• Title/Summary/Keyword: Healthcare quality assurance

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Study on the Resolution Characteristics by Using Magnetic Resonance Imaging 3.0T (3.0T 자기공명영상을 이용한 해상력 특성에 대한 연구)

  • Min, Jung-Whan;Jeong, Hoi-Woun;Han, Ji-Hyun;Lee, Si-Nae;Han, Song-Yi;Kim, Ki-Won;Kim, Hyun-Soo;Son, Jin-Hyun
    • Journal of radiological science and technology
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    • v.43 no.4
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    • pp.251-257
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    • 2020
  • This study was purpose to quantitative evaluation of edge method of modulation transfer function(MTF) and physical image characteristics of by obtain the optimal edge image by using magnetic resonance imaging(MRI). The MRI equipment was used (MAGNETOM Vida 3.0T MRI, Siemense healthcare system, Germany) and the head/neck matrix shim MR coil were 20 channels(elements) receive coil. The MTF results of showed the best value of 0.294 based on the T2 Nyquist frequency of 1.0 mm-1. The MTF results of showed that the T1 image is 0.160, the T1 CE image is 0.250, T1 Conca2 image is 0.043, and the T1 CE (Concatenation) Conca2 image is 0.190. The T2 image highest quantitatively value for MTF. The physical image characteristics of this study were to that can be used efficiently of the MRI and to present the quantitative evaluation method and physical image characteristics of 3.0T MRI.

The Development of Safety and Essential Performance Criteria for Lower Extremity Robotic Assisted Gait Training System (하지 로봇재활의료기기의 안전성 및 필수성능 평가 기준 개발)

  • Yong Wan Kang;Ji Yean Kwon
    • Journal of Biomedical Engineering Research
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    • v.44 no.3
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    • pp.190-203
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    • 2023
  • The purpose of this study is to provide basic data to ensure the safety and essential performance of a Lower Extremity robotic assisted gait training system and to provide advanced technology and technical basis to the industry handling the system. Based on IEC 60601-1:2012/AMD2:2020 (Medical Electrical Equipment - General requirements for basic safety and essential performance of medical electrical equipment), IEC 62366-1:2015/AMD1:2020 (Medical devices - Part 1: Application of usability engineering to medical devices) and EN ISO 14971:2019 (Medical devices - Application of risk management to medical devices), the requirements for ensuring the safety and essential performance of the Lower Extremity robotic assisted gait training system were derived. Through the Delphi survey method and scenario analysis, which reflects the opinions and knowledge of experts in the fields of development, testing and review of technical documents, and quality assurance of medical devices, validity and reliability were conducted and obtained results with adequate content validity ratio (CVR; 0.7≤) and excellent reliability (Cronbach's α; 0.9≤). As a result, it was confirmed that the reliability and validity of the risk management process to ensure the safety and essential performance of the Lower Extremity robotic assisted gait training system are required a model can be established to provide measures to reduce risks according to the level of risk exposure caused by usage.

New Reliability Criteria for Korean Workers' Health Examination Spirometry Results (근로자건강진단 폐활량검사에서 새로운 신뢰성기준 적용 결과)

  • Yong Lim WON;Hwa-Yeon LEE;Jihye LEE
    • Korean Journal of Clinical Laboratory Science
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    • v.55 no.4
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    • pp.276-283
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    • 2023
  • The Occupational Safety and Health Research Institute is currently evaluating spirometry tests used for worker health examinations by applying the 2005 American Thoracic Society (ATS) and European Respiratory Society (ERS) spirometric test standardization guide and reviewing the application of the 2019 ATS/ERS guide. To compare results obtained using the new evaluation criteria with previous results and determine whether it is appropriate to apply them to Korean workers' health examinations, we reviewed spirometry results from 325 special health examination institutions. Although evaluation criteria such as extrapolation volume, correction error, and forced inspiratory vital capacity were applied more strictly, institutions had higher reliability scores. Primarily because the acceptability and repeatability of forced expiratory volume in 1 second and forced vital capacity were judged separately, and thus, deduction width was reduced. The study shows that adopting the new evaluation criteria would reduce the possible use of inappropriate data, increase tester and doctor understanding of result selection and interpretation, increase result reliability, and reduce the testing burden.

Practical Understanding of Gross Examination Techniques (육안검사기술의 실무적 이해)

  • Woo-Hyun JI
    • Korean Journal of Clinical Laboratory Science
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    • v.56 no.1
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    • pp.89-98
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    • 2024
  • Gross examination techniques (GETs) of specimens collected from cancer surgery or endoscopy comprise the act of recording visual information about cancer for accurate histopathological diagnosis and collecting sections of the lesion to create microscopic specimens. GETs must include concise and accurate expressions, appropriate structuring, sufficient resections, error-free standardization of important information, and photo-diagramming of complex specimens. To increase the satisfaction of pathological interpretation, it is a task that must be performed accurately and carefully to gain confidence on a theoretical and practical basis with a sufficient understanding of gross examination. Based on the experience of clinical pathologists in the field of GETs, additional specimen types should be identified as viable candidates. Also, their needs and concerns regarding treatment should be carefully considered. In addition, departments at each institution should review the national focus on clinical partnerships, continuous professional training, diagnostic errors, and value-based healthcare provision.

A Secure and Lightweight Authentication Scheme for Ambient Assisted Living Systems (전천 후 생활보조 시스템을 위한 안전하고 경량화 된 인증기법)

  • Yi, Myung-Kyu;Choi, Hyunchul;Whangbo, Taeg-Keun
    • The Journal of the Institute of Internet, Broadcasting and Communication
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    • v.19 no.4
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    • pp.77-83
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    • 2019
  • With the increase in population, the number of such senior citizens is increasing day by day. These senior citizens have a variety of care needs, but there are not enough health workers to look after them. Ambient Assisted Living (AAL) aims at ensuring the safety and health quality of the older adults and extending the number of years the senior citizens can live independently in an environment of their own preference. AAL provides a system comprising of smart devices, medical sensors, wireless networks, computer and software applications for healthcare monitoring. AAL can be used for various purposes like preventing, curing, and improving wellness and health conditions of older adults. While information security and privacy are critical to providing assurance that users of AAL systems are protected, few studies take into account this feature. In this paper, we propose a secure and lightweight authentication scheme for the AAL systems. The proposed authentication scheme not only supports several important security requirements needed by the AAL systems, but can also withstand various types of attacks. Also, the security analysis results are presented to show the proposed authentication scheme is more secure and efficient rather than existing authentication schemes.

Quality Assurance of Volumetric Modulated Arc Therapy for Elekta Synergy (Elekta Synergy 선형가속기를 이용한 입체적세기조절회전방사선치료(VMAT) 정도관리)

  • Shim, Su-Jung;Shim, Jang-Bo;Lee, Sang-Hoon;Min, Chul-Kee;Cho, Kwang-Hwan;Shin, Dong-Oh;Choi, Jin-Ho;Park, Sung-Ill;Cho, Sam-Ju
    • Progress in Medical Physics
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    • v.23 no.1
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    • pp.33-41
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    • 2012
  • For applying the quality assurance (QA) of volumetric modulated arc therapy (VMAT) introduced in Eulji Hospital, we classify it into three different QA steps, treatment planning QA, pretreatment delivering QA, and treatment verifying QA. These steps are based on the existing intensity modulated radiation therapy (IMRT) QA that is currently used in our hospital. In each QA step, the evaluated items that are from QA program are configured and documented. In this study, QA program is not only applied to actual patient treatment, but also evaluated to establish a reference of clinical acceptance in pretreatment delivering QA. As a result, the confidence limits (CLs) in the measurements for the high-dose and low-dose regions are similar to the conventional IMRT level, and the clinical acceptance references in our hospital are determined to be 3 to 5% for the high-dose and the low-dose regions, respectively. Due to the characteristics of VMAT, evaluation of the intensity map was carried out using an ArcCheck device that was able to measure the intensity map in all directions, $360^{\circ}$. With a couple of dosimetric devices, the gamma index was evaluated and analyzed. The results were similar to the result of individual intensity maps in IMRT. Mapcheck, which is a 2-dimensional (2D) array device, was used to display the isodose distributions and gave very excellent local CL results. Thus, in our hospital, the acceptance references used in practical clinical application for the intensity maps of $360^{\circ}$ directions and the coronal isodose distributions were determined to be 93% and 95%, respectively. To reduce arbitrary uncertainties and system errors, we had to evaluate the local CLs by using a phantom and to cooperate with multiple organizations to participate in this evaluation. In addition, we had to evaluate the local CLs by dividing them into different sections about the patient treatment points in practical clinics.

Clinical Trials and Accuracy of Diagnostic Tests (진단법의 임상시험연구와 진단정확도)

  • Lee, You-Kyoung;Lee, Sang-Moo
    • Journal of Genetic Medicine
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    • v.8 no.1
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    • pp.28-34
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    • 2011
  • Most clinicians understand clinical trials as the evaluation process for new medicine before their use. However, clinical trials can also be applied to laboratory diagnostic tests (LDTs) to verify diagnostic accuracy and efficacy before their clinical laboratory implementation for patients. The clinical trial of LDT has two distinctive characteristics that are different from the case of pharmaceuticals and thus worth special consideration. One of them is the level of evidence. The well-designed randomized controlled trials (RCTs) are known to provide the best evidence to prove the clinical efficacy of any pharmaceutical products. However, RCTs lose practicality when applied to LDTs due to various issues including ethical complications. For this reason, comparative study format is considered more feasible approach for LDTs. In addition pharmaceuticals and LDTs are different in that the user's intervention is not required for the former but critical to the latter. Moreover, in the case of pharmaceuticals, end-products are produced by manufacturers before being used by clinicians. However, in LDTs, once reagents and instruments are provided by manufacturers, they are first utilized by clinical laboratories to produce test results in order for clinicians to use them later. In other words, when it comes to LDTs, clinical laboratories play the role of manufacturers, providing reliable test results with improved quality assurance. Considering the distinctive characteristics of LDTs, we would like to offer detailed suggestions to successfully perform clinical trials in LDTs, which include analytical performance measures, clinical test performance measures, diagnostic test accuracy measures, clinical effectiveness measures, and post-implementation surveillance.

The Role of Perfusionists during the COVID-19 Pandemic and Clinical Laboratory Technologists: Comparison of Training Systems in Japan and the United States (코로나19를 통해서 바라본 체외순환사의 역할과 임상병리사: 일본과 미국의 양성체계를 비교)

  • Dong-Ok, Aum;Dae Jin, Kim;Dae Eun, Kim;Myong Soo, Kim;Bon-Kyeong, Koo
    • Korean Journal of Clinical Laboratory Science
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    • v.54 no.4
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    • pp.293-297
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    • 2022
  • In 2022, Korea reported a total of 224 perfusionists, employing nurses or clinical laboratory technologists (also known as medical technologists) to provide hospital self-education or reliable education. In 2021, the total number of perfusionists in Japan was 2,100, mainly supported by clinical engineering technologists. During the same period, the number of perfusionists reported in the United States was 4,212, who had received training in the master's program, post-bachelor certificate program, and bachelor's program. Most personnel in the USA were graduates of healthcare sciences or life sciences. Perfusionists must be knowledgeable in heart anatomy, physiology, pharmacology, pathology, hemodynamics, laboratory analysis, and quality assurance, as well as techniques to operate the cardiopulmonary bypass machine (heart-lung bypass machine). These are jobs similarly handled by clinical laboratory technologists. The importance of perfusionists became more prominent during two major crises: the MERS-CoV and COVID-19 pandemic. Currently, perfusionists play a significant role in the rapidly expanding field of extracorporeal membrane oxygenation (ECMO) and extracorporeal circulation during cardiac surgery. Results of the current study indicate that hospitals offering cardiac surgery and infectious disease hospitalization need to be institutionalized to secure a certain number of qualified perfusionists. In the future, we look forward to establishing a perfusion technology association under the Korean Society for Clinical Laboratory Physiology to provide academic exchanges.

How to Implement Quality Pediatric Palliative Care Services in South Korea: Lessons from Other Countries (한국 소아청소년 완화의료의 발전 방안 제언: 국외 제공체계의 시사점을 중심으로)

  • Kim, Cho Hee;Kim, Min Sun;Shin, Hee Young;Song, In Gyu;Moon, Yi Ji
    • Journal of Hospice and Palliative Care
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    • v.22 no.3
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    • pp.105-116
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    • 2019
  • Purpose: Pediatric palliative care (PPC) is emphasized as standard care for children with life-limiting conditions to improve the quality of life. In Korea, a government-funded pilot program was launched only in July 2018. Given that, this study examined various PPC delivery models in other countries to refine the PPC model in Korea. Methods: Target countries were selected based on the level of PPC provided there: the United Kingdom, the United States, Japan, and Singapore. Relevant literature, websites, and consultations from specialists were analyzed by the integrative review method. Literature search was conducted in PubMed, Google, and Google Scholar, focusing publications since 1990, and on-site visits were conducted to ensure reliability. Analysis was performed on each country's process to develop its PPC scheme, policy, funding model, target population, delivery system, and quality assurance. Results: In the United Kingdom, community-based free-standing facilities work closely with primary care and exchange advice and referrals with specialized PPC consult teams of children's hospitals. In the United States, hospital-based specialized PPC consult teams set up networks with hospice agencies and home healthcare agencies and provide PPC by designating care coordinators. In Japan, palliative care is provided through several services such as palliative care for cancer patients, home care for technology-dependent patients, other support services for children with disabilities and/or chronic conditions. In Singapore, a home-based PPC association plays a pivotal role in providing PPC by taking advantage of geographic accessibility and cooperating with tertiary hospitals. Conclusion: It is warranted to identify unmet needs and establish an appropriate PPD model to provide need-based individualized care and optimize PPC in South Korea.