• Title/Summary/Keyword: Hospital system

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The Effectiveness of Osteoplasty System (Vertebroplasty using Large Cannula-low Pressure Delivery System) in Compression Fracture and other Spinal Pathology

  • Kang, Jeong-Han;Kuh, Sung-Uk;Shin, Zun-Zae;Cho, Yong-Eun;Yoon, Young-Sul;Chin, Dong-Kyu
    • Journal of Korean Neurosurgical Society
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    • v.38 no.4
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    • pp.259-264
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    • 2005
  • Objective : The vertebroplasty is an excellent procedure in spine compression fracture, but there are some problems such as cement leakage and difficulties in bone biopsy. Recently, the osteoplasty system is developed to solve these problems, so we will report the usefulness of the osteoplasty system. Methods : From January 2003 to November 2003, there are 9patients with simple osteoporotic spine compression fracture, 2 compression fracture patients combined with suspicious spinal metastasis, 1patient with suspicious primary bone tumor, and 2patient with infection on spine. All patients were treated using the osteoplasty system. Results : All 11 compression fracture patients were relived the back pain after the osteoplasty and there is no complication. The bone biopsies in 3 suspicious cancer patients were also effectively performed using the osteoplasty system; negative result in 2patients and positive result in 1patient. The culture result of spontaneous discitis was no growth for 48hours. The spine tuberculosis was confirm using the osteoplasty system. Conclusion : The osteoplasty system has distinguished advantages in comparison with the vertebroplasty. That is, the risk of cement leakage is lower than vertebroplasty because of low pressure delivery system. And we can obtain the specimen effectively in bone biopsy because of large cannula. In conclusion, we emphasize that the osteoplasty system is a more useful procedure in spine compression fracture especially in the patient needed bone biopsy for diagnosis.

Association Between Anxiety and Depression and Gastroesophageal Reflux Disease: Results From a Large Cross-sectional Study

  • Choi, Ji Min;Yang, Jong In;Kang, Seung Joo;Han, Yoo Min;Lee, Jooyoung;Lee, Changhyun;Chung, Su Jin;Yoon, Dae Hyun;Park, Boram;Kim, Yong Sung
    • Journal of Neurogastroenterology and Motility
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    • v.24 no.4
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    • pp.593-602
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    • 2018
  • Background/Aims The different clinical manifestations of gastroesophageal reflux disease (GERD) may be influenced by associated psychological factors. We evaluated the psychological status (anxiety and depression) according to each subtype of GERD. Methods Subjects who underwent esophagogastroduodenoscopy and completed a symptom questionnaire between January 2008 and December 2011 were analyzed. The subjects were classified into the following groups: erosive reflux disease (ERD), non-erosive reflux disease (NERD), asymptomatic erosive esophagitis (AEE), and controls. Anxiety and depression were assessed using the State-Trait Anxiety Inventory and Beck Depression Inventory, respectively. Results We analyzed 19 099 subjects: 16 157 (84.6%), 176 (0.9%), 1398 (7.3%), and 1368 (7.2%) in the control, ERD, NERD, and AEE groups, respectively. Multiple multinomial logistic regression revealed a significant association of increased state (adjusted OR, 1.89; 95% CI, 1.53-2.33) and trait anxiety (adjusted OR, 1.78; 95% CI, 1.34-2.35) and depression (adjusted OR, 2.21; 95% CI, 1.75-2.80) with NERD. ERD group showed a significant association only with state anxiety (adjusted OR, 2.20; 95% CI, 1.27-3.81) and depression (adjusted OR, 2.23; 95% CI, 1.18-4.22). The AEE group, however, did not show any significant association with psychological factors. Conclusion This cross-sectional study revealed that anxiety and depression levels were significantly higher in subjects with GERD (notably in the NERD) than in controls.

Nursing Delivery System Improvement Plan in A Hospital (간호전달 체계 개선 방안 - 일 병동을 중심으로 -)

  • Lee, Jin-Hi;Lee, Sung-Ae;Ham, Yong-Hee;Yang, Myong-Ju;Kim, Ok-Sohn
    • Quality Improvement in Health Care
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    • v.3 no.2
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    • pp.52-59
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    • 1997
  • Background : In many Nursing Delivery System, Nursing Department at D Hospital had used to traditional nursing practice model what is called functional activities based system. It has a lot of merit that carried out specialized and rapid works but tend to ignore indivisual professional responsibility and task-based work assignments. In addition this system showed high turnover rates due to heavy workload, timesum of handing over duties, lack of support from peers and interstaff communication. So we performed conversion of Nursing Delivery System to My Patients Nursing Care System for providing comprehensive nursing to patient and reducing turnover rates and increasing job satisfaction to nurse. Method : 1. 1st step(96.4.9): Detected the problem of Nursing delivery System and estabilished improving planning 2. 2nd step(96.4.26): Visited other hospital on job training 3. 3th step(96.4.29): Discussed to premonitoring problem after conversion Nursing Delivery System and prepared structure 4. 4th step(96.5.6): My Patients Nursing Care System practical application 5. 5th step(96.7.20): Held complementary meeting 6. 6th step(96. 7): The other ward application 7. 7th step(96. 10): Extended application to whole wards Results: 1. Workload: (1) reduction(55.6%) (2) addition(44.4%) 2. Strong points after conversion: (1) decreased timesum of handing overduties (35.2%) (2) increased responsibility(33%) (3) broaden nurse's outlook to duties(14.8%) 3. Shortcoming after conversion: (1) understanding difficulties except my patient(57.8%) (2) weak teamwork(23.3%) (3) intensive stress to low grade nurse(12.2%) 4. Effective complemental way: (1) manpower(76.7%) (2) conversion of though (8.9%) (3) education(14.4%) 5. Patient's satisfaction: (1) satisfaction(64%) (2) no effect(36%) 6. Physician and peer's satisfaction: (1) satisfaction(12.5%) (2) dissatisfaction(21.6%) (3) no interest(44.3%) 7. Nurse's satisfaction: (1) satisfaction(74.7%) (2) dissatisfaction(5.5%) (3) unknown(20.5%) 8. Want to continued: (1) want(76.4%) (2) try to any other system(18%) Conclusion : Even though Nursing Delivery System conversion still has many problem, we gained more merits than traditional nursing delivery system. So we suggest that My Patients Nursing Care System should be encouraged for comprehensive nursing care and satisfaction to nurses.

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Design of Hospital Management System Using the Statistic Methodologyo (통계적(統計的) 방법(方法)에 의한 병원관리(病院管理) System 설계(設計))

  • Lee, Sang-Wan;Lee, Geun-Bu
    • Journal of Korean Society for Quality Management
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    • v.13 no.2
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    • pp.21-28
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    • 1985
  • The purpose of this study is to analyze the direct relationship between doctors and number of patients to be treated by applying many kinds of IE techniques. Generally, doctors in this research work both at Out Patient Data & In Patient Data. Under the hospital management system that they are applying in, doctor's daily working schedules are instable because the number of OPD patients daily. Therefore, the amount of time they spend for inward patients are variable too. So the numbers of patients have great influence to the whole hospital system management.

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Chronic Subdural Hematomas : A Comparative Study of Three Types of Operative Procedures

  • Lee, Joon-Kook;Choi, Jong-Hun;Kim, Chang-Hyun;Lee, Ho-Kook;Moon, Jae-Gon
    • Journal of Korean Neurosurgical Society
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    • v.46 no.3
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    • pp.210-214
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    • 2009
  • Objective : Several surgical procedures have been reported for the treatment of chronic subdural hematoma (CSDH). We compared the results of treatments for CSDH obtained from one burr-hole craniostomy with closed system drainage with or without irrigation, two burr-hole craniostomy with closed system drainage with irrigation, and small craniotomy with irrigation and closed-system drainage. Methods : Eighty-seven patients with CSDH underwent surgery at our institution from January 2004 to December 2008. Our patients were classified into three groups according to the operative procedure; group I, one burr-hole craniostomy with closed system drainage with or without irrigation (n=25), group II, two burr-hole craniostomy with closed system drainage with irrigation (n=32), and group III, small craniotomy with irrigation and closed-system drainage (n=30). Results : Age distribution, male and female ratio, Markwalder's grade on admission and at the time of discharge, size of hematoma before and after surgery, duration of operation, Hounsfield unit of hematoma before and after surgery, duration of hospital treatment, complication rate, and revision rate were categories that we compared between groups. Duration of operation and hospitalization were only two categories which were different. But, when comparing burr hole craniostomy group (group I and group II) with small craniotomy group (group III), duration of post-operative hospital treatment, complication and recurrence rate were statistically lower in small craniotomy group, even though operation time was longer. Conclusion : Such results indicate that small craniotomy with irrigation and closed-system drainage can be considered as one of the treatment options in patients with CSDH.

Successful emergency transcatheter aortic valve implantation

  • Lee, Jung-Hee;Ji, Ah-Young;Kim, Young Ju;Song, Changho;Jin, Moo-Nyun;Kim, Sun Wook;Hong, Myeong-Ki;Hong, Geu-Ru
    • Journal of Yeungnam Medical Science
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    • v.31 no.2
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    • pp.144-147
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    • 2014
  • Despite the necessity of surgical aortic valve replacement, many patients with symptomatic severe aortic stenosis (AS) cannot undergo surgery because of their severe comorbidities. In these high-risk patients, percutaneous transcatheter aortic valve implantation (TAVI) can be safely accomplished. However, no study has shown that TAVI can be performed for patients with severe AS accompanied by acute decompensated heart failure. In this case report, 1 patient presented a case of severe pulmonary hypertension with decompensated heart failure after diagnosis with severe AS, and was successfully treated via emergency TAVI. Without any invasive treatment, acute decompensated heart failure with severe pulmonary hypertension is common in patients with severe AS, and it can increase mortality rates. In conclusion, TAVI can be considered one of the treatment options for severe as presented as acute decompensated heart failure patients with pulmonary hypertension.

The superior lateral genicular artery flap for reconstruction of knee and proximal leg defects

  • Low, O-Wern;Loh, Tian Fu;Lee, Hanjing;Yap, Yan Lin;Lim, Jane;Lim, Thiam Chye;Nallathamby, Vigneswaran
    • Archives of Plastic Surgery
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    • v.49 no.1
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    • pp.108-114
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    • 2022
  • Reconstruction of defects around the knee region requires thin and pliable skin. The superior lateral genicular artery (SLGA) flap provides an excellent alternative to muscle-based flaps. The anatomy and the surgical techniques of the SLGA flap were reviewed and the results of cases using the SLGA flap for coverage of knee and proximal leg defects were analyzed. SLGA flaps were performed in two cases and followed up for at least 6 months. Twelve articles on the use of the SLGA flap were also identified. A review of 39 cases showed that the mean diameter of the perforator supplying the skin of the flap was 1.04 mm, while the mean diameter of the SLGA at its origin was 1.78 mm. The mean length of the pedicle measured from the origin of the popliteal artery was 7.44 cm. The average dimensions of the flap were 14.8×6.6 cm with primary closure of the donor site in 61.5% of cases. Of these cases, 38.5% were due to trauma, 23.1% were post-burn complications, 12.8% were defects after resection of tumors, and 10.3% were for ulcers post-bursectomy. The most common complication was flap tip necrosis. All studies reported favorable outcomes with complete wound healing.

Economic Analysis of Introduction of Third Party Logistics System in a Tertiary Hospital (상급종합병원 3자 물류외주시스템 도입의 경제성 분석)

  • Byeoung Heon Yoo;Jin-Won Noh;Sei-Jong Baek;Eun Woo Nam
    • Korea Journal of Hospital Management
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    • v.28 no.1
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    • pp.1-13
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    • 2023
  • Purpose: This study purposed to analyze the economic feasibility of introducing a third party logistics system as a strategic alternative to hospital management. Methods: Economic analysis was performed by measuring changes in costs and benefits before and after implement the third party logistics system and estimating the size of net benefits for the next five years for the target hospital. A questionnaire survey and in-depth interview with stake-holders were conducted to find out the satisfaction and effectiveness of the system. Findings: According to results, the cost-benefit ratio for the implementation of the system was 1.18. For the next five years, the cost-benefit ratio was 1.48, the net present value was about 1.7 billion won, and the internal rate of return was 64%. The satisfaction of internal stake-holders was relatively high, in terms of improving the concentration of unique tasks and increasing the efficiency of inventory management. Practical Implications: It was found that the increase in benefits had a greater effect on the change in the cost-benefit ratio than the increase in costs resulting from the expansion of logistics, and the increase in the present value of net benefits gradually decreased as the cost increased. In addition, overall job satisfaction and satisfaction with outsourcing companies were relatively low, which means that stabilization of the new system is important. Further study is needed for more accurate economic analysis.

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A Study on the Actual Condition of Temporary Workers in Hospital (병원의 비정규직 실태조사)

  • Moon, Young-Joon;Ahn, In-Whan;Lee, Yong-Kyoon
    • Korea Journal of Hospital Management
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    • v.12 no.3
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    • pp.120-144
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    • 2007
  • In 1997, in the course of overcoming economic crisis caused by the shortage of foreign currency there was a significant phenomenon, the irregularization of human labour resources. There was no exception in hospital, either. Most hospitals put a lot of thought to solve the problem about irregular workers. Between employee and employer the problem of irregular workers has been raised as a main topic of all. The objectives of this study were to inspect the actual state of irregular workers and to understand the positive effect of protecting irregular workers, recently established and revised, on the human resources management of hospitals. After enacting irregular labours protection acts there were many opinions that the labour rules of hospitals would be changed.(56.7%). The plan to solve irregular worker's wage issues would he carried out step by step, but some hospitals have not examined the plan yet,(81.9%). Many hospitals had a plan that irregular worker's wage would be actualized in two or three years.(78.3%) The method, to solve the problem of irregular workers arc as follows: 1) the introduction of functional wage system, 2) the convert from automatic rising wage system to annual wage system, 3) the incentive grade system according to management result, 4) lower functional group wage system, 5) non-term contract wage system. From the point of the opening medical market and securing competitive power of hospitals, it is prospected that irregular works would be increased also in future. So to manage irregular workers effectively would be essential in maintain hospital's competitive power and improve medical service. The result, of this study were a, follow: (1) In hospital, the ratio of irregular workers in hospitals was lower than that of all irregular workers in Korea. (2) In hospital, the wage level of irregular workers was higher than that of irregular workers in Korea. (3) In hospital, the social insurance application ratio of irregular workers was higher than that of all workers in Korea. (4) In hospital, there seems to be no appropriate and active measures to improve labour condition of irregular workers, yet. (5) In many hospitals, the policy of irregular workers would be expected to revised for the law standards. In this study the actual conditions and problems of irregular workers were proposed and it was expected to contribute decisions-making in hospital management, especially when using human resources.

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A Study on the Development of Hospital Management Award Programme in Korea (병원경영대상 시상제도의 설계 연구)

  • Jung, Doo-Chae;Kim, Young-Hoon;Kim, Gi-Chul;Sohn, Tae-Yong
    • Korea Journal of Hospital Management
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    • v.13 no.3
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    • pp.94-113
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    • 2008
  • The purpose of this study to develop the Hospital Management Award(HMA) programme which would be a basic information for advancing hospital industry in Korea. HMA programme in the study are designed with general census building method of researchers and with the data of professions opinion which was survey with structured questionnaire Major results of this study are as follows. First, Hospital Management Award(HMA) programme is perceived very necessary and useful for advancing hospital industry of Korea (positive response rate: 93.0%). Second, Criteria, Classification of hospitals may be the function, size and ownership of hospital. Third Evaluating area of hospital management, examining method and evaluation marking points are designed on the basis of hospital management information system. Forth, this study suggests same strategies for execution of the programme. On the basis of the study results this study suggests that Hospital Management Award(HMA) programme would rather actualized in advance by formal institute and/or association. And some in depth studies are required mainly for development of the action plan of HMA programme.

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