• Title/Summary/Keyword: Patients Waiting Time

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An Application of a Jackson Network for Waiting Time Reduction at the Emergency Care Center (잭슨 네트워크를 이용한 응급실의 대기 시간 단축 연구)

  • Kim, Su-Mi;Seo, Hee-Yeon;Lee, Jun-Ho;Kwon, Yong-Kap;Kim, Seong-Moon;Park, In-Cheol;Kim, Seung-Ho;Lee, Young-Hoon
    • Korean Management Science Review
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    • v.27 no.1
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    • pp.17-31
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    • 2010
  • Patients entering an emergency care center in a hospital usually visit medical processes in different orders depending on the urgency level and the medical treatments required. We formulate the patient flows among diverse processes in an emergency care center using the Jackson network, which is one of the queueing networks, in order to evaluate the system performances such as the expected queue length and the expected waiting time. We present a case study based on actual data collected from an emergency care center in a hospital, in order to prove the validity of applying the Jackson network model in practice. After assessing the current system performances, we provide operational strategies to reduce waiting at the bottleneck processes and evaluate the impact of those strategies on the entire system.

An Analysis of Factors Affecting Satisfaction of Physical Therapy Patients (물리치료 내원환자의 만족도에 영향을 미치는 요인 분석)

  • Sohn, Ae-Ree;Kim, Mi-Won
    • Journal of Korean Physical Therapy Science
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    • v.9 no.4
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    • pp.63-72
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    • 2002
  • Patient satisfaction is an important factor in evaluating the quality of care. Patient satisfaction may be used to evaluate provider services and facilities, and used to predict the patient returns to a facility. The patients d whether the patient returns to a facility or whether the patient recommends the facility to other people may be affected by a variety of factors of patient satisfaction. Low satisfaction may result in poor compliance with the potential of waste of resources and suboptimal clinical outcome. This study is to identify factors of patient satisfaction that will affect patients decision whether the patient returns or not. A self-administered questionnaire survey was conducted in Seoul, Chung-Joo and Bu-Cheon cities, Survey data was obtained from 743 patients who visited the physical therapy practice at university hospitals, general hospitals and clinics. Response rate was 94.4%. The instrument developed by Goldstein et al. (2000) was used and translated into Korean. Several items were added to the instrument. Patient's opinions of service in each domain measured using 5-point Likert-type scales that ranged from strongly disagree to strongly agree. A multiple-regression analytic approach was used to predict overall satisfaction of physical therapy. Age, kindness, scheduling, convenience of parking, privacy, and waiting time predicted the overall satisfaction of physical therapy. The older patients had higher level of satisfaction with physical therapy compared with the younger patients. Patient satisfaction were more affected by access (scheduling and waiting time), administrative technical management (convenience of parking), and interpersonal management (kindness of physical therapists and other staffs) than clinical technical management (physical therapists' skills).

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Utilization of Computer System for Outpatient's Dispensing Affairs in Hospital Pharmacy (병원약국의 외래조제업무에 대한 컴퓨터의 이용)

  • Ro, Hwan-Seong
    • Journal of Pharmaceutical Investigation
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    • v.23 no.2
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    • pp.97-102
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    • 1993
  • Hospital pharmacy services are divided into dispensing affairs for inpatients and outpatients, pharmaceutical service, stock control, intravenous admixture service, drug information service, pharmacokinetic consultation service, education and research work, etc. But among those affairs, dispensing affair for outpatient is perceived as the most important work in Korea, because it is linked directly with hospital service for patients. Therefore, total computer system for dispensing area was adopted from opening point of hospital in 1989 in Asan Medical Center. Utilization of computer system for outpatient dispensing area is as follows; 1) Order communication system of prescription by Total Hospital Information System, 2) Automatic print-out system of direction for use by sticker connected with on-line net work, 3) Use of automatic tablet counting and packaging machines connected with on-line net work. Those computer system resulted in curtailment of pharmacy manpower and shortening of waiting-time for outpatient.

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Computerized Measurement for Asthma-Specific Quality of Life: Comparison with a Conventional Paper-and-Pencil Questionnaire (터치스크린 컴퓨터를 이용한 천식 특이형 삶의 질 측정)

  • Lee, Eun-Hyun
    • Journal of Korean Academy of Nursing
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    • v.39 no.6
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    • pp.781-787
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    • 2009
  • Purpose: The purpose of this study was to evaluate a computerized touch-screen version of the asthma-specific quality-of-life (cA-QOL) questionnaire against the conventional paper-and-pencil version (pA-QOL) for equivalence, time for completion, user preference, and ease of use. Methods: A total of 261 patients were recruited. A randomized cross-over design was used. Patients in group A completed the cA-QOL first while waiting to see a physician, and completed the pAQOL version after seeing the physician. Patients allocated in group B completed these questionnaires in the reverse order. The patients were asked questions about user preference and ease of use of the cA-QOL. The time taken to complete both versions of the questionnaire was measured. Results: Weighted kappa coefficients of all items showed almost perfect agreement. The time required to complete the pA-QOL is faster than the time for cA-QOL. The patients who preferred the cA-QOL were 37.5%, while those who preferred the pA-QOL were 29.9%. Most patients reported that the cA-QOL was "easy" or "very easy" to complete. Conclusion: The cA-QOL is the computerized equivalent of the pA-QOL. The findings herein demonstrate that the cA-QOL can be helpful to nurses in busy practices for assessing, collecting, and evaluating their patients' health related quality of life.

Korean Scaling Fear(KSF-1.1) and related factors in scaling patients (일부 스케일링환자들의 한국형 스케일링두려움의 정도 및 관련요인)

  • Cho, Myung-Sook
    • Journal of Korean society of Dental Hygiene
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    • v.13 no.6
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    • pp.977-985
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    • 2013
  • Objectives : The purpose of the study is to investigate Korean scaling fear (KSF)-1.1 and related factors in scaling patients. Methods : The subjects were 314 scaling patients in 7 dental clinics in Daegu from April to June, 2013. Data were analyzed for simple frequency rate, t-test and ANOVA(Sheffes's post hoc) for the identification of the differences between KSF-1.1 and variables. Multiple regression was analyzed for the impact of independent variable on the score of KSF-1.1. Results : Mean score of KSF-1.1 in 314 scaling patients was 2.60. Female patients (2.71) had a higher score than male (2.47) (p<0.01). Those who didn't get a regular dental check up(2.87) tended to have higher fear level than those who had regular checkup (2.46) (p<0.001). Those who experienced dental pain (2.90) had significantly higher score than those who had not (2.46) (p<0.001). There was a significant difference between three groups (yes 3.03, ordinary 2.79, and no 2.42) in scaling (p<0.001) and financial burden (p<0.001). Variables associated with score of KSF-1.1 were gender(${\beta}$=0.21, p<0.05), waiting time for scaling(${\beta}$=0.24, p<0.01) and financial burden (${\beta}$=0.22, p<0.02) by multiple regression analysis. Conclusions : The influencing factors of scaling were gender, financial burden, waiting time for scaling that may effect on a score of KSF-1.1.

The experimental study of oral care for early radiation therapy in the head and neck cancer patients (두경부 악성종양 환자에서 조기 방사선치료를 위한 구강관리법에 대한 실험적 연구)

  • Moon, Won-Kyu;Cha, In-Ho;Kim, Hyung-Jun;Jung, Young-Soo;Lee, Chun-Ui;Lee, Jong-Young;Ryu, Mi-Heon;Yoo, Jae-Ha
    • Journal of the Korean Association of Oral and Maxillofacial Surgeons
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    • v.37 no.3
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    • pp.169-175
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    • 2011
  • Background: Teeth requiring extraction before radiotherapy in head & neck cancer patients should be removed as long as possible before the initiation of radiation therapy. Conventionally, a minimum 2-week waiting primary healing period is recommended. Although the above 2-week period is ideal, it was not uncommon for the radiotherapist and cancer patient to feel an urgent need to process with radiotherapy despite the need for dental care. Therefore, alternative approaches for early radiotherapy, including conservative endodontic treatment and a 1-week waiting primary healing period after dental extraction at the time of radiotherapy, were considered and applied based on the experimental study Materials and Methods: Eighteen dogs were processed for histopathologic wound healing. The effect of the primary endodontic treatment and extraction before early radiotherapy was examined. Results: No specific complication, such as, post-extraction wound infection, radiation osteitis and osteoradionecrosis, were encountered despite the early radiotherapy. Conclusion: Based on the experimental study, a minimum 1-week waiting primary healing period for oral care before radiotherapy is suitable for the early radiotherapy in head and neck cancer patients.

Utilization Status of Emergency Medical Service for Children (아동의 응급의료서비스 이용실태)

  • Jeon, Hye-Jin;Kim, So-Sun;Bae, Hyun-A;Yoo, Il-Young
    • Child Health Nursing Research
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    • v.14 no.1
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    • pp.5-13
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    • 2008
  • Purpose: This study was done to describe utilization status of emergency medical service for children at one university affiliated hospital located in Seoul. Data were obtained from the medical records of patients under 13 years of age who visited the ER from January 1 to December 31, 2006. Method: Medical records missing the time of discharge were excluded in the analysis of waiting time, which resulted in 19,766 cases. Data were analyzed using SPSS WIN 14.0 version. Result: There were slightly more boys (58.4%), average age of the children was 3.97 years of age. More children at the aged 1 to 3 years (51.3%) visited the ER. Fever was the most frequent complaint: 5,180 cases (24.38%). The other complaints were head or facial laceration (10.55%), vomiting (9.63%), abdominal pain (8.06%), cough (7.67%), and painful limb swelling (6.34%). Average waiting time before the first medical examination was 17 minutes, and average ER stay time was 3 hours and 23 minutes. Conclusion: The results suggest the need to assign a nurse specialist for pediatric ER to provide more efficient care for the children. Also, extra staff assignment during the evening shift or extending office hours of local pediatricians should be considered.

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Factors Related to Waiting and Staying Time for Patient Care in Emergency Care Center (응급의료센터 내원환자 진료시 소요시간과 관련된 요인)

  • Han, Nam Sook;Park, Jae Yong;Lee, Sam Beom;Do, Byung Soo;Kim, Seok Beom
    • Quality Improvement in Health Care
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    • v.7 no.2
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    • pp.138-155
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    • 2000
  • Background: Factors related to waiting and staying time for patient care in emergency care center (ECC) were examined during 1 month from Apr. 1 to Apr. 30, 1997 at an ECC of Yeungnam university hospital in Taegu metropolitan city, to obtain the baseline data on the strategy of effective management of emergency patients. Method: The study subjects consisted of the 1,742 patients who visited at ECC and the data were obtained from the medical records of ECC and direct surveys. Results: The mean interval between ECC admission time and initial care time by each ECC duty residents was 83.1 minutes for male patients and 84.9 minutes for female patients, and mean ECC staying time (time interval between admission and final disposition from ECC) was 718.0 minutes in men and 670.5 minutes in women. As the results, the mean staying time in ECC was higher in older age, and especially the both of initial care time and staying time were highest in patients of medical aid, and shortest in patients of worker's accident compensation insurance. The on admission or not, previously endotracheal-intubation state of patient. The ECC staying ti initial care time was much more delayed in patients of not having previous medical records and the ECC staying time was higher in referred patients from out-patient department, in transferred patients from the other hospitals and patients having previous records, and in patients partly used the order-communicating system. The factors associated with the initial care time were the numbers of ECC patients and the existence of any true emergent patients, being cardiopulmonary resuscitation (CPR) statusme was much more longer in patients of drug intoxication, in CPR patients, in medical department patients, in transfused patients and in patients related to 3 or more departments. And according to the numbers of duty internships, the ECC staying time for four internships was more longer than for five internships and after admission ordering was done, also-more longer in status being of no available beds. As above mentioned results, the factors for the ECC staying time were thought to be statistically significant (P<0.01) according to the patient's age and the laboratory orders and the X-ray films checked. And also the factor for the ECC staying time were thought to be statistically significant (P<0.01) according to the status being of no available beds, the laboratory orders and/or the special laboratory orders, the X-ray films checked, final disposing department, transferred to other hospital or not, home medication or not, admission or not, the grades of beds, the year grades of residents, the causes of ECC visit, the being CPR status on admission or not, the surgical operation or not, being known personells in our hospital. Conclution: Authors concluded that the relieving method of long-staying time in ECC was being establishing the legally proved apparatus which could differentiate the true emergency or non-emergency patients, and that the methods of shortening ECC staying time were doing definitely necessary laboratory orders and managing beds more flexibly to admit for ECC patients and finally this methods were thought to be a method of unloading for ECC personnels and improving the quality of care in emergency patients.

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Survey of Doctors' Role Expectation and Patients Satisfaction with Referral Centers (의료협력센터에 대한 개원의 역할기대와 환자 만족도 조사)

  • Han, Sun-Hee
    • Journal of Korean Academy of Nursing Administration
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    • v.13 no.1
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    • pp.74-81
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    • 2007
  • Purpose: This study focuses on doctors' role expectation and patients satisfaction with the referral centers to get necessary basic Method: There were 495 subjects in this study. 245 of them were doctors working in the 397 clinics and hospitals which have made contracts with the referral center in Y General Hospital located in J city, and 250 were patients who had been treated in it. The data were collected from Sep. 25 to Oct. 21, in 2006. Data analysis was processed with SPSS/WIN 14.0 electronically. Results: Concluding cooperative treaties with other clinics and hospitals, doctors expect the following effects: First, the improvement of the treatment quality of patients. The patients satisfaction ranking order for using referral centers is as follows: kindness of the staff, treatment reservation, doctor's satisfying explanation. providing one-stop service, reduction of waiting time for treatment, evasion of repetitive tests. Conclusion: Referral centers should provide various services totally and actively which reflect the role expectation and satisfaction of doctors and patients altogether.

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A STUDY ON THE EFFECTS OF SEDATION AND RELATED VARIABLES FOR PEDIATRIC DENTAL PATIENTS (소아환자의 진정요법 효과와 그와 연관된 변수에 대한 연구)

  • Kim, Kyoung-Hee;Kim, Seung-Oh;Kim, Jong-Soo
    • Journal of the korean academy of Pediatric Dentistry
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    • v.34 no.2
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    • pp.234-246
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    • 2007
  • The combination of chloral hydrate and hydroxyzine is one of the safest and most commonly used drug regimens for sedating young, uncooperative pediatric dental patients. Midazolam IM or IN and $N_2O/O_2$ inhalation is sometimes administered with chloral hydrate and hydroxyzinecombination when deeper and longer sedation is needed. The purpose of this study was to assess the outcome and safety of chloral hydrate, hydroxyzine and $N_2O/O_2$ in the sedation of a large number of uncooperative pediatric dental patients and to identify variables associated with their effectiveness. In a nine-month retrospective study, 171 records of sedation performed in 94 healthy children(male 46, female 48) with mean age of $30{\pm}8$ months were reviewed. The authors analyzed several variables such as age, sex, weight, methods of drug delivery, waiting time after drug delivery, treatment rendered, treatment time, adverse events, sedation outcome. Eighty five percent of sedation had success behavioral outcome. Sedation sessions rated success used more $N_2O/O_2$ administration and had longer treatment duration than sedation sessions rated failure. A children patient under 36 months of age had enough sleep by only oral administration and the mean waiting time of this case was significantly shorter than that of a children patient over 36 months of age. There was a clear correlation between age and $N_2O/O_2$ using tine, but no correlation between weight and $N_2O/O_2$ using time. There was no statistically significant difference among variables of treatment duration, $N_2O/O_2$ administration and adverse event.

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