• 제목/요약/키워드: Quality of Medical Care

검색결과 1,579건 처리시간 0.027초

급성기병원에서의 간호 · 간병통합서비스 운영 전후 낙상 및 욕창 발생 변화 (Performance of Comprehensive Nursing Care Service in an Acute Care Hospital: Focusing on Accidental Falls and Pressure Injuries)

  • 남승남;류혜란;김세현;서수량;오윤희;최선미;정은진
    • 임상간호연구
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    • 제29권1호
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    • pp.56-66
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    • 2023
  • Purpose: This study aimed to investigate whether the comprehensive nursing care service positively affected accidental falls and pressure injuries. Methods: This study was a retrospective study that analyzed the accidental falls and pressure injuries cases in an acute care hospital located in Seoul and compared the rates of accidental falls and pressure injuries before and after the comprehensive nursing care service was operated. Results: Comparing the accidental fall incidence rates per 100 person-months between a comprehensive nursing care ward and a general ward, it showed fewer accidental falls by 0.44 in comprehensive nursing care wards, but the result was not statistically significant. In the case of pressure ulcers, the incident rate per 100 person-month was 6.17 in general wards and 4.77 in comprehensive nursing care wards, which showed that the number of pressure ulcer patients was lower in comprehensive nursing care wards, however it was also not statistically significant. Conclusion: It is not confirmed that the operation of the comprehensive nursing care service contributes to the reduction of accidental hospital falls or pressure injuries. Follow-up studies are recommended to determine the effectiveness of comprehensive nursing services in quality indicators.

일개 교육병원에서 의무기록의 충실도의 대한 조사 (Survey of completeness of medical records in one educational hospital using new checklist)

  • 박석건;김홍태;김광환;서순원
    • 한국의료질향상학회지
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    • 제4권2호
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    • pp.174-183
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    • 1997
  • Background : Medical records thought to be reflecting the quality of medicine. By this ground, examination of medical records can be served to evaluate, and to improve the quality of medical care. To examine the medical records, we need some standards or checklists which can be used to sort out the problems. Methods: We developed checklists for medical records evaluation. We studied 1,677 medical records about its completeness using this checklists in one educational hospital. Survey was completed by 5 well trained staffs of medical record department. Results are analyzed. SPSS/PC+ program was used for statistics. Results : 13.8% of discharge summary was incomplete. Recording of the demographic information was also poor in incomplete medical records compared to complete ones. Progress note was recorded average 4.16 times during 11.9 hospital days. After 4th hospital day, recording rate of progress note dropped sharply. Rate of professor's signature on operation records was poor(27%). He or she who described the discharge summary well also wrote progress note well. Conclusions: Fill-up of demographic date should be stressed during medical record education program. Strategy to create the environment emphasizing the responsibility of professor on quality medical record should be made. We suggest new index (number of records/hospital stay) for the evaluation of completeness of progress note.

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임상진단명에 따른 질병분류체계 구축모형 개발 - 안과를 대상으로 - (Development of Construction Model of Disease Classification on Clinical Diagnosis in Ophthalmology)

  • 서진숙;신희영;기창원
    • 한국의료질향상학회지
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    • 제10권2호
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    • pp.204-215
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    • 2003
  • 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.

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진료재료의 관리개선을 통한 운영재고 절감 방안 (Measures to Reduce Medical Supplies in Stock through Improved Manageme)

  • 김경미;박지혜
    • 한국의료질향상학회지
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    • 제19권1호
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    • pp.74-81
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    • 2013
  • Research Problem: 45-65% of all medical supplies in hospital are used in operating rooms. Medical supplies in operating rooms are difficult to manage in general because many of them are frequently used and come in a variety of types. Purpose: Our aim was to strive for user-friendliness and reduce the inventory through efficient management of medical supplies stocked in operating rooms. Medical Facility: Korea University, Ansan Hospital Quality Improvement Activity: On the last day of each month, we checked the inventory of medical supplies in all operating rooms by identifying the amount of medical supplies in each room, warehouse, and OCS, identified problems, and presented the ways to improve. Improvement Outcome: We increased the number of post-processing medical supply items by 8%, and reduced the inventory cost by 15% through improved management of medical supplies.

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간호전달체계 현황 및 간호서비스의 질에 영향을 미치는 요인 (The status nursing care delivery system and the influencing factors on quality of nursing care)

  • 김지연;박보현;고유경
    • 한국병원경영학회지
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    • 제21권2호
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    • pp.24-36
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    • 2016
  • The aims of this study is to investigate the status of nursing care delivery systems and nurse staffing levels and to analyze differences in the quality of nursing care by the type of nursing care delivery system. This research was based on data from 723 nurses working in 55 medical and surgical units in 26 general hospitals. Descriptive statistics on nurse staffing levels and the nursing care delivery system, and multi-level logistic regression were used to estimate the determinants of quality of nursing care. The number of patients per nurse is 17.74 patients in functional nursing care and 15.56 patients in total nursing care. In comparison to hospitals adopting total nursing care, hospitals with functional nursing care had greater patients. The nurses rated units using total nursing care as significantly better quality of nursing care than the units with functional nursing care. Total nursing care or modified total nursing care, rather than functional nursing care, could lead to improvement in the quality of care(total nursing care OR=3.895, modified total nursing care OR=2.475). Patient-centered approaches under proper circumstances can be successfully implemented and the positive effects demonstrated.

요양병원 입원급여 적정성 평가 결과를 활용한 요양병원 입원환자의 장기입원 관련 요인 탐색 연구 (An exploratory study of factors related to long-term hospitalization of inpatients using the quality assessment data for long-term care hospitals)

  • 이지윤;남은우;정형선;허민희;노진원
    • 한국병원경영학회지
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    • 제28권3호
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    • pp.58-67
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    • 2023
  • Purpose: The purpose of this study was to analyze the factors associated with long-term hospitalized patients in long-term care hospitals using the quality assessment data for long-term care hospitals by the Health Insurance Review. Methods: Among 1,376 long-term care hospitals, frequency analysis and descriptive statistics were used to analyze the characteristics of these hospitals. Multiple linear regression was conducted to examine the associations between infrastructure characteristics, medical personnel characteristics, health outcomes and the proportion of long-term hospitalized patients. Results: The research findings indicate that the number of patients per doctor, the number of patients per nurse, and the number of patients per nursing staff were positively associated with the proportion of long-term hospitalized patients. Among health outcomes, a higher proportion of patients with more than a 5% weight loss compared to the previous month and the proportion of patients showing improvement in ADL, were more likely to have a lower proportion of long-term hospitalized patients. However the proportion of diabetic patients with HbA1c test results within the appropriate range was positively associated with the proportion of long-term hospitalized patients. Conclusion: The present study results provide fundamental data for the establishment of policies for long-term care hospitals. Based on this study, it is important to suggest screening methods for unnecessary long-term hospitalizations, such as sufficient medical personnel to improve the quality of care in long-term care hospitals. It is also necessary to clearly separate the roles of medical institutions and long-term care facilities and implement policies to support patients' social reintegration.

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영리병원도입 정책의 추진경과 (The progress of for-profit hospital related policy)

  • 김철신
    • 대한치과의사협회지
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    • 제49권9호
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    • pp.511-518
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    • 2011
  • Policy of for-profit hospitals permission has provoked debate on how to enhance health care system and medical service industry. The government says that for-profit hospitals could help improve the quality of medical care and develop medical tourism. On the other hand, Medical care related NGO insist that for-profit hospitals will not fix the existing medical problems in Korea, only create new ones. Recently, a type of for-profit hospitals emerged in dentistry and caused much trouble. Accordingly, We try to carefully look at for-profit hospitals related policy and debate.

Feasibility to Expand Complex Wards for Efficient Hospital Management and Quality Improvement

  • CHOI, Eun-Mee;JUNG, Yong-Sik;KWON, Lee-Seung;KO, Sang-Kyun;LEE, Jae-Young;KIM, Myeong-Jong
    • 산경연구논집
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    • 제11권12호
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    • pp.7-15
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    • 2020
  • Purpose: This study aims to explore the feasibility of expanding complex wards to provide efficient hospital management and high-quality medical services to local residents of Gangneung Medical Center (GMC). Research Design, Data and Methodology: There are four research designs to achieve the research objectives. We analyzed Big Data for 3 months on Social Network Services (SNS). A questionnaire survey conducted on 219 patients visiting the GMC. Surveys of 20 employees of the GMC applied. The feasibility to expand the GMC ward measured through Focus Group Interview by 12 internal and external experts. Data analysis methods derived from various surveys applied with data mining technique, frequency analysis, and Importance-Performance Analysis methods, and IBM SPSS statistical package program applied for data processing. Results: In the result of the big data analysis, the GMC's recognition on SNS is high. 95.9% of the residents and 100.0% of the employees required the need for the complex ward extension. In the analysis of expert opinion, in the future functions of GMC, specialized care (△3.3) and public medicine (△1.4) increased significantly. Conclusion: GMC's complex ward extension is an urgent and indispensable project to provide efficient hospital management and service quality.

한방의료 이용실태에 관한 조사 연구 - 전국 한의원 이용자를 중심으로 - (A Study on Utilization Patterns of Oriental Medical Care)

  • 이규식;조경숙
    • 보건행정학회지
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    • 제9권4호
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    • pp.120-139
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    • 1999
  • The objectives of this study were to examine the utilization patterns of oriental medical care and to discover problems in its delivery. The data for this study were collected from a questionnaire survey mailed out from March 10 to April 9 1999 to 6.346 oriental medical clinic. The questionnaires were then distributed to two patients in each clinics. Of these questionnaires. 670 were completed and returned. The major statistical methods used for the analysis were the t-test. ANOVA, and x$^2$-test. The major findings are as follows: 1. Respondents reported visiting oriental doctors twice as often as they visited western doctors(All those completing the survey received the questionnaire at oriental medical clinics). 2. The number of reported visits to oriental physicians according to among gender, age, marital status, education, income and residence. Males, married respondents, the elderly and the residents of rural areas visited oriental physicians more frequently than females, singles, younger respondents and urbanites. Those people belonging to the middle income class and middle education level also more frequently visited oriental physicians. 3. There are several factors that restrict the utilization of oriental medical care, such as the limitation of the scientific diagnostic instrument use commonplace reliance upon western medical techniques, and the perception of high price for oriental medical care. It is very important to focus oriental medical care onto the fields of acupuncture, circulatory system disease, musculoskeletal system ailments, etc. to improve the utilization of oriental medical care. Other policies for the improvement of oriental medical care include the standardization of price, quality and quantity of oriental medicine.

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일 시범 지역 의료급여수급권자 대상의 텔레케어 사례관리 효과 (The Effects of Tele-care Case Management Services for Medical Aid Beneficiaries)

  • 안양희;김의숙;고일선
    • 지역사회간호학회지
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    • 제21권3호
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    • pp.351-361
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    • 2010
  • Purpose: This study was done to analyze the effects of tele-care case management services using secondary data. Methods: A descriptive research design was utilized, and the participants were 134 medical aid beneficiaries who were in either the high-risk group or the preventive group. Casemanagement services were delivered by 8 care managers. Data were analyzed using PAWS Statistics 17 through descriptive statistics and paired t-test. Results: After the case management intervention, the participants' health quality of life, self-care competency, and reasonable medical care utilization increased significantly for the high-risk group. However there were no significant changes in the preventive group. Conclusion: The results showed that the tele-care case management services were effective for high-risk medical aid beneficiaries. Further studies with controls for constitutional variables and a comparison group are required to validate the robustness of the effectiveness of the case management program in the present study.