• Title/Summary/Keyword: Referral center

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Sterile Panniculitis in a Maltese Dog

  • Hwang, Mee-Na;Lee, Jae-Hee;Han, Man-Gil;Suk, Joo-Yeun;Gwon, Ryu-Hee;Jung, In-Sung
    • Proceedings of the Korean Society of Veterinary Clinics Conference
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    • 2007.05a
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    • pp.109-109
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    • 2007
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Cutaneous Liposarcoma in a Mongrel Dog

  • Lee, Jae-Hee;Hwang, Mee-Na;Han, Man-Gil;Jang, Se-Ung;Hong, Yeun-Jung;Lee, Gi-Jong;Jung, In-Sung
    • Proceedings of the Korean Society of Veterinary Clinics Conference
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    • 2007.05a
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    • pp.110-110
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    • 2007
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A Case of End-On Colostomy in a Dog Suffering from Dyschezia

  • Yeon-Jung Hong;Hyung-Kyu Chae;Sung-Jun Yoon;Kyoung-In Shin;Hyun-Min Hwang;Ju-Yeon Jung;Seongjin Yun;Byeong-Jun Jang;Oh-Kyeong Kweon
    • Journal of Veterinary Clinics
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    • v.39 no.6
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    • pp.384-389
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    • 2022
  • A 12-year-old Shetland sheepdog with dyschezia was presented to the clinic. Dyschezia was considered to have been caused by rectal stricture due to a perianal mass containing the distal colon, rectum, and anus. Considering the histological findings and gross appearance of the perianal mass, an aggressive form of adenocarcinoma was diagnosed and a poor prognosis was expected. An endon colostomy was successfully performed to improve quality of life, which had been decreased by the dyschezia. Postoperative fecal evacuation was well-managed by the owner using a disposable colostomy bag in addition to a previously reported flange and drainable pouch. The dog survived for three months and had a satisfactory quality of life. Surgery and postoperative management in such cases will be helpful in the treatment of defecation disorders in animals.

Survey of Doctors' Role Expectation and Patients Satisfaction with Referral Centers (의료협력센터에 대한 개원의 역할기대와 환자 만족도 조사)

  • Han, Sun-Hee
    • Journal of Korean Academy of Nursing Administration
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    • v.13 no.1
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    • pp.74-81
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    • 2007
  • Purpose: This study focuses on doctors' role expectation and patients satisfaction with the referral centers to get necessary basic Method: There were 495 subjects in this study. 245 of them were doctors working in the 397 clinics and hospitals which have made contracts with the referral center in Y General Hospital located in J city, and 250 were patients who had been treated in it. The data were collected from Sep. 25 to Oct. 21, in 2006. Data analysis was processed with SPSS/WIN 14.0 electronically. Results: Concluding cooperative treaties with other clinics and hospitals, doctors expect the following effects: First, the improvement of the treatment quality of patients. The patients satisfaction ranking order for using referral centers is as follows: kindness of the staff, treatment reservation, doctor's satisfying explanation. providing one-stop service, reduction of waiting time for treatment, evasion of repetitive tests. Conclusion: Referral centers should provide various services totally and actively which reflect the role expectation and satisfaction of doctors and patients altogether.

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The effect of operating the referral center on the Length of stay of transferred inpatients in a tertiary medical center (진료의뢰센터 운영이 전원환자의 재원일수에 미치는 영향 - 일개 3차 의료기관 진료의뢰센터 경유 환자를 중심으로 -)

  • Cho, Sang-Ok;Park, Eun-Cheol;Son, Tae-Yong;Kang, Hee-Chung;Yu, Seung-Hum
    • Korea Journal of Hospital Management
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    • v.10 no.3
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    • pp.67-84
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    • 2005
  • To compare differences of LOS between the group of inpatients via referral centers(the referral group) and the group of inpatients via different routes (the general group) and analyze factors which determine the difference. The 9,484 cases of newly inpatients of Mar., Jun., Sep., Dec. of year 2003 were used for the data. We calculate the Case-mix index of length of stay($CMI_{LOS}$) to compare LOS adjusted with the disease as the ratio of a patient' LOS to all patients' average LOS by 21 classification diagnosis group. We conducted t-test to compare differences of $CMI_{LOS}$ between two groups and multiple regression to analyze factors determining the difference. $CMI_{LOS}$ was 0.94 in the referral group, which was smaller than 1.01 in the general group. LOS was 7.5days in the referral group, which was 0.6day shorter than that in the general group. Multiple regression also showed that $CMI_{LOS}$ was smaller in the referral group than in the general group after controlling patients' general characteristics, diagnostic information variables. The referral centers can be said to playa role in decreasing LOS. We suggest that variety of depth studies on referral centers should be continued at the strategic level of hospital management using additional medical informations.

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Development and Analysis of System Dynamics Model for Predicting on the Effect of Patient Transfer Counseling with Nurses (간호사의 전원상담 효과 예측을 위한 시스템다이내믹스 모델 개발 및 분석)

  • Byun, Hye Min;Yun, Eun Kyoung
    • Journal of Korean Academy of Nursing
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    • v.48 no.5
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    • pp.554-564
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    • 2018
  • Purpose: This study aimed to construct a management model for patient transfer in a multilevel healthcare system and to predict the effect of counseling with nurses on the patient transfer process. Methods: Data were collected from the electronic medical records of 20,400 patients using the referral system in a tertiary hospital in Seoul from May 2015 to April 2017. The data were analyzed using system dynamics methodology. Results: The rates of patients who were referred to a tertiary hospital, continued treatment, and were terminated treatment at a tertiary hospital were affected by the management fee and nursing staffing in a referral center that provided patient transfer counseling. Nursing staffing in a referral center had direct influence on the range of increase or decrease in the rates, whereas the management fee had direct influence on time. They were nonlinear relations that converged the value within a certain period. Conclusion: The management fee and nursing staffing in a referral center affect patient transfer counseling, and can improve the patient transfer process. Our findings suggest that nurses play an important role in ensuring smooth transitions between clinics and hospitals.

Diagnostic Imaging Features of Abdominal Foreign Body in Dogs; Retained Surgical Gauze (개에서 복강내 잔존한 거즈 이물의 진단영상)

  • Choi, Ji-Hye;Kim, Gye-Dong;Keh, Seo-Yeun;Jang, Jae-Yong;Choi, Hee-Yeon;Yoon, Jung-Hee
    • Journal of Veterinary Clinics
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    • v.28 no.1
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    • pp.94-100
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    • 2011
  • This study was performed to describe the radiographic and ultrasonographic features of retained surgical gauze known as gossypiboma in 9 dogs. Female dogs (n = 8) were at higher risk and seven out of the eight cases had a history of ovariohysterectomy. Seven dogs were symptomatic and the most common clinical signs were vomiting, anorexia, and inertia. A palpable abdominal mass was detected in six dogs. Radiographic signs included a localized abdominal mass with soft tissue density (n = 7) or a mass containing speckled gas (n = 1). Ultrasonography showed a hypoechoic mass with a hyperechoic center (n = 4), or a homogeneous hypoechoic mass (n = 3). The remaining dogs (n = 2) showed an intestinal wall surrounding a hyperechoic center. Regardless of the characteristics of a mass, an acoustic shadowing was accompanied from the center of a mass in all dogs. Ultrasonography also revealed complications such as adhesion between a mass and adjacent organs, and peritonitis and intestinal obstruction around a mass. The gossypiboma can be considered when a hypoechoic mass accompanying a hyperechoic center with acoustic shadowing is observed on ultrasound examination.

A Study on Anticipating Factors and Satisfaction of Local Clinics to 2nd Referral Hospitals based on Collaboration Hospital System (개원의의 진료의뢰시 기대요인 및 만족도에 관한 연구 - 협력병원체제 여부를 중심으로-)

  • Kim, Dong-Il;Kim, Hae-Joon;Yoon, Seok-Jun;Mun, Yeong-Bae
    • Quality Improvement in Health Care
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    • v.9 no.2
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    • pp.198-208
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    • 2002
  • Background : This research, as a part of improving management process of college hospital in this rapidly changing circumstances, is searching for the actual state of private clinics referring patients to referral center including college hospitals. Methods : This research examined the sense of satisfaction and requesting degree in using referral center and by analyzing the correlation and differences among factors such as primary factors regarded as selecting ones in referring patients to a referral center in college hospital and expecting factors expected to be supported to patients and cooperative hospitals. Results : The main researched results are as follows. First, as for the primary factors, the differences between cooperative and uncooperative hospitals revealed the fact that choosing target hospital in accordance with cooperative relation and convenient process in referring patients are important. Second, satisfaction rates, analyzed from the paired t-test revealed kindness and convenience as the top priorities, while sending patients back again and benefit of supporting such as the use of facilities were revealed as the least satisfactory aspects, despite the fact that they should be fulfilled through actual service. Conclusion : The recognition of the practitioner is examined and analyzed in this research by examining primary factors in selecting college hospitals, expecting factors expected to be supported to patients and satisfaction degree, which are expected to be used as basic materials for the development of referral center of college hospitals.

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Design of a Hospice Referral System for Terminally Ill Cancer Patients Using a Standards-Based Health Information Exchange System

  • Lim, Kahyun;Kim, Jeong-Whun;Yoo, Sooyoung;Heo, Eunyoung;Ji, Hyerim;Kang, Beodeul
    • Healthcare Informatics Research
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    • v.24 no.4
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    • pp.317-326
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    • 2018
  • Objectives: The demand for hospice has been increasing among patients with cancer. This study examined the current hospice referral scenario for terminally ill cancer patients and created a data form to collect hospice information and a modified health information exchange (HIE) form for a more efficient referral system for terminally ill cancer patients. Methods: Surveys were conducted asking detailed information such as medical instruments and patient admission policies of hospices, and interviews were held to examine the current referral flow and any additional requirements. A task force team was organized to analyze the results of the interviews and surveys. Results: Six hospices completed the survey, and 3 physicians, 2 nurses, and 2 hospital staff from a tertiary hospital were interviewed. Seven categories were defined as essential for establishing hospice data. Ten categories and 40 data items were newly suggested for the existing HIE document form. An implementation guide for the Consolidated Clinical Document Architecture developed by Health Level 7 (HL7 CCDA) was also proposed. It is an international standard for interoperability that provides a framework for the exchange, integration, sharing, and retrieval of electronic health information. Based on these changes, a hospice referral scenario for terminally ill cancer patients was designed. Conclusions: Our findings show potential improvements that can be made to the current hospice referral system for terminally ill cancer patients. To make the referral system useful in practice, governmental efforts and investments are needed.