• 한국방재안전학회논문집
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• 제9권1호
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• pp.39-45
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• 2016

세월호 참사 등 각종 재난에 있어 재난의료대응체계의 문제점이 노출되었는데, 이 중 현장응급의료지원팀의 현장대응 불가, 현장에서의 소방, 의료진의 협업 곤란, 현장의료지원 및 부상자의 수용, 진료를 위한 체계적이고 세부적인 매뉴얼 미비가 중요한 사항이었다. 따라서 2014년 5월부터 중앙응급의료센터 내 재난응급의료상황실 설치 운용에 따른 기존의 비공식적으로 흩어져 있던 재난의료대응 매뉴얼 수집, 수정 및 이에 대한 교육이 필요한 상황이 되었으며, 재난응급의료상황실을 중심으로 한 재난 초기 의료대응체계를 확립할 필요성이 대두되었다. 중앙응급의료센터의 재난의료대응 개선 방안은 신속대응반 중심의 빠른 출동 체계 수립이나, 실제 적용할 체계가 미흡하여, 2014년 2월 응급의료법 개정 시행규칙에 따라 국가와 지자체에 재난대응 매뉴얼을 개발하고 기본안을 마련하기로 하여, 본 연구진은 학술적, 실무적으로 적절한 국가재난의료 매뉴얼을 국내 최초로 개발하였으며, 이를 훈련 및 시뮬레이션을 통하여 적용하였고 그 과정을 정리 분석하였다.

• 한국문헌정보학회지
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• 제44권1호
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• pp.267-295
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• 2010

2006년 개정된 도서관법은 도서관정책 추진체계와 관련하여 중앙정부와 광역자치단체의 책임과 역할을 강조하여 그 실행을 위한 제도적 기구를 설립하도록 규정하고 있다. 도서관법에서는 지역대표도서관은 지역 내 모든 관종을 포괄하여 지역 도서관 정책을 추진하도록 구상되어 있다. 이 연구에서는 지역대표도서관 중심의 협력 시범운영과 직원 설문, 간담회를 통해, 지역대표도서관 중심의 지역단위 협력 방안을 검토하였다. 연구 결과, 협력의 지역범위별, 관종별, 분야별 차원을 고려하여 '지역대표도서관 중심의 협력체계 모델'과 '운영모델', '단계별 추진계획'을 제시하였다. 또한 '지역대표도서관 지정 건립 및 정착 방안'과 '제도적 개선 방안', '개별도서관 역량 강화 방안'을 제안하였다.

• 한국콘텐츠학회논문지
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• 제14권5호
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• pp.411-424
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• 2014

본 연구의 목적은 서비스품질을 활용한 측정기준을 설정하여 지역문화축제에 대한 인식수준을 파악함과 동시에 서비스품질에 대한 중요도-성취도 분석을 통하여 향후 서비스품질 향상 및 방문객의 축제이용시 이용극대화를 위한 효율적인 개선운영방안을 모색하여 지역문화축제의 질적향상에 도움이 되고자 한다. 중요도와 성취도간 대응일치 t-test 결과 1)응답성 요인에서는 휴식공간여부, 시설배치도, 의사전달, 화장실비치/청결도 2) 확신성 요인에서는 음식가격, 종업원의 친절, 3)신뢰성 요인에서는 (행사장까지)축제팸플릿, 안내시설/표지판, 친절도, 스케줄안내, 신속한 대응 등 모든 항목, 4) 유형성 요인에서도 지역문화인지도, 유익성, 스토리텔링 등 모든 항목에서 5) 공감성 요인에서는 행사의 다양성과 축제내용 항목에서 유의한 차이가 있는 것으로 나타났다.

• 한국산학기술학회논문지
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• 제21권2호
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• pp.448-459
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• 2020

최근 도시재생사업을 실질적으로 추진하는 도시재생지원센터에 대한 논의가 활발히 진행되고 있다. 그 이유는 역할과 권한이 명확하지 않고, 각 지자체 센터별 운영 경험이 축적되지 않아 많은 시행착오와 부작용이 따르고 있기 때문이다. 따라서 본 연구는 충북지역 도시재생지원센터를 대상으로 운영 현황을 분석하여, 향후 바람직한 도시재생지원센터의 운영 방안을 모색하는 데 있다. 이를 위해 기초현황과 설문조사 자료를 활용하였으며, 특히 관계자 심층면담을 통한 현장중심의 연구를 수행하였다. 충북지역 도시재생지원센터는 첫째, 광역센터·기초센터·현장센터간 역할 및 업무분담이 명확하지 않다는 점, 둘째, 센터 운영 방식의 한계와 운영 자율성 및 독립성이 확보되지 않은 점. 셋째, 도시재생 참여주체로써 행정에 비해 상대적으로 매우 낮은 권한과 위상을 갖고 있다는 점. 넷째, 도시재생 관련 전문 인력 확보 부족과 직원 고용의 불안전성이 전반적인 문제점으로 도출되었다. 따라서, 향후 도시재생사업이 더욱 체계적이고 효율적으로 추진되기 위해서는 우선 현장의 목소리에 귀를 기울여 각 지역마다 실제적 여건이 반영될 수 있는 안정적인 운영시스템 구축이 반드시 필요할 것으로 보인다.

• 한국의료질향상학회지
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• 제2권2호
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• pp.32-45
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• 1996

Background : A critical path defines an optimal sequencing and timing of interventions by physicians, nurses, and other staff for a particular diagnosis or procedure, designed to better utilize resources, maximize quality of care, and minimize delays. It can be thought of as a visualization of the patient care process. In this study, a review of appendectomy patient records was undertaken to identify a critical path for the management of this treatment. Methods: For this study, records of patients under 15 or over 65 years of age were excluded ; cases where the patient was pregnant, or where complications developed were also excluded. The remaining 21 cases were divided into two categories according to the indication for appendectomy : for acute appendicitis, and for perforated appendix or drainage of periappendical abscess. The time frame for the review was from patient examination immediately prior to operation, through discharge. The study team was composed of a surgeon, research head nurse, education head nurse, surgical part head nurse, and medical recorder. Following their review of the 21 charts, the team determined an appropriate progression and schedule for an appendectomy. Result : Through the chart and literature review, the following aspects of the care process were identified as typical and tracked : monitoring/assessment, treatment, lines/drains, medication, activity, diet, tests and patient education. Conclusion : From this study, the design team determined two separate critical paths : one for appendectomy only, and one for appendectomy plus drainage. Next, these paths must be validated and fine-tuned through clinical implementation. In addition, a comparison of our design with the critical paths determined at other hospitals would be extremely valuable for advancing research in this area. Lastly, the critical path approach to improving patient care and maximizing hospital resources should be applied to other procedures.

• 한국도서관정보학회지
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• 제8권
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• pp.69-96
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• 1981

We all know that we can not keep a proper social life without language. Yet language is so much a part of our environment that we hardly realize it is there. The purpose of this study is to provide an understanding of the linguistical aspect of communication process in order to carry out a successful human relations in the operation of libraries. Human development rests upon man's capacity to digest large quantities of knowledge and it is language which allows facts to be communicated, stored, and disseminated. An attempt was made in this study to illustrate the elementary meaning-of-words aspect of communication. In order to share the most commonly agreed meanings in interpersonal communication, a careful study of semantic noises is important. In a constant struggle to meet client needs, staff and administrators, librarian must understand communication dialogues, their messages and be able to read all level of meanings. In order to perform a successful function of the librarian, to act as a link-man or communicator and to cope with its ever growing information, it is suggested that the deep understanding of the following linguistical aspect of communication elements is essential. 1. Characteristics of Language: (1) Words have different meanings to different people. (2) Words vary in the degree of abstraction. (3) Language is incomplete by its nature. (4) Language reflects not only the personality of the individual but also the culture of man's society. 2. Noises in transmitting meanings: (1) Mechanical or Technical noises. (2) Semantic Noises (3) Noises caused by the psychological factors a. attention b. perception, sensation, cognition and perceptual field. 3. Linguistic Stratum Languages differ considerably in vocabulary by the physical and cultural environment setting as well as situation of individual living. There are seven different language stratum which reflects different region, sex, age, profession, special social stratum, academic and tabooed words.

• 간호행정학회지
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• 제21권3호
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• pp.243-253
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• 2015

Purpose: The purpose of this study was to identify the impact of practical communication strategies (PCS) on the reduction of AEs (Adverse Events) in pediatric cardiac ICU (PCICU). Methods: Intra-operative findings and care plans were documented and shared between staff members on a daily basis from the day of operation to the day of general ward transfer. Incidence of AEs was investigated in all patients who were admitted to the PCICU and was compared with incidence of AEs one year after establishment of PCS. Results: The study population consisted of 216 patients in pre-PCS group and 156 patients in post-PCS group. Incidence of readmission decreased from 6.0% (13/216) in pre-PCS group to 0.6% (1/156) in post-PCS group (${\chi}^2=7.23$, p=.010). Incidence of other major complications decreased from 4.2% (9/216) to 0.6% (${\chi}^2=6.66$, p=.012). Minor AEs such as intervention omission, order error, and protocol misunderstanding were reduced from 23.3 cases per 100 patient-days to 7.5 cases per 100 patient-days (${\chi}^2=20.31$, p<.001). Conclusion: Handover protocol is an effective strategy to reduce AEs for critically ill patients after pediatric cardiac surgery. Efforts to develop effective communication strategies should be continued and outcome research about communication strategies for patient safety should be further studied.

• 한국중재학회지:중재연구
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• 제26권4호
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• pp.129-149
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• 2016

Medical dispute means the dispute between the hospital and the patient due to a medical accident. In general, medical accidents must be in accordance with the terms that are used in the medical dispute adjustment method stated in Article 2 (definition). In relation to this, there is a need to discuss an efficient operation scheme for Alternative Dispute Resolution (ADR) in medical disputes. In addition, it is necessary to look at issues of civil liability and criminal liability. In particular, in the consumer dispute arbitration committee, there is a case to make a "decision not to adjust" in aggressive intervention in the process of conflict resolution. The medical staff, on the basis of its "decision," can use this as a proven material for civil and criminal cases. This is rather upon the determination of the consumer council as a typical side effect to defend the user's perspective. This is the "decision" as was expressed from an order, "not adjusted." It is also determined to be easy and clearly timely. In the medical litigation, it is requesting the burden of proof of a patient's cause-and-effect relationship with the doctors committing negligence and medical malpractice. This seems to require the promotion of legislation in the direction to reduce future cases. It is determined that the burden of proof of medical accidents must be improved. The institution receiving the medical accident should prevent a closure report. Further, it is necessary to limit the transition to a franchise point. In this paper, we understand the problems of the current medical dispute resolution system, trying to establish a medical dispute resolution system desirable through an efficient alternative. In addition, it wants help in the protection and realization in medical consumers' and patients' rights. The relevant authorities will take advantage of these measures. After all, this could contribute to the system for a smooth resolution of a medical dispute.

• 한국환경보건학회지
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• 제43권3호
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• pp.214-222
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• 2017

Objectives: A hospital is a complex building that serves many different purposes. The indoor environment in a hospital plays a major role in patient well-being and the work efficiency of the hospital staff. This study was conducted to evaluate overall comfort in two major hospitals over the course of one year. Methods: Various indoor environmental conditions were measured in two general hospitals for one year (April 2014 to April 2015). Monitoring alternated between the hospitals at one month per respective monitoring session. The indoor air temperature, relative humidity (RH), mean radiant temperature and air velocity were measured in order to calculate the predicted mean vote (PMV). Carbon dioxide concentration, noise level and illumination level were concurrently measured and applied to the overall IEQ acceptance model for the hospitals (IEQh). Results: The IEQh at the two general hospitals was different at five spaces within a building. The IEQh for summer and winter were significantly different. Real-time IEQh demonstrated that indoor comfort was affected by the hospital's operating hours due to operation of the HVAC system. The percentage of indoor comfort in the hospitals was higher using PMV than IEQh. Conclusion: IEQh in the hospitals was different at locations with different purposes. Indoor comfort assessment using IEQh was stricter than with PMV. Additional research is needed in order to optimize the IEQh model.

• 의학교육논단
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• 제10권1호
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• pp.35-42
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• 2008

Purpose : Since PBL was first developed by Howard Barrows at McMaster, it has been adopted as one of the best teaching and learning methods in medical schools throughout the world. However, the educational superiority of PBL relative to traditional approaches is less clear. Given the somewhat extensive resources required for the operation of PBL curriculum, this gives reason for concern. The aim of this study is to review experiences of PBL in other medical schools and learn how to implement PBL in our school. Methods : This study was undertaken in two stages. In the first stage, PBL curricular examples in 7 medical schools (University of Pennsylvania, University of Melbourne, University of Maastricht, McMaster University, Flinders University, Harvard medical school. University of California at L.A.) were collected and summarized. In the second stage, a careful search for articles of journals published since 2000 regarding PBL group assessment, effectiveness of PBL and group facilitation skills was conducted. Results : PBL is generally introduced in a core curriculum in undergraduate medical education. Relating to small group assessment, the perception of students has been well developed. but the current PBL assessment tool needs to be revised, to develop thinking skills of students. The PBL graduates considered themselves as having much better interpersonal skills, better competencies in problem solving and self-directed learning than the non-PBL graduates. Tutors used various techniques to raise awareness, facilitate the group process and direct learning. Conclusions : The following three aspects can be regarded as important in this study. First, to implement PBL in our school more effectively, it might be considered, which curriculum content can be best learned with PBL. Second, to enhance students' thinking skills during PBL, a new assessment tool needs to be developed. Third, tutors' competencies are important to facilitate, group process, so it would be worthwhile including in staff development.