• Korea Journal of Hospital Management
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• v.27 no.3
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• pp.39-49
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• 2022

Purposes: This study purposed to analyze the relationship between patient safety and patient-centerendess. Methodology: The comprehensive scores from patient safety assessment program and patient experience survey conducted by Health Insurance Review & Assessment Service were used as independent variables and dependent variables. This study analyzed the relationship between 4 patient safety-related areas(i.e. risk standardized readmission ratio, intensive care unit, preventive antibiotic, the drug evaluation) and 6 patient experience areas(i.e. nurse services, doctor services, medication & treatment, hospital environment, patient's right, overall experience) by using robust regression analysis. Findings: According to results, the score in 'patient's right' and 'risk standardized readmission ratio' areas were found to have a significant relationship, and 'overall experience' and the 'preventive antibiotic' areas. The ratio of senior beds and specialists was a general characteristics of hospitals that had a significant relationship on patient experience assessment. Practical Implication: The relationships between patient safety and patient experience assessment were varied depending on areas. Further study is needed to make clear the supposed relationship.

• The Korean Journal of Emergency Medical Services
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• v.22 no.3
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• pp.47-54
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• 2018

Purpose: The purpose of this study was to present evidence for quality management based on analysis of patient transportation and response intervals among emergency medical squads. Methods: The chi-square test was used to determine whether mental status and patient assessment affected direct medical control and hospital destination. One way analysis of variance was used to compare response intervals depending on mental status and patient assessment using data drawn from 1172 prehospital care reports. Results: There was a statistically significant relationship between mental status and direct medical control (p<.001); there was a statistically significant relationship between patient assessment and hospital destination (p=.011). However, there was no statistically significant relationship between mental status and hospital destination. The interval from arrival at the patient's side to departure from the scene showed a statistically significant difference (p<.001, p<.001), however, it took the longest time (16.8 minutes) in unresponsive patients. It showed a statistically significant difference (p<.001) in the interval from arrival at patient's side to departure from the scene depending on patient assessment; however, it took the longest time (9.6 minutes) in emergency patients. Conclusion: There was call for direct medical control based on patient assessment; however, patient transportation and response intervals were not appropriate.

• Quality Improvement in Health Care
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• v.22 no.2
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• pp.43-73
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• 2016

Purpose: The aims of this study were to assess the presence of core patient safety practices in Korean hospitals and assess the differences in reporting and learning systems of patient safety, infrastructure, and safe practices by hospital characteristics. Methods: The authors developed a questionnaire including 39 items of patient safety staffing, health information system, reporting system, and event-specific prevention practices. The survey was conducted online or e-mail with 407 tertiary, general and specialty hospitals. Results: About 90% of hospitals answered the self-reporting system of patient safety related events is established. More than 90% of hospitals applied incidence monitoring or root cause analysis on healthcare-associated infection, in-facility pressure ulcers and falls, but only 60% did on surgery/procedure related events. More than 50% of the hospitals did not adopted present on admission (POA) indicators. One hundred (80.0%) hospitals had a department of patient safety and/or quality and only 52.8% of hospitals had a patient safety officer (PSO). While 82.4% of hospitals used electronic medical records (EMRs), only 53% of these hospitals adopted clinical decision support function. Infrastructure for patient safety except EMRs was well established in training, high-level and large hospitals. Most hospitals implemented prevention practices of adverse drug events, in-facility pressure ulcers and falls (94.4-100.0%). But prevention practices of surgery/procedure related events had relatively low adoption rate (59.2-92.8%). Majority of prevention practices for patient safety events were also implemented with a relatively modest increase in resources allocated. Conclusion: The hospital-based reporting and learning system, EMRs, and core evidence-based prevention practices were implemented well in high-level and large hospitals. But POA indicator and PSO were not adopted in more than half of surveyed hospitals and implementation of prevention practices for specific event had low. To support and monitor progress in hospital's patient safety effort, national-level safety practices set is needed.

• The Korean Journal of Emergency Medical Services
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• v.28 no.1
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• pp.97-112
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• 2024

Purpose: This study compared the relative importance of educational content, teaching methods, and evaluation methods in the patient assessment curricula of 119 emergency medical technicians (EMTs). Methods: First, we identified the educational content, training hours, and teaching and evaluation methods of the existing patient assessment curriculum based on the National Competency Standard learning module. Second, we surveyed 30 EMTs affiliated with 119 services using the Analytic Hierarchy Process (AHP) method. Subsequently, we compared the differences between the current curriculum and the AHP analysis results. Results: Currently in operation, the "Advanced EMT Course" comprises three learning modules: assessment of patient status, scene size-up and triage, and assessment using monitoring devices. Among these, content related to the assessment of patient status received the most allocated time and was deemed the most important according to the AHP survey results. Conversely, while less time was allocated to scene size and triage compared with assessment using monitoring devices, the former was assessed as more important than the latter in the AHP results. Furthermore, scenario-based team training and procedure-focused individual practice were evaluated as relatively important teaching methods, while practical examination using a checklist was deemed the most appropriate evaluation method for all learning content. Conclusion: To improve the patient assessment curriculum, we propose adjusting teaching hours and introducing new teaching and evaluation methods based on the results of relative importance. The proposed improvement plan will contribute to enhancing the competency of 119 EMTs.

• Journal of Korean Academy of Nursing
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• v.37 no.1
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• pp.145-155
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• 2007

Purpose: The purpose of this study was to describe and to analyze real communication about a patient's discomfort between a patient with cancer and a nurse. Method: A dialogue analysis method was utilized. Fifteen patients and 4 nurses who participated in this research gave permission to be videotaped. The data was collected from January, 3 to February 28, 2006. Results: The communication process consisted of 4 functional stages: 'introduction stage', 'assessment stage', 'intervention stage' and 'final stage'. After trying to analyze pattern reconstruction in the 'assessment stage' and 'intervention stage', sequential patterns were identified. In the assessment stage, if the nurse lead the communication, the sequential pattern was 'assessment question-answer' and if the patient lead the communication, it was 'complaint-response'. In the intervention stage, the sequential pattern was 'nursing intervention-acceptance'. Conclusion: This research suggests conversation patterns between patients with cancer and nurses. Therefore, this study will provide insight for nurses in cancer units by better understanding communication behaviors.

• The Journal of the Korean dental association
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• v.57 no.2
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• pp.64-73
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• 2019

Authors have selected a physiological bad breath patient( 62 years old, male ) among the bad breath outpatients who have visited the halitosis control clinic in Korea University Medical Center(KUMC). The patient visited the halitosis control clinic for his oral malodor control, 3 times from April to June in 2018, and in August the patient visited to KUMC malodor control clinic again for his assessment of his two months efforts. Getting the data about the patient's endeavor to get over his physiologic oral malodor and the estimation of the patient's satisfaction level at his oral malodor improvement by a questionnaire method, and the organoleptic level assessment by the dentist, then we could propose an estimation method of the physiologic oral malodor patient care prognosis.

• Journal of The Korean Society of Integrative Medicine
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• v.9 no.2
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• pp.109-117
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• 2021

Purpose : This study examined the differences in occupational therapists' jobs depending on their past clinical careers using a survey of the importance of occupational therapy tasks in South Korea. This survey sought to provide fundamental data for strengthening occupational therapists' capacities and developing clinical training programs for therapists' future careers. Methods : An online survey was used to collect data from 93 South Korean occupational therapists. The subjects were divided into three groups for the analysis of the importance of occupational therapy tasks, depending on the length of their clinical careers: less than 3 years, from 4 to 6 years, and over 7 years. Results : A within-groups comparison of task importance found that "occupational therapy evaluation" was most important in all three groups. In between-groups comparisons, "patient information check", "assessment planning and establishment", "sensory function assessment", "social skills assessment", "developmental function improvement", "basic daily activities training", "social skills improvement", and "patient education" demonstrated statistically significant differences (p<.05). Each group showed different priorities. In the less-than-3-years group, "understanding of patient's needs" was most important, followed by "arm function improvement", "arm function assessment", "nerve, musculoskeletal, and motor-related functional improvement", and "basic daily activities training". In the 4-to-6-years group, "arm function assessment" was most important, followed by "basic daily activities assessment", "patient's needs", "arm function improvement", and "patient information check". In the over-7-years group, "understanding of patient's needs" was most important, followed by "patient information check", "basic daily activities assessment", "basic daily activities training", and "sensory function assessment". Conclusion : This study found that what occupational therapists consider important in their jobs varies according to their past clinical career and that occupational therapists with more than 7 years' experience are more aware of the importance of diverse fields of occupational therapy. Differentiated education that considers length of career and a range of training programs for more experienced occupational therapists will be needed in the future.

• The Korean Journal of Emergency Medical Services
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• v.15 no.2
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• pp.67-84
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• 2011

Purpose: The aim of this study is to present the basic data for qualitative improvement of emergency care for emergency patient by paramedic in fire station by understanding the level of awareness and practice in prehospital and transfer step, and understanding the level of emergency care and improvement of clinical knowledge through hospital clinical training. Methods: The researchers explained the objective for 143 persons who completed hospital clinical training from June 2nd, 2006 to October 23rd, 2009 among paramedic in fire station. The questionnaire in this research consisted of 80 questions. In the reliability for the awareness of emergency patient assessment, cronbach's $\alpha$ was 0.95, and in the reliability for emergency care fulfillment, cronbach's $\alpha$ was 0.93. reliability for clinical knowledge improvement is cronbach's $\alpha=.95$, and reliability for emergency care fulfillment is cronbach's $\alpha=.82$. Collected data was analyzed through SPSS 18.0 statistics program for frequency, percentage, average, standard deviation, Paired t-test, t-test, Correlation Coefficient, and internal consistency reliability was analyzed by cronbach's $\alpha$. Results: 1) The paramedic awareness and practice difference for emergency patient is statistically signification for general patient assessment(t=14.159, p=.000), trauma patient assessment(t=11.288, p=.000), internal medicine patient assessment(t=10.898, p=.000), and it shows the level of practice is lower than the level of awareness. 2) The paramedic difference between the level of awareness and practice according to whether or not they have clinical career is not signification on awareness(t=3.119, p=.125), and is high on practice(t=3.119, p=.002). 3) The correlation between paramedic awareness and the level of practice shows positive correlation(r=.61, p=.000). The higher the awareness of emergency patient assessment is, the higher the level of practice is. 4) The difference between paramedic clinical knowledge improvement and the level of emergency care practice is statistically significant(t=3.351, p=.001). 5) 89.6%(128 persons) of paramedic replied hospital clinical training experiences are helpful for field activity. 92.3%(133 persons) replied they apply well for clinical knowledge learned during hospital clinical training and emergency care skills in the field. Conclusion: Paramedic in fire station must evaluate the patient's initial assessment and activate the transfer system to the emergency department. It is necessary to develop and implement the effective education program continuously. The education program should systemize currently operated hospital clinical training. emergency disease and symptoms emergency care method, and practice mainly skill education should be progressed. In the prehospital and transfer management, high quality of medical assessment is required to the emergency medical service system. Medical direction from the doctors can feedback the paramedic continuously and continuing education must be provided to the paramedic in fire station.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.17 no.7
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• pp.211-219
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• 2016

The current study was conducted to make pre-post comparisons of education done for 119 emergency medical technicians (EMT) on the patient assessment performance. The data are expected to offer applicable training methods and educational resources for emergency medical services. Twenty six EMT from four cities and provinces participated in the study, which was carried out from 14 to 17 December, 2015. The technicians performed a patient assessment and marked reports on simulated patients. In the course of the assessment, a pre-post evaluation of education was done using a checklist regarding the respective symptoms, such as headache, chest pain, and dyspnea. The median value (quartile value) was used as the descriptive analysis. While patient assessment scores marked 66 points (54.00-80.25) out of 100 (p<0.01) before education, there was a significant increase in the after-education scores, which reached 88.5 points (80.00-93.00). The patient assessment performances revealed a significant increase (p<.0.01) in 5 chest pain, 7 headache, and 9 dyspnea items after education. Similarly, there was an increase in wanting to meet the EMT again scale in regards to categories involved in developing positive relations with patients. Moreover, the adequacy in the patient condition reports all marked a significant increase (p<0.01) in assessment categories. The present study shows that education based on simulation practices are necessary for improvements in patient assessment performance of 119 EMT. Therefore, practical and systematic patient assessment educations may serve as a prerequisite. Further opportunities should be provided for the EMT consistently.

• Health Policy and Management
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• v.26 no.4
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• pp.289-304
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• 2016

Background: Rehabilitations in subacute phase are different from acute treatments regarding the characteristics and required resource consumption of the treatments. Lack of accuracy and validity of the Korean Diagnosis Related Group and Korean Out-Patient Group for the acute patients as the case-mix and payment tool for rehabilitation inpatients have been problematic issues. The objective of the study was to develop the Korean Rehabilitation Patient Group (KRPG) reflecting the characteristics of rehabilitation inpatients. Methods: As a retrospective medical record survey regarding rehabilitation inpatients, 4,207 episodes were collected through 42 hospitals. Considering the opinions of clinical experts and the decision-tree analysis, the variables for the KRPG system demonstrating the characteristics of rehabilitation inpatients were derived, and the splitting standards of the relevant variables were also set. Using the derived variables, we have drawn the rehabilitation inpatient classification model reflecting the clinical situation of Korea. The performance evaluation was conducted on the KRPG system. Results: The KRPG was targeted at the inpatients with brain or spinal cord injury. The etiologic disease, functional status (cognitive function, activity of daily living, muscle strength, spasticity, level and grade of spinal cord injury), and the patient's age were the variables in the rehabilitation patients. The algorithm of KRPG system after applying the derived variables and total 204 rehabilitation patient groups were developed. The KRPG explained 11.8% of variance in charge for rehabilitation inpatients. It also explained 13.8% of variance in length of stay for them. Conclusion: The KRPG version 1.0 reflecting the clinical characteristics of rehabilitation inpatients was classified as 204 groups.