• 한국식품영양학회지
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• 제27권2호
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• pp.310-317
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• 2014

The purposes of this study were to identify the relative importance attributes, deduct the ideal combination of total utility and establish the marketing strategies for quality improvement of foodservice at funeral halls of medical centers. Data were collected using self-administered questionnaires from 102 funeral foodservice employees and 71 chief mourners or the bereaved. According to the results from a conjoint analysis, among foodservice employees at funeral hall, the relatively important attributes were 'taste (52.84%)', 'menu variety (24.419%)' and 'price (22.741%)'; among chief mourners or the bereaved, they were 'taste (50.004%)', 'price (31.388%)' and 'menu variety (18.008%)'. The ideal combination of total utility was different between funeral foodservice employees and chief mourners or the bereaved; it was higher among chief mourners or the bereaved (1.211) compared to funeral foodservice employees (1.169). Thus, there should an endeavor to improve the foodservice quality in funeral halls of medical centers through better taste, low price and similar menu variety.

• Journal of Korean Neurosurgical Society
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• 제30권sup1호
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• pp.25-29
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• 2001

Objective : Intracranial metastasis is responsible for nearly 50% of mortalities of systemic cancers. Although its frequency is increasing and there is little doubt that improving the quality and expectancy of life is the final goal, the mode of treatment is still disputed. The authors report the postoperative motor function after surgery in patients with metastatic tumors around the motor cortex. Materials and Methods : We studied 24 patients with metastatic tumors around the central sulcus during the last 22 months. Motor function was assessed pre- and post-operatively as well as its response to corticosteroids. MRI, neuronavigation system and intraoperative ultrasonography were used for tumor localization and functional MRI and cortical stimulator were used to define the motor cortex. Results : Single metastasis was found in 13 cases(54%) and 11 cases(44%) had multiple foci. Thirteen cases were located in precentral, 7 in postcentral, and 4 in superior or middle-frontal lobe. The most common primary focus was the lung(16 cases). There was no difference in postoperative motor function improvement between the steroid responsive group and non-responsive group(92% versus 90%). Ninty-two percent of the patients showed significant improvement of motor function and lived independently but there was worsening in the upper extremity in one and in another no improvement. Whole brain radiation of 3000cGy was given in all cases and 4 patients died of recurrence in primary or intracranial focus during mean follow-up periods of 14 monthes. Conclusion : Surgery may provide substantial improvement of the motor function and quality of life of the patients with metastatic tumors around the motor cortex.

• 정보처리학회논문지D
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• 제10D권5호
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• pp.781-792
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• 2003

오늘날 소프트웨어가 중심이 죄는 의료기기의 폭발적 증가로 인해 의료용 소프트웨어는 의료 서비스의 경쟁력 확보를 위한 중요한 수단이 되고 있으며 의료 서비스의 품질이 의료기기뿐만 아니라 의료용 소프트웨어의 품질에 지대한 영향을 받게 되었다. 그러나 의료용 소프트웨어의 품질에 관한 국내의 관련 연구ㆍ개발이 아직 미흡한 실정이며 의료용 소프트웨어의 품질저하로 인한 의료 서비스의 질적 저하를 유발할 수 있는 문제점이 발생할 수 있다. 따라서, 의료기기의 발전과 아울러 의료용 소프트웨어의 품질 향상을 통해 의료 서비스의 질적 수준을 제고할 필요가 있다. 따라서, 본 논문에서는 ISO/IEC 12119를 기반으로 의료용 소프트웨어를 시험하여 결과론 산출할 수 있는 시험모듈과 품질검사표를 개발하여 의료용 소프트웨어 시험에 적용할 수 있도록 하였다.

• 한국의료질향상학회지
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• 제3권2호
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• pp.60-68
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• 1997

Background : Medical records are used to assess clinical performance of physicians and quality of care. The contents which are written in medical records are considered as the objective evidences to know what the doctors think about the patient's problems. But the problem to use medical records as the assessment tools is the incompleteness of medical recording. The purpose of this study is to know if the completeness of medical recording is correlated to quality of care for inpattients and it can predict physicians's quality of care. Method : 32 clinical physicians reviewed 200 patients' medical records who were selected randomly from the inpatients who were admitted to the university hospital during July, 1995 and June, 1996. The reviewers used the structured evaluation questionnaires which were composed of two part. One part evaluated the completeness of the medical recording and the other evaluating appropriateness of diagnosis and treatment processes. We summated the scores of each items and calculated percentile scores. Results : The mean percentile score of completeness of the medical recording was 67.9% in 1995 and 79.8% in 1996. The mean percentile score of appropriateness was 52.2% in 1995 and 69.5% in 1996. This change between 1995 and 1996 was statistically significant. In non-surgical patients, the percentile scores of the completeness and those of the appropriateness were correlated positively and this correlation was statistically significant(p<0.05). In surgical patients, the positve correlation between the completeness and the appropriateness was also statistically significant(p<0.05). Discussion : In conclusion, the completeness of medical recording is considered as the good predictor of the quality of care for inpatients.

• 한국정보통신학회:학술대회논문집
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• 한국정보통신학회 2014년도 춘계학술대회
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• pp.728-731
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• 2014

오늘날 IT 기술의 지속적인 발전과 국민의 평균 수명이 연장되면서 의료 서비스의 질도 중요한 관심사가 되고 있다. 개인의 일상에서 생성되는 트윗 빅 데이터를 분석해서 의료정보의 질 관리 툴로 사용한다. 분석된 빅 데이터는 근거중심의학에 기반한 향상된 의료정보를 제공한다. 또한 만성질환의 추적관찰이 가능하고 유병자의 추가적인 합병증 발생률을 감소시킬 수 있다. 따라서 효율적인 질병 치료와 질병 예방이 가능하게 된다.

• 한국의료질향상학회지
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• 제10권2호
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• pp.176-189
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• 2003

Background : Gastric cancer is the most common malignant tumor in Korea. Surgical operation is one of the major treatment modalities for gastric cancer patients. Therefore, gastrectomy is one of the most common procedures in General Surgery. There were variation in length of hospital stay and medical treatment for gastrectomy between three surgeons at Asan Medical Center. Clinical pathways have received considerable attention as a tool for reducing the medical practice variation, increasing the efficiency of care process, and improving the quality of care. The aim of this study was to evaluate the effect of a clinical pathway for gastrectomy in gastric cancer patients. Methods : The clinical pathway for gastrectomy was developed and implemented by a multidisciplinary group in Asan Medical Center. A computerized clinical pathway program was developed and revised after a pilot test. A total of 145 patients underwent gastrectomy by three surgeons at Asan Medical Center. We compared the length of hospital stay, patient satisfaction, and the unplanned readmission rate between the pre-pathway group (n=67) and the post-pathway group (n=78). We also investigated the degree of satisfaction among the physicians and nurses who were main end-users of the clinical pathway. Results : The clinical pathway was applied to all target patients. The average length of hospital stay was shortened from 12.7days to 10.6days (p<0.01). The degree of patient satisfaction with the care process changed from 90.3% to 89.2% after the implementation of the clinical pathway, but the difference was not statistically significant (p=0.761). Unplanned readmission rate was 2.9% in the pre-pathway group and 0% in the post-pathway group. More than 90% of physicians and nurses answered that the clinical pathway had been a useful tool in their medical practice. Conclusions : The findings of the study demonstrated that implementation of the clinical pathway for gastrectomy produced substantial reduction in the length of hospital stay while improving the quality of patient outcomes. The computerized clinical pathway program can be used as one of the powerful patient management tools for reducing the practice variations and increasing the efficiency of care process in Korean hospital settings.

• 대한치과의사협회지
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• 제39권5호통권384호
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• pp.405-410
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• 2001

• 한국의료질향상학회지
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• 제14권2호
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• pp.125-132
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• 2008

Background : The number of outpatient injected anticancer drug is increasing. and the pathway of prescribing, compounding, and injecting anticancer drug is processed very rapidly in out-patient department. Moreover, Dose of anticancer drug is often changed depending on side effect of patients. So we need more effective inspection of anticancer drug prescriptions. The purpose of this study was to analyze the prescription errors for anticancer drugs in Out-Patient Department and to suggest system to prevent them. Method : The study took place at Asan Medical Center from July to September 2007. The pharmacists performed inspection of anticancer drug prescriptions before compounding and injecting. We used protocol-based anticancer drug order program and Electronic Medical Record (EMR). Result : During the study period, we analyzed 4683 prescriptions for out-patient. And we detected 55 medication errors (1.2%). Most common errors included dosage above or below the correct ones (56.3%), followed by incorrect treatment duration. Because most of dosing errors were in the range of usual dosage, it was hard to detect them. So when inspecting the prescription, we considered the medical records of individual patients. As a result, we could raise the efficiency of intervention. Therefore inspection using EMR could possibly reduce the number of anticancer drug errors. Conclusion : we are preventing the medication errors on stability and dosage above or below the maximum therapeutic dose according to the previous inspection system. However most of dosing errors were in the range of usual dosage according to the result of this study. Because of there was interpatient variability of dosage depending adverse effect. For improvement of quality assurance, we suggest inspection system based on patient's medical history.

• 의학교육논단
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• 제11권2호
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• pp.15-24
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• 2009

Medical Students' competencies depend on the medical school curriculum. Basic medical education, in particular, is an important starting point for further medical competency development. We aimed to identify the most important areas of reform in the basic medical education curriculum of Yonsei Medical School. To accomplish this, we sought case studies of different medical schools and discussion points for quality improvement methods. A qualitative comparison method saturated through the systematic discussions on the emerging thematic approaches to determine the current directions in medical school curriculum reform. The discussions, which involved 7 experts, spanned 8 months and were based on a literature review, with focus on the 7 selected case studies. From the discussions, we concluded that in order to improve basic medical education curriculum, the following measures need to be carried out. First, an outcome-based curriculum is to be designed. The expected outcome is to be deliberately and succinctly defined and should be expressed as teaching and learning objectives. Second, the core subjects and elective subjects are to be classified on the basis of the aim, content, and passage level of the subjects. Hence, the core curriculum must be treated as a standard part of medical knowledge, and the elective curriculum must be richer and more in-depth. Third, universities should institutionalize regular evaluation of their departments. Appropriate and just evaluations should be made, and feedback given to the school's administrative department. Fourth, the departmental and administrative management of the basic medical education curriculum should be harmonized with each other. Finally, teaching and learning resources are to be increased and diversified and made available to professors and students for basic medical education.

• 한국의료질향상학회지
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• 제2권1호
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• pp.110-117
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• 1995

The Comprehensive quality assurance for radiation oncology provides an overall organizational structures, responsibilities, procedures, processes and resources for assuring the quality of patient management by radiation treatment. Superior performance of modern radiotherapy equipment will be essential part of quality assurance in radiation oncology, which high degree of accuracy and consistency should be maintained under the optimal quality assurance program. Besides quality control of all radiation equipment, this review also emphasizes quality assurance of clinical aspect such as adequacy of the medical decision-making which eventually leads to the treatment prescription, accuracy of treatment procedure from treatment preparation to radiation delivery, and the significance of assessment of treatment outcomes with structure and process.