• 제목/요약/키워드: Out-patient Department

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Element of Marketing: SERVQUAL Toward Patient Loyalty in the Private Hospital Sector

  • AKOB, Muhammad;YANTAHIN, Munawar;ILYAS, Gunawan Bata;HALA, Yusriadi;PUTRA, Aditya Halim Perdana Kusuma
    • The Journal of Asian Finance, Economics and Business
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    • 제8권1호
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    • pp.419-430
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    • 2021
  • The study aims to analyze the factors that shape patient loyalty, namely, by involving the service quality factor (SERVQUAL), hospital image, patient value, and patient satisfaction in private hospitals. This study was conducted in Makassar City, Indonesia, with a sample of 296 eligible samples from private hospitals. The sample criteria were patients with outpatient and hospitalization status. Then, this study developed 23 hypotheses to test the statistical relationship between direct, intervening and multiple-effect models. Problem-solving and research focus are carried out using a quantitative method approach with a PLS-SEM-based testing tool. The bootstrapping method is being used with the constant bootstrapping step to demonstrate the results of hypothesis testing; we find that the overall hypothesis has a positive and significant effect. The combination of testing models involving several variables shows that a patient's loyalty can be formed if a patient's satisfaction has been realized. Satisfaction can be realized if the value-customer has been felt by the patients. Therefore, the hospital image must be directly proportional to service quality. Service quality is the essence of service that directly affects customers; service quality is also the reason that shapes consumer perceptions in increasing rationalization and solid customer (patient's) decision-making.

뇌졸중 환자의 비골신경 자극에 따른 보행 양상의 변화 (Change of gait pattern of a patient with cerebral stroke by peroneal nerve stimulation therapy)

  • 최산호;이일석;홍해진;오재건;성강경;이상관
    • 대한중풍순환신경학회지
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    • 제14권1호
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    • pp.61-70
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    • 2013
  • ■ Objectives The goal of this pilot study is to observe the change of gait pattern in a patient after peroneal nerve electrical stimulation(PNST). ■ Methods We analyzed the gait pattern of stroke patient using treadmill gait analysis system before and after PNST for seven weeks. The PNST was carried out for 20minutes every day except Sunday. In addition, the measurement was carried out every Saturday. At the fifth week, the PNST was not carried out to confirm whether the effect of PNST was disappeared immediately when PNST was not applied. ■ Results After PNST, while heel contact time and heel max force increased and forefoot and midfoot max force decreased, the gait parameters such as cadence, velocity, swing phase, stance phase, total double support, step length, stride length, step time, stride time and forefoot contact time, were not changed. ■ Conclusion Gait of a patient with cerebral stroke was changed positively after PNST.

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Implant-assisted Removable Prosthetic Rehabilitation of a Patient with Crossed Occlusion

  • Oh, Hyun-Su;Lim, Young-Jun;Kim, Myung-Joo;Kwon, Ho-Beom
    • Journal of Korean Dental Science
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    • 제14권1호
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    • pp.32-39
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    • 2021
  • 'Crossed occlusion' is the condition in which occlusal intercuspation is lost when several teeth on upper and lower jaw remain. This report describes a clinical case in which a patient had two upper-left posterior teeth and two lower-right posterior teeth; typically known as left-right crossed occlusion. Considering the patient's general condition and financial situation, the treatment plan included placement of two implants on each jaw against the remaining teeth using surgical guide. To find out the ideal position of implants, digital diagnostic wax-up was preceded by superimposing the cast and cone beam computed tomography image, which was aided with radiographic stents. The consequent surveyed implant bridge provided stable vertical stop for fabrication of the implant assisted removable partial dentures. The patient was satisfied with the functionality and esthetics of definitive prosthesis.

Non-Surgical Resolution of Inflow Cannula Obstruction of a Left Ventricular Assist Device: A Case Report

  • Lee, Yoonseo;Sung, Kiick;Kim, Wook Sung;Jeong, Dong Seop;Shinn, Sung Ho;Cho, Yang Hyun
    • Journal of Chest Surgery
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    • 제54권6호
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    • pp.543-546
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    • 2021
  • A 55-year-old woman who had received an implantable left ventricular assist device 3 months earlier presented with dyspnea and a low-flow alarm of the device. Computed tomography and log-file analysis of the device system suggested inflow cannula obstruction. Since the patient had cardiogenic shock due to pump failure, venoarterial extracorporeal membrane oxygenation (ECMO) was initiated. With ECMO, surgical exchange of the pump was considered. However, the obstruction spontaneously resolved without surgical intervention. It turned out that an obstructive thrombus was washed out by rebooting the pump. Moreover, the thrombus was embolized in the patient's left subclavian artery. The patient underwent heart transplantation 4 months after the pump obstruction accident and continued to do well.

환자중심성의 개념적 구성 요소: 환자와 가족구성원의 관점 (Conceptual Constructs of Patient Centeredness: Perspective of Patients and Family Members)

  • 김은나;옥민수;신유경;조민우;이진용;도영경
    • 한국의료질향상학회지
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    • 제25권2호
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    • pp.26-43
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    • 2019
  • Purpose:The objective of this study was to identify the conceptual constructs of patient centeredness from the perspective of patients and family members in Korea, and to compare them with those included in the Picker Institute framework. Methods: Two focus group discussions were conducted. Each focus group consisted of six participants who had experienced being either a patient or a caregiver. We carried out a thematic analysis, and then compared the contents of our focus group discussions with the components of patient-centered care outlined by the Picker Institute. Results: Six conceptual constructs of patient centeredness emerged from the focus group discussions. Five of these overlapped with those outlined by the Picker Institute: 1)respect for patients' values, preferences, and needs, 2) coordination and integration of care, 3) information, communication, and education, 4) physical comfort, and 5) emotional support and alleviation for fear and anxiety. A new component that was not mentioned in the Picker Institute framework emerged from this study: "ease of making a complaint." Currently, "involvement of family and friends" and "continuity and transition" were not prominent components of patient centeredness according to our focus group discussions. Conclusions: This study presents the conceptual constructs of patient centeredness, five of which overlap with those outlined by the Picker Institute, and provides a qualitative basis of the patient experience survey currently being implemented by the Health Insurance Review & Assessment Service in Korea.

Application of 3D Simulation Surgery to Orbital Wall Fracture : A preliminary Case Study

  • Choi, Jong-Woo
    • Journal of International Society for Simulation Surgery
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    • 제1권1호
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    • pp.16-18
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    • 2014
  • The orbit has a very special anatomical structure. The complex anatomical structure should be restored when we encounter the patient with orbital wall fracture. Unless these specific anatomy were reconstructed well, the patient should suffer from various complications such enophthalmos, diplopia or orbital deformity. In addition, because the patient has a his own specific orbital shape, individualized approach will be necessary. The aim of this trial is to try to restore the original orbit anatomy as possible based on the mirrored three dimensional CT images based on the computer simulation. Preoperative computed tomography (CT) data were processed for the patient and a rapid prototyping (RP) model was produced. At the same time, the uninjured side was mirrored and superimposed onto the traumatized side, to create a mirror-image of the RP model. In order to restore the missing skipped images between the cuts of CT data because of the thinness of the orbital walls, we manipulated the DICOM data for imaging the original orbital contour using the preoperatively manufactured mirror-image of the RP model. And we fabricated Titanium-Medpor to reconstruct three-dimensional orbital structure intraoperatively. This prefabricated Titanium-Medpor was then inserted onto the defected orbital wall and fixed. Three dimensional approach based on the computer simulation turned out to be very successful in this patient. Individualized approach for each patient could be an ideal way to manage the traumatic patients in near future.

Current Status of Patient Safety Regulations, Guidelines and Support Mechanisms in Korean Hospitals

  • Lee, Jae Ho;Kim, Jeong Eun;Kim, Suk Wha;Lee, Sang Il;Jung, Yoen Yi;Kim, Moon Sook;Jang, Seon Mi
    • Perspectives in Nursing Science
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    • 제10권2호
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    • pp.158-166
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    • 2013
  • Purpose: This study was conducted to investigate patient safety regulations and guidelines in order to understand their current status, and to examine support measures to improve patient safety in Korean hospitals. Methods: The participants were the safety officers from hospitals with 200 or more beds and 112 hospitals responded to the online survey. The questions covered patient safety regulations, the performance level of patient safety activities, patient safety incident reporting systems, the dedicated professional, training, support mechanisms, and expectations of reporting systems. Results: Among preventative measures, fall prevention and hand hygiene were reported to be most widely practiced (92% and 91%, respectively). Time-out for invasive procedures showed a relatively low practice rate at 70%. Among patient care activities, transfusion, surgery and sedation, medication, and infection management were performed by 84, 74, 93 and 93% of the hospitals, respectively. Patient safety activities included patient safety committee, patient safety cooperation between decision-making bodies, patient safety workshops, seminars, lectures, and training for employees. Conclusion: Patient safety regulations and guidelines have not yet been sufficiently prepared, and a public institution such as a certification authority is of crucial importance to enforce these guidelines.

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제왕절개술후 자가진통법을 이용한 정맥내 Nalbuphine은 경막외 Morphine과 Bupivacaine 혼합제를 대치할 수 있나? (Intravenous Patient-Controlled Analgesia with Nalbuphine: Could be an Alternative to Epidural Patient-Controlled Analgesia with Morphine-Bupivacaine for Pain Relief after Cesarean Delivery?)

  • 이종석;이윤우;윤덕미;남용택;송근호
    • The Korean Journal of Pain
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    • 제10권1호
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    • pp.34-41
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    • 1997
  • Background : Patient-controlled analgesia(PCA) is a safe and effective technique for providing postoperative pain relief. Studies that compare epidural vs intravenous routes of opiate administration show conflicting results. We designed a prospective, randomized, controlled study to evaluate the safety and efficacy of epidural(EPI-PCA) morphine-bupivacaine versus intravenous (IV-PCA) nalbuphine when administered with a PCA system. Methods : Forty healthy women were randomly assigned to receive an epidural bolus of morphine 3 mg and 0.5% bupivacaine 10 ml, followed by a EPI-PCA with 0.01% morphine and 0.143% bupivacane (basal infusion 1 ml/hr, bolus 1 ml, lock-out interval 30 min) or intravenous bolus of nalbuphine 0.1 mg/kg followed by a IV-PCA with nalbuphine(basal infusion 1 mg/hr, bolus 1 ml, lock-out interval 20 min) for pain relief after cesarean delivery. This study was conducted for 2 days after cesarean section to compare the analgesic efficacy, side effects, patient satisfaction either as EPI-PCA or as IV-PCA. Results : EPI-PCA group had significant lower visual analog pain scale(VAS) at immediate postoperative period, whereas no significant difference was observed when pain was assessed at other time sequence. Urinary retention and pruritus were more frequent with EPI-PCA group, although the incidence of other side effects were the same. Conclusions : Although EPI-PCA with morphine-bupivacaine was of significantly lower VAS at immediate postoperative period, IV-PCA with nalbuphine is a safe and effective alternative to EPI-PCA with morphine-bupivacaine for providing pain relief after cesarean delivery. Further studies about IV-PCA with nalbuphine are needed to control the immediate postoperative pain and to further improve effective pain management.

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한방치료로 호전된 횡문근 융해증 환자 치험 1례 (A Case Report of Rhabdomyolysis Patient Treated with Traditional Korean Medicine)

  • 고홍제;신정철
    • Korean Journal of Acupuncture
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    • 제34권3호
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    • pp.172-178
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    • 2017
  • Objectives : The purpose of this study is to report a case of traditional Korean Medicine effect on a patient with rhabdomyolysis who appealed leg pain, numbness and weakness. Methods : A patient received traditional Korean Medicine including acupuncture, herbal medicine, moxibustion, and cupping therapy daily. We evaluated the clinical results by observing the patient's symptoms, NRS(Numerical Rating Scale), MMT(Manual Muscle Test) grade and DITI(Digital Infrared Thermal Imaging). Results : After traditional Korean Medicine, the patient's pain and numbness decreased from NRS 10 to 1~2 and weakness improved from Gr3- to Gr4. And CPK(creatine phosphokinase) numerical value decreased from 330(IU/L) to 164 and body heat status improved. Conclusions : Traditional Korean Medicine can be effective in reducing rhabdomyolysis patients' symptoms and changing examination numerical value. And further studies on traditional Korean Medicine of rhabdomyolysis should be carried out.

뇌졸중 환자의 손가락 재활운동을 위한 손 및 손가락 고정장치 개발 (Development of Hand and Fingers Fixing System for Stroke Patient's Rehabilitation Exercise)

  • 김현민;김갑순
    • 한국정밀공학회지
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    • 제29권7호
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    • pp.753-761
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    • 2012
  • This paper describes development of a hand and finger fixing system for the rehabilitation exercise of patient's fingers. In order to exercise the finger rehabilitation using a finger rehabilitation robot, a patient's hand or fingers are fixed safely. In this paper, The hand and fingers fixing system can safely fix stroke patient's hand and fingers by pressing with force control system. The characteristic test of the system was carried out. It is thought that the system could be used for fixing their fingers in stroke patient's finger rehabilitation exercise.