• 보건행정학회지
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• 제25권3호
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• pp.229-239
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• 2015

Background: The hospital accreditation program in Korea has been conducted since 2011 in order to improve patient safety and healthcare service quality. This study was conducted to find factors associated with satisfaction as surveyor and reliability of surveyors in hospital accreditation program. Methods: This study was performed targeting 217 responded to the survey among 412 surveyors who had participated in the accreditation survey for acute care hospitals from December 2010 to February 2014. Results: The average number of survey per surveyor is 2.35. We divided surveyors into those who participated in the survey more than 3 times and less than 3 times in order to judge the professionalism of surveyors according to the number of survey participation. Those factors that have an influence on the satisfaction as surveyors include: activity period as surveyor, role in the survey team, experience of survey in other fields, experience as consultant and the useful education and proper composition of survey team (p<0.05). Those factors that have an influence on the reliability for fellow surveyors include: number of beds of hospitals they belong, experience of survey in other fields, useful education, proper composition of survey team and difficulty in leadership interview (p<0.05). Conclusion: It is important to provide useful education and proper composition of survey team to increase the satisfaction as surveyors and the reliability for fellow surveyors.

• Clinical Endoscopy
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• 제57권3호
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• pp.302-308
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• 2024

With incessant advances in information technology and its implications in all domains of our lives, artificial intelligence (AI) has emerged as a requirement for improved machine performance. This brings forth the query of how this can benefit endoscopists and improve both diagnostic and therapeutic endoscopy in each part of the gastrointestinal tract. Additionally, it also raises the question of the recent benefits and clinical usefulness of this new technology in daily endoscopic practice. There are two main categories of AI systems: computer-assisted detection (CADe) for lesion detection and computer-assisted diagnosis (CADx) for optical biopsy and lesion characterization. Quality assurance is the next step in the complete monitoring of high-quality colonoscopies. In all cases, computer-aided endoscopy is used, as the overall results rely on the physician. Video capsule endoscopy is a unique example in which a computer operates a device, stores multiple images, and performs an accurate diagnosis. While there are many expectations, we need to standardize and assess various software packages. It is important for healthcare providers to support this new development and make its use an obligation in daily clinical practice. In summary, AI represents a breakthrough in digestive endoscopy. Screening for gastric and colonic cancer detection should be improved, particularly outside expert centers. Prospective and multicenter trials are mandatory before introducing new software into clinical practice.

• 핵의학기술
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• 제19권2호
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• pp.108-111
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• 2015

Purpose Lately, in accordance with the increasing interest about Healthcare accreditation program and International laboratory accreditation scheme, requirements about the instrument quality management are gradually taking shape. In nuclear medicine In vitro laboratory, the most typical instruments are multi detector gamma counter and automatic dispensing system. Each laboratory continue with the quality control adequate for circumstances. The purpose of this study is to application and establish the new Calibrator[I-125]Set which is efficient at standardization of equipment quality management. Materials and Methods Deviation between detectors were measured with 12 solid samples of the Calibrator[I-125]Set. their activities differ from each other by less than 1%. Multi detector gamma counters are GAMMA-10;Shinjin medics. Inc, Goyansi, Korea(Gamma counter A), SR300;Stratec biomedical systems AG, Gewerbestr, Germany(Gamma counter B) and COBRA II; Packard Instrument Co. Inc, Meriden, USA(Gamma counter C). Evaluation of two automatic dispensing system used A, B liquid tracer of the Calibrator[I-125]Set. After dispensing and counting, calculated using the ratio of the measured value and proposed value. We used solution A for 20, 25ul and solution B for 50, 100ul. Method of data analysis and reference range was provided by kit documentation. Furthermore, we could calculate our counter efficiency indirectly. Results The CV(%) of measured values by Gamma counter A, B, C are 0.34, 0.70, 1.30. Calculated value are 1.05314, 2.10419, 4.08485. Provided reference range is less than 3. A dispensing system's calculated values are 0.986, 0.989, 1.023, 1.017 and B are 0.874, 0.725, 1.021, 0.904. Provided reference range is from 0.95 to 1.05. Also, counter's efficiency are 74.18, 72.79, 74.32% at counter A, B, C and efficiency of the one detector counter is 79.26%. Conclusion If using this Calibrator[I-125]Set after verifying whether quality assurance, is applicable to equipment quality management on behalf of the role of gold standard.

• 대한방사선기술학회지:방사선기술과학
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• 제33권4호
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• pp.387-394
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• 2010

보건의료 분야에서 방사선은 의료기기 등의 멸균을 목적으로 빠르게 기존 방법을 대체하고 있으며 국제적으로, 정립된 엄격한 품질기준을 적용하고 있다. 방사선 멸균의 품질관리는 조사된 제품의 흡수선량이 요구 조건 및 기준에 부합하고 있음을 보증하는 것인데, $Co^{60}$ 동위원소를 이용하는 감마선 조사와는 달리 기계 전기적 방법에 따른 전자빔 조사는 더욱 많은 공정인자에 대해 기술적인 접근 방법이 필요하다. 국내에서는 2000년대 초반부터 전자빔 가속기의 보급이 시작되어 연구 및 산업분야에 이용되고 있으나 국제적 품질체계에 부합한 흡수선량의 품질에 관련된 연구는 매우 미흡한 실정이다. 서울방사선서비스는 2008년 10 MeV, 8 kW 사양의 대단위 전자빔 조사시설을 설치, 운영하기 시작하였는데, 전자빔 가속기, 제품운송장치, 안전장치, 기록관리 및 하위 구성장치가 통합시스템을 구성하여 우수제조기준에서 요구하는 공정품질 및 제품추적이 가능하도록 설계되었다. EN ISO11137로 대표되는 국제 표준의 이행을 위해서는 표준이 의도하는 바를 정확히 이해하고 장치의 설계기준부터 운영단계 별로 요구되는 품질시험을 정해진 절차 및 기준에 부합하도록 수행하여야 한다. 본 연구에 사용된 조사시설의 설계 시방을 제시하고 이를 구현하는데 필요한 핵심 장치의 설계 기준 및 특징에 대해 소개하였다. 또한 흡수선량 품질보증이라는 목적을 달성하기 위해 다양한 공정인자에 대한 품질시험결과를 제시하고 제시된 기준과 비교, 평가하였다.

• 한국치위생학회지
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• 제14권6호
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• pp.789-794
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• 2014

The increasing cross-border mobility of dental school or dental hygiene students, educators, practitioners, programs and providers takes challenges for existing national quality assurance and accreditation frameworks and bodies, as well as for the systems for recognizing foreign qualifications. The new dental hygiene accreditation system was introduced to encourage the improvement of dental hygiene programs, to ensure the quality of education and, most of all, to establish an internationally compatible system of evaluation and accreditation. The accreditation procedure takes 1 year to complete. The result of the accreditation is released after evaluation via self-study report, site visit, preliminary draft report, responses from the institution and the results from the conciliation and review committees. The result from the accreditation procedure is either 'accreditation' or 'no accreditation'. Accredited schools receive one of several statuses following the evaluation. These are next general review, interim report and interim visit or suspension. Dental healthcare quality is not improved instantaneously, but instead gradually through continuous communication within the dental field. For this accreditation system to be successful, the following are essential: the accreditation agency should adopt hygiene education accreditation; it needs to become financially independent and managed efficiently; the autonomy and regulations surrounding the system need to be balanced; the professionalism of the system is ensured; and the dental field which includes not only dental program, but also hygiene program, needs to play an active role in the operation of the system.

• Perspectives in Nursing Science
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• 제15권2호
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• pp.81-91
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• 2018

Purpose: This study aimed to suggest strategies for advancing local-government-based accreditation systems and surveyor training in long-term care facilities in Korea. Methods: A comprehensive review of the literature including research papers and official reports issued by governments from the United States, Australia, and Japan was conducted to explore domestic and international policies related to long-term care facility certification and accreditation systems. Results: The USA has two types of care quality assurance systems including mandatory certification (5-star rating system) by the Centers for Medicare and Medicaid Services and voluntary accreditation by the Joint Commission on Accreditation of Healthcare Organizations. Australia operates a government-based mandatory accreditation system for all long-term care facilities through the Australian Aged Care Quality Agency. Japan, particularly the Tokyo district, operates a third-party evaluation system that involves the voluntary participation of long-term care facilities. Conclusion: This study provides several strategies to enhance accreditation processes and surveyors'expertise. For instance, motivating facilities to voluntarily participate in accreditation is necessary by 1) providing sufficient and continuous consultations and feedback about how to improve care quality, 2) differentiating accreditation domains and indicators from the national health insurance certification system, and 3) actively utilizing accreditation results and providing incentives.

• 한국의학물리학회지:의학물리
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• 제21권2호
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• pp.223-231
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• 2010

국내 개설된 방사선종양학과 중 선형가속기 및 근접치료기기가 설치되어 환자치료를 시행하고 있는 총 72개 기관에 대해 설문을 수행하였다. 설문은 선형가속기, 근접치료기기 등의 품질관리 효율성을 파악하기 위해 주기별 품질관리 수행여부, 수행인력 및 주체, 수행 시간을 조사하였다. 선형가속기 및 근접치료기기에 대한 각각의 품질관리 검사 항목에 대한 주기별 수행 여부를 조사하였다. 조사결과 품질관리 검사항목 수에서 미국 및 유럽의 품질관리 지침서와 비교하여 일일 및 주간점검 항목수의 경우는 8~10로서 유사한 결과를 보였으나, 월간과 연간점검 항목 수는 미국 및 유럽의 경우 17~21 항목이었고, 국내의 경우는 15.5로 낮게 나타났다. 또한 국내의 여건은 품질관리를 수행 할 인력 및 시간의 부족과 제한으로 인해 미국 및 유럽의 품질관리 지침서에서 권고하는 소요인력 및 시간과 비교하여 대략 50% 수준의 낮은 수치를 보였다. 따라서 본 연구에서 수집한 국내 방사선종양학과의 품질관리 검사항목 및 실행 주기, 수행 인력 및 수행시간에 관한 현황 조사 결과와 기존에 발표된 미국의학물리학회 TG-40 보고서 및 유럽의 품질관리 지침서를 활용한다면 국내 실정 및 각 기관에 적합한 품질관리 지침서를 수립하는데 유용할 것으로 기대된다.

• 대한임상검사과학회지
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• 제37권3호
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• pp.178-184
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• 2005

Carry over contamination has been reduced in some systems by flushing the internal and external surfaces of the sample probe with copious amount of diluent. It between specimens should be kept as small as possible. A built-in, continuous-flow wash reservoir, which allows the simultaneous washing of the interior and exterior of the syringe needles, addresses this issue. In addition, residual contamination can further be prevented through the use of efficient needle rinsing procedures. In discrete systems with disposable reaction vessels and measuring cuvets, any carry over is entirely caused by the pipetting system. In analyzers with reuseable cuvets or flow cells, carry over may arise at every point through which high samples pass sequentially. Therefore, disposable sample probe tips can eliminate both the contamination of one sample by another inside the probe and the carry over of in specimen into the specimen in the cup. The results of the applicative carry over experiment studied on 21 items for total protein (TP), albumin (ALB), total bilirubin (TB), alkaline phosphatase (ALP), aspratate aminotranferase (AST), alanine aminotranferase (ALT), gamma glutamyl transferase (GGT), creatinine kinase (CK), lactic dehydrogenase (LD), creatnine (CRE), blood urea nitrogen (BUN), uric acid (UA), total cholesterol (TC), triglyceride (TG), glucose (GLU), amylase (AMY), calcium (CA), inorganic phosphorus (IP), sodium (Na), potassium (K), chloride (CL) tests in chematology were as follows. Evaluation of process performance less than 1% in all tests was very good, but a percentage of ALB, TP, TB, ALP, CRE, UA, TC, GLU, AMY, IP, K, Na, and CL was 0%, implying no carry over. Other tests were ALT(-0.08%), GGT(-0.09%), CK(0.08%), LD(0.06%), BUN(0.12%), TG (-0.06%), and CA(0.89%).

• 한국병원경영학회지
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• 제11권1호
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• pp.31-53
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• 2006

The objective of this study is to examine the effectiveness of the strategy of hospital specialization by analyzing the differences in expected and perceived services, perceived service quality, satisfaction, and intentions to revisit and recommend the hospital to others between general and specialty hospitals. Data were collected using self-administered questionnaire from patients admitted to four study hospitals: two speciality and two general hospitals. The questionnaire was developed based on SERVQUAL to measure five dimensions of service quality. Four hundreds questionnaires were distributed to inpatients or their guardians and 282 returned questionnaires were used in the analyses. The significance of the differences in study variables between specialty and general hospitals were tested by t-test and $x^2$-test. The factor analysis result confirmed the construct validity of 28 questions asked to measure service quality and resulted in four dimensions of service quality: reliability, assurance, tangible and empathy/responsiveness. Cronbach's Alpha ranged from .9013 to .9358, that confirmed the internal consistency of answers. The study results indicated that patients who used specialty hospitals had higher levels of expected and perceived service, a higher level of perceived service quality, and higher levels of service satisfaction than patients who used general hospitals. Percents of patients who had the intention to revisit the hospital and to recommend the hospital to others were higher among patients in specialty hospitals. The most frequent reason to choose the hospital was the excellence of doctors in both general(29.9%) and specialty(43.8%) hospitals, that was followed by convenient transportation(15.3%) and someone know works at the hospital(15.3%) in general hospitals and other's recommendation(14.6%), and nice amenities(13.1%) in specialty hospitals. Although there were no significant differences in clinical department, age, and sex of patients between general and specialty hospitals, patients who visited speciality hospitals had higher levels of education and income than their counter part in general hospitals. These results suggested that specialty hospitals performed better than general hospitals. Specialization could be a viable strategy to tide over recent financial difficulties experienced by hospitals, particularly small- and medium-sized hospitals.

• 간호행정학회지
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• 제22권1호
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• pp.46-56
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• 2016

Purpose: Purpose of this study was to identify major trends of action research from 2006 to 2013 and suggest directions for activating and advancing domestic action research in nursing. Methods: A review was made of 118 action research studies in hospital settings reported in international journals. Search from PubMed, Ovid, and CINHAL was done using analysis criteria developed by the researchers. General and methodological characteristics and focus on changing outcomes of action research were analyzed. Results: The major group of researchers belonged to colleges/universities (40.7%). Methods included use of qualitative methods (61.0%), research questions (24.6%), and use of theoretical models (35.6%). Prevalent data collection methods were interviews (20.2%), and 48.3% showed more than a 1-cycle process including spiral circulation structure. Focus of changing outcomes of the 56 papers including more than 1-cycle were practice (66.1%), environment (8.9%), client-nurse (7.1%). Conclusion: Trends in action research in nursing were identified providing necessary reasons to increase action research in nursing as follows: needs of various researchers including stakeholders as well as healthcare providers, various research designs including unconstrained reflection and writing, specific presentation of adapted theoretical models and action strategies, and quality assurance for validity and reliability of research processes and outcomes.