Kim, Hye Sook;Chae, Young-Moon;Tark, Kwan-Chul;Park, Hyun-Ju;Ho, Seung-Hee
Quality Improvement in Health Care
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v.8
no.2
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pp.186-207
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2001
Background : This study presented an analysis of healthcare quality indicators using data mining and a development of decision support system for quality improvement. Method : Specifically, important factors influencing the key quality indicators were identified using a decision tree method for data mining based on 8,405 patients who discharged from a medical center during the period between December 1, 2000 and January 31, 2001. In addition, a decision support system was developed to analyze and monitor trends of these quality indicators using a Visual Basic 6.0. Guidelines and tutorial for quality improvement activities were also included in the system. Result : Among 12 selected quality indicators, decision tree analysis was performed for 3 indicators ; unscheduled readmission due to the same or related condition, unscheduled return to intensive care unit, and inpatient mortality which have a volume bigger than 100 cases during the period. The optimum range of target group in healthcare quality indicators were identified from the gain chart. Important influencing factors for these 3 indicators were: diagnosis, attribute of the disease, and age of the patient in unscheduled returns to ICU group ; and length of stay, diagnosis, and belonging department in inpatient mortality group. Conclusion : We developed a decision support system through analysis of healthcare quality indicators and data mining technique which can be effectively implemented for utilization review and quality management in a healthcare organization. In the future, further number of quality indicators should be developed to effectively support a hospital-wide Continuous Quality Improvement activity. Through these endevours, a decision support system can be developed and the newly developed decision support system should be well integrated with the hospital Order Communication System to support concurrent review, utilization review, quality and risk management.
Although the success of the Papanicolaou test as a screening tool of cervical cancer is evident, there still exists $2{\sim}5%$ of discrepancy rate by both human and machine. To improve the qualilty of cervico-vaginal cytology, the authors compared cervicovaginal smear with cervical biopsy diagnoses, and analysed the causes of discrepancies. Among 30,922 cervicovaginal smears from June 1996 to April 1997 at our hospital, there were 271 cases of cervicovaginal smear with subsequent cervical punch or LEEP cone biopsies within several months. The biopsies and smears from a total of 98 discordant cases were reviewed. The discrepancy was attributed to sampling errors in 43 cases(43.9%), and to cytologic diagnosis in 49 cases(50.0%). Among these, 43 cases were interpretative errors(categories A;19, B;16 and C;8) whereas six cases were screening errors(categories B:2 and C:4). Among cervical biopsy cases, errors were present in four. As for 10% random rescreening, cytotechnologists reviewed 3,196 of 30,922 smears during the same period, There were 43 cases of screening error(categories A;27, B;16). Cytologic/histologic correlation was superior to 10% random rescreening of negative cases. The most effective method for quality improvement in cervicovaginal cytology was to implement both quality control(rescreening) and qualify assurance(cytologic/histologic correlation) programs.
This study was conducted to analyze the status radiological imaging examinations assessment in Korea medical institutions conducted in the public sector and suggest a direction for improvement. Among the assessment of medical institutions, the main assessment related to radiographic imaging examinations are the certification evaluation of medical institutions and the adequacy assessment of radiographic imaging examinations. The certification evaluation of medical institutions evaluates the image inspection operation process, provision of accurate results, and compliance with safety management procedures. In the assessment of adequacy of radiographic imaging examinations, structural indicators related to manpower and equipment, patient evaluation implementation rate, and exposure reduction programs were included. However, for safer and higher-quality radiological imaging examinations, it is necessary to increase the participation rate of medical institutions in certification evaluations. In addition, it is necessary to improve the manpower indicator, and incentive payments can be considered to induce quality improvement of medical institutions in the future. Integrated management of radiation exposure at the national level should also be carried out simultaneously.
Objectives : This study is to evaluate the quality of life and amount of stress after the treatment among the patients who visited hospital due to traffic accident. Methods : We evaluated 40 patients who have been treated by western medicine for 3 months but showed no improvements. We surveyed VNRS, SF-36 and IES-R-K scores before treatment began and treated patients twice a week for 4 weeks with acupuncture, chuna theraphy, herbal medicine. After 4 weeks of treatment, we surveyed VNRS, SF-36 and IES-R-K scores again and compared with the scores of before treatment. Results : VNRS score and SF-36 scale and IES-R-K scale showed significant improvement after the treatment, compared to the treatment before. Conclusions : The amount of pain and stress, physical condition, all showed improvement among the patients who came to Oriental medicine hospital due to traffic accident.
Objectives : The study of Traditional Korean medical therapy has recently become a popular academic field as proven to be an great alternative to the limitation of Western medical treatment. However, there has been little study examining the Quality of life to investigate the Effectiveness of Recent Traditional Korean Medical Therapy on Treating Allergic Rhinitis. Thus, this study aims to reveal the characteristics of Allergic Rhinitis patients, their clinical symptoms, and other accompanying diseases. Moreover, it attempts to investigate the sense of improvement and satisfaction from the Allergic Rhinitis patients treated with Traditional Korean Medical therapy by examining Quality of Life Questionnaires. Subject and Method : A total of 380 subjects that consists of allergic rhinitis patients and non patients were participated in this study. 330 allergic rhinitis patients were divided into two groups; the experimental group (230 subjects) was treated with Traditional Korean Medical therapy, and the control group (100 subjects) was not treated with any other therapy. Also, the normal control group (50 subjects) who had no symptoms of the allergic rhinitis was participated in this study as well. All the subjects were asked to answer to the questionaries that consist of two parts such as recalling the symptoms that they had 3 month ago, and describing the current symptoms that they had the present. The experimental group also was asked to answer the quality of life questionnaire before and after the therapy. Results: The results of investigating recent Traditional Korean therapy are as follows: 1. The reservoir rate of other disease was 39.0% in the control group and 34.8% in the experimental group. These were higher than the rate of the normal control (10.0%), which reveals the clinical characteristics of allergic rhinitis patients. 2. The symptoms of Allergic Rhinitis showed improvement after Traditional Korean medical therapy, which can be shown by its statistical significance. (p=.000<.001). 3. 97.0% of the Allergic Rhinitis patients treated with the Korean Therapy answered the improvement of symptom within 4 weeks, and 88.3% of the patients were satisfied with the Traditional Korean medical therapy. 4. The Nasal symptoms had prominently positive effect at the most as the symptoms significantly affect sleep disturbances, ocular symptoms, activity limitation, and emotional problems.
Recently, medical market has been changing not for the sake of treatment of the disease but for high quality of health. Therefore, South Korea medical tourism service needs to understand and improve for the differences perceptions of medical tourists and health professionals for customer satisfaction. The purpose of this study is to understand the structure of medical tourism market through theoretical consideration and to suggest the factors which need to be taken precedence for improvement of South Korea medical tourism service through analysis differences between consumers and suppliers. To analyze the difference of awareness, we reconstructed the questionnaires focussing on evaluation factors and articles about medical tourists selection attributes and health professionals way to invigoration through previous research and precedence study. After that, we also collected the data based on reconstructed questionnaires. After we compared each collected responses from medical tourists and health professionals, also analyzed the differences of awareness by applying Johari's Window to those differences. In conclusion, there is no relation between medical tourist and health professionals about th differences of awareness in functional quality and cost that is a direct effect to transaction in current medical tourism of South Korea. In contrast, there are differences of awareness between a process which support medical tourism and technical quality. Therefor, we expect to invigorate medical tourism by innovation of supportive process and technical quality.
This study calculated the potential customer satisfaction improvement index (PCSI index) and average satisfaction coefficient (ASC) by categorizing quality attributes based on the Kano analysis for medical service quality. This study seeks to suggest ways to increase the efficiency of medical business management by determining priority to improve after applying the indexes to IPA. To achieve such purposes, this study conducted a survey on 150 outpatients of a premium general hospital and 200 workers in four different sections in the same hospital. As a result of the analysis, there was a difference in the awareness of service quality to improve patient satisfaction between the outpatients and workers. Therefore, the focus should be put on those items deemed important by the patients rather than those that the workers called attention to in order to effectively improve service quality. Along with efforts to alleviate or eliminate inconveniences experienced by patients, it is necessary to provide training programs for workers on customer reception and management such as delivering services with a kind manner and giving explanations in a proper and professional manner and exhibiting the right attitude.
Purpose:Hospitals provide top medical service using exceptional manpower, medical technology, and state-of-the-art equipment, thus raising the standard of customer satisfaction. In addition, their medical service is becoming higher than before. One-stop service is a good way to improve the quality of customer-centered service as a qualitative marketing strategy. This study thus aims to facilitate subsequent research and compare customer satisfaction before and after one-stop service. Methods: The study included 72 patients who received the reserved examination and one-stop service for 20 days from April 23 to May 12, 2014. The surveyed questionnaire data were analyzed using SPSS 18.00. Results: The comparison results of customer satisfaction showed that the satisfaction score was generally high in the areas of kindness of examination staff, the speedy/accuracy of work processing of examination staff, and the kindness of reservation staff. The group before one-stop service showed their dissatisfaction with repeated visits and difficulty of booking a desired day. The group after one-stop service showed dissatisfaction with the long waiting time for examination or same-day treatment. Conclusion: The one-stop service showed good results, but new uncomfortable issues for the customer were revealed as well, which may result in more work of employees. Considering the characteristics of various clinical departments, the author hopes to find an efficient operation plan through the development and improvement of an appropriate one-stop service method.
Kim, Moo Seong;Ha, So Young;Bae, Yoon Hyuk;Jung, Yong Tae;Kim, Sung Tae;Lee, Won Hee;Go, Yeon Joo
Quality Improvement in Health Care
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v.18
no.1
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pp.27-36
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2012
Objectives : A protocol called "critical pathway" was developed to standardize the management of hospital patients the day after they underwent gamma knife radiosurgery. The quality of improvement in patient outcomes was evaluated. Methods : Critical pathway was developed, according to the regulations of the I hospital, by analyzing the medical records of 22 inpatients who underwent gamma knife surgery within the period from January to April 2011 on the day of the surgery. The study included a group of 22 patients admitted to the hospital the day after they underwent gamma knife radiosurgery, between July and September 2011. The control group included 22 patients who had surgery employing the same method within the period from May to June 2011. To measure the effects on quality improvement, the average length of stay, the execution rate of the hospital discharge notice system, daily hospital revenue, and the satisfaction of the patients and the medical team were assessed. The patient questionnaire employed a four-point Likert scale while the medical-staff questionnaire employed a five-point Likert scale. Result : The average length of stay was significantly shorter in the study group compared to the control group (2.3 days vs. 3.8 days, P<0.05). The execution rate of the hospital discharge notice system was higher in the study group (100% vs. 72%) than in the control group. Daily hospital revenues were higher by 264,178 Korean won in the study group when compared to the control group. The study group showed greater satisfaction of patients compared to the control group based on a four-point Likert scale (P<0.05). The study group showed greater satisfaction in medical team compared to the control group based on a five-point Likert scale (P<0.05). Conclusion : The development and implementation of a critical pathway protocol for hospital admission the day after gamma knife radiosurgery is an effective care process that improves the clinical quality.
Kyunghee Chun;Tae Hee Lee;Soojin Jung;Young-soon Park
Korean Medical Education Review
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v.25
no.2
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pp.102-108
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2023
This study shares details on the operating process and results of the cohort of students and graduates that was designed and implemented at Konyang University College of Medicine in Daejeon and discusses future directions for cohort establishment and improvement. First, Konyang University College of Medicine established the necessity and defined the purpose of cohort design and implementation. A task force was formed to establish guidelines for analysis targets, procedures, reports, and data management, and cohort operation was classified as a quality control activity. Data were collected through surveys of current students and graduates, and data generated during the curriculum were collected, analyzed, and reported every 2 years. The cohort data collection and analysis methods are designed by the Department of Medical Education, and data collection is carried out by the administrative team and each committee. Data management and analysis are handled by the Center for Medical Education Support, and analysis and reporting are conducted by the Department of Medical Education. Various members of the medical school are working to collect and analyze data, report findings, provide feedback, and improve. In the future, we plan to advance database computerization and work toward more effective data analysis. Cohort operation should not be another burden for medical schools; instead, it is hoped that operating cohorts will be a meaningful activity to increase the effectiveness of medical education and help in the operation and policy decisions of medical schools.
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