• Title/Summary/Keyword: Hospital Service Quality

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Behavior Patterns of Health Care Utilization in Terminal Cancer Patients (말기암 환자들의 의료이용행태)

  • Han, Tae-Hyung;Cho, Byung-Jin;Shin, Baek-Hyo
    • The Korean Journal of Pain
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    • v.12 no.1
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    • pp.101-107
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    • 1999
  • Background : In order to improve the quality of life of dying patients, they need to receive not only the physical, psychological, social, and spiritual care, but also systematic and continuous care to die with dignity. However, no adequate medical services are available for these terminal cancer patients. We studied their behavior patterns of health care utilization to understand more of their medical and social needs. Methods : We investigated 108 bereaved families through the telephone interview with structured questionnaires. They were randomly selected through the retrospective chart review of the terminal patients who passed away due to cancer. Results : Most of the terminal cancer patients received their care from proper medical services including admission to hospital (45.4%), outpatient clinic (22.2%), emergency room (16.7%), and oriental medicine (12.0%). But during the terminal phase of their illness, 32.4% of patients never received medical care including oriental medicine, and 28.7% received alterative natural care. 26 bereaved families (24.1%) pointed out the indifference of medical staff as a problem receiving proper hospital care, and 22 (20.4%) emphasized emotional strain of their helplessness with the patients' suffering as a problem of caring at home. Over 90% suggested availability of continuous care, hospice care, home care, and 24 hour telephone service to be improved. Conclusions : Due to various reasons, adequate medical care is not delivered to the terminal cancer patients in our present medical system. These problems can be approached with the establishment of proper education and medical delivery system. The role of comprehensive medical specialty cannot be overly emphasized to accomplish this most effectively.

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Design and Implementation of A Medical Prescription Documents Based on XML (XML 기반의 의료정보시스템의 표준 처방전 설계 및 구현)

  • Seong Kyoung
    • Proceedings of the Korean Institute of Information and Commucation Sciences Conference
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    • 2006.05a
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    • pp.1055-1059
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    • 2006
  • With the recent drastic development of Internet technology, electronic prescription and prescription EDI system is used for the hospital and doctor's office and the medical business area is rapidly developed and considered as the one making a very great profit. The system to reduce inconvenience caused by the result of separation of medicine activity from drug one such as receiving prescription from hospital, providing it and waiting long at drug store is studied and the service quality for patient is improved by processing prescription per patient into database. In this thesis, the first achievement is that the standard format of prescription is designed, the second one is that the standard format of prescription is developed based on XML for user to issue prescription without setting up the separate environment and considering type of operating system and the last one is the database search result based on XML is implemented to help user to manage interface and maintenance easily.

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Recommendation for the Amendment of Inpatient Nursing Fee Schedules Based on Nurse Staffing Standards in General Wards of Tertiary Hospitals and General Hospitals (상급종합병원과 종합병원 일반병동의 간호관리료 차등제 간호사 배치기준 및 수가체계 개선방안)

  • Cho, Sung-Hyun;Seong, Jiyeong;Jung, Young Sun;You, Sun Ju;Sim, Won Hee
    • Journal of Korean Clinical Nursing Research
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    • v.28 no.2
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    • pp.122-136
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    • 2022
  • Purpose: This study attempted to recommend a revision of inpatient nursing fees based on analyzing current and appropriate staffing levels. Methods: Staffing grades and their inpatient nursing fees as of the first quarter of 2022 were analyzed. Nurse managers and staff nurses answered surveys about the current and appropriate staffing levels, working days, and monthly salary. A total of 101 nurse managers and 588 staff nurses working in general wards at tertiary hospitals and general hospitals participated in the study. Results: The results showed that grade 1 staffing was found in 73.3% of tertiary hospitals and 63.7% of general hospitals. The current staffing ratios of tertiary hospitals and general hospitals were 1:9.3 and 1:10.4, respectively. The appropriate staffing ratios according to nurse managers and staff nurses at tertiary hospitals were 1:7.6 and 1:7.0, respectively, and 1:8.7 and 1:8.8 in general hospitals, respectively. The average estimated annual working days of staff nurses were 235.2 days in tertiary hospitals and 240.0 days in general hospitals. The median monthly salary for staff nurses was 4.957 million won in tertiary hospitals and 4.140 million won in general hospitals. The new staffing grade system was suggested from 1:6 (Grade 1) to 1:12 (Grade 5). The new inpatient nursing fee schedules were recommended to be paid based on nursing hours per patient day of each grade. Conclusion: The new staffing grade and inpatient nursing fee schedules are expected to increase staffing levels, improve the quality of nursing care, and provide a better work environment for nurses.

Evaluation of Patients서 Satisfaction with Foodservice of Mid-size Hospitals in Busan Area (부산지역 중소병원 급식서비스에 대한 환자만족도 평가)

  • 김영선;류은순
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.32 no.7
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    • pp.1153-1163
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    • 2003
  • The purpose of this study was to evaluate the patients' satisfaction with the quality of hospital food service in Busan area. For the purpose, questionnaires were distributed to 271 hospitalized patients in 4 hospitals (three hospitals for self-operated foodservice, one for contracted foodservice) within 130 beds. The average scores were -0.99/5.00 for quality satisfaction of meal characteristics, -0.68/5.00 for service characteristics, and -0.37/5.00 for nutrition characteristics. The items of low scores in quality satisfaction were treatment of complaints, nutrition of meals, provision of nutritional information, the seasoning of the meals, selective menu, and sanitation of the meals. At the expectation and perception grid, high expectation and high perception items were cleanliness of employees' clothes, cleanliness of dish, employees' courtesy, exactness of meal time, and sanitation of the meals. High expectation and low perception items were treatment of complaints and nutrition. The patients with little appetite showed significantly (p<0.01) lower average scores in meal, service, and nutrition characteristics than those with much appetite. The self-operated foodservice operation had significantly (p<0.01) higher average scores in meal, service, and nutrition characteristics than those of the contracted foodservice operation. The patients hoped to improve the taste of cooked rice and side dish, quantity of the side dish, variety of menu, and sanitation of the meals.

Evaluation of a Community-Based Cancer Patient Management Program: Collaboration between a Hospice Center and Public Health Centers (병원 호스피스센터-보건소 연계를 통한 지역사회 재가암환자 관리 프로그램 평가)

  • Lee, Hae-Sook;Park, Sun-Hee;Chung, Young-Soon;Lee, Boo-Kyung;Kwon, So-Hi
    • Journal of Hospice and Palliative Care
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    • v.13 no.4
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    • pp.216-224
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    • 2010
  • Purpose: The purpose of this study was to evaluate a community-based cancer patient management program (CBPCMP) which was collaborated between a hospice center and public health centers. Methods: The CBPCMP proceeded on four steps; 1) Signing agreements with three public health centers, 2) Enrolling the domiciliary terminal cancer patients, 3) Providing home hospice service, and 4) Inquiring patient's level of satisfaction. From February 1 to December 31 in 2009, 43 terminal cancer patients were referred and provided with home hospice service. The hospice team made a total of 605 visits. Medical records for each visit and data from satisfaction surveys were analyzed. Results: 76.7% of patients were older than 60 years, and 90.7% of the patients were alert. The level of functional status for 76.7% of patients rated as lower than ECOG grade 1. 62.8% of the patients or their caregivers signed hospice service agreements. On the initial evaluation, the most frequent reasons for referral were general weakness (86.0%), followed by anorexia (72.1%). Nurses visited the patients' most frequently (371 visits), followed by volunteers (216 visits). Nurses provided emotional support and health promotion counseling on 95.1% and 22.9% of visits, respectively. The mean satisfaction score rated by patients and their family was 4.45 out of 5. Conclusion: This study tested CBPCMP in collaboration with hospice centers and public health centers. CBPCMP showed a possibility to improve the quality of end of life care. To insure the quality care, however, the guidelines for home hospice service should be developed.

Development of the Clinical Pathway for the Allogeneic Bone Marrow Transplantation Donor Nursing (동종골수이식 공여자 간호를 위한 표준임상지침서 개발)

  • Seol, Mi-Ee
    • Asian Oncology Nursing
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    • v.4 no.2
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    • pp.110-123
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    • 2004
  • The purpose of this study was to develop a clinical pathway for the allogeneic bone marrow transplantation donor. For this study, a conceptual framework was developed through a review of the literature including six steps which are using in Jones Hopkins Hospital. USA. The researcher reviewed 129 medical re-cords of donor who had bone marrow donation between January 2002 to January 2004, to identify the overall service contents required by these patients and to make a preliminary clinical pathway. A content validity test was done for the preliminary clinical pathway, a professional group screened 51 medical re-cords and adopted with 3 hospitalization days as the clinical pathway framework. In the fifth step, clinical pathway test was also done to 7 donors from April 28th to July, 2004. After these processes the final clinical pathway was developed. The results of this study are as follows: 1. The vertical axis of the clinical pathway Includes the following 9 items: vital signs, nursing assessment, activity, diet, intervention, medication, test, consultation and patient teaching. The duration of the horizontal axis was 3days from admission to discharge 2. Analysis of the 129 medical records indicated that the average length of stay was 3 4 days. The medical performance according to the vertical axis in the preliminary clinical pathway consisted of 51 items After clinical validity test, it steel consisted of 51 items in the final form. 3. Clinical Validity test was done to 7 bone marrow donors. During these process, The first patient was deleted because he was out of the criteria the investigate set and 6 patients were used, finally The result of this study indicated all of 7 donors were discharged on expected day. 4. Clinical pathway enables to improve the quality of care, multidisciplinary team work It also helps nursing bone marrow donor, effective education to donor or medical member. The results of this study suggest that clinical pathway may be able to improve the quality of nursing care for bone marrow transplantation donors.

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Prehospital Care of 119 Emergency Medical Technician to Trauma Patients (119구급대원의 외상환자에 대한 병원 전 응급처치와 업무수행현황)

  • Yun, Seong-Woo;Lee, Kyoung-Youl
    • The Korean Journal of Emergency Medical Services
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    • v.15 no.2
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    • pp.27-42
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    • 2011
  • Purpose: This study intended to improve quality of prehospital emergency care for trauma patients by figuring out its current situations and problems based on run-sheets and questionnaires of 119 emergency medical technicians (EMTs). Methods: This study conducted a research of 425 trauma patients transferred to the 3rd hospital in G-city by 119 ambulances from July 1, 2008 to June 30, 2009. We aslo utilized 114 copies with questionnaires of 119 EMTs working in J-province. The data were analyzed with SPSS 18.0. Results: There were 425 trauma patients including 272 men and 137 patients with traffic accident. When it comes to types of 119 EMTs who delivered cares to patients, there were 206 (48.5%) advanced EMTs, 101 (23.8%) basic EMTs, 50 (11.8%) nurses and 43 (10.2%) rescue education receivers. The most frequent measured vital sign was pulse rate (54.1%). Regarding assessment of systolic blood pressure, pulse rate and respiration rate, there were some significant differences in accordance with type of 119 EMTs. Among the 317 patients evaluated 'emergency' in field, 137 patients returned to their home. Prehospital emergency cares accounted for 861, around 2.0 treatments per a patient. In view of questionnaire, the 74.6% of 119 EMTs hoped supplement of man power for proper prehospital care to trauma patients. Conclusion: This study suggested that it is necessary to develop detailed guidelines for trauma patients so as to improve quality of trauma patient evaluation and prehospital care. Furthermore, improvement of emergency care systems will reduce mortality of trauma patients and lead to their good outcome.

The Big Data Analysis and Medical Quality Management for Wellness (웰니스를 위한 빅데이터 분석과 의료 질 관리)

  • Cho, Young-Bok;Woo, Sung-Hee;Lee, Sang-Ho
    • Journal of the Korea Society of Computer and Information
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    • v.19 no.12
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    • pp.101-109
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    • 2014
  • Medical technology development and increase the income level of a "Long and healthy Life=Wellness," with the growing interest in actively promoting and maintaining health and wellness has become enlarged. In addition, the demand for personalized health care services is growing and extensive medical moves of big data, disease prevention, too. In this paper, the main interest in the market, highlighting wellness in order to support big data-driven healthcare quality through patient-centered medical services purposes. Patients with drug dependence treatment is not to diet but to improve disease prevention and treatment based on analysis of big data. Analysing your Tweets-daily information and wellness disease prevention and treatment, based on the purpose of the dictionary. Efficient big data analysis for node while increasing processing time experiment. Test result case of total access time efficient 26% of one node to three nodes and case of data storage is 63%, case of data aggregate is 18% efficient of one node to three nodes.

Development of Case Review Form for Detecting Adverse Events (위해사건 확인을 위한 증례검토지 개발)

  • Ock, Min-su;Lee, Sang-il;Kim, Yoon;Lee, Jae-ho;Lee, Jin-yong;Jo, Min-woo;Kim, Seon-ha;Son, Woo-seung;Kim, Hyun-joo
    • Quality Improvement in Health Care
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    • v.21 no.1
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    • pp.66-76
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    • 2015
  • Objectives: The purpose of this study is to develop a case review form for detecting adverse events through a medical records review in hospitalized patients in South Korea. Methods: To develop the case review form, several literatures were reviewed, first. Through the clinical expert meeting, screening criteria were selected and case review form was developed. Result: The Korean version of case review form consisted of the review form-1 for adverse event screening and form-2 for adverse event identification. The applied methodology for the case review form is determined according to the previous studies. For example, the method used in the first stage review is nurse review. Furthermore, the National Coordinating Council for Medication Errors Reporting and Prevention index is used to categorize disability, and a scale of 1 to 6 was used in the causation scores and preventability scores, respectively. Through the clinical expert meeting, a total of 41 screening criteria were selected. Conclusion: The Korean specific case review form was developed for detecting adverse events in hospitalized patients. The results from this study can be used in a large-scale study regarding the nationwide incidence of adverse events.

The Past, Present, Future of Newborn Screening in Korea (한국 신생아 집단검사의 과거, 현재, 미래)

  • Lee, Dong Hwan
    • Journal of The Korean Society of Inherited Metabolic disease
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    • v.14 no.1
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    • pp.1-9
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    • 2014
  • Many inborn errors of metabolism can be completely cured with early detection and early treatment. This is why neonatal screening on inborn errors of metabolism is implemented worldwide. In 1991, the Ministry of Health & Social affairs adopted a nationwide service program for neonatal screening of phenylketonuria, galactosemia, maple syrup urine disease, homocystinuria, histidinemia and congenital hypothyroidism for newborns delivered from low class pregnant women registered in health centers. Government decreased the test items from six to two, PKU and congenital hypothyroidism to increase test numbers with same budget from 1995. 78 laboratories wanted to participate for neonatal screening test in 1999. Government decided to screen six items of PKU, congenital hypothyroidism, maple syrup urine disease, homocystinuria, galactosemia and congenital adrenal hyperplasia from 2006. In 2014, thirteen laboratories are participating. Inter laboratory quality control was started 6 times a year from 1994. In case a patient with an inherited metabolic disease is diagnosed by screening of government program, special milk is provided at government's expense. According to the government project, from 1997 to 2013, 7,080,569 newborns were screened. 144 PKU, 2.451 congenital hypothyroidism were detected. So incidence of PKU is 1/49,170 and congenital hypothyroidism is 1/2,888. The cost benefit of performing screening procedures coupled with treatment has been estimated to be as high as 1.77 times in PKU, 11.11 times in congenital hypothyroidism than cost without screening. By January 2007, many European countries had expanded of their newborn screening programs by inclusion of Tandem mass spectrometry. We are trying to increase the budget to test all newborns for Tandem mass spectrometry from 2016. We are considering four to five central laboratories which cover all newborns and are equipped with tandem mass spectrometer & enzyme immunoassay for TSH, 17OHP & enzyme colorimetric assay for galactose. And I hope to expand test including Wilson disease screening test and lysosomal storage diseases.