from other departments, the following steps were taken. First, an orientation program for novice medical residents led by clinical social worker was introduced/implemented. Second, posters and brochures on various financial aids programs were produced and distributed. Third, a system of early screening was built/constructed, and once a week rounds and early screening meeting were executed/carried out. Result: The department of social work's rate of consultation from other departments increased by 4.4% compared to last year, while it showed 61% increase for those wards that had an early screening meeting. In addition, the average time of consultation from other departments was reduced by 3.1 days, securing sufficient amount of time for clinical social work services, both in terms of quality and quantity. Conclusion: It is believed that the various promotional activities, along with the strengthening of accessibility to clinical social work services and early consultation on part of social disadvantaged/marginalized group, would undoubtedly help provide quality services to patients and increase their level of satisfaction. In this way, the wards can effectively reduce the number of unnecessary hospital stay days while the hospital can prevent the accumulation of outstanding bills/fees as well as contribute to the publicness of hospitals. The promotion of clinical social work programs in various ways are crucial to ensuring the satisfaction of patients and hospital staff.

• 정신신체의학
• /
• 제31권1호
• /
• pp.10-18
• /
• 2023

연구목적 본 연구는 섬망 및 우울장애로 정신건강의학과에 의뢰된 환자들의 인구학적 특성과 자문 의뢰 형태, 재협진 여부에 따른 차이를 알아봄으로써, 종합병원 입원환자에 있어 섬망 및 우울장애의 특징 및 자문 조정 정신의학의 개선 방향을 위한 자료를 얻는 것을 목표로 한다. 방 법 건국대학교병원에 2005년 8월 1일부터 2011년 12월 31일까지 입원한 환자들 중 정신건강의학과로 자문 의뢰된 4966명의 환자를 대상으로 전산화된 의무기록을 후향적으로 분석하였다. 자문의뢰형태는 정신과 과거력, 입원 시 주호소, 의뢰된 증상의 특성 등에 따라 각각 상호보완형, 병렬형, 보수형, 선행 과거력형, 오진형, 단순 재의뢰형의 총 6가지로 분류되었다. 결 과 우울장애 환자의 평균 나이는 57.0세, 섬망 환자의 평균 나이는 68.6세로 섬망 환자군에서 유의하게 더 높았다. 성비의 경우 우울장애 환자에서 여성이 66.7%, 섬망 환자에서 남성이 60.8% 로 각각 더 높았다. 입원환자의 과별 분포는 우울장애의 경우 내과계 환자의 비율이 67.7%, 섬망의 경우 외과계 환자의 비율이 50.1%로 각각 더 높은 비율을 차지하였다. 자문 의뢰 형태에서는 우울장애의 경우 병렬형-상호보완형-보수형의 순서를 보였고, 섬망 환자의 경우 보수형-병렬형-상호보완형 순서였다. 우울장애 환자군 내에서 재협진군과 1회 협진군을 비교해 보았을 때 재협진군에서 남성 비율이 유의하게 높았다. 자문 의뢰 형태 분석에서 재협진군은 병렬형-보수형-상호보완형의 빈도 순을 보였으며 1회 협진군에서 병렬형-상호보완형-보수형의 순서를 보였다. 섬망 진단 환자군 내에서 재협진군과 1회 협진군을 비교해 보았을 때 재협진군에서 외과계의 비율이 유의하게 높았다. 자문 의뢰 형태 분석에서 재협진군과 1회 협진군 모두 보수형-병렬형-상호보완형의 순서를 보였다. 결 론 정신과 자문 의뢰 형태를 분석한 결과 우울장애 환자군과 섬망 환자군에서는 연령, 성비, 자문 의뢰 형태, 재협진률 등에서 유의한 차이를 보였다. 이 같은 결과를 바탕으로 의료진은 환자를 입원시키는 시점부터 우울장애 및 섬망과 같이 호발하는 정신과적 공존 질환에 대해 정신건강의학과 자문을 통해 적극적으로 치료계획을 논의함으로써, 환자에게 이차적으로 발생할 수 있는 우울장애와 섬망 등의 위험 요인을 파악하고 조기에 개입하여 의료 서비스의 질을 향상시킬 수 있을 것이다.

• Journal of Trauma and Injury
• /
• 제30권2호
• /
• pp.25-32
• /
• 2017

Purpose: The use of computed tomography (CT) to evaluate acute abdominal complaints has increased over the past two decades. We investigated how the clinical practice of patients with intestinal perforation has changed with the increasing use of abdominal CT in the emergency department (ED). Methods: We compared ED arrival to CT time, ED arrival to surgical consultation time, and ED arrival to operation time according to the method of diagnosis from 2003-2004 and 2013-2014. Results: In patients with gastrointestinal perforation, time from ED arrival to CT was shorter ($111.4{\pm}66.2min$ vs. $199.0{\pm}97.5min$, p=0.001) but time to surgical consultation was longer ($135.1{\pm}78.8$ vs. $77.9{\pm}123.7$, p=0.006) in 2013-2014 than in 2003-2004. There was no statistically significant difference in time to operation for perforation confirmed either by plain film or CT between the two time periods. There was no statistically significant difference in length of hospital or ICU stay or mortality between the two groups. Conclusion: With the increasing use of abdominal CT in ED, ED arrival to CT time has decreased and ED arrival to surgical consultation time has increased in gastrointestinal perforation. These changes of clinical performance do not delay ED arrival to operation time or adversely influence patient outcome.

• 전기전자학회논문지
• /
• 제24권1호
• /
• pp.293-301
• /
• 2020

Consultation with the patient and doctor is very important in the examination. However, if the consultation cannot be done directly, such as corona virus, it is difficult for the doctor to determine the patient's condition more accurately. Recently, an image counseling system has been developed based on the Internet, but in the case of heart disease, remote medical counseling cannot be performed because it is not possible to stethoscope the heart sounds remotely. In order to solve this problem, it is necessary to develop an interactive mobile robot capable of remote medical consultation, and a doctor and a patient should be able to set a planting sound during consultation and transmit it in real time. In this paper, we developed a robot that can remotely control a medical counseling robot to move to a hospital room where patients are hospitalized, and to consult a patient in the room remotely from a doctor's office. A remote medical imaging stethoscope system for real-time heart sound transmission is presented. The proposed system is a kind of P2P communication that transmits video information, audio information, and control signal independently through webRTC platform, so that there is no data loss. Consults and sees doctors in real time and finds it more effective than traditional methods for patient security. The system implemented in this paper will be able to perform remote medical care in the place where the spread of diseases between humans like the recent corona 19 as well as the remote medical care of heart disease patients in the future.

• 약학회지
• /
• 제52권3호
• /
• pp.201-211
• /
• 2008

All pharmacists must provide the drug consultation whenever dispense drugs to patients by the Korean Pharmacy Law. Drug consultation is very important procedure for increasing pharmacotherapy. Because it maximizes the therapeutic effects or/and minimizes adverse drug reaction during the drug therapy. However, it is not easy to do because of the dynamic and hectic pharmacy environment. Especially, if someone has a disabling body function, they required more time and efforts to perform consultation by pharmacist. Currently several auxiliary labels for helping drug consultation are using in pharmacy practice but not for disabling patients. Therefore we developed the total 53 auxiliary labels with size of 0.7 cm (width) and 1 cm (length) by Braillewriter letters for blind patients. This research has been performed for total 12 months (Mar. 15ts, 2007$\sim$Feb. 25th, 2008) and the developing methods are consisted of 4 steps: 1) selection of essential informations, 2) simplification of information, 3) changing for Braillewriter letters, 4) application and revising by blindness patients. Also the labels are consisted of 12 for adverse reactions and precautions, 8 for directions, 2 for storages, 9 for duration, 9 for dosage forms, and 12 for common names. After developed those labels, we revised those labels by discussion with 2 blind people. In conclusion, the new auxiliary labels for blind patients can increase therapeutic effects and decrease risks from pharmacotherapy besides decreasing of pharmacist's work load in the future.

• 동서간호학연구지
• /
• 제18권2호
• /
• pp.95-103
• /
• 2012

Purpose: This methodological study was done to develop a computerized telephone triage and consultation system for patients discharged with ophthalmic disease in order to provide more efficient practice guidelines for nurses, and evaluate the usability of the system. Methods: Development of the system consisted of six phases: strategic planning, analysis, design, implementation, evaluation, modification, and maintenance. Results: In the strategic planning phase, ophthalmic problems and nursing interventions of triage algorithms and practice guidelines were cross-mapped with the Omaha system. In the analysis phase, users requirements were identified. Then infrastructure including database, nursing knowledge base, and user interface were designed in the implementation phase. Usability and satisfaction of the system presented as very positive. Telephone consultation took about 2 minutes less than time in the previous system. The system was modified based on users' comments during the evaluation phase. Conclusion: This study was the first attempt in Korea to develop computerized triage system to prompt the quality of telephone consultation. It is suggestive that the computerized triage system may improve the quality of nursing.

• 한국병원경영학회지
• /
• 제18권1호
• /
• pp.59-69
• /
• 2013

Purpose Patients should have a regular medical check-up, the cost direct and indirect medical expenses to check the results, and revisit the hospital. Some of patients often want to use the telephone for a medical consultation, Method The subjects participating in this study were a selection 485 patients who received outpatient service in Asan Medical Center and Gangbuk Samsung Hospital. The patients's favorite method for medical check-up, time, cost, fatigue, and inconvenience, in regard with the revisit to check the examination results, were researched and analyzed on identical questionnaires about them. Results The average transportation, food expenses and opportunity costs the subjects spent was 90,400 for those from the Seoul and Gyunggi area, and 269,800 from other area. And the average required time per visit was 4.13 hours for those from the Seoul and Gyunggi area, 11.84 hours from other areas, and averagely 7.72 hours for all the subjects. More than 75% of the subjects answered that they felt tired and their work was interrupted. The subjects from both areas preferred the check by phone. Conclusion If the scope of telephone medical consultation is defined and the doctor-patient certification is possible, it can be thought as an efficient alternative of the medical check-up by revisit. It is necessary to discuss an appropriate amount of the medical check-up by phone which the same cost and effort can be allocated in.