• Clinical and Experimental Pediatrics
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• 제54권12호
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• pp.477-480
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• 2011

In order to care for an ill or injured child, it is crucial that every emergency department (ED) has a minimum set of personnel and resources because the majority of children are brought to the geographically nearest ED. In addition to adequate preparation for basic pediatric emergency care, a comprehensive, specialized healthcare system should be in place for a critically-ill or injured victim. Regionalization of healthcare means a system providing high-quality and cost-effective care for victims who present with alow frequency, but critical condition, such as multiple trauma or cardiac arrest. Within the pediatric field, neonatal intensive care and pediatric trauma care are good examples of regionalization. For successful regionalized pediatric emergency care, all aspects of a pediatric emergency system, from pre-hospital field to hospital care, should be categorized and coordinated. Efforts to set up the pediatric emergency care regionalization program based on a nationwide healthcare system are urgently needed in Korea.

• 가정간호학회지
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• 제15권2호
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• pp.82-90
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• 2008

Recent shortening of hospitalization has partly led to the transition of health care services from hospitals to communities in cardiovascular (CVD) care. Home healthcare nursing is an alternative modality of care for chronically ill CVD patients. Cardiac rehabilitation (CR) has been redefined as a "secondary prevention center", consisting of: patient assessment; nutritional counseling; blood pressure and diabetes management; tobacco cessation; psychosocial management; and physical activity counseling. Improvement in health-related quality of life (HRQOL) is a major goal of the CR that integrates physical, psychological and social dimensions of care. The review of evidence on effects of CR on HRQOL may allow home healthcare nurses to provide better comprehensive care for CVD patients. There is evidence on beneficial effects of CR on HRQOL in patients with myocardial infarction (MI) as well as patients with chronic heart failure. Specifically, home-based CR, which is more cost-effective than hospital-based CR, has been reported to produce comparable improvements in HRQOL with hospital-based CR in MI patients. In conclusion, a newly-designed, home-based CR may be required to be applied to Korean home healthcare nursing system for improving HRQOL.

• 농촌의학ㆍ지역보건
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• 제16권2호
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• pp.97-119
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• 1991

본 연구는 농촌지역의 보건의료수준이 의료자원의 양적, 질적 격차와 의료이용과 의료접근도 및 건강수준의 면 등에서 도시지역보다 낙후되어 있다는 사실을 각종 통계지표를 이용하여 논증하였다. 다음으로 이러한 격차를 빚은 농촌보건사업의 문제점을 파악하여 이에 대한 대처방안을 농촌보건사업의 조직, 인력, 시설 및 장비, 재원 및 그리고 관리라는 5가지 부문으로 나누어서 모색해 보았는데 구체적으로는 첫째, 농촌보건 인력의 자질향상과 적정배치방안의 수립, 둘째, 농촌보건인력의 생산성 증대, 셋째, 보건소 및 지소의 운영개선, 넷째, 취약지 민간병원의 운영 개선, 다섯째, 사회, 경제여건의 변화에 따른 새로운 보건사업의 개발, 여섯째, 통합적인 보건의료인력관리 전담기관의 설립 등의 정책대안을 제시하고 있다.

• 한국의료질향상학회지
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• 제5권1호
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• pp.28-40
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• 1998

Background : Many patients have been frequently complaining that they have to spend couples of hours in hospital on visiting outpatient clinic. Among several steps, two major time consuming steps were waiting to see a doctor and/or waiting at pharmacy to get medicine. Therefore not only to provide the proper guidance for medication or counseling on health affairs but also to make waiting time short is very important for the better hospital services. The aim of this study is to validate several time-saving processes to reduce waiting time at outpatient pharmacy and its efficacy. Methods : We surveyed the time interval actually taken to receive medicine after issuing prescription by doctors, and analyzed the data on the bases of relevant or possible causative factors. Then following processes were given to reduce waiting time and resurveyed and compared both data to validate efficacy of those processes : 1. No work-off on Monday and Tuesday 2. Work hour shift to start 30 minutes earlier 3. Changeable work shift between outpatient pharmacy and ward pharmacy according to work load 4. Use of pre-made medicines prescribed more frequently by certain doctors at certain time 5. Cooperation with doctors to use set prescriptions. Results : Before the process, mean waiting time at pharmacy was 29.2 minutes and most time consuming period was from noon to 1 PM, 3 to 4 PM, 1 to 2 PM in order of frequency. Only 37.7 % of patients could get the medicine within 20 minutes. Three times of surveys after process showed mean waiting time at pharmacy were 18.1 minutes, 19.0 minutes, and 17.6 minutes, respectively. And 72.7 %, 81.3%, and 82.2% of patients could get the medicine within 20 minutes. Conclusion : The mean waiting time was markedly reduced with above mentioned processes which applied intradepartmently event hough with little cooperation from other department. Consequently, the complaints of patients were decreased with increasing the satisfaction degree. In conclusion, those suggestions were recommanded to improve the degree of satisfaction of patients.

• 한국응급구조학회지
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• 제23권1호
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• pp.157-163
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• 2019

Purpose: Advanced airway maintenance improves the quality of cardiopulmonary resuscitation (CPR) for out-of-hospital cardiac arrest (OHCA) patients. In this study, we evaluate the factors associated with advanced airway management while performing CPR for out-of-hospital cardiac arrest patients by 119 emergency medical technicians (EMTs). Methods: The observational analysis method was used ro retrospectively collect data from 119 rescue run sheets. This study was conducted in a fire station in Seoul, Korea. The subjects of this study were defined as OHCA patients who received CPR from July 2016 to June 2018. We divided the subjects into two groups according to whether advanced airway maintenance was performed or not, and then compared and analyzed both groups. We performed logistic regression analyses for characteristics that differed significantly between groups. Results: Out of 188 OHCA patients, 146 (77.7%) had received advanced airway management. Statistically significant differences in the logistic analysis were found regarding the total number of EMT professionals (adjusted odds ration [aOR]: 1.955; 95% confidence interval [CI]: 1.227-3.115; p=0.005) and scene-time (aOR:1.119;95%CI:1.019-1.228;p=0.019). Conclusion: Advanced airway maintenance while performing CPR for OHCA patients by EMT associated primarily with ensuring an adequate numbers of EMT professionals and sufficient scene time.

• Journal of Preventive Medicine and Public Health
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• 제33권4호
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• pp.426-435
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• 2000

Objectives : To determine the relationships among quality, satisfaction, value and purchase intention in health care service. Methods : The data were gathered from out-patients who had used hospital services. They were asked to assess service quality, satisfaction, service value, and purchase intention. A total of 557 usable questionnaires were gathered. The data were analyzed using SAS version 6.12. The analysis methods employed in the study were confirmatory analysis and covariance structural analysis. Results : Service quality exhibited a significant and positive relationship with satisfaction, service value, and purchase intention. Furthermore, satisfaction had a significant and positive relationship with purchase intention. And finally, service value had a significant and positive relationship with both satisfaction and purchase intention. Based on these findings, it is evident that satisfaction was a mediator between service quality and purchase intention. Also service value played a mediating role between service quality and satisfaction. Conclusions : These results suggest that service quality is an antecedent of satisfaction and sonics value, and exerts a stronger influence on purchase intentions than satisfaction and service value do. Thus, managers may need to emphasize service quality in health care.

• 임상간호연구
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• 제18권3호
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• pp.329-340
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• 2012

Purpose: This study was done to identify internal marketing activity, emotional labor and work-family conflict that influence turn-over in hospital nurses. Methods: Participants were 513 nurses from 2 general hospitals in Chung-nam and Gyeonggi Provinces, South Korea. Data were collected from September 1 to 30, 2011 using self-report questionnaires. Stepwise multiple regression was used to identify association between variables. Results: The mean score for internal marketing activity was $94.7{\pm}14.7$, emotional labor, $31.4{\pm}5.5$, work-family conflict, $19.6{\pm}4.1$, and turn-over, $13.7{\pm}3.4$. After adjusting for general characteristics, stepwise multiple regression showed that work-family conflict (${\beta}=.20$, p<.001), marketing activity (${\beta}=-.21$, p<.001), and emotional labor (${\beta}=.22$, p<.001) were associated with turn-over. These predictors accounted for 33% of variance in turn-over. Conclusion: The results of this study show that work-family conflict was the most influential predictor indicating a need for the development of strategies to reduce work-family conflict and emotional labor. At the same time internal marketing activity should be supported in the hospital by analyzing the needs for nurses. Also career development programs and mentor systems will be useful for effective manpower management and quality improvement of nursing services.

• 한국식품위생안전성학회지
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• 제15권3호
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• pp.186-198
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• 2000

우리 나라의 학교급식, 병원급식, 및 위탁급식 등에서 위생관리의 수준을 알아보고 앞으로의 개선 및 발전 방안을 논의하였다. 앞으로 발전을 위한 10가지 방안으로서 이들 집단급식에서 (1)인력과 전문성 보강, (2) 건물과 시설의 전용화, (3)조리장 시설 설비의 보강, (4)주 ·부재료 공급 방법의 개선 및 품질관리, (5) 정확한 기계 ·설비류의 생산과 구비, (6)검사 장비와 설비의 보강, (7)개인위생관리의 여건 강화, (8)다양한 위생교육 및 훈련, (9)수입개방에 대한 능동적 대처, (10)관련 연구 및 background data의 축적 강화 등이 이루어져야 할 것으로 도출되었다. 식품 재료를 생산하여 먹기까지에는 여러 가지 단계를 거친다. 그 중에서 조리는 먹기 직전의 단계이다. 영양적으로 우수하고 위생적으로 안전한 재료를 취득하였다 하더라도 이 과정에서 취급이 잘못되면 대규모의 건강 위해를 야기할 수 있다 또 비록 재료가 안전하지 못하였다 하더라도 이 과정에서의 위생관리를 철저히 함으로써 그 위해를 상당히 줄일 수도 있다. 바로 이러한 측면에서 우리는 집단급식 시설의 위생관리가 얼마나 중요한 가를 다시 강조하지 않을 수 없다. 음식물에 의한 위해를 예방하고 위해 요소를 사전에 차단하기 위한 노력의 일환으로 세계적으로 식품위해요소중점관리기준(HACCP)의 도입이 활발하다. 우리 나라에서는 이를 식품제조 ·가공업소에 먼저 도입하였으나 급식 시설에서 시급히 적용하여 건강 위해를 최소화하여야 할 것으로 본다.

• 보건의료산업학회지
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• 제2권1호
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• pp.137-154
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• 2008

The increase of the supply of medical service and the increase of hospitals have intensified the competition of hospitals, and the advancement towards internationalization in the opening of medical industry has triggered the infinite competition of medical profession. In addition, the high expectation of customers and quality improvement in the medical care in accordance with the improvement of overall income, and the change of active role of medical consumers according to the popularization and the improvement of rights awareness reflect the customer needs and choice in the medical service. Customers wanted to receive the kind and pleasant service under the up-to-date medical service. Therefore, as a solution, hospital coordinators were emerged for the purpose of smooth treatment and customer satisfaction by generalizing all service of hospital. Accordingly, this thesis attempted to investigate the effect of hospital coordinator education curriculum on the education satisfaction and the quality of medical service. In order to solve the purpose of this study, I, author reviewed the existing literatures, established hypothesis, and verified hypothesis by using the variety of statistics techniques such as reliability, validity, frequency analysis, and regression analysis. The verification of hypothesis is as followings: First, among education training factors of hospital coordinators, the quality of instructor significantly affects the satisfaction of hospital coordinator education training. Second, among training factors of hospital coordinator, the attitude of trainee significantly affects the training satisfaction of hospital coordinator. Third, among education training factors of hospital coordinator, education course significantly affects the training satisfaction of hospital coordinator education. As the qualities of instructor are better equipped, the satisfaction of education becomes higher. It indicates that the education method of instructors is important as an index to represent the qualities of instructor such as the appropriateness of education method, preparation, passion, visual materials, the adequacy of education procession, and specialized knowledge, and it has important effect on the satisfaction of education. In order to enhance the satisfaction of hospital coordinator education, the creation of education environment, making trainee concentrate on the education, is required by appropriately allocating programs, arousing interest in education, based on the attitude of trainee, discussion, and preliminary programs, preparation, ahead of enforcement of education. Fourth, the satisfaction of hospital coordinator education training significantly affects the reliability among the qualities of medical service. Fifth, satisfaction of hospital coordinator education training significantly affects hospitality I kindness among the qualities of medical service. If the education satisfaction of trainee is high, it is effective in the practical application such as dealing with complaints, the duty performance for the patients, and so on in offering the medical service, related to reliability and furthermore, we can find the positive change in the attitude change of medical professions related to the reliability of hospital coordinator. In addition, in the process of offering medical services such as the kind explanation on the duty, rapid response to the customers inquiry, and tidy uniform, practical effect was verified. Sixth, the education training factor of hospital coordinator significantly affects the reliability among the quality of medical service. Seventh, the education training factors of hospital coordinator significantly affect hospitality/kindness. In the education of hospital coordinator, the methods to attract the interest of trainee by emphasizing reliability should be sought and for gaining the practical effect of hospital coordinator education, the sufficient preparation and investigation on the education curriculum should be prerequisite and under this condition, intensified discussion on the instructor and education course is needed. In the design of education course, more education hours and subjects should be allocated in the part of hospitality in order to improve the practical application of hospitality. Therefore, it is meaningful in a sense that this study newly approached the components of hospital coordinator education and the need to modify the quality components of medical service in accordance with the study subjects was raised. This study also finds its meaning in that it provides basic materials for the study of future hospital coordinator education by suggesting the system development model of hospital coordinator education through preliminary study of education training. In addition, this study is meaningful in the aspect that it suggested the direction of education training by showing how the hospital coordinator education training would applied to the hospital coordinator course of the Continuing Education Center at Pusan and Kyungnam National University to some extent. Since all investigation of this study was approached from the side of hospital coordinator, the thoughts of patients who are beneficiaries of medical service, and care givers cannot be identified. Therefore, the satisfaction of patients and care givers through the experience of medical service, which is the essential prerequisite of medical service, should be importantly considered and investigated. Accordingly, The study of comparing and analyzing the views of both patients and care givers should be carried out in the future.

• 한국병원경영학회지
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• 제spc호
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• pp.85-95
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• 2016

This study is to introduce a comprehensive framework of a crisis management system developed at a prominent hospital in South Korea. Throughout recent decades, especially in the recent years, the way in which to cope with both internal and external challenges has been one of the most critical issues. Since the incident management system in the U.S. is acknowledged as the most advanced crisis management model in the world, a portion of this study refers to the Hospital Incident Command System(HICS) provided by the California Emergency Medical Services Authority(EMSA). Nevertheless, the framework suggested in this article was designed based on a distinctive Korean hospital setting. The main contents of this study are as follows; categorization of each type of crisis, organization of a crisis management team in a non-crisis or crisis state, crisis assessment by life cycle stage, and establishment of crisis management protocol. Even though many types of crises are unspecified, those can be categorized into external crisis, medical crisis, and utility & activity failure. A crisis management organization should be operated and consisted differently- depending on a crisis or non-crisis situation. From a life-cycle perspective, the range by which the crisis should be managed extends from pre-stage to post-stage of the crisis. It is important to set proper scenarios and manuals by crisis type to develop a crisis management framework of high quality. With continuous efforts, hospitals can prepare for the uncertainty to better concentrate on core business operations.