• Title/Summary/Keyword: Quality of Hospital Services

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Model Development a Womens' Health Care Center in the Community (여성건강 간호센터를 위한 모형개발 - 일개 통합시를 중심으로-)

  • Lee, Eun-Hui;So, Ae-Yeong;Choe, Sang-Sun
    • Journal of Korean Academy of Nursing
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    • v.30 no.5
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    • pp.1195-1206
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    • 2000
  • The purpose of this study was to analyze womens' health problems using Green & Kreuter's 1991 PRECEDE model and to develop a model for a womens' health care center located in the community. The subjects were recruited from Wonju City. 1. The results showed that 23% of the sample population felt there was a need for a womens' health care center. The mean number of health problems was 3.1. The prevalence rate, was 44.4%, and the rate for an artificial abortion, was 36.4%. Also 30.5% did not have a health examination in the past year. Women using the hospital for medical care accounted for 45% of the sample, while 40% used the drugstore. The average score on the HPLP was 2.41, and this was influenced by self-efficacy, family support, sexual role, and health locus of control. There are a few educational programs in the city provided by the Wonju Health Center and by community health nurse practitioners. 2. The nursing center, as defined in North America, is a nurse-anchored system of primary health care delivery or neighborhood health center. Centers offer various services ranging from primary care to the more traditional such as education, health promotion, wellness screening, and coordination of services by advanced practice nurses. For examples in Sweden MCH centers provide total services for childbearing women and their families, sexual counseling and education for adolescents, and screening by midwives for cervical cancer. 3. The developed model combines purpose, target population, organization, and services, and is related to health resources. The purpose is primary health care and promotion of the quality of life. The target population can be grouped according to the life cycle, (premarriaged age group, the childbearing/child rearing age group, and middle aged and elderly women) and focuses on self-help. The organization of the center includes an advisory committee to plan and evaluate, and a health services team that will be multidisciplinary to provide health care, counseling education, and research. The model development suggested that a variety of women's health care centers are needed to insure adequate management of women's health. Follow-up research using PROCEED is needed to analyze health outcomes. Also a health nursing specialist system is required to develop health promotion, and improve the quality of life of women.

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Through a selection factor analysis of the local healthcare institutions Building complex medical services strategy (지방의료원의 선택요인분석을 통한 복합적인 의료서비스 전략 구축)

  • Lee, Jin-Woo;Ahn, Sang-Yoon;Lee, Chong Hyung;Lee, Moo-Sik;Kim, Kwang-Hwan
    • Journal of Digital Convergence
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    • v.13 no.5
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    • pp.297-307
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    • 2015
  • This study reviews equipped with enhanced capability of medical care, quality service, accessibility, and consumer awareness to be a competitive and representative local healthcare service provider with improved administrative efficiency. The method of analysis are ANOVA and Structural Equation Modeling. The results which revealed the significant difference among demographic factors in determining the preference or degree of satisfaction at medical service to select local healthcare institutions suggest that the close review on the needs of groups of major customers of local healthcare institutions are necessary when preparing the strategy of specialized medical service of local healthcare institutions. this suggests that both images would be important factors to secure the competitive advantage of local healthcare institution and therefore the strategy maximized the enhancement of medical service with embossed image of hospital to attract customers of medical service is needed.

Development of Competencies for New Nurses and Verification of Content Validity through a Delphi Survey (델파이조사를 통한 신규간호사 역량 도출 및 내용타당도 검증)

  • Hanna Jung;Yoonjung Lee;Jung Yeon Kim;Minjin Lee;Soo Young Han;Yumie Rhee;Shinki An;Phill Ja Kim
    • Korean Medical Education Review
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    • v.25 no.2
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    • pp.159-173
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    • 2023
  • The purpose of this study was to develop and validate a competency tool for new nurses and to pilot-test it with new nurses. A Delphi survey was conducted to develop a competency tool, and a self-evaluation was conducted among new nurses who pilot-tested the finally derived competencies. The Delphi survey panel consisted of 18 people, including adjunct professors at the College of Nursing, nursing managers, and nurses with master's degrees. The Delphi survey asked about the validity of the competencies constructed in two rounds. After analyzing the Delphi results with mean, standard deviation, content validity ratio, degrees of convergence, and degrees of consensus, 12 core competencies and 36 enabling competencies were finally derived. The competencies consisted of clinical judgment and management (nine items), task competence (four items), patient orientation (five items), moral value orientation (three items), cooperation (two items), supply management (two items), professional development (three items), confidence (one item), self-control (two items), flexibility (two items), influence (one item), and nurturing others (two items). The finally derived competencies were pilot-tested with 229 new nurses who had worked for 2-12 months. The self-evaluation scores of new nurses were distributed differently according to their working period. In this study, the competencies required for new nurses were identified and the corresponding enabling competencies were identified. In the future, it is expected that a competency-based education program will be prepared based on these findings, and furthermore, it will be possible to provide high-quality medical and nursing services that meet patients' needs by improving the competency of new nurses and lowering the turnover rate.

The Indepth Analysis of Plate Waste for DM Diet Served in General Hospital (종합병원 환자 당뇨식의 찬반에 대한 심층적 분석)

  • 양일선;이해영;김정려;차지아
    • Journal of Nutrition and Health
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    • v.35 no.3
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    • pp.394-401
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    • 2002
  • The purpose of this study was to : (a) examine diabetic patients' sensory evaluation and food preferences, (b) analyze the portion sizes & plate wastes, (c) investigate the factors affecting plate wastes, and (d) determine the nutritional & mometary values of the plate wastes. A questionnaire for determining food preference and sensory evaluation was developed. Thirty-three diabetic patients who were hospitalized in Sanggye Paik hospital in Seoul were studied. Serving sizes and plate wastes were weighed by using an electric scale, and the CAN-Pro program was used to evaluate the nutritional value or the food consumed. The data were analyzed using the SAS package program for descriptive analysis, t-test, ANOVA, and the Pearson correlation. Using a five-point Likeu-type scale, the temperature s[ore ranged from 3.1 to 3.3 (1 : very poor, 5 : excellent), the preference store was 3.0-3.2 (1 : very dislike, 5:very like), the taste score was 2.9-3.2 (1 : very poor, 5 : excellent), and the amount of food served score was 2.8-3.0 (1 : too little, 5 : too much). Serving sizes were considered insufficient by patients because most of the DM diet was low in calories. Average plate waste for the DM diet was 26.2% of the total served, by weight, and was lower than that for patients consuming a normal diet, which was 30.3%, found in previous research. Those subjects who had been previously hospitalized and who wished to participate in a campaign for food waste reduction produced less plate waste than other groups (p<.05). Plate wastes of the DM diet were negatively correlated with taste, temperature, and preference, and were positively correlated with the amount served: however, these results were not statistically significant. It was found that diabetic patients consumed adequate levels of energy, protein, Ca, Fe, Vitamin B$_1$, Vitamin B$_2$, and niacin, but inadequate levels of Phosphorus, Vitamin A and Vitamin C. The plate wastes were calculated to be 26.2% of the total cost (₩ 3,489), which is ₩9l5. This represents a significant wastage of resources from the hospital. The results of this study could assist foodservice managers in both controlling food wastage, and improving the quality of hospital food services.

A Study on the Hospital Worker's Security Stress (국내 병원 종사자들의 보안스트레스에 관한 연구)

  • Hyun, Seung Hoon;Lee, Chang-Moo
    • Convergence Security Journal
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    • v.16 no.7
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    • pp.41-49
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    • 2016
  • The need for protecting computerized medical information has been growing as information and communication technology has rapidly been developed. Government is also promoting institutional improvement measures for the information protection of medical institutions. With more emphasis upon the efforts to enhance the information protection capability of the medical institution, however, it could increase stress to the hospital workers and cause a reduction in the quality of essential medical services of medical institutions. Therefore, it is necessary to research the stress from hospital workers to strengthen the protection of information that medical institutions to manage and its antecedents. Based on the results of relevant researches, this study selected several factors that affect the security stress, including work overload, invasion of privacy and work uncertainty. The sample for this study was 123 hospital workers who were surveyed by questionnaire. The factor analysis and multiple regression method were employed for the analysis of this study. The results of this study showed that work overload, invasion of privacy and some of work uncertainty were the main factors positively influencing the security stress.

A Study on Utilization of non-residential areal hospitals in Inpatient (입원의료의 타 지역 이용에 관한 연구)

  • Kim, Yoo-Mi;Kang, Sung-Hong
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.10 no.11
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    • pp.3444-3450
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    • 2009
  • Our study was carried out to suggest the way of improving the accessibility of medical service through identifying the factors that make patients be hospitalized in non-residential area not in their residential area. The subjects were 523,782 inpatients of the 2005 Patient Survey data. The 2004 Hospital Evaluation data, the 2005 census data which were obtained from the Korean National Statistics Office, and the 2006 Survey on National Healthcare Resources data were used. The data were analyzed using descriptive statistics, chi-square test and logistic regression in a SAS program. The most important factor was quality level of care of local hospitals. In the possibility of being hospitalized in non-residential areas, the region with the score of more than 9.5 per 100,000 people in the hospital evaluation was 8.3 times more than the region with the score of less than 9.5. However patients is hospitalized in the area with the hospitals with above 910 beds per 100,000 people more than in the area with the hospitals with less than 910 beds by 2.0 times. For the accessibility of medical services, government policy should focus on improving the quality of care in local hospitals not on increasing and distributing health care resources.

Behavior Patterns of Health Care Utilization in Terminal Cancer Patients (말기암 환자들의 의료이용행태)

  • Han, Tae-Hyung;Cho, Byung-Jin;Shin, Baek-Hyo
    • The Korean Journal of Pain
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    • v.12 no.1
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    • pp.101-107
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    • 1999
  • Background : In order to improve the quality of life of dying patients, they need to receive not only the physical, psychological, social, and spiritual care, but also systematic and continuous care to die with dignity. However, no adequate medical services are available for these terminal cancer patients. We studied their behavior patterns of health care utilization to understand more of their medical and social needs. Methods : We investigated 108 bereaved families through the telephone interview with structured questionnaires. They were randomly selected through the retrospective chart review of the terminal patients who passed away due to cancer. Results : Most of the terminal cancer patients received their care from proper medical services including admission to hospital (45.4%), outpatient clinic (22.2%), emergency room (16.7%), and oriental medicine (12.0%). But during the terminal phase of their illness, 32.4% of patients never received medical care including oriental medicine, and 28.7% received alterative natural care. 26 bereaved families (24.1%) pointed out the indifference of medical staff as a problem receiving proper hospital care, and 22 (20.4%) emphasized emotional strain of their helplessness with the patients' suffering as a problem of caring at home. Over 90% suggested availability of continuous care, hospice care, home care, and 24 hour telephone service to be improved. Conclusions : Due to various reasons, adequate medical care is not delivered to the terminal cancer patients in our present medical system. These problems can be approached with the establishment of proper education and medical delivery system. The role of comprehensive medical specialty cannot be overly emphasized to accomplish this most effectively.

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The Impact on the accuracy of the basic CPR according to position and foot-board height of the basic CPR provider (심폐소생술 제공자의 발판 높이와 자세가 기본심폐소생술의 정확도에 미치는 영향)

  • Choi, Eun-Sook;Cho, Keun-Ja
    • The Korean Journal of Emergency Medical Services
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    • v.12 no.3
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    • pp.27-41
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    • 2008
  • Purpose : The purpose of this study was to supply basic data for the impact on the accuracy of basic CPR according to position and foot-board height of basic CPR provider. Methods : Study design was within - group design. Subjects were 25 EMT-P Students in K city. Interventions was basic CPR performed on a resuscitation manikin placed on a hospital bed, kneeling on the bed adjacent to the manikin. Data was analyzed using descriptive statistics and Friedman test. Results : In case of the basic CPR performed on a resuscitation manikin placed on a hospital bed, ventilation accuracy was the highest in less than 160 cm height, foot-board height : $34.2{\pm}1.48cm$, 91.4% and in 161-165 cm height, foot-board height : $26.0{\pm}2.14cm$, 88.4% and in 171-175 cm height, foot-board height : $23.0{\pm}1.41cm$, 91.3% and in the above 176 cm, kneeling on the bed, 95%. Chest compression accuracy was the highest in less than 160 cm height, foot-board height : $30.2{\pm}1.48cm$, 95.6% and in 161-165 cm height, kneeling on the bed, 97.6% and in 171-175 cm height, kneeling on the bed, 98.5% and in the above 176 cm, kneeling on the bed, 98.7% and foot-board height : $20.5{\pm}1.91cm$, 98.7%. Chest compression error was due to too weak : 2.0-35.4 times. There were ststistically significant differences in 191-195 cm group according to chest compression mean depths($x^2=10.824$, p = .013) and chest compression error (p = .040). Conclusion : In contrast to current guidelines, the position and foot-board height of basic CPR provider are very important to the accuracy of the basic CPR. Furthermore, we recommend that a using real time audiovisual feedaback system significantly improve the quality of chest compression and ventilation during resuscitation.

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Differences between Diabetic Patients' Tertiary Hospital and Non-tertiary Hospital Utilization According to Comorbidity Score (당뇨병 환자의 동반상병 점수에 따른 상급종합병원 이용 차이)

  • Cho, Su-Jin;Chung, Seol-Hee;Oh, Ju-Yeon
    • Health Policy and Management
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    • v.21 no.4
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    • pp.527-540
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    • 2011
  • Some patients tend to visit tertiary hospitals instead of non-tertiary hospitals for minor illnesses, which is a chronic problem within the Korean health care delivery system. In order to reduce the number of patients with minor severity diseases unnecessarily utilizing the tertiary medical services in Korea, the Ministry of Health and Welfare raised the outpatient co-insurance rate for the tertiary hospitals in July, 2009. Another increase in the prescription drug co-insurance rate by the general and tertiary hospitals is scheduled to take place in the second half of 2011. An increase in copayments may discourage the utilization rate of medical services among the underprivileged or patients who require complicated procedures. This study aims to analyze the diabetic patients' utilization rates of tertiary hospitals according to the Comorbidity score. Diabetic patients' data was gathered from the Health Insurance Claims Records in the Health Insurance Review & Assessment Service between 2007-2009. Comorbidity scores are measured by the Charlson Comorbidity Index and the Elixhauser Index. Chi-square and logistic regressions were performed to compare the utilization rates of both insulin-dependents (n=94,026) and non-insulin-dependents (n=1,424,736) in tertiary hospitals. The higher Comorbidity outcomes in the insulin-dependent diabetic patients who didn't visit tertiary hospitals compared to those who did, was expected. However, after adjusting the gender, age, location, first visits and complications, the groups that scored >=1 on the comorbidity scale utilized the tertiary hospitals more than the O score group. Non-insulin-diabetic patients with higher Comorbidity scores visited tertiary hospitals more than patients who received lower grades. This study found that patients suffering from severe diabetes tend to frequently visit the tertiary hospitals in Korea. This result implied that it is important for Korea to improve the quality of its primary health care as well as to consider a co-insurance rate increase.

Study on image quality and dosage comparison of F/S system and DR system (F/S시스템과 DR시스템의 화질과 피폭선량 비교에 관한 검토)

  • Kim, Sun-Chil;Jung, Jae-Eun
    • Journal of radiological science and technology
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    • v.26 no.3
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    • pp.7-11
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    • 2003
  • Currently, many hospitals are hastening to introduce digital radiography systems. This is a direct result of the intentions to improve medical services and to digitalize radiology information systems, and is also leading to the improvement of medical imaging technology. Throughout F/S system's long history, many people have researched the image quality and dosage concerning these systems, and as a result, huge improvements in the dosage of patients were possible. Similarly, I believe that DR systems need the same kind of effort. Of course, decreases in dosage that ignore image quality are unthinkable. The results of experiments conducted by five hospitals during a period of 3 months brought to us the conclusions listed below. 1. Based on the comparison and analysis of the exposure control of F/S systems and DR systems, DR systems generally showed higher exposure control for parts of the phantom that became thicker, and the exposure control improved rapidly as the thickness increased. 2. DR systems still proved to be somewhat deficient in resolution measurements compared to existing F/S systems. The image processing part of DR systems contributed much to these result. 3. Under conditions used clinically, the dosage measurements of DR systems were generally higher regardless of region. 4. According to the evaluation of image quality, DR systems showed a higher degree of satisfaction as the thickness of the region became thinner. As mentioned above and based on the mutual relationship experiments between the dosage and image quality of F/S systems and DR systems, research to increase the satisfaction of DR systems must be considered.

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