• 대한간호학회지
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• 제30권5호
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• pp.1156-1169
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• 2000

The study was aimed at developing an independent hospice center model that would be best suited for Korea based on a literature review and the current status of local and international hospices. For the study, five local and six international hospice organizations were surveyed. Components of the hospice center model include philosophy, purpose, resources (workers, facilities, and equipment), allocation of resources, management, financial support and hospice team service. The following is a summary of the developed model: Philosophies for the hospice center were set as follows: based on the dignity of human life and humanism, help patients spend the rest of their days in a meaningful way and accept life positively. On the staff side, to pursue a team-oriented holistic approach to improve comfort and quality of life for terminally ill persons and their families. The hospice center should have 20 beds with single, two, and four bed rooms. The center should employ, either on a part-time or full-time basis, a center director, nurses, doctors, chaplains, social workers, pharmacists, dieticians, therapists, and volunteers. In addition, it will need an administrative staff, facility managers and nurses aides. The hospice should also be equipped with facilities for patients, their families, and team members, furnished with equipment and goods at the same level of a hospital. represented by a center director who reports to a board and an advisory committee. Also, the center director administers a steering committee and five departments, namely, Administration, Nursing Service, Social Welfare, Religious Services, and Medical Service. Furthermore, the center should be able to utilize a direct and support delivery systems. The direct delivery system allows the hospice center to receive requests from, or transfer patients to, hospitals, clinics, other hospice organizations (by type), public health centers, religious organizations, social welfare organizations, patients, and their guardians. On the other hand, the support delivery system provides a link to outside facilities of various medical suppliers. In terms of management, details were made with regards to personnel management, records, infection control, safety, supplies and quality management. For financial support, some form of medical insurance coverage for hospice services, ways to promote a donation system and fund raising were examined. Hospice team service to be provided by the hospice center was categorized into assessment, physical care, emotional care, spiritual care, bereavement service, medication, education and demonstrations, medical supplies rental, request service, volunteer service, and respite service. Based on the results, the study has drawn up the following suggestions: 1. The proposed model for a hospice center as presented in the study needs to be tested with a pilot project. 2. Studies on criteria for legal approval and license for a hospice center need to be conducted to develop policies. 3. Studies on developing a hospice charge system and hospice standards that meet local conditions in Korea need to be conducted.

• 대한간호학회지
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• 제32권2호
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• pp.155-164
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• 2002

With the dynamically changing environment of society, managing change is the vital element of organizations's survival and growth. Health care organizations have expended enormous resources to restructure patient care delivery. Despite the growing literature describing these organizational innovations, there is a paucity of credible data that reflects systematic measurement and evaluation of such changes. This study examined the nurses' psychological response toward the work process redesign, newly introduced by the nursing department in a acute care hospital. The aim of the study was to figure out how nurses's general perception of change and perceived attributes of change affected their acceptance of change during the organizational transition. This was descriptive- correlational. The sample for the study included 50 head nurses and 135 staff nurses. Data was analyzed using SPSS PC+, version 10.0. The major findings of the study were as follows: First, the mean score of the perception of change was 71.2(SD=13.8) with the range of 0-100, which means nurses generally perceived change positively. There were significant differences in perception of change by gender and education level. Head nurses perceived change more positively than staff nurses. The higher education level showed the more positive view of change. Second, among the perceived attributes of change, trialability had the highest mean score, which means nurses perceived the change more positively if it is testable on a limited basis. Relative advantage was perceived the most negatively. Finally, factors influencing the acceptability of the work-process redesign were perceived comparability, complexity, relative advantage, and observability, which accounted for 43.7% of the variance in the acceptability of change. This study evaluated the preliminary effects of the nursing process for reengineering, focusing on nurses' acceptability towards change. The usefulness of this research study was to determine the factors influencing acceptance of organizational members during transitional periods of change and to suggest effective strategies for increasing adoption as well as for decreasing resistance to change.

• 한국병원경영학회지
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• 제22권4호
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• pp.1-15
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• 2017

This study was designed to analyze the effect of servicescape and human service quality on patients' internal response and their behavioral intention in dental care organizations. Self-administered survey questionnaires with structured instruments were developed, and a total of 226 responses were used for statistical analyses using SPSS Windows version 18.0 program and AMOS 18.0 program. Major findings of the study are as follows. First, among other servicescape components, air condition environment was found to have a positive effect on patients' cognitive and physiological responses, while signals and symbols had a positive effect on cognitive and emotional responses. Second, the competence, among other factors of the human service quality, had positive influence on cognitive and emotional responses, while customer understanding affected positively on emotional response. Third, none of the servicescape components showed a direct effect on patients' behavioral intention, but their influence was mediated by internal responses. However, customer understanding, among other human service quality factors, had a direct effect on patients' behavioral intention. Fourth, emotional response, among other internal response factors, proved to have positive influence on behavioral intention. Results from this study suggest that dental care service providers can increase their competitiveness and customer satisfaction by understanding and improving the most important areas of servicescape and human service quality.

• 보건의료산업학회지
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• 제9권2호
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• pp.13-22
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• 2015

This study confirmed that the organizational health of nurses have an effect on customer orientation. This survey was conducted March 1 to 31, 2014 and a total of 210 questionnaires were used in the analysis. Descriptive statistics, t-test, ANOVA, factor analysis, and regression analysis were used to analyze the collected data in the SPSS software package. The findings are summarized as follows: First, the business environment and community-oriented organizations on health factors had an influence on customer orientation(p<.05, p<.001). Among the demographic factors, graduating from college as relevant to customer orientation. Seniority and rank in the lower tier showed that customer orientation is vulnerable. Second, when leadership was added to a conventional model, it had no significant effect on the dependent variables. The influence of community-oriented business environment factors on customer orientation was statistically significant(p<.01). In the result, we should apply proper organizational health factors to hospitals by investigating leadership, because there was difference in customer orientation according to type of leadership.

• 한국콘텐츠학회논문지
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• 제18권1호
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• pp.504-516
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• 2018

재정의 지속가능성 확보는 보편적 의료보장(UHC)을 달성하기 위해 필수적이며, 전 세계적으로 재정관리체계 구성요소 중 하나인 전략적 구매기능에 관심이 높아지고 있다. 본 연구에서는 전략적 구매의 개념과 기능을 고찰하고, 한국 건강보험제도에 있어서의 구매기능과 관련 기관을 Preker(2005)가 제시한 전략적 구매 모형에 근거하여 검토하였다. 이를 위하여 관련 문헌을 고찰하였다. 전략적 구매는 주어진 예산의 범위 내에서 국민이 필요로 하는 보건의료서비스를 제공하기 위한 전략적 활동으로 정의된다. 구매관리자는 정부 혹은 국민들을 대신하여 구매 활동을 수행하며, 정부, 구매자, 의료공급자의 관계는 주인-대리인 이론으로 설명될 수 있다. 우리나라에서의 '구매'는 '한정된 재정 내에서 국민이 필요로 하는 보건의료를 제공하기 위한 전략적 활동으로 급여 범위와 대상 설정, 상급종합병원 지정이나 정보 공개 등 양질의 의료서비스 공급자 선정 활동, 급여기준과 가격 설정, 진료비 지불방법의 설계와 운영, 심사와 평가, 모니터링 활동을 포함'하는 것으로 설명할 수 있다. 건강보험심사평가원과 국민건강보험공단이 정부의 위임을 받아 주된 구매활동을 수행하며, 의료기관평가인증원과 한국보건의료연구원 등이 일부 역할을 담당하고 있다.

• 대한한방내과학회지
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• 제39권4호
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• pp.662-675
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• 2018

Objective: The aim of this study was to establish the developmental history of hospice palliative care (HPC) with Korean medicine (KM). Methods: We compared the developmental history of HPC in Korea with that of Britain, the United States, Taiwan, Japan, and China. The articles in English or Korean published until Feb. 2017 were searched using 'Hospice' or 'Palliative care' with the name of each nation in the PubMed, MEDLINE, ScienceDirect, and CINAHL (Cumulative Index to Nursing and Allied Health Literature) databases for foreign articles and OASIS (Oriental Medicine Advanced Searching Integrated System) for domestic articles. Books and gray literature were searched on the same databases and websites of the Ministry of Health and Welfare and related organizations in each country. Results: Modern palliative care began with the hospice movement led by Dr. Cicely Saunders. HPC in Korea started earlier than in other countries but it took considerable time for social consensus, so Korean policies have only been published recently. In this process, KM was excluded from HPC. For this reason, western medicine in Korea does not fully accept the spirit of HPC, the government does not take an aggressive stance with KM, and the institutes of KM do not have any interest in HPC. The World Health Organization recommends the establishment of policies and programs connected with a country's own health care system. In 2015, the Korean government made the third comprehensive plan for the development of KM. It included critical pathway guidelines about cancer-related fatigue and anorexia. More effort is required to set up HPC than other care types because Korea has two medical systems. Conclusions: Each nation has been trying to improve systems of HPC. We need to overcome the problems and bring out the best by making our own model of HPC with KM.

• 지역사회간호학회지
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• 제8권1호
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• pp.116-132
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• 1997

The purpose of the study is to find out how laws related to the nursing profession can be improved by analyzing the rules and regulations concerning nursing. Furthermore, to help settle legal matters in the process of doing nursing work. The data used for the study are the Health and Medical Act, the Maternal and Child Health Act, the School Health Act, the Special Act for Health and Medical Service in Rural Areas, the Industrial Health & Safety Act and the Notice on Nursing Professional Courses analyzed by age and content. The results of the study are as follows : First, basic nursing practice includes 'nursing care for recuperation and assistance in medical treatment and in special areas including the pre-vention of disease, maintenance of health, control of environment, and other therapeutic activities. It is suggested that the phrase 'assistance in medical treatment' should be eliminated as it limits the basic nursing practice to the assistance of the medical treatment. Second, Article 56 of the Health & Medical Act prescribes a special nurse but it does not prescribe a specific job. Accordingly, the new provison concerning the specific jobs of a special nurse should be added or a job guide should be inseated. Third, it is prescribed that those who have completed the training course after obtaining a license are qualified to be a midwife, a special nurse and a nurse practitioner working in special areas. However, school nurses, occupational health nurses and maternal and health workers are required to obtain a nurse license, but not to take an additional training course. Nurses working in special areas should be legally recognized as nurse specialists. The regulations to control various qualification standards consistently should be established. Fourth, the qualifications and types of nurses by area prescribed by Article 54 of the Health and Medical Act are not consistent with those of special nurses as recognized by affiliated organizations of the Korean Nurse Association and some hospitals. Accordingly, the qualifications and types of special nurses should be adjusted in consideration of special nurses. Fifth, as Article 16, Paragraph 2 of the Health and Medical Act does not prescribe the type and scope of first - aid treatment that nurses can provide, the first-aid treatment of nurses might be considered as an unlicensed practice. The specific regulations regarding these matters should be established. Sixth, the contents of the nursing record, which are prescribed by Article 21 of the Health and Medical Act as a duty, include 1) matters concerning body temperature, pulse, breath and blood pressure 2) matters concerning drug prescription 3) matters concerning input and output 4) matters concerning the treatment and nursing care (Article 17 of the Enforcement Regulations, Health and Medical Act). However, these matters are limited to basic nursing care and assistance in medical treatment. The new recording methods on nursing process are suggested to be adopted legally. Seventh, the prescription right entrusted to nurses which are prescribed by the School Health Act, the Special Act on Health and Medical Service for Rural Areas, and the Industrial Health and Safety Act are not consistent with the rights of nurses as prescribed by the Health and Medical Act. New regulations prescribing the partial right for medical treatment entrusted to nurses in consideration of the restraint of time and place in emergency situations should be established.

• 산업공학
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• 제23권3호
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• pp.246-256
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• 2010

As wireless and mobile technologies have advanced significantly, lots of large sized healthcare organizations have implemented so called mobile hospital (m-Hospital) which provides a location independent and point of care (POC) clinical environment. Implementation of m-Hospital enhances quality of care because health professionals such as physicians and nurses can use hospital information systems at the very place where patients are located without any delay. This paper presents a real-time patient monitoring system based on wireless network technologies. A general framework for the patient monitoring process is introduced and the architecture and components of the proposed monitoring system is described. The system collects and analyzes biometric signals of in-patients who suffer from cancer. Specifically, it continuously monitors oxygen saturation of patients in bed and alarms health professionals instantly when an abnormal status of the patient is detected. The monitoring system has been used and clinically verified in a university hospital.

• 유통과학연구
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• 제14권7호
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• pp.21-31
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• 2016

Purpose - With globalization, medical tourism has developed as a new industry, which attracts practitioners and academics to have more interest in researches on customers' behavior. This research was to investigate empirically WOM effects on the intention of Chinese customers when they select an international medical tourism destination. Interestingly, WOM effects on their choice and decision process may vary by the extent of their severity of illness. Research design, data, and methodology - The data was collected from 1,747 potential Chinese residents in main districts of China. Moderated regression analysis was used to estimate WOM effects on Chinese customers' choice intention. Results - Results imply that WOM determinants of tie strength, credibility, and vividness do interact with medical tourism information and affect customers' intention for health care abroad. Results also reveal that the severity of illness plays a critical moderating role in customers' decision process. Conclusions - WOM and the severity of illness are important moderators for Chinese customers to make a decision for medical tourism. It provides some implications for service organizations for developing and implementing marketing strategies in international health care markets.

• 가정∙방문간호학회지
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• 제22권1호
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• pp.59-68
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• 2015

Purpose: The purpose of this study was to analyze nursing research using data envelopment analysis and suggest directions for future research. Methods: We established -criteria literature search. e reviewed 45 from RISS, KISS, National assembly library and NDSL DB. Data were collected on December 17, 2013. developed analytic framework of literature reviews using Yun's study. This framework had 8 items related to approach of data envelopment analysis. Results: literature established -criteria. Average numbers of input and output variables were 2.4 and 4.2, respectively. All selected research conducted efficiency analysis, analysis, and inefficiency analysis. However only 3 research. Conclusion: he results of studysuggest that data envelopment are needed to enhance efficiencies of nursing organization as follows individual nurse's profiling to develop customized performance management plans; patient centered nursing interventions; and financial performance financial reports.