• Korea Journal of Hospital Management
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• v.21 no.2
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• pp.13-23
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• 2016

Purpose: The purpose of this study is to compare the user satisfaction between 4-bedrooms and 5/6-bedrooms in a single general hospital. Methodology: To measure and compare multiple-bed ward user satisfaction between 4-bedrooms and 5/6-bedrooms, questionnaires were collected from 916 inpatients and 129 nurses in a single general hospital. The patient satisfaction questionnaire categories included environmental conditions, protection of privacy, and medical services. The nurse satisfaction questionnaire categories included space, infection control, patient safety, work load and psychologic view point. Findings: Satisfaction of patient who admitted in 4-bedroom to the environmental conditions and protection of privacy was higher than that of 5/6-bedroom group (3.91 vs. 3.25, p<0.001). Satisfaction of nurse who worked in 4-bedroom was higher than that of 5/6-bedroom (3.05 vs. 1.92, p<0.001). By the multiple linear regression analysis, patient satisfaction to the environmental conditions and protection of privacy was related with multi-bedroom type and location of beds; 4-bedrooms were higher than 5/6-bedrooms(p<0.001), window side bed were higher than hallway side bed(p=0.001). There was no satisfaction difference in comparing medical services between the two groups. By the multiple linear mixed regression analysis, nurse satisfaction who were assigned for 4-bedrooms were higher than that of 5/6-bedrooms in all categories(p<0.001). Practical Implications: Even though no difference has shown in medical services satisfaction between the two patient groups, multi-bedroom type may affect patient satisfaction in environmental condition, protection of privacy and may also affect overall nurse satisfaction. This result suggests that to improve multi-bedroom user satisfaction, 4-bedroom is recommended over 5/6-bedroom.

• Quality Improvement in Health Care
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• v.19 no.2
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• pp.14-34
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• 2013

Objectives: The purpose of this study is to provide comprehensive information of qualification systems of developed countries needed to establish our national system for QI(Quality improvement) specialists. Methods: All articles related to any applicable domestic or foreign countries' laws, operational status, and detailed programs for professional qualification system of QI were reviewed. Result: In the United States, a non-profit organization, Healthcare Quality Certification Commission (HQCC) has set the policies, procedures and standards in the field of health care quality. And qualification system of CPHQ (certified professional in healthcare quality) has been operated in order to authenticate the qualifications in the field of quality management. IBQH(international Board for quality in healthcare), a qualification system of experts in the United Kingdom, was designed to assist the qualification of professionals to improve the quality of healthcare. In addition, Health Research Center of Feinberg School of Medicine in Northwestern University has been operating Master's and doctoral degree programs in the field of the quality of care and patient safety and IHI (institute for healthcare improvement) open school was operating a professional training course related to the quality of care and patient safety. Conclusion: Quantity and complexity of information of the quality of care and patient safety have been increased. For reform of the health care system, a special training course of the expertise and leadership are needed. So far, there is no national professional certification courses in our nation. Therefore essential job skill should be acquired individually. For systematic and effective quality improvement activities, the educational and certification system with professional development model are needed.

• The Korean Journal of Pain
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• v.26 no.1
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• pp.39-45
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• 2013

Background: Good postoperative pain control is an important part of adequate postoperative care. Patient-controlled epidural analgesia (PCEA) provided better postoperative analgesia compared to other conventional analgesic methods, but several risks have been observed as well. We therefore surveyed the efficacy and safety of PCEA in this retrospective observational study. Methods: We analyzed collected data on 2,276 elective surgical patients who received PCEA with ropivacaine and fentanyl. Patients were assessed by a PCA service team in the post-anesthesia care unit (PACU), at 1-6 h, 6-24 h, and 24-48 h postoperatively for adequate pain control. The presence of PCEA-related adverse events was also assessed. Results: Numerical pain score (median [interquartile range]) were 3 [1-4], 5 [4-7], 4 [3-5], and 3 [3-5] in the PACU, at 1-6 h, 6-24 h, and 24-48 h postoperatively. Median pain scores in patients underwent major abdominal or thoracic surgery were higher than other surgical procedure in the PACU, at 1-6 h after surgery. Nausea and vomiting (20%) and numbness and motor weakness (15%) were revealed as major PCEA-related adverse events during the postoperative 48 h period. There were 329 patients (14%) for whom PCEA was ceased within 48 h following surgery. Conclusions: Our data suggest that the use of PCEA provides proper analgesia in the postoperative 48 h period after a wide variety of surgical procedures and that is associated with few serious complications. However, more careful pain management and sustainable PCEA monitoring considering the type of surgical procedure undergone is needed in patients with PCEA.

• Journal of Korean Neurosurgical Society
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• v.60 no.1
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• pp.54-59
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• 2017

Objective : Postoperative pain is one of the major complaints of patients after lumbar fusion surgery. The authors evaluated the effects of intravenous patient controlled analgesia (IV-PCA) using fentanyl or sufentanil on postoperative pain management and pain-related complications. Methods : Forty-two patients that had undergone surgery with lumbar instrumentation and fusion at single or double levels constituted the study cohort. Patients were equally and randomly allocated to a sufentanil group (group S) or a fentanyl group (group F) for patient controlled analgesia (PCA). Group S received sufentanil at a dose of $4{\mu}g/kg$ IV-PCA and group F received fentanyl $24{\mu}g/kg$ IV-PCA. A numeric rating scale (NRS) of postoperative pain was applied before surgery, and immediately and at 1, 6, and 24 hours (hrs) after surgery. Oswestry disability index (ODI) scores were obtained before surgery and one month after surgery. Opioid-related side effects were also evaluated. Results : No significant intergroup difference was observed in NRS or ODI scores at any of the above-mentioned time points. Side effects were more frequent in group F. More specifically, nausea, vomiting rates were significantly higher (p=0.04), but pruritus, hypotension, and headache rates were non-significantly different in the two groups. Conclusion : Sufentanil displayed no analgesic advantage over fentanyl postoperatively. However, sufentanil should be considerable for patients at high risk of GI issues, because it had lower postoperative nausea and vomiting rates than fentanyl.

• Journal of Digital Convergence
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• v.19 no.2
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• pp.307-314
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• 2021

This study was to analyze the satisfaction and intention to recommend a hospital for spinal and joint patients. Using a structured questionnaire at a spinal and joint hospital in Seoul in 2019, and the relationship between demographic and social characteristics and patient satisfaction, factors influencing hospital satisfaction, and recommendation intention were analyzed. In outpatients, hospital satisfaction was higher in neatness and cleanliness of staff, kindness and facility environment comfort, and hospital satisfaction was low in questions related to waiting time. In inpatients, women's satisfaction was higher in the nursing and hospital environment areas. The correlation analysis between the satisfaction and the willing to recommend, there was a positive correlation. In the sub-analysis, hospital satisfaction was higher in the group that responded with respect and courtesy, listening, satisfaction of the nurse, hospital cleanliness and safety. This study is can be used to improve the quality of hospital care services in related hospitals.

• Korea Journal of Hospital Management
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• v.13 no.1
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• pp.42-64
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• 2008

This study was conducted to evaluate the quality in medical records by analyzing its completeness through setting up the level of record on the patient's past history and through examining the actual medial records. Targeting the information on the patient's past history in interns' records, residents' records and nurses' records toward 403 inpatients who were admitted first in 2004 at an university hospital due to stomach cancer. We analyzed whether the charts were recorded or not, recording level, the satisfaction with the expectant level of the records in the hospital targeted for a research and the level of agreement. The results were as follows; first, as for the rate of recording those each items, they were high in the chief complaint & present illness and the past illness history. Depending on the group of recorders, the recording rate showed big difference by items. Second, as a result of measuring the level after dividing the recording level of items for the patient's past history from Level 1 to Level 4 by each item, the admission history, the past illness history, and the family history were about Level 3, and the smoking history, the medication history, the chief complaint & present illness, the drinking history and allergy were about Level 2. In the admission department, it was excellent in the interns' records for the medical department. Third, as a result of its satisfactory level by comparing the expect level of a record and the actual record by item in information on the patient's past history, which was expected by the medical-record committee members of the hospital targeted for a study. And forth, we analyzed the level of agreement with Kappa score in the level of 'Yes' or 'None' related to the corresponding matter in Level 1, in terms of information on the past history in the intern's record, the resident's record, and the nurse's record. The level of agreement in the resident's record & the nurse's record, and in the intern's record & the resident's record was from "excellent" to "a little good". There were differences in the level of completeness and in reliability for the information on the past history by the recorder group or by the admission department. The encounter process that was performed by the admission department or the recorder group, indicated the result that was directly reflected on the quality of medical records, thus it was required further study about the medical record documentation process and quality of care. The items that showed the high recording rate quantitatively were rather low, consequently we'd should develop the tool for the qualitative inspection and evaluate the medical records further. And the items were needed to be detailed in the record level were rather low, and hence there needed to be a documentation guideline and education by the clinical departments.

• Journal of the Korea Convergence Society
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• v.13 no.3
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• pp.67-75
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• 2022

Medical information is variously generated not only from medical devices but also from electronic devices. Recently, related convergence technologies from big data collection in healthcare to medical AI products for patient's condition analysis are rapidly increasing. However, there are difficulties in applying them because of independent developmental procedures. In this paper, we propose an intelligent hospital information system (iHIS) model to simplify and integrate research, development and application of medical AI technology. The proposed model includes (1) real-time patient data management, (2) specialized data management for medical AI development, and (3) real-time monitoring for patient. Using this, real-time biometric data collection and medical AI specialized data generation from patient monitoring devices, as well as specific AI applications of camera-based patient gait analysis and brain MRA-based cerebrovascular disease analysis will be introduced. Based on the proposed model, it is expected that it will be used to improve the HIS by increasing security of data management and improving practical use through consistent interface platformization.

• Journal of Korean Academy of Nursing
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• v.1 no.1
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• pp.111-132
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• 1970

An analysis of nursing activities in a in-patient ward and its management was observed in order to assess necessary number of nursing hands and find out reasonable work management with them. The study was performed with two wards of St. Mary′s Hospital, Catholic Medical Center, for the period from July to December 1970. The results and conclusions were as the following 1. The role of the nurses are determined by doctor′s order in 57.7% in kind, 80.0% in amount. and by nurses decision 20.0% in amount. 2. Works related to patient care are found to be 20.6% in the internal medicine ward and 20.4% in the surgical ward while works related to treatment are 4.7% in the former and 27.2% in the letter. Medication occupies 40.0% in the internal medical ward while 26.6% in the surgery ward, and observation occupies 34.7% in the former while 25.8% in the letter. These can be said to reflect characteristic differences bet ween the two wards. 3. When nursing functions were evaluated by importance "A" level in the amount of works to be done occupied 67.6% in the surgical ward and 62.8% in the internal medical ward. In the kind of the important works, "B"level is found to be most frequent with 50% while "A"level 43%. When evaluated by difficulty, "B"level was found to be most frequent in amount in both internal medicine and surgical wards (52.6%, 38.2%). 4. Works needing professional knowledge and skills occupied 92% in the both wards while unprofessional works 2.8% and 4.2% respectively. There are indications, however, that unprofessional works have an increasing tendency. 5. When evaluated by the amount of works, the surgical ward has 11 nurses less and the internal medicine ward 3 nurses less then the necessary number of nursing staffs. There are shortage of 12 and 6 nurses respectively when evaluated by the number of patients and 18 nurses in the both wards when evaluated by the medical regulations of the Government. 6. The ratio of the nursing staff to patient was found to be 1:11.5, 1:23.0 and 1:34.5 in the morning, evening and night turn in the surgical ward. In the medical word the ratio was 1:9.4, 1:22.0 and 1:33.0. 7. The deficiency of necessary equipment and tension accompanying management of those equipment were found to lower the effective functioning of the head nurse who is a junior manager of the ward. They also consume much of the time and energy of the nurses at work who are over burdened in most of the cases. 8. The high rate of the number of nurses who leave the job impairs the functioning of team work which is considered to be most important in the effective performance of nursing activities and thus contributes to lower the efficiency of nursing functions.

• Journal of Korean Academy of Nursing Administration
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• v.2 no.2
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• pp.59-71
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• 1996

Today, quality management is appearing as a critical issue in the field of health care service, partly because of increasing cost of health care. And qualified health care is also accepted as the right of clients, and the responsibility of health professions. So nursing profession can survive and develop only through the quality management of nursing practice like other health professions. Recently, Consumers of nursing service require the effectiveness and the efficiency of nursing practice. Effectiveness and efficiency of nursing practice can be accomplished by outcome evaluation. The focus of outcome evaluation in nurisng practice is on the change which occures in patient's health status with nurisng intervention. Evaluation of outcome is difficult because of some related problems which should be solved, or managed. These problems could be classified as problems of measurement, and attribution. To solve the problems and to evaluate the outcome in nursing practice more accurately, following tasks were suggested. 1) Outcome indicators, and outcome measurement tools should be developed. For these purpose, outcome variables that nursing interventions can contribute primarily should be found out. Also, outcome variables which are driven from nursing theories should be developed. 2) Outcome researches which can explain the effect of nursing care to patient outcomes should be performed. The outcome researches are the methods which can increase the power of nursing profession. 3) Models which can be used for the systematic and scientific quality management in nursing practice should be developed. The models should include outcome variables, and be able to explain the relationship between structure, process, and outcome aspects of quality management. 4) The method which can make patients participate in the evaluation process of quality of nursing practice should be devised. Because outcome evaluation is client-focused evaluation, the perspectives of patients should be emphasized, and reflected in the process of evaluation.

• Korea Journal of Hospital Management
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• v.10 no.3
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• pp.45-66
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• 2005

The purpose of this study was to analyze related factors affecting profitability on general hospitals(300-499 beds). The data were derived from survey by the Korean Hospital Association on 33 hospitals during 10 years (from 1993 to 2002). Profitability was measured by 3 ratios - net profit to total assets, normal profit to total assets and operating margin to gross revenue - as dependent variables. Independent variables were classified by general factors (ownership, number of bed, period of establishment, region), financial factors (total asset turnover, current ratio, liabilities to total assets, personnel costs per operation profit, material costs per operation profits), productivity index(number of daily patient per nurse), the score of quality assurance activity and the time lag score. Multiple regression model was used in this study. First, Number of bed, region was not statistically significant for profitability. But ownership was affect positively to normal profit to total assets and operating margin to gross revenue. Private hospitals had higher profitability than that of public hospitals Second, the score of quality assurance activity was not statistically significant to profitability. Third, Those hospitals having more daily patient per nurse had significantly higher profitability than the others. Fourth, Those hospitals having higher proportion in total asset turnover had significantly higher profitability than other hospitals. But liabilities to total assets and liquidity ratio had no difference to the profitability. Those hospitals having higher proportion in personnel costs and material costs per operation profits had significantly lower hospital profitability than others.