Journal of The Korea Institute of Healthcare Architecture
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v.17
no.3
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pp.35-42
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2011
Efficient space plans are built upon relations of both human and physical compositions, and the standard of the interaction is basically the human scale. Especially in medical areas, the character of the users within human scale design environment is quite significant. Unlike large hospitals with great plans and scalability performed by experts, mid-sized clinics tend to have limited space, designed by non-specialists who highlight aesthetics over functionality in floor plans which leads to poor quality in medical service. For this reason, this study will include the application of human scale based therapy rooms within the clinic from a physical standpoint and will further analyze and pinpoint any room for improvement to further enable more efficient ergonomic space planning. In this study, theoretically will contemplate over human scale, mid-sized clinic, therapies, and therapists, while the case study will include status of the recent human scale based mid-sized clinic from a physical viewpoint, classification and analysis amongst human and physical compositions chosen by discretion from either a newly opened or a newly re-modeled clinic within the last 2 years, which has 15 beds or more, minimum 3 physical therapists, with more than 5 different therapy facilities in the metropolitan area in order to measure the human scale of therapy rooms in a mid-sized clinic. As a result, the area where improvement can practically be applied is the physical composition, which does not include human scale like human composition factors as therapists and patients, and hence, I suggest the human scale applied efficient medical space plan become the base of this study and look forward to subsequent improvement in the quality of medical services.
Readmission which reflects capacity to manage patients and general level of medical services has been known for one of the causes of medical expenditure due to inefficient service. Compared to disease-specific readmission, hospital wide readmission (HWR) is relatively easy to understand, and has merit to get over limitation of collateral medical services assessment; therefore, a growing interest in development and usage of readmission indicator as quality of care indicator focusing on all-disease is detected. In this study, we investigate current state of risk standardized readmission rate indicator used in the United States, the United Kingdom, and Canada, and examine the considerations when using readmission rate as quality indicator in Korea. Differences in risk-adjustment methods were showed among countries. The United States do not control race not to hide socio-demographic factors on readmission. Canada shows differentiation compared to other countries about reflecting community factors. All three-countries utilize readmission rate as monitoring quality of care rather than incentives or penalty due to the fact that readmission rate could not represent the whole quality of hospital and has a limitation at controlling socio-economic factors. Therefore, for usage readmission rate as quality indicator in Korea, preparing readmission classification standard for Korean medical environment and additional methods for acquiring information by using discharge summary is need. Moreover, continued discussion with clinical specialists is needed for obtain clinical reliability and validity.
The purpose of this study is to analyze activating factors of medical tourism at Busan, and then decide on priority on the factors. As research methods, this study deduced priority of specialists' opinions by AHP analysis technique through structuralized questionnaire on the medical tourism's factors having been suggested from existing prior studies. The analysis results were same as followings. First, as a result of analysis on the main criteria, relative levels of importance were appeared high such as 'competitiveness', 'policy assistances from the government', 'medical care's infrastructure', and 'connectedness with regions' in order. Second, as a result of integrated results analyzing detailed criteria on the main evaluation standards, relative levels of importance were appeared high such as 'medical quality', 'health-related institution's improvement', 'medical infrastructure', 'medical charge', 'tourism-related institution's improvement', 'convenience', 'medical cooperation possibilities', and 'local industry compliance' in order. In conclusion, it is judged that activation of medical tourism shall be propelled after considering relative levels of importance on many policies or activating factors same as suggested in this study.
Lee, Young Joon;Lee, Ji Young;Kong, Seom Kim;Yeon, Gyu Min;Hong, Yoo Rha;Oh, Chi Eun
Pediatric Infection and Vaccine
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v.25
no.1
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pp.17-25
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2018
Purpose: Blood culture is an essential diagnostic tool and requires clear indications, proper techniques, and quality control. We aimed to investigate whether blood cultures in children are appropriate for indications, are performed correctly, and receive proper quality control. Methods: We conducted an online survey targeting pediatric infectious diseases (ID) specialists working in general hospitals and neonatologists (Neo) working at hospitals operating a neonatal intensive care unit in Korea. Results: Approximately 81.1% (30/37) of pediatric ID specialists and 72.2% (52/72) of Neo responded to the survey. Some of the respondents (33.3% of ID and 59.6% of Neo) performed blood culture as a regular test irrespective of the indication. Approximately 40% of ID and 65.4% of Neo ordered only one set of blood culture in patients suspected with bacteremia. The most commonly used disinfectant for skin preparation was povidone-iodine, while the skin preparation method varied by institution. Approximately two-thirds of the institutions were monitoring the blood culture contamination rate, whereas relatively few provided staff with feedback on that rate. In addition, less than half of the institutions were providing regular staff training on blood culture (40% of ID and 28.8% of Neo). Conclusions: The indication and methods of blood culture for children varied according to institution, and few hospitals exert effort in improving the quality of blood culture. Institutions have to strive constantly toward improvement of blood culture quality and evidence-based recommendations for pediatric blood cultures should be standardized.
Background: The average hospital stay in most Korean teaching hospitals is longer than that of hospitals in developed countries. The investigation of average hospital stay of teaching hospitals is considered as an important measure to evaluate the effectiveness of hospital management. In this article authors analyzed the relationship of several variables (hospital ownership, number of beds, location of hospitals, number of physician) to length of hospital stay in each clinical department. Methods: The average hospital stay of each clinical department of 184 teaching hospitals was investigated. Authors reviewed the papers of teaching hospitals, that was reported to the Korean Association of Hospitals. Results: The means of hospital stay day of hospitals were not significantly different according to the number of hospital beds and location of hospitals. Only the difference of hospital stay according to ownerships was significant. The length of stay was the highest in public hospitals and the lowest in juridical hospitals. Conclusions: The number of beds and location of hospitals were not associated with the average hospital stay. But ownerships affected the average hospital stay. The national or public hospitals had the longest length of hospital stay. Number of specialists and number of all physicians were closely related to the average hospital stay.
Journal of the Korean Society for information Management
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v.29
no.4
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pp.165-189
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2012
This study investigated the current state of online subject guides in Korean academic libraries and suggests improvement. Through the examination of 100 academic libraries' Web sites, only 14 online subject guides were identified, showing that the development of online subjects guides in Korea is still in infancy. The examined online subject guides were evaluated as high quality in terms of accessibility, integration of information resources, and format consistency, but low quality in the provision of specialized subjects, user instruction, and information retrieval systems. An online subject guide should be a one-stop service that provides fast access to information resources along with subject-specialized user instruction and effective communication with librarians.
In this study, a novel education system for inspection of concrete bridges is presented. The new education approach uses virtual reality (VR) and three-dimensional computer graphics (3DCG) in training engineers to become bridge inspection specialists. The slow time-dependent deterioration of concrete bridges can be reproduced on the computer screen in any chosen time frame, thus providing the trainees with illustrative and educative insight into the deterioration problem. In the proposed VR/3DCG approach a three-dimensional model of concrete bridge, including surfaces, viewpoints and walkthrough paths is created. With the help of this virtual bridge model, an experienced bridge inspection specialist teaches the different deterioration phenomena of concrete bridges to the trainees. The new system was tested, and the inspection results from the case bridge showed that in comparison with the traditional Japanese bridge inspection education system, the new system gives better results. In addition to the improvement of quality of bridge inspections, the new VR/3DCG system-based education brings along some other, more intangible benefits.
Purpose: Japan established the convalescent rehabilitation wards, corresponding to Korea's rehabilitation medical institutions, in 2000 and developed it into the present system through continuous revisions. This study sought to analyze the issues and tasks faced by Japan segregated by the period of revision of convalescent rehabilitation ward-related medical fee regulations, through a literature review and further aimed to explore the direction of development of domestic rehabilitation medical institutions. Methods: Ten revisions of the medical fee regulations were classified into three stages based on quality evaluation: (1) the quantitative expansion stage (2000-2006); (2) quality evaluation introduction stage (2008-2014); and (3) quality evaluation maturity stage (2016-2020). Results: The following issues and tasks emerged: (1) For the quantitative expansion stage; insufficient rehabilitation within the ward, insufficient after-hour rehabilitation, insufficient connection with acute-stage hospitals and maintenance facilities, and the low ratio of specialists. (2) For the quality evaluation introduction stage; disparity in the manpower between institutions, the necessity of a 365-day rehabilitation system, avoidance of critical patients, and the problem that an increase in the amount of rehabilitation did not lead to a qualitative improvement. 3) For the quality evaluation maturity stage; cream-skimming issues in selecting patients, inappropriate evaluation of rehabilitation effects, and the necessity of follow-up measures after discharge. Conclusion: It is worth referring to the established regulations in Japan, and concurrently it is necessary to strengthen the evaluation of the structures, processes, and results when operating and evaluating rehabilitation medical institutions in Korea taking into account the side effects that could be identified in Japan.
Background : ICD-10 Classification, which is used domestically as well as internationally, has limited use in the clinical practice since it is developed for at disease statistics and epidemiology. Therefore, the purposes of this study were to improve the quality of diagnosis by constructing a new disease classification based on the diagnoses doctors currently make in the clinical setting and connecting this classification with OCS and EMR, and to meet the demands of doctors for high quality medical study data in medical research. Methods : The specialists in each ophthalmic subfield collected clinical diagnoses and abbreviations based on the ophthalmology textbooks and confirmed the classifications. Total number of clinical diagnoses collected was totaled 672, for which ideal diagnoses had been selected and a new model of disease classification model in connection with ICD-10 was constructed. The constructed classification of clinical diagnoses consisted of six steps: the first step was the classification by ophthalmic subspecialty field; the second to fifth steps were the detailed classification by each specialty field; the sixth step was the classification by site. Results : After introducing the new disease classification, research on the use and a pre-post comparison was conducted. The result from the research on the use of the clinical diagnoses in inpatient and outpatient care has shown a gradually increasing tendency. From the pre-post comparison of EMR discharge summary diagnoses, the result demonstrated that the diagnosis was stated correctly and in detail. Since the diagnosis was stated correctly, code classification became correct as well, which makes it possible to construct high quality medical DB. Conclusion : This construction of clinical diagnoses provides the medical team with high quality medical information. It is also expected to increase the accuracy and efficiency of service in the department of medical record and department of insurance investigation. In the future, if hospitals wish to construct a classification of clinical diagnosis and a standard proposal of clinical diagnosis is presented by a medical society, the standardization of diagnosis seems to be possible.
Purpose: Nurses play an important role in ensuring patient rehabilitation and are involved in all aspects of multidimensional rehabilitation. Therefore, strengthening rehabilitation nursing education is vital to ascertain high-quality rehabilitation and optimum outcomes. This study examined the effectiveness of a new teaching reform-a modified Six-Sigma-based training program-against a conventional educational program on rehabilitation specialist nurses' core competencies, post-training performance, and satisfaction. Methods: A quasi-randomized controlled trial was conducted to assess the effectiveness of the modified training program. We recruited 56 learners from the 2020 training course at the Hunan Rehabilitation Specialist Nurse Training Base as the control group. Sixty learners from the base's 2021 training course were recruited as the intervention group. Data were collected in a consistent manner from both groups after the training program was implemented. Results: Those who underwent the modified training program showed better improvement in all core competencies than those who underwent the conventional training program (p < .05); the scores for theoretical knowledge, clinical nursing lectures, reviews, and nursing case management improved significantly following the teaching reform (p < 0.05). Further, overall satisfaction as well as base management and theoretical teaching satisfaction improved significantly (p < .05). Conclusion: The modified training program strengthens rehabilitation nurses' base management abilities; enhances their core competencies; expands their interest in and breadth, depth, and practicability of theoretical courses; and updates the teaching methods.
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