• 제목/요약/키워드: Health care quality, access, and evaluation

검색결과 13건 처리시간 0.019초

Improvement of the Trauma Care Process by Implementation of a Computerized Physician Order Entry-Based Trauma Team Approach

  • Lee, Ji-hwan;Lee, Jin-hee;You, Je-sung;Chung, Sung-phil;Kim, Hyun-jong;Cho, Jun-ho;Kim, Min-joung;Chung, Hyun-soo
    • 한국의료질향상학회지
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    • 제21권2호
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    • pp.12-24
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    • 2015
  • Purpose: The need for the rapid evaluation and treatment of emergency department patients with major trauma is essential. A computerized physician order entry (CPOE) system can improve communication and provide immediate access to information with the goal of reducing ED time delays. The aim of this study was to report on the operation of a trauma CPOE program and demonstrate its usefulness by comparing time intervals from ED arrival to various evaluation steps before and after implementation of the program. Methods: This was a before-and-after observational study from a single emergency department at an academic center. The CPOE program was implemented for 6 months and compared with the data collected from the pre-CPOE implementation period. The efficacy of the program was assessed by comparing the time difference before and after CPOE implementation based on the following factors: total boarding time in ED, door-to-disposition decision time, door-to-blood-test report time, door-to-X-ray time, door-to-CT time, and door-to-transfusion time. Results: Over a period of 6 months, the CPOE was activated for a total of 17 patients. Total boarding time was reduced significantly after implementation [median, 641.5 minutes (IQR, 367.3-859.3) versus289.0 minutes (IQR, 140.0-508.0) for pre-CPOE vs. post-CPOE, respectively, p< 0.05). Time intervals for all evaluation steps were reduced after implementation of the program. The improvements in the door-to-blood-test and door-to-CT times were both statistically significant. Conclusion: This study demonstrated that a standard CPOE system can be successfully implemented and can reduce ED time delays in managing trauma patients.

소비자와 제공자가 자각하는 간호서비스와 측정도구에 관한 연구 (A Study of the Nursing Service Perceived by Consumers and Providers, and the Tool that Measures Nursing Service)

  • 이미애
    • 대한간호학회지
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    • 제33권6호
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    • pp.772-783
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    • 2003
  • Purpose: This study was performed to measure the nursing service perceived value by consumer and providers, and to investigate the relationship among nursing service, general satisfaction and hospital revisiting intent, and to examinate the tools that measures nursing service's reliability, construct validity and usefulness. Method: The questionnaire was developed and distributed to 300 patients and 210 nurses at three general hospitals. For data analysis, SPSS/PC program was used. Result: The nursing service perceived value by providers is higher than that by consumers. There are distinctive difference in the expectation, and importance and performance values of the nursing service perceived. In examination of the relationship among nursing service, general satisfaction and hospital revisiting intent, nursing service has a deep relationship with general satisfaction, but doesn't have relationship with hospital revisiting intent. The tool that measures nursing service has a good reliability and construct validity. In analysis on the usefulness between the tools, SERVPERF tool is more useful than SERVQUAL tool. conclusion: The nursing service perceived value by consumer is different that by providers, and the tool that measures nursing service has a good reliability and construct validity. The SERVPERF tool is more useful than SERVQUAL tool.

영국의 노인공동생활주택에 대한 검토 (Review of Communal Housing for the Elderly in the UK)

  • 홍형옥
    • 가정과삶의질연구
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    • 제19권4호
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    • pp.49-68
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    • 2001
  • The purpose of this study was 1) to review communal housing in the UK, 2) to consider the policy implications for elderly communal housing in Korea. The research methods used were 1) literature review about communal housing and related policy in the UK 2) field survey in the UK 3) interpretative suggestion for the proper policy implication to develope communal housing for the elderly in Korea. Sheltered housing in the UK had been developed as communal housing for the elderly with special needs since the 1970s. The type of sheltered housing were category 1 and category 2. Very sheltered housing with more facilities and meal services was added in 1980s. Sheltered housing was evaluated as the most humanistic solution for older people in the UK in 1980s. Because of the policy of moving institutional care to community care, sheltered housing became less in demand because of more options for older people including being able to stay in their own home. So new completion of sheltered housing by registered social landlords reduced saliently. Sheltered housing already totalled over half million units in which 5% of all elderly over 65 still lived and a small quantity of private sector for sale schemes emerged in the 1990s. The reason why the residents moved to sheltered housing was for sociable, secure, and manageable living arrangements. In general the residents were satisfied with these characteristics but dissatisfied with the service charge and quality of meals, especially in category 2.5 schemes. The degree of utilisation of communal spaces and facilities depended on the wardens ability and enthusiasm. Evaluation of sheltered housing indicated several problems such as wardens duty as a \"good neighbour\" ; difficult-to-let problems with poor location or individual units of bedsittiing type with shared bathroom ; and the under use of communal spaces and facilities. Some ideas to solve these problems were suggested by researchers through expanding wardens duty as a professional, opening the scheme to the public, improving interior standards, and accepting non-elderly applicants who need support. Some researchers insisted continuing development of sheltered housing, but higher standards must be considered for the minority who want to live in communal living arrangement. Recently, enhanced sheltered housing with greater involvement of relatives and with tied up policy in registration and funding suggested as an alternative for residential care. In conclusion, the rights of choice for older people should be policy support for special needs housing. Elderly communal housing, especially a model similar to sheltered housing category 2 with at least 1 meal a day might be recommended for a Korean Model. For special needs housing development either for rent or for sale, participation of the public sector and long term and low interest financial support for the private sector must be developed in Korea. Providing a system for scheme managers to train and retrain must be encouraged. The professional ability of the scheme manager to plan and to deliver services might be the most important factor for the success of elderly communal housing projects in Korea. In addition the expansion of a public health care service, the development of leisure programs in Senior Citizens Centre, home helper both for the elderly in communal housing and the elderly in mainstream housing of the community as well. Providing of elderly communal housing through the modified general Construction Act rather than the present Elderly Welfare Act might be more helpful to encourage the access of general people in Korea. in Korea.

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