• Title/Summary/Keyword: Pathways satisfaction

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A Prospective Case Series Protocol for Clinical Pathway of Carpal Tunnel Syndrome (손목터널증후군의 한의표준임상경로 임상시험 프로토콜)

  • Park, Hye-Jin;Kim, Hyun-Tae;Park, Sun-Young;Heo, In;Hwang, Man-Suk;Shin, Byung-Cheul;Hwang, Eui-Hyoung
    • Journal of Korean Medicine Rehabilitation
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    • v.32 no.4
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    • pp.73-82
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    • 2022
  • Objectives The purpose of this study is to develop a case study protocol to complete final version of Korean medicine clinical pathway (CP) by applying Korean medicine CP based on carpal tunnel syndrome Korean medicine clinical practice guidelines developed by clinical experts to clinical field. Methods After applying previously developed CP, 10-point Likert scale questionnaires on satisfaction of CP, appropriateness and improvement on out patient department (OPD) treatments are carried out in the 2nd week of OPD treatment. An open-ended questionnaire is also carried out to ask if there is any requirement to be added or improved among CP interventions. Results Final version of CP is going to be completed based on the questionnaire, excluding articles of which average or median value is less than 5 from 10-point Likert scale. Conclusions This evidence-based case study protocol is expected to contribute development of carpal tunnel syndrome clinical pathway.

A Study on the Development of a Clinical Pathway of Korean Medicine for the Management of Patients with Ankle Sprain (족관절염좌 환자 관리를 위한 한의표준임상경로 개발 연구)

  • Yoon, Sangdo;Song, Mi-Yeon;Chung, Won-Seok;Kim, Hyungsuk;Shin, Woo-Chul;Kim, Taeoh;Cho, Whi-Sung;Seo, Yeonho;Seo, Sangwoo;Seo, Joonwon;Kang, Junhyuk;Yu, Seung-Ho;Kim, Seyun;Cho, Jae-Heung
    • Journal of Korean Medicine Rehabilitation
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    • v.32 no.3
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    • pp.141-151
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    • 2022
  • Objectives The purpose of this study is to improve the accessibility of Korean medicine by standardizing managements, improving quality of medical services, and reducing medical costs in ankle sprain by develop clinical pathway (CP). Methods The development of CP in this study is based on clinical practice guideline (CPG) for ankle sprain, and aims to maximize the quality of treatment, such as reducing treatment time and medical costs, and increasing patient satisfaction through standardized pathway. The CP was revised after consultation and review by the advisory committee. The advisory committee is consisted of a stakeholder group applying the CP. Results In previous research studies, there were no Korean medicine CP studies on ankle sprain. Based on CPG for ankle sprain and analysis of medical records, 6 types of time task matrix type CP (for Korean medicine doctors, medical assistant, patients) and 4 types of algorithm type CP (for Korean medicine clinics, Korean medicine hospitals, and cooperative practicing hospitals, public medical centers) were derived as a result. Conclusions Ankle sprain CP is expected to not only increase patient satisfaction and maximize the quality of treatment, but also reduce the financial burden of health insurance by reducing medical costs.

Why Genuine Luxury Brands Are Consumed? Counterfeits? Examining Consumer Identification

  • Suh, Hyunsuk
    • Asia Marketing Journal
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    • v.14 no.3
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    • pp.69-102
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    • 2012
  • Owing to increased number of luxury brand users, both genuine and counterfeit luxury product consumption continues to increase every year. Luxury brand is defined as use or display of a particular branded products which brings the ownership prestige apart from its functional utility(Grossmand and Shapiro 1988). Some luxury brands have imitations sold in marketplace due to their popularity. These imitations or counterfeits have been jumping on the bandwagon of the upturn in sales of their originals. The purpose of our study is to understand consumer's underlying motives to consume luxury brands, genuine and or counterfeits. To do this, we propose functional theories of attitudes, decision-making styles, and life attitudes to form the determining causes for different consumption choices of luxury brands: genuine brands, counterfeit brands, both genuine and counterfeit brands, and no consumption on luxury brands types. In proposed causal pathways, we examine moderated effects of socio-psychological factors to further investigate if consumer profiles would exert influences in causal relationships. From the existing theories of functional attitudes: value-expressive and social-adjustive attitudes, we developed and introduced a new measure of rationality-consumptive attitude. From the existing eight decision-making characteristics of consumer styles inventory(CSI), three measures of high-quality, hedonic-shopping, and price-shopping styles were primarily applied in the study along with newly introduced measure of 'high-price' being added, which makes four total. Seven life attitude measures of life purpose, life control, will to meaning, goal seeking, future mean to fulfill, life satisfaction, and religiosity were applied. Finally, such socio-psychological measures as age, gender, marital status, income, and age-gap between couples were assumed to function as moderators. With 430 valid study samples, ages from 20s to 50s, with more females(316) than males(114), with average personal possessions of 5 genuine and 9 counterfeit luxury brands, we conducted questionnaire survey. Results indicated that social-adjustive function is totally disappeared in the relationship due to current social trend of widespread consumptions on both genuine and counterfeit brands which in turn, make consumers feel less special on wearing or carrying them unlike in the past. Self-expressive function and rationality-consumptive functions act as strong catalysts for genuine brand consumption and counterfeit brand consumption, respectively. On consumers' decision-making styles, high-price sublation is the most powerful indicator anticipating counterfeit consumption, even more powerful than personal incomes. In life attitude, the overall model fit was not validated, and only life control and life satisfaction are proven to be significant on both genuine and counterfeit product consumptions. Employment of socio-psychological factors in the model improved understanding of users further. Young consumers tend to go for genuine products over counterfeits. Consumers in different income groups; low, medium and high, all significantly consume genuine products for reasons of different decision-making styles. The results indicated that consumers whose personal disposition is predisposed to consume products in the form of reflection of his or her personality, go only for genuine brands for quality reason, while consumers who rationally consume products for its function or usability, go only for counterfeits for high-price sublation reason. Meanwhile, both product users support for high-price orientation who are not well off.

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Critical Pathway for Operable Gastric Cancer (위암수술 환자에서의 Critical Pathway의 개발과 적용)

  • Song, Kyo-Young;Kim, Seung-Nam;Park, Cho-Hyun
    • Journal of Gastric Cancer
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    • v.5 no.2
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    • pp.95-100
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    • 2005
  • Purpose: Critical pathways (CP), also known as clinical pathways, are management plans that display goals for patients and have led to improved outcomes for many disease entities. This study was aimed at developing a critical pathway for the surgical treatment of gastric cancer patients and evaluating its usefulness. Materials and Methods: A CP was developed and implemented by a team of surgeons, nurses, nutritionists, and administrative officials. Among the 117 patients who received curative gastrectomies for gastric cancer at Kangnam St. Mary's Hospital, The Catholic University of Korea, between October 2003 and August 2004, 26 patients were treated according to the CP. We evaluated its usefulness by comparing the clinical characterisctics, postoperative progress, hospital stays, and costs between the CP and the non-CP groups. Patient satisfaction was also surveyed with questionnaires. Results: Of the initial 26 patients in the CP group, two were excluded from the final evaluation; one patient had a duodenal stump leakage, and the other had a gastric stasis postoperatively. In 8 patients, protocol violation occurred; six patients refused to be discharged on the $7^{th}$ postoperative day, one patient who had an gastric staisis postoperatively stayed for 2 additional days, and one patient who needed ICU care stayed for 4 additional days. The drop-out rate was $7.7\%$ (2/26), and the variance rate was $30.8\%$ (8/26). The mean hospital stay was 11.3 days ($10\~15$ days) for the CP group compared with 17.5 days ($9\∼68$ days) for the non-CP group, resulting in a difference of about 6 days (P<0.05). The mean hospital stays after surgery were 10.3 days ($7\∼68$ days) and 8.3 days ($7\∼12$ days) for the non-CP and the CP groups, respectively, but the difference was statistically not significant (P>0.05). The mean charge during the hospital stay was higher in the non-CP group ( $\\$ 6,292,200) than in the CP group ( $\\$ 4,863,685). The charge per hospital day was higher in the CP group ( $\\$ 430,414) than in the non-CP group ( $\\$ 359,554). Patient satisfaction was higher in the CP group than in the non-CP group. Conclusion: By developing and applying a critical pathway in the surgical treatment of stomach cancer patients, we could reduce the length of hospital stay as well as the cost. A multi-centered prospective study to establish a standard treatment pathway and to demonstrate its effectiveness is needed in the future.

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A Study on Enrollment Satisfaction, Career Directions, and Image of Dental Hygienists for Dental Hygiene Students in Some Regions (일부지역 치위생(학)과 학생들의 진학만족도와 진로방향, 치과위생사 이미지에 관한 연구)

  • Moon, Seon-Jeong;Ku, In-Young;Choi, Hwa-Young;Ka, Kyung-Hwan
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.16 no.1
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    • pp.564-575
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    • 2015
  • A self-administered survey was conducted in dental hygiene students at colleges or universities in Daegu and North Gyeongsang Province to provide basic data necessary to suggest standards for the direction of career for dental hygiene students and construct desirable image of dental hygienists. The data were collected from February to May 2013; with the exception of 46 questionnaires containing insincere responses, 1,679 were finally analyzed using SPSS/Win 18.0, drawing the following conclusion: The freshmen showed higher levels of regret for selection and enrollment recommendation than the sophomores, juniors, or seniors and the sophomores, juniors, and seniors showed higher levels of willingness to change courses than the freshmen; thus, those in lower grades showed higher environment satisfaction. As for desired career, regardless of grades, they showed higher preference for being employed as a dental hygienist; as for desired paths to get a job, the freshmen were more likely to get professors' recommendations and the sophomores, juniors, and seniors showed higher preference for open recruitment. They showed higher preference for getting a job in a large city because of greater possibility of improvement. As for the desired period of employment, regardless of grades, they showed higher preference for employment before getting married and for reemployment after their children grew up; as for desired workplace, the freshmen showed higher preference for a dental clinic in a hospital, whereas the sophomores, juniors, and seniors showed higher preference for a dental hospital. As for the differences in image of dental hygienists by grades, the freshmen and sophomores showed higher levels of attitudes than the juniors; the freshmen and sophomores showed higher levels of beliefs than the juniors or seniors; and the seniors showed higher levels of values than the freshmen, sophomores, or juniors, and the sophomores and juniors showed higher levels of values than the freshmen; thus, students in lower grades showed higher levels of attitudes and beliefs and those in higher grades showed higher levels of values. Such factors of enrollment satisfaction as willingness to change courses and persuasion to make enrollment had significant effects on image of dental hygienists. Dental hygiene students need to make efforts to establish a job identity and get desirable image of dental hygienists and to make constant efforts to promote more accurate and positive image of dental hygienists through systematic and positive public relations.

Development of a Clinical Pathway for Gastrectomy and Effect of Its Implementation in One Tertiary Hospital (위절제술 환자의 표준진료지침 개발 및 적용 효과)

  • Kim, Eun-Hee;Kim, Chul-Gyu;Lee, Sun-Gyo;Kim, Soon-Duck;Lee, Hae-Ok;Kwon, Jeong-Soon;Lee, Kyeong-Mi;Lee, Min-Mi;Sim, Soon-Mi;Lyu, Yong-Man;Sin, Jong-Sik;Kang, Eun-Hee;Lee, Sang-Il;Kim, Byung-Sik;Oh, Sung-Tae;Yook, Jeong-Hwan;Park, Su-Kil
    • Quality Improvement in Health Care
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    • v.10 no.2
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    • pp.176-189
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    • 2003
  • Background : Gastric cancer is the most common malignant tumor in Korea. Surgical operation is one of the major treatment modalities for gastric cancer patients. Therefore, gastrectomy is one of the most common procedures in General Surgery. There were variation in length of hospital stay and medical treatment for gastrectomy between three surgeons at Asan Medical Center. Clinical pathways have received considerable attention as a tool for reducing the medical practice variation, increasing the efficiency of care process, and improving the quality of care. The aim of this study was to evaluate the effect of a clinical pathway for gastrectomy in gastric cancer patients. Methods : The clinical pathway for gastrectomy was developed and implemented by a multidisciplinary group in Asan Medical Center. A computerized clinical pathway program was developed and revised after a pilot test. A total of 145 patients underwent gastrectomy by three surgeons at Asan Medical Center. We compared the length of hospital stay, patient satisfaction, and the unplanned readmission rate between the pre-pathway group (n=67) and the post-pathway group (n=78). We also investigated the degree of satisfaction among the physicians and nurses who were main end-users of the clinical pathway. Results : The clinical pathway was applied to all target patients. The average length of hospital stay was shortened from 12.7days to 10.6days (p<0.01). The degree of patient satisfaction with the care process changed from 90.3% to 89.2% after the implementation of the clinical pathway, but the difference was not statistically significant (p=0.761). Unplanned readmission rate was 2.9% in the pre-pathway group and 0% in the post-pathway group. More than 90% of physicians and nurses answered that the clinical pathway had been a useful tool in their medical practice. Conclusions : The findings of the study demonstrated that implementation of the clinical pathway for gastrectomy produced substantial reduction in the length of hospital stay while improving the quality of patient outcomes. The computerized clinical pathway program can be used as one of the powerful patient management tools for reducing the practice variations and increasing the efficiency of care process in Korean hospital settings.

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Analysis of Qigong Curriculum Has Established and Qigong-related Clubs in College of Oriental Medicine (전국 한의과대학 기공학 과목 개설 및 기공 동아리 현황)

  • Kim, Ki-Jin;Han, Chang-Hyun;Lee, Sang-Nam;An, Hee-Duk;Kwon, Young-Kyu;Choi, Sun-Mi
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.22 no.5
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    • pp.1112-1118
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    • 2008
  • Qi is in the capacity of pivotal element to describe the life, based on the principles of remedy such as Qigong, meridian pathways, acupuncture, moxibustion and herbal medicine. The purpose of this study was to identify the status of course offered Qigong and Qigong-related clubs in 11 college of oriental medicine. For survey courses offered Status of Qigong in 11 college of oriental medicine, I checked its homepage in august 2008. And about the facts that I could not verify information from the homepage, I obtained through the phone manner. For survey Qigong-related clubs in 11 college of oriental medicine, I phoned the president of union clubs and found out Qigong-related clubs. And then I phoned the presidents of Qigong-related clubs that consented before the fact, investigated the overall situation of clubs. Nine out of 11 college of oriental medicine offered course of Qigong. All of them are opened as major in a premedical course. Six universities have practical training. Six out of 11 college of oriental medicine had Qigong-related clubs. And the number of club is 12. The number of club in Daeguhaany university, 4, is the most. The number of membership of club in Daeguhaany university, 61, is the most too. Most of them are co-majoring both Jung-gong and Dong-gong. It is considered that in lecture of Qigong, It is in a need of lecturing in a regular course with clinical contents, rather than lecturing in a premedical course with basic contents. Of spontaneous club activities, after graduation so that they can get practical help for future. I think from now on we need to investigate deeply practical rate of satisfaction and the present condition of clubs.

A Study on the Development and Application of Korean Medical Critical Pathway of Lumbar Disc Herniation in Four Different Medical Associations (요추 추간판 탈출증의 4종 한의표준임상경로(CP) 개발 및 시범적용 연구)

  • Kim, Jung-Hyun;Chae, Sang Yeup;Ko, Min-Jung;Jo, Min-Gi;Jang, Jun-Yeong;Kim, Jun Yeon;Kim, Ha-Na;Park, Kyeong Ju;Hwang, Ji-Min;Goo, Bonhyuk;Park, Yeon-Cheol;Baek, Yong-Hyeon;Nam, Sang-Soo;Seo, Byung-Kwan
    • The Journal of Korean Medicine
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    • v.42 no.3
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    • pp.1-8
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    • 2021
  • Objectives: A critical pathway defines the optimal care process, sequencing and timing of intervention by multi-disciplinary health care teams for a particular diagnosis and procedure. It plays an important role as a cost-effective health care delivery system and a tool for quality control of medical and dental services by means of standardizing medical practices. The aim of this study is to investigate the satisfaction of patients and medical staff after implementation of a critical pathway for Korean medical treatment of lumbar disc herniation in integrative medical. Methods and Results: The pre-critical pathway group included 3 patients who underwent the implementation procedure from October 2020. All three patients have successfully been applied critical pathways during inpatient and outpatient treatment. Additionally, medical staff members were satisfied with the usefulness of the critical pathway. Conclusions: The implementation of critical pathway for the Korean medical treatment with lumbar disc herniation in integrative medical hospital can appraise possible applicability in actual clinical field.

A Review Study on Major Factors Influencing Chlorine Disappearances in Water Storage Tanks (저수조 내 잔류염소 감소에 미치는 주요 영향 인자에 관한 문헌연구)

  • Noh, Yoorae;Kim, Sang-Hyo;Choi, Sung-Uk;Park, Joonhong
    • Journal of Korean Society of Disaster and Security
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    • v.9 no.2
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    • pp.63-75
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    • 2016
  • For safe water supply, residual chlorine has to be maintained in tap-water above a certain level from drinking water treatment plants to the final tap-water end-point. However, according to the current literature, approximately 30-60% of residual chlorine is being lost during the whole water supply pathways. The losses of residual chlorine may have been attributed to the current tendency for water supply managers to reduce chlorine dosage in drinking water treatment plants, aqueous phase decomposition of residual chlorine in supply pipes, accelerated chlorine decomposition at a high temperature during summer, leakage or losses of residual chlorine from old water supply pipes, and disappearances of residual chlorine in water storage tanks. Because of these, it is difficult to rule out the possibility that residual chlorine concentrations become lower than a regulatory level. In addition, it is concerned that the regulatory satisfaction of residual chlorine in water storage tanks can not always be guaranteed by using the current design method in which only storage capacity and/or hydraulic retention time are simply used as design factors, without considering other physico-chemical processes involved in chlorine disappearances in water storage tank. To circumvent the limitations of the current design method, mathematical models for aqueous chlorine decomposition, sorption of chlorine into wall surface, and mass-transfer into air-phase via evaporation were selected from literature, and residual chlorine reduction behavior in water storage tanks was numerically simulated. The model simulation revealed that the major factors influencing residual chlorine disappearances in water storage tanks are the water quality (organic pollutant concentration) of tap-water entering into a storage tank, the hydraulic dispersion developed by inflow of tap-water into a water storage tank, and sorption capacity onto the wall of a water storage tank. The findings from his work provide useful information in developing novel design and technology for minimizing residual chlorine disappearances in water storage tanks.