• 한국병원경영학회지
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• 제22권3호
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• pp.144-156
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• 2017

Purpose: Crisis is inevitable to every organization and therefore, successful crisis management is critical to the organizations' survival and prosperity. With the understanding, this study aims to draw propositions for successful crisis management of hospitals when facing infectious disease outbreak. For the purpose, a case of a small and medium sized hospital's experience of crisis management during 2015 Middle East Respiratory Syndrome outbreak was analyzed. Methodology/Approach: The detailed internal circumstances and experiences of the hospital during the MERS outbreak were identified by in-depth interview as well as the extensive material review, and analyzed under the view of the theories of accident, error, and crisis in relation of organization management Findings: Overall, nine propositions are drawn by the phase of crisis. In pre-crisis phase, for example, 'the hospital preparedness has positive influence on the effective responding to the crisis'. In detection phase, 'the mindfulness of the hospital organizations' as well as the individuals' has positive influence on detecting the crisis signals'. In crisis phase, for example, 'improvising naturally occurs in crisis by the unknown disease, therefore, a component site supervisor coordinating such improvision is important'. Lastly, in post-crisis phase, 'successful crisis responding experience facilitates the positive hospital culture'. Practical implication: From the experience of a small and medium size hospital, it is suggested that proactive system approach oriented by safety is beneficial for effective crisis management.

• 대한정형외과스포츠의학회지
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• 제3권1호
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• pp.73-80
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• 2004

목적: 중범위와 대범위 전층 회전근 개 파열에서 관절경 하의 봉합술과 소절개 봉합술을 비교하기 위함이다. 재료 및 방법: 중범위와 대범위의 전층 회전근 개 파열 34예를 대상으로 하였으며, 관절경 하 봉합술을 시행한 13예를 제 1군으로, 소절개 봉합술을 시행한 21예를 제 2군으로 하였다. 파열 크기는 1 cm에서 5 cm까지 였다. 평균 추시 기간은 24(범위; 12$\~$36)개월과 28(범위;12$\~$36)개월이었다. VAS (Visual Analogue Scale) 동통 점수를 이용하여 주관적 통증을 비교하였고, ADL (Activity of Dally Living) 일상 생활 지수를 이용하여 비교하였으며, 기능 평가는 UCLA (University of California LA)점수를 이용하여 비교하였다. 양 군의 만족도를 측정하여 비교하였다. 결과: 최종 추시에서 동통과 기능 점수는 향상되었으나 통계적으로 의미있는 차이는 없었다(p>0.05). VAS 동통 점수, ADL 일상 생활 지수, UCLA 점수, 만족도는 차이가 없었다(p>0.05). 결론: 중범위와 대범위 전층 회전근 개 파열에서 관절경 하의 봉합술과 소절개 봉합술은 VAS, ADL, UCLA점수에서 통계적으로 의미 있는 차이가 없었으며, 비슷한 임상적 결과를 보였다.

• 한국의료질향상학회지
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• 제15권1호
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• pp.123-133
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• 2009

Background : The principal diagnosis has been used in many different fields such as hospital statistics, medical research, insurance claim, national health statistics and so on. Some principal diagnoses have a relatively low level of reliability in the medium-sized hospitals. The purpose of this study is to identify the reliability level of principal diagnoses and to suggest ways to improve reliability of the principal diagnosis. Method : Data were collected from a medium-sized hospital located in Pusan. The discharge summaries on 323 patients who were discharged in January, 2008 and the outpatient summaries on 251 patients who visited the hospital on March 28, 2008 were collected, and descriptive analysis was performed using SPSS version 12.0K. Result : The findings are the followings: (1) the diagnostic consistency rate between medical records and doctors' was 92.0%; (2) the diagnostic consistency rate between medical records and insurance claims was 86.1%; (3) the diagnostic consistency rate between doctors' diagnoses and insurance claims was 80.2%. The evidence seems to indicate that some principal diagnoses have reliability problems in the medium-sized hospitals. Conclusion : The results of this study suggest the followings: (1) employees should be trained and supervision of hospital activities are needed; (2) network systems should be constructed for each department; (3) professions need to be fostered (4) doctors' awareness of medical records should be changed.

• 대한간호학회지
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• 제50권4호
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• pp.621-630
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• 2020

Purpose: This study was aimed to evaluate the external validity of a carbapenem-resistant Enterobacteriaceae (CRE) acquisition risk prediction model (the CREP-model) in a medium-sized hospital. Methods: This retrospective cohort study included 613 patients (CRE group: 69, no-CRE group: 544) admitted to the intensive care units of a 453-beds secondary referral general hospital from March 1, 2017 to September 30, 2019 in South Korea. The performance of the CREP-model was analyzed with calibration, discrimination, and clinical usefulness. Results: The results showed that those higher in age had lower presence of multidrug resistant organisms (MDROs), cephalosporin use ≥ 15 days, Acute Physiology and Chronic Health Evaluation II (APACHE II) score ≥ 21 points, and lower CRE acquisition rates than those of CREP-model development subjects. The calibration-in-the-large was 0.12 (95% CI: - 0.16~0.39), while the calibration slope was 0.87 (95% CI: 0.63~1.12), and the concordance statistic was .71 (95% CI: .63~.78). At the predicted risk of .10, the sensitivity, specificity, and correct classification rates were 43.5%, 84.2%, and 79.6%, respectively. The net true positive according to the CREP-model were 3 per 100 subjects. After adjusting the predictors' cutting points, the concordance statistic increased to .84 (95% CI: .79~.89), and the sensitivity and net true positive was improved to 75.4%. and 6 per 100 subjects, respectively. Conclusion: The CREP-model's discrimination and clinical usefulness are low in a medium sized general hospital but are improved after adjusting for the predictors. Therefore, we suggest that institutions should only use the CREP-model after assessing the distribution of the predictors and adjusting their cutting points.

• Journal of Korean Biological Nursing Science
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• 제23권4호
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• pp.318-329
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• 2021

Purpose: This study was conducted to identify factors affecting COVID-19 vaccination and associated side effects among health care workers in a small and medium-sized hospital. Methods: In May 2021, 301 workers out of a total of 670 working in a small and medium-sized hospital in Gyeonggi-do, were surveyed. The small and medium-sized hospital treats patients with COVID-19. Health care workers across different medical institutions responded with self-reported internet questionnaires. Factors influencing COVID-19 vaccination were analyzed via logistic regression. Results: Out of 301 subjects, 89.0% showed an intention to inoculate, and 85.7% were vaccinated against COVID-19. The most frequent reason for vaccination was responsibility as a medical worker. The fear of adverse reactions was the most frequent reason for non-vaccination. Adverse reactions after inoculation occurred in 70.9% of cases, and 30.6% were referred for treatment of adverse reactions. The factors ultimately influencing COVID-19 vaccination were vaccination intention, previous side effects from other vaccinations, occupation, and age. Conclusion: In order to improve the effectiveness of COVID-19 vaccination, a systematic approach is required to determine the risk factors associated with the young age of the administrative staff/personnel, subjects with a history of side effects associated with other vaccines, and health care workers who do not intend to be vaccinated. It is important to develop strategies to improve immunization. In addition, accurate and essential information regarding the side effects of vaccination is needed, along with appropriate education and publicity.

• 한국응용과학기술학회지
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• 제39권6호
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• pp.839-852
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• 2022

본 연구는 중소병원간호사가 급격하게 변화하는 의료환경에 유연하게 대처할 수 있도록 업무 스트레스 및 회복탄력성, 간호업무성과를 파악하고 영향요인을 확인하기 위한 서술적 조사연구이다. 연구대상자는 S지역에 소재하는 4개 중소병원에서 근무하는 간호사 219명이었으며, 구조화된 설문지를 이용하여 조사하였다. 수집된 자료는 기술통계, t-test, ANOVA, Pearson's 상관관계 분석 및 다중회귀분석을 이용하여 분석하였다. 중소병원 간호사의 업무 스트레스와 간호업무성과는 음의 상관관계(r=-0.150, p<.05), 업무 스트레스와 회복탄력성은 양의 상관관계(r=0.160, p<.05). 간호업무성과는 회복탄력성과 양의 상관관계를 보였다(r=0.351, p<.01). 간호업무성과에 영향을 미치는 변수는 회복탄력성(𝛽=.231, p<.01)이였으며, 설명력은 17.4%로 나타났다(Adj.R²=0.174, p<.001). 따라서 간호사의 간호업무성과를 향상시키기 위해서는 회복탄력성을 증가시킬 필요가 있으며, 이를 위해서는 간호사 개인의 역량에 맞는 다양한 교육 프로그램을 개발하여 적용할 필요가 있겠다.

• 대한간호학회지
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• 제34권7호
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• pp.1243-1254
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• 2004

Purpose: This study was performed to give direction to quality improvement strategies of nursing services by comparing the differences in quality perceptions and satisfaction for nursing services between patients and nurses in small-medium sized general hospitals with 200 beds. Method: The subjects, who were 150 inpatients and 162 nurses of 4 general hospitals in a community, answered a self-report questionnaire with a SERVQUAL scale. Result: There were differences between patients' and nurses' expectations and perceptions of nursing service and satisfaction. In the service expectation, the highest factor was 'the responsiveness', and in the perceived performance, the highest was the 'assurance'. In addition, overall patients' perceptions on nursing services showed higher than nurses'. There were positive correlations among the expectations and perceptions on nursing service, and satisfaction. The correlation between perception and satisfaction was higher than the correlation between expectations and satisfaction. Conclusion: To improve the nursing service quality at small-medium hospitals, strengthening the 'assurance' factor and improving the nursing service support system is needed. Also, this study on nurses' perceived nursing service at small-medium sized hospitals should be duplicated.

• 근관절건강학회지
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• 제24권3호
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• pp.159-170
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• 2017

Purpose: The purposes of this study were to identify musculoskeletal symptoms and to investigate factors associated with musculoskeletal symptoms in small and medium sized hospital nurses. Methods: The data were collected from 206 nurses working in Jeonnam. We used self administration questionnaires of KOSHA GUIDE H-9-2012 for musculoskeletal symptoms, PWI-SF for psychosocial stress, KOSS for job stress, and HPLP-II for health behaviors. The collected data were analyzed using the $x^2$, t-test, and logistic regression analysis in SPSS Ver. 23.0. Results: Sixty-six percent of the subjects had musculoskeletal symptoms. The shoulder had the highest symptom at 38.3%, followed by lower back at 32.5%, and neck at 29.1%. The mean and standard deviation score of psychosocial stress were $24.06{\pm}6.01$, those of job stress were $2.38{\pm}0.23$, and those of health behaviors were $2.14{\pm}0.39$. The items that were significantly different according to musculoskeletal symptoms were career ($x^2=6.67$, p<.036), one week overtime ($x^2=7.27$, p<.026), subjective health status ($x^2=4.29$, p<.038), and psychosocial stress ($x^2=7.99$, p<.010). In logistic regression analysis, career, and psychosocial stress were found to affect musculoskeltal symptoms. Conclusion: It is necessary to conduct preventive intervention to reduce musculoskeletal symptoms according to career and psychosocial stress for small and medium sized hospital nurses.

• 한국생활환경학회지
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• 제25권1호
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• pp.90-97
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• 2018

The purpose of this study is to compare and analyze the air infections in middle and small hospitals with the facilities of large national hospitals that have air-borne infection isolation (AII) wards through actual condition investigation and airflow analysis simulation (CFD) and to provide basic data for prevention. The method and scope of the study are as follows. First, through literature review, data related to prevention of infection spread in domestic medical institutions were investigated. Second, we conducted a survey on the status of isolation facilities to prevent the spread of infectious diseases in large hospitals and small and medium - sized clinics in Korea. Third, airflow analysis simulation (CFD) was carried out using the isolation ward of the nationally designated inpatient ward and the data of the plane and facility system of the small clinic. As a result of the study, it is found that regulations applicable to small and medium-sized clinics are insufficient. In addition, the simulation results show that the infectious disease virus is likely to spread to other patients in the hospital.

• 융합정보논문지
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• 제7권4호
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• pp.61-67
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• 2017

경쟁이 치열해진 의료 환경에서 중소병원 또한 환자 중심의 고객 만족은 불가피한 실정이다. 이에 본 연구는 중소병원 경영전략 수립에 필요한 방향성을 제시하고자 이용 고객(환자)이 지각하는 서비스 지향성이 관계결속과 친사회적 행동에 미치는 영향을 알아보는데 그 목적이 있다. 서비스 지향성의 구성요인을 중소병원의 특성에 맞게 고객 대우, 서비스 실패회복, 서비스 표준으로 구성하였다. 이때 서비스 지향성의 3가지 하위요인이 관계결속에 영향을 미처 친사회적인 행동을 유발하는지를 검증하기 위해 AMOS를 통해 경로 분석하였다. 연구 결과 서비스 지향성의 하위요인 모두 본 연구에서는 유의미한 결과를 보였으며, 관계결속과 친사회적 행동 또한 유의미한 영향을 미친다는 결과가 도출되었다. 이런 연구 결과에 근거하여 시사점을 제시하고 미래 연구를 제안하였다.