• Title/Summary/Keyword: Quality of Hospital Services

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Integrated medical treatment experience of cancer patients -grounded theory around- (암환자의 통합의학 치료경험 - 근거이론을 중심으로 -)

  • Moon, Joon Seok;Shin, Heon Tae
    • Journal of Society of Preventive Korean Medicine
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    • v.21 no.1
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    • pp.107-119
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    • 2017
  • Purpose : Recently, cancer has become a chronic disease that requires supervision because of early diagnosis and the development of therapeutic technology. As a result, cancer patients are interested in improving the quality of their lives besides the treatment of cancer itself. Therefore, it is necessary to conduct a qualitative research to understand the vivid experiences of cancer patients and structure their treatment experience. Among qualitative researches, grounded theory is developed based on the data collected in the field. The grounded theory research method is easy to analyze for the process and structure of the treatment experience. Therefore, the purpose of this study is to provide basic data on the integrated medical experience of cancer patients Methods : Participants were conveniently selected, and the criteria for selection were for those who had more than 1 month of hospitalization so that they could dictate their situation and experience in a meaningful manner. Data was collected through in-depth interviews and continued until the data were saturated through theoretical sensitivity and continuous comparison methods. The collected data were analyzed through the process of open-coding, axial coding, and selection coding, which are the research methods of grounded theory. Results : Cancer patients differ in their path, purpose, and attitudes depending on their respective situations and the internal and external resources of individuals. There is also a difference in the perception of their situation among the cancer patients and their families. Cancer patients were shown to recognize and cope with problems in the integrated medical treatment process, and have been classified into 6 different types after the results. Cancer patients showed positive changes in terms of physical, emotional, and lifestyle after their integrated medical treatment. Cancer patients perceived the integrated medical treatment process as a horizontal relationship structure and with diversity. Conclusions : The experience of integrated medical treatment of cancer patients is a process of rehabilitation that heals the body and restores life within the interaction of support system, contextual situation, and internal resources of the individual. Despite this, there is a need not only for the efforts of integrated medical service providers but also institutional support in the future with regards to the current weaknesses and points for improvement. In addition, there is a need for an objective criterion to measure the outcome of integrated medicine for the standardization of integrated medical services.

A study on the measurement and processing of medical service experience data - From the perspective of realizing patient-centeredness - (의료서비스 경험데이터의 측정 및 가공에 관한 연구 -환자중심성 실현 관점에서-)

  • Jinho, Ahn;Jungmin, Choi
    • Journal of Service Research and Studies
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    • v.13 no.3
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    • pp.147-159
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    • 2023
  • This study is a study to develop a model for measurement and processing of experience data, which is emerging as a core value in quality management of medical services. In the theoretical background, a literature study was conducted on the importance of experience in medical service, measurement and processing of experience data, and realization of patient-centeredness. Based on these literature and theoretical background research results, operational definitions were performed for the following four research variables, and statistical tests were conducted. Hypothesis 1 is the effect of measuring experience data from the perspective of three factors on persona modeling, Hypothesis 2 is the effect of persona modeling on service blueprint visualization, Hypothesis 3 is the effect of service blueprint visualization on realization of patient-centeredness, and Hypothesis 4 is persona modeling This is the effect that modeling has on the realization of patient-centeredness. After data-based testing of factor analysis, reliability analysis, and correlation analysis, all four hypotheses were adopted as a result of verification using regression analysis. In conclusion, in an era where it is difficult to recognize the value of having only good medical staff and medical equipment in hospitals, it was possible to grasp the meaning that what kind of medical service experience is continuously obtained is more important to patients than the effectiveness of medical staff and medical equipment. In the era of the service economy, the core of hospital service competitiveness is providing attractive experiences, which is the real strength of hospitals, so the measurement and processing of experience data, which is the subject of this study, will have an important meaning in realizing patient-centeredness and realizing smart hospitals.

Needs of Preoperative Blood Sample Test in Surgical Extraction: Suggestion of New Policy (치아 외과적 발거 전 혈액검사의 필요성과 이의 정책적 제시)

  • Seo, Mi Hyun;Kim, Soung Min;Oh, Jin Sil;Myoung, Hoon;Lee, Jong Ho
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.34 no.5
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    • pp.332-336
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    • 2012
  • Purpose: The third molar extraction is one of the mostly performed procedures in the department of oral and maxillofacial surgery. In most of dental clinic or hospital, the third molar extraction used to be frequently performed in an office-based surgery, and most patients did not have specific medical history with young ages. Medical history taking are dependent on the only way by asking to the patients about their individual conditions. Therefore, as the specialists of the oral and maxillofacial surgery in the field of dentistry, we suggest a new policy that the preoperative lab must be performed routinely before extraction of the third molar. Methods: This study is based on 1,096 patients who have been managed with third molar extractions, from March 2008 to September 2011 by a single surgeon. The preoperative lab, including complete blood count, coagulation panel, chemistry and serology, was performed before any surgical procedures. The results were informed to the patients regardless of their abnormalities, and any abnormalities related to the surgical procedures, such as platelet count and coagulation factors, were checked and corrected safely. Results: Through the preoperative blood test, systemic diseases that the patients had not recognized before, such as anemia, leukopenia, fatty liver and chronic renal disease, were identified. Patients with acute or chronic leukemia, Hepatitis B, and HIV positive, were also detected as a small number. Also, the possibilities of the cross-infection between dentists and patients or between patients and patients, and any other emergency situations can be prevented; as well as the public health condition can be improved, too. The patients were satisfied with low cost preventive blood test and high quality of medical services. Conclusion: Therefore, routine medical lab testing, including history taking are needed before an office-based minor surgery, such as third molar extractions, and these results were suggested as a new policy in the field of dentistry.

Hospice Medicine and Nursing Ethics (호스피스의료와 간호윤리)

  • Moon, Seong-Jea
    • The Korean Society of Law and Medicine
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    • v.9 no.1
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    • pp.385-411
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    • 2008
  • The goal of medicine is to contribute to promoting national health by preventing diseases and providing treatment. The scope of modern medicine isn't merely confined to disease testing, treatment and prevention in accordance to that, and making experiments by using the human body is widespread. The advance in modern medicine has made a great contribution to valuing human dignity and actualizing a manly life, but there is a problem that has still nagged modern medicine: treatment and healing for terminal patients including cancer patients. In advanced countries, pain care and hospice medicine are already universal. Offering a helping hand for terminal patients to lead a less painful and more manly life from diverse angles instead of merely focusing on treatment is called the very hospice medicine. That is a comprehensive package of medical services to take care of death-facing terminal patients and their families with affection. That is providing physical, mental and social support for the patients to pass away in peace after living a dignified and decent life, and that is comforting their bereaved families. The National Hospice Organization of the United States provides terminal patients and their families with sustained hospital care and home care in a move to lend assistance to them. In our country, however, tertiary medical institutions simply provide medical care for terminal patients to extend their lives, and there are few institutional efforts to help them. Hospice medicine is offered mostly in our country by non- professionals including doctors, nurses, social workers, pastors or physical therapists. Terminal patients' needs cannot be satisfied in the same manner as those of other patients, and it's needed to take a different approach to their treatment as well. Nevertheless, the focus of medical care is still placed on treatment only, which should be taken seriously. Ministry for Health, Welfare & Family Affairs and Health Insurance Review & Assessment Service held a public hearing on May 21, 2008, on the cost of hospice care, quality control and demonstration project to gather extensive opinions from the academic community, experts and consumer groups to draw up plans about manpower supply, facilities and demonstration project, but the institutions are not going to work on hospice education, securement of facilities and relevant legislation. In 2002, Ministry for Health, Welfare & Family Affairs made an official announcement to introduce a hospice nurse system to nurture nurse specialists in this area. That ministry legislated for the qualifications of advanced nurse practitioner and a hospice nurse system(Article 24 and 2 in Enforcement Regulations for the Medical Law), but few specific plans are under way to carry out the regulations. It's well known that the medical law defines a nurse as a professional health care worker, and there is a move to draw a line between the responsibilities of doctors and those of nurses in association with medical errors. Specifically, the roles of professional hospice are increasingly expected to be accentuated in conjunction with treatment for terminal patients, and it seems that delving into possible problems with the job performance of nurses and coming up with workable countermeasures are what scholars of conscience should do in an effort to contribute to the development of medicine and the realization of a dignified and manly life.

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A Study on Utilization of non-residential areal in Operation patient (수술환자의 타지역 의료이용에 관한 연구)

  • Nam, Moon-Hee;Kim, Sung-Soo;Park, Il-Su;Kang, Sung-Hong;Kim, Won-Joong;Choi, Soon-Ho;Jo, Hye-Kyung;Kim, Young-Taek;Hong, Sung-Ok
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.11 no.6
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    • pp.2078-2087
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    • 2010
  • This study conducted a chi-square test and a logistic regression analysis by not only using a investigation data of discharged patients with damages from 2004 to 2006, but also using a census and a research data on the actual condition from health care system. The result follows; First, the centralization of medical utilization of operation patients is becoming apparent, centrally the capital area. To improve this, a policy that can not only provide medical centers and sickbed, but also improve the quality of local medical treatments for the localization of medical treatments. Second, propelling localization policy of certain diseases for the localization of medical utilization is needed as the rate of non-residential of operation patients that have diseases of the eye and adnexa, or cancers is high. Third, a localization policy for patients with damages is needed as the rate of treatments in other regions of operation patients with industrial accidents is increasing day by day.

The relationship between the professional self-concept of dental hygiene and organizational socialization (치과위생사의 전문직 자아개념과 조직사회화의 관련성)

  • Kim, Young-Sun;Cho, Myung-Sook;Lee, Jung-Hwa
    • Journal of Korean Dental Hygiene Science
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    • v.4 no.2
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    • pp.9-18
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    • 2021
  • Background: Based on the individualistic approach of experienced dental hygienists, this study attempted to provide basic data to find effective measures of human resource management by analyzing the correlation between organizational socialization and professional self-concept. Methods: Dental hygienists currently working in the Daegu area were evaluated. Nine questions related to duties, twenty-seven questions related to professional self-concept, and thirty-eight questions related to organizational socialization were included in the study. The reliability was professional self-concept (Cronbach's α = 0.859) and organizational socialization (Cronbach's α = 0.840). Results: Of the total 135 points for professional self-concept, the mean score of the participants was 62.67±8.45 points. In the sub-area, flexibility was the highest at 19.28±2.46 points, and communication was the lowest at 9.69±1.44 points. Of 190 points, organizational socialization averaged at 123.40±12.82 points. In the subarea, personal characteristics were the highest at 30.37±3.71 points, and occupational identity was the lowest at 10.34±1.94. Higher age (F=30.89, p<0.000), marital status (F=10.22, p<0.002), graduate or higher educational qualification (F=9.16, p<0.000), were associated with a higher position (F=20.62, p<0.000) and work experience (F=22.66, p<0.0000), when there was no intention to turnover (F=8.05, p<0.000). Organizational socialization was higher in participants with higher age (F=7.89, p<0.000), educational qualification (F=8.02, p<0.000), and position (F=5.12, p<0.007); higher work experience in general hospital (F=4.50, p<0.012); no intention to turnover (F=7.450, p<0.000); and no intention to turnover (F=24.46, p<0.000). Organizational socialization showed a significant positive correlation with professional self-concept (r=0.721, p<0.000); job performance and skills (r=0.615, p<0.000) and organizational commitment and satisfaction (r=0.610, p<0.000) showed a high positive correlation. Turnover intention (β=0.213, p<0.000) was found to have a significant effect on organizational socialization. Leadership (β=0.168, p<0.05) and satisfaction (β=0.483, p<0.000) were found to have a significant effect. The total explanatory power of this variable was 62.7%. Conclusion: To ensure successful organizational socialization, human resource management should be performed through regular verification, which can result in improved quality of dental care services.

A Context-Aware Treatment Guidance System (상황인지를 이용한 진료 안내 시스템)

  • Jung, Hwa Young;Park, Jae Wook;Lee, Yong Kyu
    • Journal of the Korea Society of Computer and Information
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    • v.19 no.1
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    • pp.141-148
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    • 2014
  • As the quality of the medical treatment service provided by large hospitals grow, the number of patients utilizing the facilities is increasing dramatically. Various studies such as order communication system and treatment guidance system are under their process in order to shorten the waiting time for patients. However, the existing methods assign the treatments in successive order without recognizing the situation of each treatment, therefore increasing a patient's standby time at a hospital. This paper proposes a context-aware treatment guidance system, which recognizes the previously undermined estimated waiting time of each treatment for a patient and recommends a treatment with shorter estimated sojourn time first. This context-aware treatment guidance system provides detailed information of treatment services based on the recommended order of treatments to a patient's smartphone. By utilizing the context-aware treatment guidance system introduced in this paper, patients can reduce their standby time at hospitals to the minimum while hospitals can efficiently service more patients at the same amount of time. The proposed context-aware treatment guidance system proves to be outstanding in treatment order recommendation through comparisons to previously used methods.

Influencing Factors the Psychological Well-being of Psychiatric Nurse (정신과 간호사의 심리적 안녕감 영향 요인)

  • Choi, Jae Eun;Bae, Jeong Yee
    • Journal of Naturopathy
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    • v.11 no.2
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    • pp.85-92
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    • 2022
  • Background: Research is necessary to enhance the mental health of psychiatric unit nurses and the quality of nurse services. Purpose: This study was to obtain primary data for enhancing the psychological well-being of psychiatric nurses by investigating the factors that affect them. Methods: This study was conducted as a descriptive research study. The study period was from February 18 to March 31, 2019, with the subjects being 150 psychiatric nurses working in the ward of a psychiatric hospital in Gyeongnam. We used questionnaires on job stress measurement, the Korean version of the interpersonal response index, resilience scale, and psychological well-being. The collected data were analyzed using the SPSS program. Results: The subjects' levels of the job stress, empathy, resilience, and psychological well-being ranged from 2.34 to 3.33 points. The level of recovery resilience and well-being according to the subject's characteristics is 40 years or older, married, religious, ten years of nurse experience, above average economic level, psychiatric qualifications, senior nurse or higher, resilience education. All participants were significantly (p < .001). Conclusions: In this study, psychological well-being increased as the job stress was low and empathy and resilience were high. Therefore, it should make a proper education program to improve the strength and well-being of psychiatric nurses.

Institutionalization of a Patient-Sitter Program in Acute Care Hospitals (보호자 없는 병원 제도화 방안)

  • You, Sun-Ju;Choi, Yun-Kyoung
    • The Journal of the Korea Contents Association
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    • v.13 no.6
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    • pp.370-379
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    • 2013
  • In an effort to resolve the burden of patients hiring patient sitters, this study sought to review the Ministry-of-Health-and-Welfare-initiated pilot program of running hospitals without patient-sitter to identify its background, operation method, performance results, and limitations. Based on the review, the study derived the necessity of introducing a hospital system without patient-sitter as well as its operation and systemization methods. The ministry-initiated pilot programs were conducted twice: in 2007, and in 2010. A review of the 2007 pilot program revealed that the patients and families' satisfaction score with nursing services was 9.1 points (on a 10-point scale), their intention to reuse the service was 97.8%, and their intention to recommend the service was 98.0%, all high scores. Appropriate nursing manpower, derived from the 2007 pilot project, indicated 2.3 patients per nurse and 4.0 patients per nurse aid. The 2010 pilot project results indicated that the patients and families' satisfaction was high at 8.0-9.1 points (on a 10-point scale), and that the intention to reuse and recommend the service was also high. Compared with the 2007 pilot project, however, the types of medical institutions and the nurse to patient ratios were diverse, offering limitations. In conclusion, to systemize hospitals without patient-sitter, it is necessary to develop policies designed to establish criteria for the appropriate nurse to patient ratio and skill-mix, to standardize the work, to prepare finances for securing nursing staff, to evaluate the nursing demands, and to monitor the quality management.

Economic evaluation of a weekly administration of a sustained-release injection of recombinant human growth hormone for the treatment of children with growth hormone deficiency (소아 성장호르몬결핍증 치료에 사용되는 성장호르몬 서방형 주사제의 경제성 평가)

  • Kang, Hye-Young;Kim, Duk Hee;Yang, Sei-Won;Kim, Yoon-Nam;Kim, Miseon
    • Clinical and Experimental Pediatrics
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    • v.52 no.11
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    • pp.1249-1259
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    • 2009
  • Purpose:From a societal perspective, we evaluated the cost-effectiveness of a novel sustained-release injection of recombinant human growth hormone (GH) administered on a weekly basis compared with that of the present daily GH injection for the treatment of children with GH deficiency. Methods:Health-related utility for GH therapy was measured based on the visual analogue scale. During July 2008, caregivers of 149 children receiving GH therapy form 2 study sites participated in a web-based questionnaire survey. The survey required the caregivers to rate their current subjective utility with daily GH injections or expected utility of weekly GH injections. Because there was no difference in the costs of the daily and weekly therapies, for the purposes of this study, only drug acquisition costs were considered. Results:Switching from daily to weekly injection of GH increased the utility from 0.584 to 0.784 and incurred an extra cost of 4,060,811 Korean won (KW) per year. The incremental cost-utility ratio (ICUR) for a base case was 20,305,055 KW per quality-adjusted life year (QALY) gained. Scenario analyses showed that the ICUR ranged from 15,751,198 to 25,489,929 KW per QALY. Conclusion:The ICUR for a base case and worst case scenario analyses ranged from 0.85 to 1.37-times per capita gross domestic product of Korea, which is considered to be within the generally accepted willingness-to-pay threshold. Thus, it is concluded that switching from daily to weekly injection of GH would be cost-effective.