• Title/Summary/Keyword: Medical practice management

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Medico Legal Aspects of Clinical Practice Guideline (표준 치료 지침서(Clinical Practice Guideline)의 의료법학적 의의)

  • Bae, Hyun-A
    • The Korean Society of Law and Medicine
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    • v.9 no.2
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    • pp.181-207
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    • 2008
  • With recent emphasis on evidence based medicine, clinical practice guidelines are seen as a potential mechanism by which unify various managerial and professional approaches to improving the quality of care. The development process of guidelines has been the subject of much research. and it is need translating the medical evidence of research into a clinical practice guidelines. the gathered evidence needs to be interpreted into a clinical, public health, policy, or payment context. The term 'clinical practice guidelines' can evoke a diverse range of responses from healthcare personnel. Clinical practice guidelines are increasingly used in patient management but some clinicians are not familiar with their origin or appropriate applications. Understanding the limitations as well as benefits of CPG could enable clinicians to have clearer view of the place of guidelines in every practice. In the context of increasing complaints and litigation in healthcare, the legal implications of clinical practice guidelines are of increasing importance. Clinical practice guidelines could, in theory, influence the manner in which the courts establish negligence by suggesting the doctor breached the duty of care by failing to provide the required standard of medical care. In several studies, the CPGs were relevent to and played a pivotal role in the proof of negligence. Much depends on the quality of guidelines and the tools developed and the authoritativeness of a guideline. Recently, there are several opinions the court also should review the validity and reliability of expert testimony including medical evidence. and widespread use of guidelines in malpractice lawsuit could lead the physicians to greater compliance with guidelines in the long term. In conclusion, Health care reformers, physicians as well as guidelines developers should understand that guidelines have both medical and legal aspects as a double-edges sword. so clinicians, legal representatives and decision-makers should not defer unduly to guidelines.

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Clinical Practice Guideline of Korean Medicine for Stroke : Preliminary Guideline and Recommendation (중풍환자에 대한 일차 한의임상진료 가이드라인)

  • Han, Chang-Ho
    • The Journal of Internal Korean Medicine
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    • v.33 no.4
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    • pp.347-366
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    • 2012
  • The aim of this new statement is to provide comprehensive and timely evidence-based recommendations on stroke management for clinical practitioners. Many countries are already well engaged in developing and releasing their own clinical practice guidelines, whereas Korean Medicine (KM) is still beginning. It will take time and effort to develop evidence-based guidelines and recommendations of KM or other traditional medicine because they are weak in the area of scientific evidence. The clinical practice guideline of Korean medicine for stroke was formulated through extensive review of published literature and consensus meeting of Korean medicine specialists. This project was supported by a grant of the Oriental Medicine R&D Project, the Ministry of Health and Welfare. Referring to guidelines developed in other countries, the experts in the subject tried to organize and develop guidelines and recommendations adequate for domestic medical circumstances. In December, 2008, a multi-disciplinary team called the Evidence Based Clinical Practice Guidelines Development Group (EBCPGsDG) for Stroke was organized. The writing committee was comprised of experts in internal medicine, acupuncture, rehabilitation, and Sasang constitution. Outside specialists and associated panels were invited for consultation. The scope of the guideline encompasses acupuncture, moxibustion and herbal medicine (including Korean medicine, traditional Chinese medicine, Kampo medicine) as interventions for stroke patients. It includes statements about ischemic stroke (I63), stroke not specified as hemorrhage or infarction (I64), and sequelae of cerebrovascular disease (I69) according to the International Classification of Disease (ICD). The committee subdivided the description of herbal medications into acute stroke management, subacute stroke management, post-stroke management, and secondary prevention of stroke. Guidelines on the practice of acupuncture and moxibustion were described in order for acute stroke management, subacute stroke management, chronic stroke management, and post-stroke rehabilitation. Clinicians who are working in the field of stroke care can adopt this guideline for their practice.

A Study on Students' Recognition and Practice of Patient's Medical Information Protection, who are majoring in Medical Records (의무기록 전공학생들의 환자 의료정보 보호인식과 실천인식에 관한 연구)

  • Jung, Sang-Jin
    • The Journal of the Korea Contents Association
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    • v.16 no.1
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    • pp.585-594
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    • 2016
  • This study is aimed at researching and analyzing the students' recognition and practice of the patents medical information, who are majoring in medical records and will be working as medical records technician, letting them recognize the importance of information, and at offering basic data required for development of medical records curriculum and for establishment of medical records protection policy. This study was conducted from 18th May through 6th June 2015, targeting 340 students enrolled four universities, by t-test, variance analysis, Pearson correlation analysis and multiple regression analysis. As a result of this study, the point of protection recognition and practice recognition is 3.55 and 3.49, respectively, out of 5. With regard to recognition of medical information protection, there was a significant difference in grade, satisfaction for major, experience of medical information protection education and recognition of law, while for recognition of practice, in grade, satisfaction for major, educational experience and damage of medical information exposure. Recognition of protection and recognition of practice had a significant static correlation, and recognition of information exposure, recognition of social issue and recognition of legal system had significant positive effect on recognition of practice. In order to raise the recognition of protection and recognition of practice, based on this study, it is considered necessary for the universities to educate the damage of medical information exposure and importance of medical records management, and to raise the students' recognition.

Infection control awareness and practice for clothing management in 119 emergency medical technicians (구급대원의 의복관리를 위한 감염관리 인지도와 수행도)

  • Jeong, Ji-Yeon;Jeong, Eun-Kyung;Yun, Hyeong-Wan
    • The Korean Journal of Emergency Medical Services
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    • v.18 no.2
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    • pp.21-33
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    • 2014
  • Purpose: A descriptive study design was used to investigate infection management awareness and infection management performance for clothing management in 119 emergency medical technicians (EMTs). Method: 188 paramedics and basic EMTs completed questionnaires between March 1 and April 30, 2013 in Jeollabuk-do. Results: Participants' average score for infection control awareness was 2.69 and that for performance was 1.58, with the differences being statistically significant (t = 931.455, p = .003). Participants' general characteristics resulted in differences in infection management performance. Women (1.63) have scored higher than men (1.28), and the difference was statistically significant (t = 11.174, p = .001). Participants who had clinical experience (1.63) had higher scores than participants who did have clinical experience before (1.53) and, again, the difference was significant (t = 7.167, p = .009). Conclusion: Education program for infection management is need to be developed for more effective infection management.

Investigation of Infection Control Management in Occupational Therapy and Clinical Practice Students (작업치료(학)과 임상실습 학생들의 감염관리 인식 및 실태조사)

  • Won, Junghee;Chang, Moonyoung
    • Journal of The Korean Society of Integrative Medicine
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    • v.7 no.3
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    • pp.95-107
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    • 2019
  • Objective : The aim of this study was to investigate the infection management awareness and infection prevention management status of students who participated in occupational therapy and clinical practice. Methods : The study was carried out from June 27th to August 4th, 2017, to survey the awareness and practice of infection control in 11 practice institutes among 193 students who had experience in 8 universities. Results : A total of 93.3 % of the respondents said that they needed education about infectious diseases, but 53.3 % of them did not receive infection prevention education at school or in clinical trial institutes. Hygienic practices for infection prevention and infection control practices related to handwashing were high, but the use of protective equipment was poor in the observation of swallowing disorder treatment. It is also important to educate students who have been trained in infection control. However, infection prevention training at universities and training centers is insufficient suggesting the importance of future infection education. Conclusion : Infection control education to prevent infection is necessary not only for clinicians but also for students participating in on-the-job training. Effective efforts are also needed in universities and clinical practice institutes so that infectious disease prevention education can be implemented. This study provides basic data for infection control education in universities and practice educational institute that perform clinical training and occupational therapy.

Interventional Pain Management in Rheumatological Diseases - A Three Years Physiatric Experience in a Tertiary Medical College Hospital in Bangladesh

  • Siddiq, Md. Abu Bakar;Hasan, Suzon Al;Das, Gautam;Khan, Amin Uddin A.
    • The Korean Journal of Pain
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    • v.24 no.4
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    • pp.205-215
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    • 2011
  • Background: Interventional pain management (IPM) is a branch of medical science that deals with management of painful medical conditions using specially equipped X-ray machines and anatomical landmarks. Interventional physiatry is a branch of physical medicine and rehabilitation that treats painful conditions through intervention in peripheral joints, the spine, and soft tissues. Methods: A cross-sectional study was conducted using three years of hospital records (2006 to 2008) from the Physical Medicine and Rehabilitation Department at Chittagong Medical College Hospital in Bangladesh, with a view toward highlighting current interventional pain practice in a tertiary medical college hospital. Result: The maximum amount of intervention was done in degenerative peripheral joint disorders (600, 46.0%), followed by inflammatory joint diseases (300, 23.0%), soft tissue rheumatism (300, 23.0%), and radicular or referred lower back conditions (100, 8.0%). Of the peripheral joints, the knee was the most common site of intervention. Motor stimulation-guided intralesional injection of methylprednisolone into the piriformis muscle was given in 10 cases of piriformis syndrome refractory to both oral medications and therapeutic exercises. Soft tissue rheumatism of unknown etiology was most common in the form of adhesive capsulitis (90, 64.3%), and is discussed separately. Epidural steroid injection was practiced for various causes of lumbar radiculopathy, with the exception of infective discitis. Conclusion: All procedures were performed using anatomical landmarks, as there were no facilities for the C-arm/diagnostic ultrasound required for accurate and safe intervention. A dedicated IPM setup should be a requirement in all PMR departments, to provide better pain management and to reduce the burden on other specialties.

An Overview of Korean Resource-Based Relativ Value Scale (상대가치 개발의 총괄)

  • 김한중;손명세;조우현;박은철;이선희;강형곤;허영주;원종욱;김양균
    • Health Policy and Management
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    • v.5 no.2
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    • pp.202-229
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    • 1995
  • In Korea, Resource-Based Relative Value Scale(RBRVS) is suggesting to the alternative of Korean Medical Fee Schedule. This study developed to methodology of RBRVS applicable to Korean situation and applied to services of internal medicine and general surgery. Our methodology of RBRVS is basically same to Hsiao's. But there are some differences between our method and H냐매's because Korean medical situation differs to American. The first difference is method of measurement of work. The Unit of work in our study is total work including intra-servic work and pre-/post-service work. Secondly, in extrapolation, we use primary data gathered to small group of physician. Tertially, in measurement of practice cost, we directly survey to budget data of hosptials and analyse practice costs by service. Some results are presented in a companion article.

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Knowledge, Attitude, and Practice of Radiation Management among Radiation Generating Device Manufacturers and Medical Personnel (방사선 발생장치 제조업체 및 의료기관 종사자의 방사선 관리에 대한 지식, 태도 및 실천)

  • Kim, Kyu-Hwan;Bae, Seok-Hwan
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.22 no.2
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    • pp.418-426
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    • 2021
  • This study investigates the perception of radiation safety management in radiation generator manufacturing workers and medical institutions. The basic data obtained is further applied to improve active coping ability and safety levels. The knowledge and attitude practice score of radiation was found to be related to gender, age, marital status, occupation, position, current work period, total work period, radiation related work period, the manual available, defense facility maintenance, number of defense equipment, radiation safety education, special health examination, and recognition of radiation terms. In particular, the knowledge score of radiologists was highest among the radiation-related occupations (<0.05). Radiation safety management requires active defense endeavors to prevent radiation exposure, by both workers of radiation manufacturers and medical institutions. Moreover, institutional devices such as compliance with guidelines, periodic education, facility reinforcement, manual preparation, and special health checkups are required for efficient radiation safety management.

A Study on Approach toward Integrative Dental-Hygienist Curriculum Model (치과위생사 통합교육과정 모형 접근에 관한 연구)

  • Hwang, Mi-Yeong;Lee, Chun-Sun
    • Journal of Korean society of Dental Hygiene
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    • v.7 no.4
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    • pp.595-609
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    • 2007
  • The purpose of this study was to classify the courses of the dental-hygiene curricula into several categories by field, to incorporate the subjects in the same category into an integrated course, and to suggest how to ensure the successful phase-in application of integrative education according to Ronald M. Harden's 11-stage integrative ladder model. The findings of the study were as follows: 1. When the existing curricula were analyzed, it's found that many credits were provided to the courses in the area of basic dentistry that offered both theory and practice. In particular, the subjects tested by the national examination were offered by every college. In the field of public oral health, the largest number of credits was allocated to theory of oral prophylaxis and practice courses. In clinical area, clinical practice, in the area of dental office management, dental insurance course was given the largest credit. There were 31 to 61 major subjects in the colleges, which indicated that the major subjects were segmented in detail. 2. It seemed necessary to incorporate the subjects in the field of basic dentistry into oral biology, and theory of oral prophylaxis/practice, preventive dentistry/practice, preclinical stage, emergency treatment and introduction to dental hygiene should be integrated in to clinical dental hygiene. The courses in clinical area should be combined into clinical dentistry, and in the field of medical management, dental insurance, hospital management and medical relation law should be incorporated into management of dental clinic. 3. In the 11-stage integrative ladder, the subjects in the same field could perfectly be incorporated as the stages advanced. Each of the subjects was less emphasized, and communication and joint plans among teachers who were respectively in charge of the courses were increasingly considered important. Specifically, there should be a consensus among the teachers in regard to the outline of teaching programs, order of education. objects and objectives of programs and what and how to evaluate.

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The Development of Discharge Analysis Educational Program on NCS-Based for Medical Information Management (NCS 기반 의료정보관리를 위한 퇴원분석 교육프로그램 개발)

  • Choi, Joon-Young
    • The Journal of the Korea institute of electronic communication sciences
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    • v.12 no.5
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    • pp.957-964
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    • 2017
  • In this study, It developed a program to carry out the training courses for NCS based medical information management tasks and to can understand the practical working knowledge of learners. This program is an educational program that can generate medical information by analyzing data of medical records after generating and storing data of medical records. Because the contents of the medical records vary and there are quantitative differences in the medical records, the contents of the medical records can be summarized and stored in the discharge analysis program for the standard of educational data. The medical terminology DB, medical terminology related DB, medical care related DB by the NCS ability unit element can be constructed and managed using the program. The following are the contents that can be learned through operation of the program. first, it's can understand Medical information DB management regulations through understanding sturucture of database. Second, it can understand the structure and function of the diagnostic code and medical practice code that are input to the discharge analysis program. The diagnostic codes and medical practice codes entered in the discharge analysis program can be searched and analyzed by each fields. Third, It can be advance medical information management ability by inputting and extracting data and generating medical information. In this study, It developed program that Students can be obtained Knowledge of medical information management and improved management competency by generate and analyze medical record data using discharge analysis program.