• Title/Summary/Keyword: Quality Improvement(QI)

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The Evaluation of Effect in employees' health examination program with web and OCS (Web 및 OCS(Order communication system)를 활용한 직원 건강검진 프로그램의 효과분석)

  • Song, Jung Hup;Ha, Tae Hi
    • Quality Improvement in Health Care
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    • v.15 no.2
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    • pp.121-130
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    • 2009
  • Objectives : To evaluate the effect of heath examination program which introduce web-based input system, OCS(Order communicating system) and interface with national health insurance corporation, this study was done. Method : To Exam/Order and tests separately at anytime, the experimental health examination program which had web-based questionnaire input system, on-line measurement input system, interface program with national health insurance corporation and introduced OCS was developed. Experiment and old examination program were compared in terms of satisfaction and cost. Result : The 95.7% of respondents were satisfied with web-based input system, the 95.4% satisfied with OCS use, and 97.8% satisfied with test at anytime they want. The cost and time reduction between experiment and old program were 4,159,000won and $600.3{\pm}5.75$(seconds) per man input-time. Conclusion : The experimental health examination program is good for employee and hospital. If the health examination program for non-employee will be developed, it will be done efficiently and effectively, but Internet securities will be considered.

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Perception of Nurse Experts on the Contribution of Nursing Interventions to NOC Nursing Outcomes in General Hospitals in Korea

  • Lee Byoungsook
    • Journal of Korean Academy of Nursing
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    • v.35 no.4
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    • pp.649-655
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    • 2005
  • The purpose of this study was to identify the perception of nurse experts on the contribution of nursing interventions to Nursing Outcomes Classification NOC nursing outcomes. A nursing outcome is a nursing-sensitive patient outcome primarily affected by nursing interventions. As one of the standardized language systems of nursing outcomes, the NOC must be examined for applicability before it is used in Korea. Data were collected in February and March 2003 using a 5-point Likert scale. For data collection, 230 quality improvement (QI) or quality assurance (QA) nurses from general hospitals in Korea were asked to rate the extent that nursing interventions contribute to each of the NOC nursing outcomes (2000) in their hospitals. Ninety-six nurses from 63 hospitals responded and the response rate was $41.7\%$. Mean scores for perception of contribution of nursing interventions to each of the NOC nursing outcomes ranged from 2.18 to 4.54. Vital Signs Status had the highest score (M = 4.54), and Abuse Recovery: Financial, the lowest score (M = 2.18). Of the seven NOC domains, the mean score was highest for Physiologic Health (M = 3.91) and lowest for Community Health (M = 2.92). Of the 29 NOC classes, the mean score for perceived contribution was highest for Metabolic Regulation (M = 4.32) and lowest for Community Well-Being (M = 2.92). Participants perceived that nursing interventions in general hospitals in Korea contributed, at least to a certain extent, to most of the NOC nursing outcomes. Based on these results, NOC should have relatively good applicability in Korea.

The Development of Satisfaction Tool to Health Care Services - focused on Patients and their families - (의료 서비스에 대한 만족도 측정 도구의 개발)

  • Kang, So-Young;Lee, Sun-Mi
    • Quality Improvement in Health Care
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    • v.3 no.1
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    • pp.104-124
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    • 1996
  • Background : In these days, the health care organizations have concerned about customer-centered care in order to empower the competitiveness on the health care markets. The departments working for quality management of the hospitals have used health care quality indicators in terms of medical areas as well as service areas of the hospitals. However, there were insufficient efforts to develop the credible measurement to seek the customers' needs, their expectations and their satisfaction levels related to health care services because various kinds of challenges were in the process of scale development to measure customers' satisfaction in health care. The purpose of this study was to develop the satisfaction scale to health care services in a Korea health care organization and to test its tool with validity and reliability. Method : The concept of this tool was acceptability that one of the components of health care quality defined by Donabedian. Acceptability has the five dimensions of concept: Accessibility; Patient-Practitioner Relations; Amenities; Patient Preferences as to the effects of care; and Patient Preferences as to the costs of care. The Satisfaction Tool to Health Care Services was reviewed by expert panel with five researchers, including hospital managers and a professor related to quality management of the hospitals. As a result, the content validity index was .84 in the outpatient satisfaction tool. The inpatient satisfaction tool had .87 of the content validity index. The Satisfaction Tools to Health Care Services finally consisted of 44 items for outpatients/their families and of 60 items for inpatients/their families. Study subjects of the construct validity test were 479 outpatients/their families and 561 inpatients/their families who visited or admitted at a University hospital from July 1, 1996 through August 10, 1996. The data were examined by Factor Analysis with SPSS. Result : The items of Satisfaction tools for outpatients/their families were categorized by eleven factors with eigenvalue greater than 1.0 accounting for 64.2 percent of the variation in item scores. Also, the items of inpatient tool had eleven factors with eigenvalue greater than 1.0 accounting for 60.3 percent of the variation in item scores. The reliability of overall scale were .95 and .96 for the outpatients/their families satisfaction scores and inpatient/their families satisfaction scores. The internal consistency reliability with eleven factors was ranged from .30 to .94 for inpatients/their families. The Satisfaction Tool with eleven factors for inpatients/their families had internal consistency reliability ranged from .53 to .89. Conclusion : The Satisfaction Tools to Health Care Services focused on outpatients/their families and inpatients/their families developed in this study had a high reliability and the strong evidence of content validity and construct validity based on quality concept. Therefore, this tool would be utilized as a credible quality indicator of health care services to assess the quality problems and to monitor the quality improvement activities in Korean Health Care Organizations.

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A Study on the Nurses' Thinking Skills and Problem Solving Abilities for Quality Management in Healthcare Services (질 관리에 대한 간호사의 사고유형과 문제해결력)

  • Ko, Ja Kyung;Park, Yon Ok
    • Quality Improvement in Health Care
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    • v.5 no.2
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    • pp.238-256
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    • 1998
  • Background : There have been many studies and efforts about quality management in health services, but these were not focused on the thinking ability of the personnel. In this study, We planned to define the relationship between Quality Management(QM) and thinking skill, and analyzed critical thinking skill and problem solving ability of the nurses for QM in healthcare. Methods : We surveyed 260 nurses in 3 hospitals by using questionnaires about thinking skills and QM from November 18 to 28, 1998. The response rate was 76.9%. We described and analyzed the data by descriptive statistics, t-test, ANOVA, Pearson correlation, and non-parametric Friedman test using SPSS Win 7.5. Results : This study revealed that 1) understanding level of QM concepts was very low and insufficient, 2) willingness to practice QM in healthcare was relatively high and affirmative, but the positive attitude taking part in the program of QM is very low(4.5%), 3) even though the necessity of QM was recognized, actual application of critical thinking skills and problem solving abilities is lacking, 4) the production of idea for QM was the most insufficient, and so the next of the problem solving process(QA cycle) was the same. Conclusion : Based on the above results, we can conclude that understanding the concepts of QM is very important to solve problems about QM in healthcare. For development of thinking skill to promote critical problem solving ability for QM in healthcare, it is necessary to improve curriculum of nursing education and teaching-learning methods of QM strategy and technique.

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Analyzing the Effect of Microbial Consortia Fermentation on the Quality of HnB by Untargeted Metabolomics

  • Ling Zou;Hong Zhang;Zhonghua Liu;Jianfeng Sun;Yang Hu;Yishu Ding;Xinwei Ji;Zhenfei Yang;Qi Zhang;Binbin Hu
    • Journal of Microbiology and Biotechnology
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    • v.34 no.9
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    • pp.1890-1897
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    • 2024
  • Fermentation has been identified as an effective strategy to alter the chemical makeup of tobacco, thereby enhancing its quality. The deliberate introduction of microorganisms can hasten the fermentation process. In this research, microbial consortia harvested from the tobacco surface were utilized to enhance the tobacco quality. This enhancement also elevated several sensory attributes of HnB cigarettes, such as aroma richness, moisture, strength, and reduced irritation, achieving a sensory quality rating of 84.5. This marks a notable improvement compared to the 82 rating of the original, unfermented cigarettes. Untargeted metabolomics analysis revealed a decrease in total polyphenols and unsaturated fatty acids, while the levels of polyacids, alcohols, ketones, furans, and other compounds increased in the fermented tobacco. Additionally, KEGG pathway enrichment analysis indicated that the enhancement in tobacco quality through microbial consortia fermentation is linked to various biological pathways, with pathways related to fatty acid and amino acid degradation playing pivotal roles. The findings of this study will serve as a reference for the commercial production of HnB cigarettes, and the elucidated mechanism offers a theoretical basis for exploring microbial fermentation as a means to improve tobacco quality.

Study on Development of Assessment Guideline and Endpoints for Clinical Trial with Antitumor Natural Products (천연물 항암제제 임상시험 평가지표 개발연구)

  • Namgung, Mi-Ae;Chang, Yoo-Sung;Jeong, Seung-Gi;Kim, Jin-Seung;Yoon, Sung-Woo;Jang, Ki-Young;Yoo, Hwa-Seung;Jung, Myeon-Woo;Lee, Sung-Ho;Kim, Sung-Hoon
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.20 no.6
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    • pp.1678-1727
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    • 2006
  • This study was perfromed to develop the assessment guideline and endpoints for clinical trial with anticancer herbal medicine. The botanical products used to humans for long time may be applied to phase 3 clinical trial after submitting the evidences for safety and efficacy of them or completion of basic requirement of phase 1 and phase 2 for safety confirmation and dose determination. Syndrome improvement was chiefly evaluated by Zubrod and karnofsky(%) methods. We suggest the general clinical trial assessment with botanical products, by following assessment points, that is, tumor size for 50 points, survival fate for 10 points, major syndromes for 40 points. It is recommendable that the each symptom of Qi deficiency syndrome, blood deficiency syndrome and Qi stagnation syndrome was allocated by assessment points, Similarly, the each symptom was given the assessment points according to the severity of symptom, for example, slight for 3 points, moderate for 2 points and severe for 1 point in hepatocelluar carcinoma and lung cancer. Then, the efficacy of botanical products was evaluated by the difference between pre-treatment and post-treatment. Asking the neoplastic patients of questionnaire on physical, emotional, cognitive, social and role subjects availability, three more syndromes (Fatigue, Pain and Nausea/Vomit), quality of life(QOL) will be evaluated by GLM statistics. In addition, in case of lung cancer, 13 questions will be asked by the EORTC QLQ-C13 forms. As the assessment of endpoints for efficacy to reduce side effects induced by chemotherapy and radiotherapy, the data of image scanning and hemato-urinalysis can be usefully applied on immune response, weight loss, indigestion, hemopoietic damage and injury of liver and kidney, while the changes of syndromes of side effect can be evaluated by differentiation methods of Qi and blood and five viscera. However, it is still necessary to determine the ratio between scientific analytical method and Oriental differentiation method as well as confirm the Oriental assessment endpoints by clinical trial. In addition, we suggest the continuous development of assessment endpoints on other carcinomas except of hepatocelluar carcinoma and lung cancer in future.

Could Clinical Pathways Improve the Quality of Care in Patients with Gastrointestinal Cancer? A Meta-analysis

  • Song, Xu-Ping;Tian, Jin-Hui;Cui, Qi;Zhang, Ting-Ting;Yang, Ke-Hu;Ding, Guo-Wu
    • Asian Pacific Journal of Cancer Prevention
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    • v.15 no.19
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    • pp.8361-8366
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    • 2014
  • This meta-analysis was performed to assess the implementation effects of clinical pathways in patients with gastrointestinal cancer. A comprehensive search was conducted in the Cochrane Library, PubMed, EMBASE, Web of Science and Chinese Biomedical Literature Database (from inception to May 2014). Selection of studies, assessing risk of bias and extracting data were performed by two reviewers independently. Outcomes were analyzed by fixed-effects and random-effects model meta-analysis and reported as mean difference (MD), standardized mean difference (SMD) and odds ratio (OR) with 95% confidence intervals (CI). The Jadad methodological approach was used to assess the quality of included studies and the meta-analysis was conducted with RevMan 5.1 software. Nine citations (eight trials) involving 642 patients were included. The aggregate results showed that a shorter average length of stay [MD = -4.0; 95% CI (-5.1, -2.8); P < 0.00001] was observed with the clinical pathways as compared with the usual care. A reduction in inpatient expenditure [SMD = -1.5; 95% CI (-2.3, -0.7); P = 0.0001] was also associated with clinical pathways, along with higher patient satisfaction [OR = 4.9; 95% CI (2.2, 10.6); P < 0.0001]. Clinical pathways could improve the quality of care in patients with gastrointestinal cancer, as evidenced by a significant reduction in average length of stay, a decrease in inpatient expenditure and an improvement in patient satisfaction. Therefore, indicators and mechanisms within clinical pathways should be a focus in the future.

Analysis of Quality Measurement & Evaluation Index in applying Web Information Service I (Web 정보서비스 평가를 위한 기존 측정지표 분석 I)

  • Yoo, Sa-Rah
    • Journal of the Korean Society for Library and Information Science
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    • v.34 no.3
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    • pp.133-156
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    • 2000
  • A fundamental issue to consider when searching Web information is the quality of information itself and of service. If a Quality Information System (QIS) of Digital Library is sought, new measurement criteria and evaluation index for Web information service are required. Reliance on the existing evaluation criteria is not acceptable if data retrieved are not information and the service is only noise to end-user. Applying existing evaluation criteria of online database to Environmental & Energy Engineering Web DB revealed the limitations and provided a practical and case-based information for improvement. No attempt was made to survey comprehensively all of the evaluation methods that could possibly be relevant. Instead, this discussion concentrates on the information service evaluation index being developed in the KDPC Project. The research found that domestic Web-DB service are still woefully insufficient to conduct comprehensive investigations on environmental topics. More qualified and specialized R&D Web information service and the development of new evaluation criteria based on this investigation(research I.) will be discussed in follow-up research II.

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Effects of enzymolysis and fermentation of Chinese herbal medicines on serum component, egg production, and hormone receptor expression in laying hens

  • Mei Hong Jiang;Tao Zhang;Qing Ming Wang;Jin Shan Ge;Lu Lu Sun;Meng Qi Li;Qi Yuan Miao;Yuan Zhao Zhu
    • Animal Bioscience
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    • v.37 no.1
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    • pp.95-104
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    • 2024
  • Objective: In the present study, we aimed to investigate the effects of enzymolysis fermentation of Chinese herbal medicines (CHMs) on egg production performance, egg quality, lipid metabolism, serum reproductive hormone levels, and the mRNA expression of the ovarian hormone receptor of laying hens in the late-laying stage. Methods: A total of 360 Hy-Line Brown laying hens (age, 390 days) were randomly categorized into four groups. Hens in the control (C) group were fed a basic diet devoid of CHMs, the crushed CHM (CT), fermented CHM (FC), and enzymatically fermented CHM (EFT) groups received diets containing 2% crushed CHM, 2% fermented CHM, and 2% enzymatically fermented CHM, respectively. Results: Compared with crushed CHM, the acid detergent fiber, total flavonoids, and total saponins contents of fermented CHM showed improvement (p<0.05); furthermore, the neutral and acid detergent fiber, total flavonoids, and total saponins contents of enzymatically fermented CHM improved (p<0.05). At 5 to 8 weeks, hens in the FC and EFT groups showed increased laying rates, haugh unit, albumin height, yolk color, shell thickness, and shell strength compared with those in the C group (p<0.05). Compared with the FC group, the laying rate, albumin height, and Shell thickness in the EFT group was increased (p<0.05). Compared with the C, CT, and FC groups, the EFT group showed reduced serum total cholesterol and increased serum luteinizing hormone levels and mRNA expressions of follicle stimulating hormone receptor and luteinizing hormone receptor (p<0.05). Conclusion: These results indicated that the ETF group improved the laying rate and egg quality and regulated the lipid metabolism in aged hens. The mechanism underlying this effect was likely related to cell wall degradation of CHM and increased serum levels of luteinizing hormone and mRNA expression of the ovarian hormone receptor.

Survey on Pattern Identification and Treatment of Chronic Fatigue in Korea Medicine (만성피로의 한의임상진료현황에 대한 조사 연구)

  • Kim, Ji Won;Kim, Hyo Jin;Jang, Eun Su;Jung, Hyun Jung;Hwang, Min Woo;Nam, Dong Hyun
    • Journal of Physiology & Pathology in Korean Medicine
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    • v.32 no.2
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    • pp.126-133
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    • 2018
  • The aim of this survey is to investigate the current state of pattern identification, treatment and management on chronic fatigue in the Korean medicine. From May 25, 2017 to June 7, we distributed contents of questionnaires to 17,992 Korean medical doctors via e-mail, and then received answers from 329 people. The surveys were conducted by a specialized research organizations. Researchers were blinded to the participant's personally identifiable information or whether they participated in the investigation. In Korea, almost Korean medicine doctors (94.5%) used pattern identification in the treatment of chronic fatigue patients. The main diagnostic methods were visceral (38.5%), qi-blood-fluid-humor (32.3%), and sasang constitutional pattern identification (14.3%). The high-frequent therapy were herbal medicine (37.0%), acupuncture (27.9%), moxibustion (11.7%), and cupping (8.6%). The primary goals of treatment were Improvement and relaxation of stress condition (18.1%), improvement of quality of life (13.1%), increase of functional vitality (34.0%), and fatigue management (23.3%). The key factors affecting treatment outcomes were the patient's aggressiveness in treatment (23.5%) and his/her lifestyle and environment(22.7%). This study was a pioneering research for chronic fatigue on the aspect of medical service provider in the Korean medicine. We hope that this study can be used as a basis for developing a more appropriate and reasonable practice guidelines for chronic fatigue.