• 제목/요약/키워드: Patient Related Management

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The Development of Blood Bank Management Program (혈액 은행 전산 처리 프로그램의 개발)

  • Kim, Jong-Won;Lee, Seung-Kuk;Han, Kyou-Sup;Kim, Jin-Q;Cho, Han-Ik;Kim, Sang-In
    • Proceedings of the KOSOMBE Conference
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    • v.1989 no.05
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    • pp.75-76
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    • 1989
  • The blood bank is a field of clinical pathology which requires the most accuratemaintenanceofrecording. Because the mistake in it is directly related to a patient's life. So, the computerization of the blood bank is urgent to maintain a log blook arid to compare the patient's current data with past result. We developed the blood bank management program using 32 bit minicomputer. This is composed of 4 parts; a management of routine test result, special test result, the blood issue and statistics. The management of routine test result handles the patient's information and blood typing and compares above results with the past one of same patient. The management of special test result are for special immunohematologic tests like an irregular antibody, Coombs' test, and etc. Blood issue part records the type of the blood bag, component, and the name of issuer. Statistic part are made to get statistics of each day and each month by the blood type, and the type the blood component. The program is secured by the maintenance of operator's operation history and thu provision of the security code to each operator, without which no one can enter the system and after the content. So the stability and reliability of the data is obtained. This program will be upgraded for bar-code using system in the near future.

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Limitations and Improvement of Using a Costliness Index (진료비 고가도 지표의 한계와 개선 방향)

  • Jang, Ho Yeon;Kang, Min Seok;Jeong, Seo Hyun;Lee, Sang Ah;Kang, Gil Won
    • Health Policy and Management
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    • v.32 no.2
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    • pp.154-163
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    • 2022
  • Background: The costliness index (CI) is an index that is used in various ways to improve the quality of medical care and the management of appropriate treatment in medical institutions. However, the current calculation method for CI has a limitation in reflecting the actual medical cost of the patient unit because the outpatient and inpatient costs are evaluated separately. It is desirable to calculate the CI by integrating the medical cost into the episode unit. Methods: We developed an episode-based CI method using the episode classification system of the Centers for Medicare and Medicaid Services to the National Inpatient Sample data in Korea, which can integrate the admission and ambulatory care cost to episode unit. Additionally, we compared our new method with the previous method. Results: In some episodes, the correlation between previous and episode-based CI was low, and the proportion of outpatient treatment costs in total cost and readmission rates are high. As a result of regression analysis, it is possible that the level of total medical costs of the patient unit in low volume medical institute and rural area has been underestimated. Conclusion: High proportion of outpatient treatment cost in total medical cost means that some medical institutions may have provided medical services in the ambulatory care that are ancillary to inpatient treatment. In addition, a high readmission rate indicates insufficient treatment service for inpatients, which means that previous CI may not accurately reflect actual patient-based treatment costs. Therefore, an integrated patient-unit classification system which can be used as a more effective CI indicator is needed.

Urgent problems and solution strategies in 2nd cycle of long-term care hospital accreditation (요양병원 인증 2주기 당면과제 및 해결방안)

  • Kim, Kyung Sook
    • Korea Journal of Hospital Management
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    • v.21 no.3
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    • pp.65-70
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    • 2016
  • The Long-Term Care Hospital (LTCH) accreditation system was initiated in 2013 in the form of mandatory accreditation system in order to improve patient safety and the quality of medical service at LTCHs. By June 2016, the accredited LTCHs were 76.2%. This research was conducted to review the implementation process in the first cycle and to promote development of the second cycle of LTCH accreditation system. There are some changes which reinforced the accreditation standards, accreditation survey, and public access to accreditation results in order to strengthen patient safety in the first cycle LTCH accreditation system. LTCHs which participated in the accreditation system achieved certain outcomes in respect to patient safety and employee satisfaction. However, there are several urgent problems in placement criteria of night duty health care providers, reinforcement plans in the accreditation system, and incentives for accredited hospitals. In order to solve these problems, the most important thing is to clearly recognize the fact that the healthcare accreditation system is not the means for control and regulate hospitals but a system to induce hospitals to continue to strive for improvements in patient safety and medical service quality. In addition, it is required that LTCHs, accrediting agency and the Ministry of Health and Welfare compromise and cooperate to seek solutions every time issues related to the accreditation system arise.

Improving the Simulation of a Mobile Patient Monitoring System for Node Diversification and Loss Minimization (노드 다변화 및 손실률 최소화를 위한 이동환자 상시 모니터링 시스템 시뮬레이션 개선 연구)

  • Choi, Eun Jung;Kim, Myuhng Joo
    • Journal of Korea Society of Digital Industry and Information Management
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    • v.7 no.4
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    • pp.15-22
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    • 2011
  • U-Healthcare service is a real-time service using the vital signs which are continuously transferred from monitoring sensors attached to mobile patients under the wireless network environments. It should monitor the health condition of mobile patients everywhere at any time. In this paper, we have improved two features of the three layered mobile patient monitoring system with load balancing ability. First, the simulation process has been improved by allowing the number of related nodes to be changed. Secondly, we have modified S node to which queue is added to reduce the loss rate of collecting data from patients during the delay of S node process. And the data from the patient with high priority can be transferred to the server immediately through the filtering function. Furthermore, we have solved the problem of redundancy in sharing information among S nodes by differentiating process time to each S node. By performing a DEVS Java-based system simulation, we have verified the efficiency of this improved system.

Factors Related to Long-term Hospital Length of Stay and Opinions on Discharge-related Community-based Medical and Welfare Service on Elderly Patients with Chronic Diseases in Korean Veterans Hospitals

  • Yoon, Young Mi;Park, Jin Hee;Hwang, Moon Sook
    • Research in Community and Public Health Nursing
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    • v.33 no.4
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    • pp.357-371
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    • 2022
  • Purpose: This study aims to investigate factors related to long-term length of stay (LOS) of patients with chronic diseases in Korean veterans hospitals. Methods: The subjects were 196 elderly patients with chronic disease staying in the hospital for more than 10 days, Data were collected by the survey of patients with structured questionnaires and medical records review by nurses from July 15 to August 10, 2019. Collected data were analyzed using t-test, ANOVA, Pearson's correlation coefficient and stepwise multiple regression. Results: The present and desired LOS were 37.78±32.66 days and 60.87±45.95 days, respectively. Factors affecting hospital LOS were found to be main disease (genitourinary) (p<.001), assistance in activities of daily living (p<.001), area of hospital (p<.001), payment of medical fees (p=.026), hospital satisfaction (p=.036) and the explanatory power of these variables was 26.4%. The most common health problems that need to be solved after discharge were symptom alleviation and health promotion. These problems can be solved using community-based facility services or visiting medical-welfare services (especially home care nursing). Conclusion: In order to reduce hospital LOS, the following measures are required: personalized self-management education, provision of transportation services for dialysis therapy of inactive patients, linking patients with visiting medical-welfare services including home care nursing and mobile healthcare services, operation of the case management system including the notice of the discharge date at admission, interim check of patient status, and connecting the patient with community resources or transferring the patient to long-term care facilities at discharge.

A Case Report of a Drop Foot After Veno Venous Extracorporeal Membrane Oxygenation for a Patient Diagnosed COVID-19

  • Byunghoon Lee;Yong Beom Shin;Kwangha Lee;Myung Hun Jang
    • Physical Therapy Rehabilitation Science
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    • v.12 no.1
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    • pp.43-47
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    • 2023
  • Objective: To present a case study of a 69-year-old woman with COVID-19 who developed neurological complications due to Extracorporeal Membrane Oxygenation (ECMO) therapy and highlight the importance of daily neurological examinations and rehabilitation in the early detection and management of ECMO-related neurological complications in an isolation ICU. Design: A case report Methods: The patient received ECMO therapy, followed by neurological monitoring and rehabilitation in an isolation ICU. Daily neurological examinations were conducted to monitor the patient's neurological symptoms. Computed tomography was performed to confirm the presence of a hematoma in the left hamstring, which was identified as the cause of the neurological complication. Ultrasound-guided aspiration was immediately performed, and sciatic neuropathy predominantly involving the peroneal division was identified after aspiration. Results: Successful recovery was made possible by the early detection of neurological complications and rehabilitation in an isolation ICU. Although electrodiagnostic tests were not performed due to limited access to the isolation ICU, the appropriate intervention time could be determined through daily neurological examinations and rehabilitation, thereby minimizing neurological sequelae. Conclusions: ECMO-related neurological complications are well known, and their recognition in the ICU can be challenging. The presented case highlights the importance of daily neurological examinations and rehabilitation in the early detection and management of ECMO-related neurological complications in an isolation ICU, which can minimize neurological sequelae.

Nurse의s Perception in the Homecare Needs of Cancer Patient (간호사가 지각한 암환자의 퇴원후 가정간호요구)

  • Kwon, In-Soo;Eun, Young
    • Journal of Korean Academy of Nursing
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    • v.28 no.3
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    • pp.602-615
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    • 1998
  • The purpose of this descriptive study was to identify the homecare needs of the discharged patient with cancer as perceived by nurses caring hospitalized cancer patients. At two hospitals in Gyeongnam, 74 nurses responded to an open-ended questionnaire consisting of four need categories : 1) educational & informational need, 2) physical need, 3) emotional need, 4) social need. Respondents were asked to list above ten needs of cancer patient in each category. Two researchers analyzed the data by content analysis method. The findings are summarized as follows : 1) A total of 1,417 need items were generated by nurses. The largest number of needs were in the educational & informational need category(475 items, 36.3%). Physical(414 items, 31.6%), emotional (237 items, 18.1%) need were the second, third largest, and social(184 items, 14.0%) need made up the smallest category. 2) In the educational & informational need category, there were seven subcategories of prognosis, diet & exercise, medication & pain, wound care, folk remedy, personal hygiene, comfort. The need items related to prognosis of cancer accounted for almost a half(48.2%) of the total. 3) In the physical need category, there were ten subcategories of personal hygiene, skin & tissue, nutrition, side effect on treatment, exercise, pain, elimination, equipment, comfort & safety, others. The largest number of needs were in subcategory of the personal hygiene(82 items, 19.8%). 4) In the emotional need category, there were four subcategories of emotional support related to disease, emotional support related to routine life, spiritual support, maintenance of relationship with nurse & doctor. The largest number of needs were in subcatgory of the emotional support related to disease(96 items, 40.5%). 5) In the social need category, there were five subcategories of support for social life, household management, legal support, the use of volunteer service, financial support. The largest number of needs were in support for social life subcategory(58 items, 31.5%).

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Job Satisfaction and Patient Satisfaction Related to Nurse Staffing (종합병원 간호인력에 따른 직무만족${\cdot}$환자만족 비교)

  • Kim, Jong-Kyung
    • Journal of Korean Academy of Nursing Administration
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    • v.13 no.1
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    • pp.98-108
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    • 2007
  • Purpose: The objective of this research was to explore the levels of patient satisfaction and job satisfaction according to the level of nurse manpower, in order to provide effective management for nurses. Methods: The research was conducted from November 1 to December 30, 2006, with a survey of 310 nurses and 240 patients at eight tertiary hospitals in Seoul. Data were collected according to the level of nurse manpower from the first (a nurse vs. patient ratio of below 2.0) to the sixth (a ratio of over 4.0) rank. The survey tools were used Park-Yoon's job satisfaction (1992) and Wandelt and Ager (1974)'s patient satisfaction. The acquired data were analyzed with SPSS $PC^+$ 12.0 program using descriptive methods, ${\chi}^2$ test, ANCOVA, and Scheffe. Results: Overall job satisfaction of nurses showed 3.10 and patient satisfaction of patients showed 4.15. Analysis based on the level of nurse manpower showed that hospitals of first and second rank had higher scores than those of lower rank for nurse's job satisfaction and patient satisfaction. Conclusion: Hospitals with a higher level of nurse manpower showed higher score of nurse's job satisfaction and patient satisfaction.

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Factors related to willingness of choosing the same hospital (입원환자의 재선택 의향과 결정요인)

  • Seol, Dong-Won;Yu, Seung-Hum;Park, Eun-Cheol;Kim, Eun-Suak
    • Korea Journal of Hospital Management
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    • v.2 no.1
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    • pp.65-79
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    • 1997
  • This study aims to measure in-patients' willingness to choose the same hospital, and to define the related factors. The willingness was measured by the fact whether in-patients would return to the same hospital for their future hospitalization and can be said as the essence of ascertaining patients' satisfaction. Data was collected from 236 patients hospitalized in two hospitals selected according to its superiority, one being superior in medical technique, the other being superior in facility and equipment. To enhance the comparability between the two hospitals, the department and the diagnosis were matched, and structured questionnaires were self-fill-up. The main findings are as follows. Hospitals were analyzed by their superiority : medical services, facility and equipment. In case of hospitals with superior medical services, the willingness was proportional to positive doctor-patient relationship, to satisfaction with the medical level, and to the acknowledgement of utility in cure. In case of hospitals with superior facility and equipment, the willingness was proportional to the satisfactory state of overall facility. Two types of hospitals were combined and analyzed. The willingness for choosing hospitals with superior medical services was stronger than that for choosing the other hospitals. The satisfaction with overall facility, satisfaction with medical level, acknowledgement of utility in cure, positive doctor-patient relationship, and better consultation produced higher willingness to choose the same hospital. The willingness for the option shows to what degree the hospital suffices patients' expectation. Patients' understanding views were obviously influential. The satisfaction level for medical aspect was more influential than the level for non-medical aspect.

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Psychodynamic Psychotherapy of PTSD (외상 후 스트레스 장애의 역동정신치료)

  • Kim, Jung-Young;Park, Jong-Il;Yang, Jong-Chul
    • Anxiety and mood
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    • v.11 no.2
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    • pp.106-113
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    • 2015
  • In psychodynamic therapy, trauma related symptoms are considered as an attempt to overcome the traumatic experiences. Therefore, psychodynamic psychotherapy regards the symptom not as a patient's defect but as an adaptive reaction. In contrast to other therapies, psychodynamic theory places heavy emphasis on the understanding and resolution of the patient's symptoms. In addition, transference is a distinctive feature of this theory, which plays a significant role of reflecting the realistic evaluation on the therapist's characteristics, and in guaranteeing the therapeutic alliance. The psychodynamic therapist inducts meaning from the patient's unconscious mind. The therapist's task is to help the patient to better understand defense mechanisms guide their management of experiences and reactions, and facilitate a better understanding of their personal experiences.