• Title/Summary/Keyword: Medical quality management

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A Prediction Model for the Radiation Safety Management Behavior of Medical Cyclotrons (의료용 Cyclotron의 방사선안전관리 행위 예측모형)

  • Jung, Ji-Hye;Han, Eun-Ok;Kim, Ssang-Tae
    • Journal of Radiation Protection and Research
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    • v.33 no.2
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    • pp.77-86
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    • 2008
  • This study attempted to provide reference materials for improving the behavior level in radiation safety managements by drawing a prediction model that affects the radiation safety management behavior because the radiation safety management of medical Cyclotrons, which can be used to produce radioisotopes, is an important factor that protects radiation caused diseases not only for radiological operators but average users. In addition, this study obtained follows results through the investigation applied from January 2 to January 30, 2008 for the radiation safety managers employed in 24 authorized organizations, which have already installed Cyclotrons, through applying a specific form of questionnaire in which the validity was guaranteed by reference study, site investigation, and focus discussion by related experts. The radiation safety management were configured as seven steps: Step 1 is a production preparation step, Step 2 is an RI production step, Step 3 is a synthesis step, Step 4 is a distribution step, Step 5 is a quality control step, Step 6 is a carriage container packing step, and Step 7 is a transportation step. it was recognized that the distribution step was the most exposed as 15 subjects (62.5%), the items of 'the sanction and permission related works' and 'the guarantee of installation facilities and production equipments' were the most difficult as 9 subjects (37.5%), and In the trouble steps in such exposure, the item of 'the synthesis and distribution' steps were 4 times, respectively (30.8%). In the score of the behavior level in radiation safety managements, the minimum and maximum scores were 2.42 and 4.00, respectively, and the average score was $3.46{\pm}0.47$ out of 4. Prosperity and well-being programs in the behavior and job in radiation safety managements (r=0.529) represented a significant correlation statistically. In the drawing of a prediction model based on the factors that affected the behavior in radiation safety managements, general characteristics, organization characteristics, and selfefficacy didn't show a significant path statistically in which the prosperity and well-being programs in job characteristics affected the behavior in radiation safety managements. Therefore, it is necessary to establish a strategy that improves the level of prosperity and well-being levels in job characteristics in order to increase the behavior in radiation safety managements. Thus, this study provides basic materials for the radiation safety management of Cyclotron through the full-scale investigation that is first applied in Korea.

Effect of Physical Environment of Hospital on Customer' Satisfaction and Worth of Mouth, Revisit Intention (병원의 물리적 환경이 고객만족과 구전, 재방문 의도에 미치는 영향)

  • Kim, Jin-Sae
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.13 no.10
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    • pp.4645-4652
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    • 2012
  • Recently the demand for hospital care increased competition and a variety of new and expansion is a real situation that faced with a situation. These factors, in reality, the importance of the physical environment of the hospital soon for the hospital's survival and development, as well as the native functionality of the hospital to gain the core a competitive edge is being evaluated as a core competence. therefore this study aims to examine the effect of the physical environment of medical institutions on visits in patients satisfaction, worth of mouth and revisit intention. Some useful strategic materials derived from this study could be considerably useful to the managers of medical institutions. The results of this study are summarized as follows. First, the key elements which can decide the quality of the physical environment of medical institutions are accessibility, cleanness and convenience. Second, the perceived physical environment makes a positive influence on visits in patients satisfaction. Third, the more satisfaction the customers can perceive, the higher rises the worth of mouth. Fourth, the more satisfaction the customers can perceive, the higher rises the revisit intention.

The Bone Mineral Density Value According to the Operating Time of the Dual Energy X-ray (이중 에너지 엑스레이 흡수기의 가동 시간에 따른 골밀도 값의 평가)

  • Lee, Hae-Jung;Kim, Ho-Sung;Kim, Eun-Hye
    • The Korean Journal of Nuclear Medicine Technology
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    • v.14 no.1
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    • pp.40-45
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    • 2010
  • Purpose: Recently, the performance of the X-ray tube was very much improved by the power generation of the technology. However, the overload of equipment is occurred by the increment of the equipment operating time according to the increment of the examination number of cases. The X-ray dose can change by heat occurrence of the X-ray tube due to this. Moreover, the change of the bone mineral density value is possible to occur. Therefore, We tries to whether the change of the bone mineral density value of each equipment according to the difference of the examination number of cases and operating time occur or not. Materials and Methods: The BMD value was measured by the Aluminum Spine Phantom and the European Spine Phantom in each equipment, in order to find out about the difference of the time general classification bone mineral density value by using the Dual energy X-ray absorptiometry. And after scanning each phantom by using X-ray dose meter (Unfors Mult-O-Meter), a dose was measured by the same condition. As to, an average and standard deviation were found and the change of each equipment much BMD value was compared and it evaluated. Results: $Mean{\pm}SD$ of each equipment by using the Aluminum Spine Phantom, A equipment was $1.174{\pm}0.002$, $1.171{\pm}0.005$, $1.173{\pm}0.005$, B equipment was $1.186{\pm}0.003$, $1.187{\pm}0.003$, $1.185{\pm}0.003$, C equipment was $1.180{\pm}0.003$, $1.182{\pm}0.004$, $1.183{\pm}0.002$, D equipment was $1.188{\pm}0.004$, $1.185{\pm}0.003$, $1.185{\pm}0.004$. By using the European Spine Phantom, A equipment was $1.143{\pm}0.006$, $1.153{\pm}0.009$, $1.161{\pm}0.003$, B equipment was $1.134{\pm}0.004$, $1.13{\pm}0.008$, $1.127{\pm}0.015$, C equipment was $1.143{\pm}0.006$, $1.134{\pm}0.01$, $1.133{\pm}0.006$, D equipment was $1.14{\pm}0.001$, $1.122{\pm}0.002$, $1.131{\pm}0.008$, altogether included in the normal range. Conclusion: There was no significant change of the BMD value of using a phantom by time zones. Therefore, if the quality control is made to use the extent management method of the equipment for beginning in the present application, the reliability of the BMD equipment will be able to be enhanced.

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Relationships among Activity Status, Anxiety, Depression, Social Support, Symptom Experience, and Functional Status in Lung Cancer Patients based on the Theory of Unpleasant Symptoms (폐암 환자의 활동상태, 불안, 우울, 사회적 지지, 증상경험과 기능적 상태의 관계: 불쾌감이론 기반으로)

  • Kim, Keum Soon;Yi, Myungsun;Bang, Kyung-Sook;Cho, Young Ae;Lee, Jung Lim;Lee, Eun
    • Perspectives in Nursing Science
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    • v.10 no.2
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    • pp.87-96
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    • 2013
  • Purpose: The purpose of this study was to investigate the relationships of activity status, anxiety, depression, social support, symptom experience, and functional status in patients with lung cancer based on the theory of unpleasant symptoms. Methods: The participants for this study were 101 lung cancer patients who visited the out-patient department for treatment or follow-up at one hospital in Seoul. Data were collected from January 1 to February 8, 2013 using self-reported questionnaires and clinical records. To measure variables, the functional scale and symptom scale of the European Organization for Research and Treatment of Cancer (EORTC) Quality of Life Questionnaire-Core 30, EORTC QLQ-Lung Cancer 13, Eastern Cooperative Oncology Group Performance Status, Hospital Anxiety and Depression Scale, and Multidimensional Scale of Perceived Social Support were used in this study. The data were analyzed using SPSS 19.0 software for Windows. Results: The symptom experience showed more severity in patients with lower activity status, higher anxiety and depression. With lower activity status and social support, functional status was lower. When anxiety, depression, and symptom experience were higher, functional status was also lower. The significant factors predicting symptom experience were depression, anxiety, activity status, and social support, which explained 57.8% of the variance. Conclusion: These results suggest that psychological factors such as anxiety and depression had a negative influence on the symptom experience of lung cancer patients. Therefore, providing emotional support based on the patients' needs prior to providing symptom management could be a useful strategy for improving symptom experience and functional status.

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A study on the development of severity-adjusted mortality prediction model for discharged patient with acute stroke using machine learning (머신러닝을 이용한 급성 뇌졸중 퇴원 환자의 중증도 보정 사망 예측 모형 개발에 관한 연구)

  • Baek, Seol-Kyung;Park, Jong-Ho;Kang, Sung-Hong;Park, Hye-Jin
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.19 no.11
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    • pp.126-136
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    • 2018
  • The purpose of this study was to develop a severity-adjustment model for predicting mortality in acute stroke patients using machine learning. Using the Korean National Hospital Discharge In-depth Injury Survey from 2006 to 2015, the study population with disease code I60-I63 (KCD 7) were extracted for further analysis. Three tools were used for the severity-adjustment of comorbidity: the Charlson Comorbidity Index (CCI), the Elixhauser comorbidity index (ECI), and the Clinical Classification Software (CCS). The severity-adjustment models for mortality prediction in patients with acute stroke were developed using logistic regression, decision tree, neural network, and support vector machine methods. The most common comorbid disease in stroke patients were hypertension, uncomplicated (43.8%) in the ECI, and essential hypertension (43.9%) in the CCS. Among the CCI, ECI, and CCS, CCS had the highest AUC value. CCS was confirmed as the best severity correction tool. In addition, the AUC values for variables of CCS including main diagnosis, gender, age, hospitalization route, and existence of surgery were 0.808 for the logistic regression analysis, 0.785 for the decision tree, 0.809 for the neural network and 0.830 for the support vector machine. Therefore, the best predictive power was achieved by the support vector machine technique. The results of this study can be used in the establishment of health policy in the future.

A Clinical Analysis on Outpatients with Sudden Sensorineural Hearing Loss of Korean Medicine Ophthalmology, Otolaryngology & Dermatology Department at Daejeon Korean Medicine Hospital - From January, 2013 to December, 2021 - (대전한방병원 한방안이비인후피부과로 내원한 돌발성 난청 환자 특성 분석 - 2013년 1월부터 2021년 12월까지 -)

  • Choi, Yoon-Young;Byun, Jung-Ah;Baek, Jong-Chan;Hwang, Mi-Lee;Ahn, Jae-Hyun;Jung, Hyun-A
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.35 no.4
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    • pp.31-46
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    • 2022
  • Objectives : The purpose of this study is to analyze outpatients who visited for treatment for sudden sensorineural hearing loss in ophthalmology & otolaryngology & dermatology clinic of Daejeon Korean medical hospital from January 1st, 2013 to December 31th, 2021. Methods : We retrospectively analyzed outpatients who visited for treatment for sudden sensorineural hearing loss in ophthalmology & otolaryngology & dermatology clinic of Daejeon Korean medical hospital from January 1st, 2013 to December 31th, 2021. according to year, season, gender, age, clinical symptoms, number of visits and initial degree of hearing loss. The statistical analysis performed using IBM SPSS 25.0 for Windows. Results : The results of analyzing the medical records of 194 patients are as follows. 1. The number of patients showed a gradual increase from 2014 to 2021 and spring was highest in season. Acc ording to gender, women visited more than men and the age group that visited the most was middle-aged, including 40s and 50s. 2. Patients experienced 13 symptoms and the average number was 4.06. In the analysis of the major symptoms according to gender, hyperacusis and headache were found to be more common in female. 3. The average of initial hearing loss was 52.54dB and was higher in male. The loss was relatively higher in 60s or older than in the younger age group. Conclusions : If treatment and management methods that reflect these symptoms are developed, it is thought that it will greatly helpful to improve the quality of life of patients with sudden hearing loss.

Early Diagnosis and Management of Chronic Obstructive Pulmonary Disease (만성 폐쇄성 폐질환의 조기 진단과 관리)

  • Lee, Sei-Won;Yoo, Jee-Hong;Park, Myung-Jae;Kim, Eun-Kyung;Yoon, Ho-Il;Kim, Deog-Kyeom;Lee, Chang-Hoon;Park, Yong-Bum;Park, Joo-Hun;Hwang, Yong-Il;Jung, Ki-Suck;Yoo, Kwang-Ha;Park, Hye-Yoon;Lee, Jae-Seung;Huh, Jin-Won;Oh, Yeon-Mok;Lim, Seong-Yong;Jung, Ji-Ye;Kim, Young-Sam;Kim, Hui-Jung;Rhee, Chin-Kook;Kim, Young-Kyoon;Kim, Jin-Woo;Yoon, Hyoung-Kyu;Lee, Sang-Do
    • Tuberculosis and Respiratory Diseases
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    • v.70 no.4
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    • pp.293-300
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    • 2011
  • Chronic obstructive pulmonary disease (COPD) is a substantially under-diagnosed disorder, and the diagnosis is usually delayed until the disease is advanced. However, the benefit of early diagnosis is not yet clear, and there are no guidelines in Korea for doing early diagnosis. This review highlights several issues regarding early diagnosis of COPD. On the basis of several lines of evidence, early diagnosis seems quite necessary and beneficial to patients. Early diagnosis can be approached by several methods, but it should be confirmed by quality-controlled spirometry. Compared with its potential benefit, the adverse effects of spirometry or pharmacotherapy appear relatively small. Although it is difficult to evaluate the benefit of early diagnosis by well-designed trials, several lines of evidence suggest that we should try to diagnose and manage patients with COPD at early stages of the disease.

Effect of Organizational Support Perception on Intrinsic Job Motivation : Verification of the Causal Effects of Work-Family Conflict and Work-Family Balance (조직지원인식이 내재적 직무동기에 미치는 영향 : 일-가정 갈등 및 일-가정 균형의 인과관계 효과 검증)

  • Yoo, Joon-soo;Kang, Chang-wan
    • Journal of Venture Innovation
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    • v.6 no.1
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    • pp.181-198
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    • 2023
  • This study aims to analyze the influence of organizational support perception of workers in medical institutions on intrinsic job motivation, and to check whether there is significance in the mediating effect of work-family conflict and work-family balance factors in this process. The results of empirical analysis through the questionnaire are as follows. First, it was confirmed that organizational support recognition had a significant positive effect on work-family balance as well as intrinsic job motivation, and work-family balance had a significant positive effect on intrinsic job motivation. Second, it was confirmed that organizational support recognition had a significant negative effect on work-family conflict, but work-family conflict had no significant influence on intrinsic job motivation. Third, in order to reduce job stress for medical institution workers, it is necessary to reduce job intensity, assign appropriate workload for ability. And in order to improve manpower operation and job efficiency, Job training and staffing in the right place are needed. Fourth, in order to improve positive organizational support perception and intrinsic job motivation, It is necessary to induce long-term service by providing support and institutional devices to increase attachment to the current job and recognize organizational problems as their own problems with various incentive systems. The limitations of this study and future research directions are as follows. First, it is believed that an expanded analysis of medical institution workers nationwide by region, gender, medical institution, academic, and income will not only provide more valuable results, but also evaluate the quality of medical services. Second, it is necessary to reflect the impact of the work-life balance support system on each employee depending on the environmental uncertainty or degree of competition in the hospital to which medical institution workers belong. Third, organizational support perception will be recognized differently depending on organizational culture and organizational type, and organizational size and work characteristics, working years, and work types, so it is necessary to reflect this. Fourth, it is necessary to analyze various new personnel management techniques such as hospital's organizational structure, job design, organizational support method, motivational approach, and personnel evaluation method in line with the recent change in the government's medical institution policy and the global business environment. It is also considered important to analyze by reflecting recent and near future medical trends.

Advances in Radiation Oncology in New Millennium in Korea (21세기 방사선종양학의 전망:최근의 진보와 한국에서의 발전)

  • Huh, Seung-Jae;Park, Chan-Il
    • Radiation Oncology Journal
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    • v.18 no.3
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    • pp.167-176
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    • 2000
  • The objective of recent radiation therapy is to improve the quality of treatment and the after treatment quality of life. In Korea, sharing the same objective, significant advancement was made due to the gradual increase of patient number and rapid increase of treatment facilities. The advancement includes generalization of three-dimensional conformal radiotherapy (3D-CRT), application of linac-based stereotactic radiosurgery (SRS), and furthermore, the introduction of intensity modulated radiation therapy (IMRT). Authors in this paper prospectively review the followings: the advancement of radiation oncology in Korea, the recent status of four-dimensional radiation therapy, IMRT, the concept of the treatment with biological conformity, the trend of combined chemoradiotherapy, the importance of internet and radiation oncology information management system as influenced by the revolution of information technology, and finally the global trend of telemedicine in radiation oncology. Additionally, we suggest the methods to improve radiotherapy treatment, which include improvement of quality assurance (QA) measures by developing Koreanized QA protocol and system, regional study about clinical protocol development for phase three clinical trial, suggestion of unified treatment protocol and guideline by academic or research societies, domestic generation of treatment equipment's or system, establishment of nationwide data base of radiation-oncology-related information, and finally patterns-of-care study about major cancers.

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Effects of Oral Health Knowledge and Practices on Decayed, Missing and Filled Teeth Index and Quality of Life -Path Analysis Using Structural Equation Modeling- (구강보건 지식과 실천이 우식경험치아와 삶의 질에 미치는 영향 -구조방정식을 이용한 경로분석을 중심으로-)

  • Lee, Young-Soo;Bae, Sung Yoon;Ji, Jae-Hoon
    • Journal of dental hygiene science
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    • v.13 no.1
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    • pp.1-12
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    • 2013
  • This study aims to measure oral health knowledge and practice level among dental clinic patients, and examine their relationships with decayed, missing and filled teeth (DMF) index and the oral health-related quality of life (QOL). Empirical data have been collected from 311 patients through structured questionnaires and dental examinations conducted in Busan area. According to the analysis of causal relationship, oral health knowledge turned out to have a direct effect on oral health practices, which exerted both direct and indirect effects on DMF index and oral health-related QOL. While DMF index directly affected the oral health-related QOL, oral health knowledge proved to have only an indirect effect on DMF index and oral health-related QOL, mediated by oral health practices. Considering all these findings, effective oral health education and other intervention programs should focus on motivating people to participate in the active practices of desirable oral health behaviors, which will lead to the prevention of oral diseases and the subsequent improvement in the QOL.