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Quality Improvement Priorities for Cosmetic Medical Service Using Kano Model and Potential Customer Satisfaction Improvement Index (Kano 모델 및 잠재적 고객만족 개선 지수를 이용한 미용성형의료서비스 품질 개선 우선순위)

  • Park, Youyoung;Jung, Hunsik
    • Journal of Korean Society of Industrial and Systems Engineering
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    • v.42 no.3
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    • pp.176-183
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    • 2019
  • The environmental changes in the Korean cosmetic medical service industry in the $21^{st}$ century are forming intense competition among medical institutions due to the quantitative expansion of its market. For stable growth of the cosmetic medical service industry, continuous quality improvement is necessary based on empirical research on the quality of cosmetic medical services rather than external expansion. The purpose of this study is to classify the quality attributes of cosmetic medical service using Kano model and to derive the degree of satisfaction and dissatisfaction of each quality attributes through Customer Satisfaction Coefficient (CSC). Through this, the study identified strategic priorities and suggested specific step-by-step approaches and quality improvement priorities that can increase customer satisfaction using the Potential Customer Satisfaction Improvement Index (PCSI Index). Based on SERVPERF, this study used measurement tools consisting of five dimensions : tangibles, reliability, responsiveness, assurance, and empathy. In addition, it was used of measurement items reconstructed into positive, negative, and satisfaction questions for Kano model analysis, CSC analysis, and PCSI Index analysis. A total of 300 medical consumers who experienced cosmetic medical services for the past one year in medical institutions such as plastic surgery and dermatology were collected with convenient sampling. As a result, urgent items for improving the quality of service using the PCSI Index, 'Consideration for customer benefits' in empathy category was followed by 'Immediate help' and 'Sincere response' in responsiveness category, and 'Understanding customer needs' in empathy category, respectively. That is, it is required to improve human service quality attributes such as empathy and responsiveness rather than physical service quality attributes. This study contributes practically in that it provides specific and discriminatory approaches to improve customer satisfaction on cosmetic medical service quality and suggests improvement priorities.

A Study of Nursing Manpower Requirements based on the Nursing Times spent in Operating Room of an University Hospital (수술실 간호인력의 수요측정 및 간호제공량분석 - 수술대기시간과 수술시간을 중심으로 -)

  • YooN Ke Sook
    • Journal of Korean Public Health Nursing
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    • v.1 no.1
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    • pp.45-61
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    • 1987
  • This Study was an attempt to estimate the optimum numbers of Operating Room Nursing Manpower by measuring the amount of service hours required by the patients in Operating Room in relation to the service amount actually provided by the nurses. The major concern of this study was placed on the measurement of Nursing Service Requirements by using the Operating Room (O. R) Patient Acuity System recently developed by M. M. Hart to classify the O. R. patients into four groups according to the degree of the complexity of operative procedure and some other elements which increase nursing activities in respect of patient care; Acuity IV group is the one requires nursing services most, on the other hand Acuity I requires least. nu sing The objectives of this study were as follows; 1. To analyze functions of the nursing personnel in O. R. by time unit and to estimate the average time a nurse can activate for productive functions. 2. To measure the actual amount of nursing times provided by nurses to the surgical patients. 3. To develop a patient classification system in order to measure the amount of Nursing services required by the patients. 4. To calculate an appropriate number of nursing manpower to meet the needs of the patients. In order to conduct the research both selected nurses and patients in 'S' University Hospital were Studied by utilizing the O. R. Patient Acuity System as well as the Classification Chart developed by Association of Operating Room Nurses (A. O. R. N) as a means of classifying functions of O. R. nurses. That is; Functions of the 10 selected O. R. nurses observed during the period of June 30 to July 4, 1986, whereas the amount of nursing services required by or provided to the 974 patients who had received surgeries during the period of June 9 to July 4, 1986. The results of this study were as follows; 1) The actual working hours per a nurse averaged 6.7 hours a day. 2) Each nurse's daily routine schedule consists of $71.4\%$ for Technical Functions, $16.1\%$ for Nonprodective Functions, $6.6\%$ for Assessment and Evaluation, $3.9\%$ for Overseeing and Supervision and the rest $2.0\%$ for Patient Preparation respectively. 3) Preoperative waiting time per a patient was 24.1 minutes on the average; for the first case was 10.7 minutes, whereas for the following cases was 32.0 minutes. 4) Total Operation time for the 974 patients during the period of observation for this study amounted to 2759.6 hours, weekly hour was equivalent to 689.9 hours, Whereas daily operation time averaged 130 hours. Meanwhile the average operation time per patient was 2.8 hours ; for the case of Acuity IV was 5.6 hours, 5. 1 hours for the case of Acuity III, 2.3 hours for Acuity II and 1.1 hours for Acuity I. 5) According to the O. R. Patient Acuity System, $64.5\%$ of the whole patients belonged to Acuity II, $23.7\%$ to Acuity III, 11. $3\%$ to Acuity IV and $0.7\%$ to Acuity I respectively. 6) Required amount of nursing times based on the preoperative waiting time and operation time was 7167.8 person hours, which showed that $5.5\%$ of them needed for preoperative nursing care, whereas the rest $94.5\%$ for intraoperative nursing care. In terms of the O. R. Patient Acuity System, $49.7\%$ of total nursing service requirements was needed for Acuity II patients, $27.4\%$ for Acuity III patients, $17.2\%$ for Acuity IV patients and $0.2\%$ for Acuity I patients. 7) The rate of the nursing services provided against the required nursing times was about $81.4\%$ on the average; some departments, like those of Plastic Surgery, Otolaryngology and Ophthalmology whose patients mostly belonged to Acuity II recorded hegher provision rate than average, whereas other departments of Thoracic Surgery. Neurosurgery and Orthopedic Surgery whose patients belonged to Acuity III and Acuity IV as well as Acuity II recorded lower provision rate than average. 8) Subsequently, required numbers of nursing manpower was 10.7 nurses additionally. Based on the above findings the following recommendations will be made; 1) this study recommends, develops. and adopts an accurate and realistic O. R. Patient Acuity System which can help measure the nursing service requirements objectively to elicit the rationales of allocation of nursing personnels. 2) this study proposes storongly place nurses who take the role of preoperative nursing care exclusively for the waiting patients in O. R. and shortening their waiting time by close communication between the designated O. R. and the ward.

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Esthetic Root Coverage for Gingival Recession (심미적인 결과를 얻기 위한 치근 피개술)

  • Ahn, MyungHwan
    • Journal of the Korean Academy of Esthetic Dentistry
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    • v.26 no.1
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    • pp.4-16
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    • 2017
  • In dental esthetics, soft tissue plays an important part, probably very large portion of it. A clear understanding of the periodontal tissues and its management around teeth and implants help us to develop concepts for a modern dental treatment that addresses the needs of demanding patients in regard of esthetics and durability. When we talk about esthetic, we can say that one of the most important element is a harmonization with gingiva (soft tissue) called 'Pink Esthetic' As for the pink esthetics, gingival line(contour) takes most of the influence on esthetic result; it consists of labial gingival level, interproximal papilla height, and a line that connects them. In the gingival recession, labial gingival level and gingival contour move to the apical portion, and the root area is exposed. It leads to the unesthetic result. Root coverage technique is classically used to treat gingival recession (marginal tissue recession) of natural teeth. It is an essential technique on periodontal plastic surgery part. It is also a very useful technique to recover soft tissue problems in implant dentistry. So, root coverage technique must be mastered for a good implant esthetic result. The general overview of root coverage procedures will be discussed with step by step explanation to get more esthetic result.

Analysis of the Issues received by Quality Improvement Department and their Management in a Medical Center (일 의료원의 통합 고충처리센터 접수 내용과 이에 대한 해결방안 분석)

  • Tark, Kwan-Chul;Park, Hyun-Ju;Chun, Ja-Hae;Kang, Eun-Sook;Moon, Ju-Young;Choi, Mi-Young;Kim, Hyun-Ju;Kang, Jin-Kyung
    • Quality Improvement in Health Care
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    • v.7 no.1
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    • pp.118-131
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    • 2000
  • Background : A continuous healthcare quality improvement is needed to provide high quality healthcare service as well as to maintain trust in terms of satisfying the needs of the patients. Recently it also became an essential issue. in hospital management, recognized for it's competitive potentiality among healthcare organization groups. This study was conducted to analyze patient complaints and issues received by the Quality Improvement Department. Its purpose is to improve healthcare qualities within the hospital, as well as establish policies and appropriate strategies in hospital management. Method : From July 1st to September 30th of the year 1999, we analyzed all complaints and issues made by various patients and their families, which were received through 24 hour phone consultation, numerous suggestion boxes, letters and E-mails, The issues were classified into 16 different categories based on a Patient Satisfaction Assessment Tool. All data were segregated according to the departmental frequencies and their contents. To come up with for environmental and patient satisfaction improvement, all complaints or issues were communicated with hospital administrators, medical and nursing staff and employees. Comprehensive customer satisfaction activities including improving phone etiquette were discussed in Customer Satisfaction Team, CQI Team and each Department. All opportunities for improvement were implemented. Feedback actions were discussed. Results : A total of 317 cases were collected. Issues regarding parking and other accommodation facilities were most common complaints that were 14.5% of total. Issues regarding admission rooms (10.7%), admission procedures (10.7%), waiting room environment (8.8%), nurses and nurse assistants (7.6%), physicians (6.6%) and others (23%) followed. Thirteen of 45 departments received more than 8 complaints. The Nursing Department had the most complaint, receiving 9.8% of total complaints. Complaints regarding the Nursing Department were predominantly related to the environment of patient rooms. The Department of Psychiatry for phone etiquette (4.7%), Department of Otolaryngology for the nursing staff's attitude and phone etiquette (4.4%), and the Admission Department followed. As a part of efforts to improve patient satisfaction, a new parking structure was built and reallocation of the parking space was done. Renovation of other accommodation facilities were carried out by hospital administration, Monthly phone call and answering attitude survey was done by QI Department. Based on this survey we made a phone etiquette manual and distributed throughout the hospital. Compare to the last year, Patient Satisfaction Index measured by Korea Productivity Center using National Customer Satisfaction Index was improved 7 points. According to our organization's own study, we confirmed the phone etiquette was improved 11% than last year. Conclusions : Issues related to parking and other accommodation facilities ranked first followed by complaints made regarding the patient care area, the admission and cashier process, and nurses' and doctors' attitude. The Nursing and Psychiatry Departments need improvement regarding phone etiquette. Results were shared and played a vital role in policymaking and strategic planning of the hospital. It is imperative that we keep our database updated by listening to and solving the needs of each patient. The CQI activities can be achieved only by full commitment of the hospital top management supported by related personal.

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