Purpose: This study intends to offer strategic implications that can be used in Korean medicine hospitals through analysis of causal relationship among factors focusing on image improvement and trust building. Methods: Differential model was introduced to test causal relationship. Questionnaire was developed, and data was collected and analyzed with Structural Equation Modeling. Results: Medical service has effects on image, trust, and CS. CS has an effect on trustworthiness, and trustworthiness has positive effect on loyalty intention and has negative effect on switching intention. Emotional attachment has moderating functions between trust and loyalty intention and between trust and switching intention. Conclusion: This study offers practical implications to relevant managers, at the same time it has limitations that omits relevant study of inducing factor for emotional attachment.
Objectives: A hospital is a complex building that serves many different purposes. It has a major impact on patient's well-being as well as on the work efficiency of the hospital staff. Thermal comfort is one of the major factors in indoor comfort. The purpose of this study was to determine thermal comfort in various locations in a hospital. Methods: Various indoor environmental conditions in a general hospital were measured in February 2014. The predicted mean vote (PMV) and carbon dioxide ($CO_2$) concentration were measured simultaneously in the lobby, office, restaurant, and ward. Results: The ward was the most thermally comfortable location (PMV=0.44) and the lobby was the most uncomfortable (PMV = -1.39). However, the $CO_2$ concentration was the highest in the ward (896 ppm) and the lowest in the lobby (572 ppm). The average PMV value was the most comfortable in the ward and the lowest in the lobby. In contrast, for concentration of carbon dioxide, the highest average was in the ward and the lowest in the lobby. Due to air conditioner operation, during operating hours the PMV showed values close to 0 compared to the non-operating time. Correlation between PMV and $CO_2$ differed by location. Conclusion: The PMV and concentration of carbon dioxide of the hospital lobby, office, restaurant and ward varied. The relationship between PMV and carbon dioxide differed by location. Consideration of how to apply PMV and carbon dioxide is needed when evaluating indoor comfort.
Journal of The Korea Institute of Healthcare Architecture
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v.23
no.4
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pp.17-25
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2017
Purpose: Since hospitals have a big impact on the natural and social environment, hospitals' sustainability must be considered in various aspects including environmental, social, and economical aspects. So far, research on sustainable hospitals has mainly been conducted on indoor environment, but outdoor space of hospital is as important as well. The purpose of this research is to study the sustainability of hospital outdoor space and to make proposals for improving sustainable regional public hospitals. Methods: Through preceding research analysis and literature review, the concept of sustainable outdoor space of hospital was defined. Also, the evaluation contents of outdoor space were extracted from domestic and foreign green building certification criteria. With this analytic frame, we visited 4 regional public hospitals in Korea, interviewed the facility managers, and analyzed sustainability of hospital outdoor space. Results: Analysis of 4 regional public hospitals reveals that there is a lack of consideration for sustainability in all 4 categories; urban and network, natural environment, community, and user. In terms of community, sustainability has rarely been applied to all four hospitals. The site selection and terrain of the site were essential to sustainability. Implications: Establishing a master plan considering future expansion is critical. Also more attempt to show regional characteristics is needed. It is necessary to design a comprehensive outdoor space that considers sustainability and also healing environment. Level difference in the site can be used as a design element.
Soo Hong Kim;Seung Jun Lee;Mun Hyeok Lim;Hye Min Park;Min Seok Gang;Gun Ho Kim;Kyoung Won Nam
Journal of Biomedical Engineering Research
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v.45
no.1
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pp.49-55
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2024
Accurate measurement of blood pressure is essential for classifying an individual's disease, identifying blood pressure-related risks, and managing health. Due to the environmental and health hazards of mercury sphygmomanometers, automatic sphygmomanometers using the oscillometric method are widely used in hospitals as well as in general homes, and have established themselves as a practical standard sphygmomanometer. In this study, we developed a blood pressure simulator using an actuator that provides simulated pressure to an automatic blood pressure cuff. The developed blood pressure simulator adopts an arm-shaped cylindrical shape similar to the situation in which a person measures blood pressure with an automatic blood pressure monitor, and implements a method of transmitting pressure to the cuff using a pressure plate. Accuracy was evaluated through the mean and standard deviation of the difference with the commercialized blood pressure simulator BP PUMP 2, and reproducibility was confirmed using two automatic blood pressure monitors. The developed blood pressure simulator enables automatic blood pressure monitoring in a simple manner and also meets the evaluation standards for accuracy and reproducibility. In the future, as a standardized blood pressure simulator, it is expected to be of great help in evaluating and verifying the performance of automatic blood pressure monitors by supplementing precise hardware and software and building a blood pressure database.
Data stored in hospital information systems has a great potential to improve adequacy assessment and quality management. Moreover, an establishment of a data warehouse has been known to improve quality management and to offer help to clinicians. This study constructed a data mart that can be used to analyze antibiotic usage as a part of systematic and effective data analysis of infection control information. Metadata was designed by using the XML DTD method after selecting components and evaluation measures for infection control. OLAP-a multidimensional analysis tool-for antibiotic usage analysis was developed by building a data mart through modeling. Experimental data were obtained from data on antibiotic usage at a university hospital in Cheonan area for one month in July of 1997. The major components of infection control metadata were antibiotic resistance information, antibiotic usage information, infection information, laboratory test information, patient information, and infection related costs. Among them, a data mart was constructed by designing a database to apply antibiotic usage information to a star schema. In addition, OLAP was demonstrated by calculating the statistics of antibiotic usage for one month. This study reports the development of a data mart on antibiotic usage for infection control through the implementation of XML and OLAP techniques. Building a conceptual, structured data mart would allow for a rapid delivery and diverse analysis of infection control information.
In case of Senior Hospitals, meticulous care is required in both amount and quality of natural lighting because of the semi-long term residence of patients. Natural lighting has a huge impact on the physical and psychological part for the seniors. Likewise, natural lighting is an important factor considered for hospital design because it can also effect hospitalization period of patients. Research subject was K Senior Hospital which was determined as the courtyard-type building made to provide healing environment through natural lighting. Analysis was performed by dividing the space of K Senior Hospital into Central Treatment Department directly used by patients, Outpatient Department(OPD), Ward Department, Common Use Department. Research was carried out in two ways of integration value analysis using SPACE SYNTAX and illumination intensity analysis using ECOTECT. K Senior Hospital intended to actively let in natural light through courtyard and to make patients exposed to natural light when they walk along the circuit corridor built around the courtyard. This environmental consideration affected the utilization rate of Common Use Department and residence time of patients raising the average of Common Use Department on every floor. As a resuit of this study presenting type C and type D, part of four types of illumination intensity, takes higher percentage of almost every spaces compare to the others therefore K Senior Hospital was designed on the assumption of healing environment composition through natural light. The result of this research would be used meaningfully in the space programming phase of Senior Hospitals in the future. Utilization rate can be adjusted using illumination intensity value in the space that integration rate should be planed to be high. The use(purpose) of space and integration rate can be used as a guideline to set illumination intensity of natural.
Park, Min Ji;Lee, Dong Hun;Shin, Young Lim;Hong, Yong Hee
Journal of Genetic Medicine
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v.13
no.1
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pp.41-45
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2016
Marfan syndrome (MFS) is an inherited connective tissue disorder with a mutation in the fibrillin-1 (FBN1) gene. Fibrillin is a major building block of microfibrils, which constitute the structural component of the connective tissues. A 10-year-old girl visited our hospital with the chief complaint of precocious puberty. According to her medical history, she had a pulmonary wedge resection for a pneumothorax at 9 years of age. There was no family history of MFS. Mid parental height was 161.5 cm. The patient's height was 162 cm (>97th percentile), and her weight was 40 kg (75th-90th percentile). At the time of initial presentation, her bone age was approximately 11 years. From the ophthalmologic examination, there were no abnormal findings except myopia. There was no wrist sign. At the age of 14 years, she revisited the hospital with the chief complaint of scoliosis. Her height and weight were 170 cm and 50 kg, respectively, and she had arachnodactyly and wrist sign. We performed an echocardiograph and a test for the FBN1 gene mutation with direct sequencing of 65 coding exons, suspecting MFS. There were no cardiac abnormalities including mitral valve prolapse. A cytosine residue deletion in exon 7 (c.660delC) was detected. This is a novel mutation causing a frameshift in protein synthesis and predicted to create a premature stop codon. We report the case of a patient with MFS with a novel FBN1 gene missense mutation and a history of pneumothorax at a young age without cardiac abnormalities during her teenage years.
Kim, Youngaee;Yim, Ohyon;Kim, Jungshin;Yi, Jongse;Ahn, Uijong
Journal of The Korea Institute of Healthcare Architecture
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v.19
no.3
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pp.21-28
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2013
Purpose: General hospital in korea is getting large-scaled, specialized and upgraded. So, nursing unit of race track type has been advanced along with a spatial organization, building equipment and environmental approach. This study is to search the guidelines for renovation of nursing unit with race track type in the case of K university hospital in Daejeon. Methods: 9 cases of recently opened general hospital has been analyzed for spatial and environmental design solution. Questionnaires and interviews about user needs of nursing staff, patient and visitors, have been conducted for a nursing care system and facility of nursing units in K university hospital. Results: The user needs are represented as followings. Center core public zone in each floor plan and center core nursing station and supporting areas in nursing unit are good for an adjacency and separation of spatial organization. Toilet of group patient room is necessary to equip for easy, safe and infective aspects, and so toilet install will decrease the patient number and increase the nursing care service. Hall type of station front is good for visibility and observation. It is appropriate to renovate into south facing group patient room for privacy, enough space for nursing care facility and supporting area, enough width of door to move portable medical equipment, room for medical doctor and practical student, noise absorbing of day room. Implications: Upgrading the nursing care service and facility equipment is necessary to reflect the user needs and cooperate with hospital management.
Purpose: This study aimed to assess hand hygiene (HH) compliance among visitors at a long-term care hospital in South Korea. Methods: The study was conducted at a 502-bed long-term care hospital located in Gyeonggi-do Province. From July 1 to August 15, 2017, including more than 6 weekends and one holiday, a trained observer covertly assessed visitors' HH at all five units (360 beds in total) of the study hospital building until the completion of 1,000 HH opportunities (i.e., 200 opportunities per unit). The modified World Health Organization (WHO) HH observation form was used. Instead of professional categories and the "before clean/aseptic procedure" moment, the estimated age range for each visitor were recorded in four categories: children (<14 years old), adolescents (14~18), adults (19~64), and the elderly (${\geq}65$). The collected data were analyzed using SPSS 22.0. Results: A total of 1,000 HH opportunities were observed from 766 visitors (an average of 1.31 per visitor) and the overall HH compliance rate was 20.3%. Overall, 53.7% of the HH cases were performed with soap and water. Among the 4 HH moments, the "after body fluid exposure risk" moment showed the highest compliance rate (83.5%); 93.9% used soap and water. The most commonly exposed potential body fluid among visitors was saliva (48.1%). Conclusion: For hospital visitors in long-term care hospitals, HH education programs including HH moments need to be developed and implemented. Further studies are necessary to evaluate visitors' HH compliance in various hospital settings and find the related variables influencing visitors' HH.
Purposes: It is very important to establish a clinical data warehouse based on a common data model to offset the different data characteristics of each medical institution and for drug surveillance. This study attempted to establish a clinical data warehouse for Dankook university hospital for drug surveillance, and to derive the main items necessary for development. Methodology/Approach: This study extracted the electronic medical record data of Dankook university hospital tracked for 9 years from 2013 (2013.01.01. to 2021.12.31) to build a clinical data warehouse. The extracted data was converted into the Observational Medical Outcomes Partnership Common Data Model (Version 5.4). Data term mapping was performed using the electronic medical record data of Dankook university hospital and the standard term mapping guide. To verify the clinical data warehouse, the use of angiotensin receptor blockers and the incidence of liver toxicity were analyzed, and the results were compared with the analysis of hospital raw data. Findings: This study used a total of 670,933 data from electronic medical records for the Dankook university clinical data warehouse. Excluding the number of overlapping cases among the total number of cases, the target data was mapped into standard terms. Diagnosis (100% of total cases), drug (92.1%), and measurement (94.5%) were standardized. For treatment and surgery, the insurance EDI (electronic data interchange) code was used as it is. Extraction, conversion and loading were completed. R language-based conversion and loading software for the process was developed, and clinical data warehouse construction was completed through data verification. Practical Implications: In this study, a clinical data warehouse for Dankook university hospitals based on a common data model supporting drug surveillance research was established and verified. The results of this study provide guidelines for institutions that want to build a clinical data warehouse in the future by deriving key points necessary for building a clinical data warehouse.
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