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The study on outpatient-clinic practice by shift system at a hospital in Taegu (대구지역 한 중소병원의 교대제 근무에 의한 외래진료에 관한 연구)

  • Song, Jung Hup;Kim, Jing Kyun;Ha, Young Ae;Yeh, Min Hae
    • Quality Improvement in Health Care
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    • v.1 no.2
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    • pp.44-59
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    • 1994
  • Medical consumers(patients) want evening-clinic because of busy work. For patient's convenience and improving service, hospital should accept it. Considering payment system and patient's demand, personnel expenses, hospital can not accept. The practice of shift system to accept patient's demand and hospital's economic aspect was made. To analysis the effect of the system and probability to alternative to evening clinic this study was done. This study was composed of basal study, intervention, evaluation of effect. The basal study were composed of studying demand on evening clinic, the number of beds, doctors employee, the time table of practice and work, and the number of patients at arrival time. The intervention composed of changing of practice time, changing of working time by the number of patients at arrival time, increasing of employee. The evaluation of effect were composed of evaluating the number of patient at time, the effect of shift system, the comparison of the number of in and out patients and questionnairing the practice of shift system. In the practice time at 2 shift system First team works 7-15 hours and Second team 12-20 hours. there are no lunch and supper time. At 18-20 hours the number of patients were 25-30. The number of patient a depart were 6-7. The number of out-patient increase in 13% and inpatient increase in 10% before the system. Doctors(100%), employee(94.6%), and patients(86.4%) approved this system. The advantage of this system were utilization of surplus time, lengthen the practice time, even distribution of patients and shortening of waiting time, rapid treatment of emergent patients. The disadvantage of this system were shortage of manpower, not all depart practice, continuity of practice, no lunch and supper time, irregular rounding. At present because of small Demanding on evening clinic, this shift system was economical. To succeed this study more effectively all depart in hospital participate. But because of economical reason it is impossible for hospital to do it. If the government assist the economic loss that all depart participate in this system it is very helpful for hospital to succeed in implementing this system more early.

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Nutrition Teachers (Dietitians)' Perceptions of Barriers to Implementation of HACCP System in School Foodservices in the Gyeongnam Area (경남지역 학교급식 HACCP 시스템 적용 장애요인에 대한 영양(교)사의 인지도 분석)

  • Hwang, Hye-Ok;Kim, Hyun-Ah
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.41 no.10
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    • pp.1475-1485
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    • 2012
  • This study was conducted in order to understand nutrition teachers (dietitians)' perceptions of barriers to implementation of HACCP system in school foodservices in Gyeongnam, Korea. Questionnaires were distributed to 350 nutrition teachers (dietitians) from November to December of 2009, and 214 were collected and analyzed. The results of this study were as follows. First, nutrition teachers (dietitians) recognized the following as barriers in implementing the HACCP system: 'the status of facilities and utilities'> 'monitoring'> 'work satisfaction'> 'foodservice employees'> 'cooperation of HACCP team'> 'cooperation of persons concerned besides foodservice employees'> 'understanding the HACCP system'. Second, total working experience was found to be the factor most affecting 'cooperation of HACCP team (p<0.01)', 'cooperation of persons concerned besides foodservice employees (p<0.01)', 'foodservice employees (p<0.05)', and 'work satisfaction (p<0.05)'. Further, 'the status of facilities and utilities' was significantly affected by 'construction/reconstruction of kitchen (p<0.01)', 'division of kitchen area (p<0.01)', 'existence of preliminary preparation room (p<0.01)', and 'existence of dishwashing room (p<0.01)'. Third, dietitians perceived the following concerning hindrance factors of the HACCP system according to CCP stage: 'CCP 1'> 'CCP 3'> 'CCP 2, 'CCP 6'> 'CCP 4'> 'CCP 8'> 'CCP 7'> 'CCP 5'. In conclusion, this study showed that nutrition teachers (dietitians) in the Gyeongnam area recognized 'the status of facilities and utilities' from HACCP areas and 'CCP 1 (menu planning)' from CCP stages as the greatest barriers to implementing the HACCP system in school foodservices. To implement the HACCP system successfully in school foodservices, facilities and utilities should be properly equipped, and menu planning training for nutrition teachers (dietitian) should be conducted.

ESG Variables Selection for Container Port Using WNA (워드네트워크 분석을 활용한 컨테이너부두 ESG 변수 선정)

  • Shin, Jong-Bum;Kim, Kyung-Tae;Kim, Hyun-Deok
    • Journal of Korea Port Economic Association
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    • v.39 no.2
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    • pp.15-23
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    • 2023
  • In a situation where the necessity and importance of ESG management is increasing recently, it is judged that selecting important ESG-related variables for container terminals, which are the bases of export and import logistics, among various variables of ESG evaluation agencies will help to establish ESG management strategies for container terminals which led us to proceed with this study. The results of word network analysis are summarized as follows. The weighed degree, that is, the AWD of Environmental management(E) variables, is obtained in the order of Environmental Protection Investment(54), Environmental Awareness Education(45), Work Team Structure(31), Environmental certification(32). Page Ranks, the order of centrality and connectivity index is Environmental Awareness Education(0.0765), Employee Engagement(0.0765), Environmental Protection Investment(0.0761), Work Team Composition(0.0761), and Environmental certification(0.0761). The AWD(Average Weighed Degree) of the Social Responsibility Management(S) variables, followed by Protecting workers' human rights and contributing to local communities(68), Safety Education(63), Safety certification(59), and Responding to infectious diseases(40). Orders by Page Ranks, centrality and connectivity Index, are Protecting workers' human rights and contributing to local communities(0.165), Safety Education(0.153), Safety Certification(0.144) and Responding to infectious diseases(0.102). The AWD of Governance and Ethical management(G) variables, followed by Anti-corruption(27), Transparent management(24), Mutual cooperation between stakeholders(19), and Sustainability reporting(9). Page Ranks, the order of centrality and connectivity index is the Anti Corruption(0.241), Transparent management(0.216), Mutual cooperation between stakeholders(0.174), Directors' roles and responsibilities(0.105), Shareholder protection(0.097) and Sustainability Report(0.096).

Steel Plate Faults Diagnosis with S-MTS (S-MTS를 이용한 강판의 표면 결함 진단)

  • Kim, Joon-Young;Cha, Jae-Min;Shin, Junguk;Yeom, Choongsub
    • Journal of Intelligence and Information Systems
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    • v.23 no.1
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    • pp.47-67
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    • 2017
  • Steel plate faults is one of important factors to affect the quality and price of the steel plates. So far many steelmakers generally have used visual inspection method that could be based on an inspector's intuition or experience. Specifically, the inspector checks the steel plate faults by looking the surface of the steel plates. However, the accuracy of this method is critically low that it can cause errors above 30% in judgment. Therefore, accurate steel plate faults diagnosis system has been continuously required in the industry. In order to meet the needs, this study proposed a new steel plate faults diagnosis system using Simultaneous MTS (S-MTS), which is an advanced Mahalanobis Taguchi System (MTS) algorithm, to classify various surface defects of the steel plates. MTS has generally been used to solve binary classification problems in various fields, but MTS was not used for multiclass classification due to its low accuracy. The reason is that only one mahalanobis space is established in the MTS. In contrast, S-MTS is suitable for multi-class classification. That is, S-MTS establishes individual mahalanobis space for each class. 'Simultaneous' implies comparing mahalanobis distances at the same time. The proposed steel plate faults diagnosis system was developed in four main stages. In the first stage, after various reference groups and related variables are defined, data of the steel plate faults is collected and used to establish the individual mahalanobis space per the reference groups and construct the full measurement scale. In the second stage, the mahalanobis distances of test groups is calculated based on the established mahalanobis spaces of the reference groups. Then, appropriateness of the spaces is verified by examining the separability of the mahalanobis diatances. In the third stage, orthogonal arrays and Signal-to-Noise (SN) ratio of dynamic type are applied for variable optimization. Also, Overall SN ratio gain is derived from the SN ratio and SN ratio gain. If the derived overall SN ratio gain is negative, it means that the variable should be removed. However, the variable with the positive gain may be considered as worth keeping. Finally, in the fourth stage, the measurement scale that is composed of selected useful variables is reconstructed. Next, an experimental test should be implemented to verify the ability of multi-class classification and thus the accuracy of the classification is acquired. If the accuracy is acceptable, this diagnosis system can be used for future applications. Also, this study compared the accuracy of the proposed steel plate faults diagnosis system with that of other popular classification algorithms including Decision Tree, Multi Perception Neural Network (MLPNN), Logistic Regression (LR), Support Vector Machine (SVM), Tree Bagger Random Forest, Grid Search (GS), Genetic Algorithm (GA) and Particle Swarm Optimization (PSO). The steel plates faults dataset used in the study is taken from the University of California at Irvine (UCI) machine learning repository. As a result, the proposed steel plate faults diagnosis system based on S-MTS shows 90.79% of classification accuracy. The accuracy of the proposed diagnosis system is 6-27% higher than MLPNN, LR, GS, GA and PSO. Based on the fact that the accuracy of commercial systems is only about 75-80%, it means that the proposed system has enough classification performance to be applied in the industry. In addition, the proposed system can reduce the number of measurement sensors that are installed in the fields because of variable optimization process. These results show that the proposed system not only can have a good ability on the steel plate faults diagnosis but also reduce operation and maintenance cost. For our future work, it will be applied in the fields to validate actual effectiveness of the proposed system and plan to improve the accuracy based on the results.

Development of Standard Process for Private Information Protection of Medical Imaging Issuance (개인정보 보호를 위한 의료영상 발급 표준 업무절차 개발연구)

  • Park, Bum-Jin;Yoo, Beong-Gyu;Lee, Jong-Seok;Jeong, Jae-Ho;Son, Gi-Gyeong;Kang, Hee-Doo
    • Journal of radiological science and technology
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    • v.32 no.3
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    • pp.335-341
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    • 2009
  • Purpose : The medical imaging issuance is changed from conventional film method to Digital Compact Disk solution because of development on IT technology. However other medical record department's are undergoing identification check through and through whereas medical imaging department cannot afford to do that. So, we examine present applicant's recognition of private intelligence safeguard, and medical imaging issuance condition by CD & DVD medium toward various medical facility and then perform comparative analysis associated with domestic and foreign law & recommendation, lastly suggest standard for medical imaging issuance and process relate with internal environment. Materials and methods : First, we surveyed issuance process & required documents when situation of medical image issuance in the metropolitan medical facility by wire telephone between 2008.6.1$\sim$2008.7.1. in accordance with the medical law Article 21$\sim$clause 2, suggested standard through applicant's required documents occasionally - (1) in the event of oneself $\rightarrow$ verifying identification, (2) in the event of family $\rightarrow$ verifying applicant identification & family relations document (health insurance card, attested copy, and so on), (3) third person or representative $\rightarrow$ verifying applicant identification & letter of attorney & certificate of one's seal impression. Second, also checked required documents of applicant in accordance with upper standard when situation of medical image issuance in Kyung-hee university medical center during 3 month 2008.5.1$\sim$2008.7.31. Third, developed a work process by triangular position of issuance procedure for situation when verifying required documents & management of unpreparedness. Result : Look all over the our manufactured output in the hospital - satisfy the all conditions $\rightarrow$ 4 place(12%), possibly request everyone $\rightarrow$ 4 place(12%), and apply in the clinic section $\rightarrow$ 9 place(27%) that does not medical imaging issuance office, so we don't know about required documents condition. and look into whether meet or not the applicant's required documents on upper 3month survey - satisfy the all conditions $\rightarrow$ 629 case(49%), prepare a one part $\rightarrow$ 416 case(33%), insufficiency of all document $\rightarrow$ 226case(18%). On the authority of upper research result, we are establishing the service model mapping for objective reception when image export situation through triangular position of issuance procedure and reduce of friction with patient and promote the patient convenience. Conclusion : The PACS is classified under medical machinery that mean indicates about higher importance of medical information therefore medical information administrator's who already received professional education & mind, are performer about issuance process only and also have to provide under ID checking process exhaustively.

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A Study in an Effective Programs for Emergency Care Delivery System (응급의료 전달체계의 충실 방안)

  • Kwon Sook Hee
    • Journal of Korean Public Health Nursing
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    • v.9 no.1
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    • pp.83-102
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    • 1995
  • As the society is being industrialized, the fast-paced economic development that has caused substantial increase in cerebrovascular and coronary artery diseases and the industrial development and increased use of means of transportation have resulted in the rapid rise of incidents in external injuries as well. So the pubic has become acutely aware of the need for fast and effective emergency care delivery system. The goal of emergency care delivery system is to meet the emergency care needs of patients. The emergency care delivery system is seeking to efficiently satisfy the care needs of people. Therefore the purpose of this study is designed to develop an effective programs for emergency care delivery system in Korea. The following specific objectives were investigated. This emergency care delivery system must have the necessary man power, for transfering the patients, communication net work, and emergency care facilities. 1) Man power Emergency care requires n0t only specialized traning in the emergency treatment but also knowledge and experience i11 other related area, so emergency care personnel traning program should be designed in order to adapt to the specific need of emergency patients. It will be necessary to ensure professional personnel who aquires the sufficient traning and experience for emergency care and to look for legal basis. We have to develop re-educational programs for emergency nurse specialist. They should be received speciality of emergency nursing care so that they will work actively and positively in emergency part. Emergency medical doctor and nurse specialist should be given an education which is related in emergency and critical care. Emergency care personnel will continue to provide both acute and continuing care as partner with other medical team. 2) Transfering the patients. Successful management of pre-hospital care requires adequate traning for the emergency medical technician. Traning program should be required to participate in a actual first aids activites in order to have apportunities to acquire practical skills as well as theoretical knowledge. The system of emergency medical technician should be remarkablly successful with first responder firefighters. Establishing this system must add necessary ambulances operating at any given time. It will be necessary to standardize the ambulance size and equipment. Ambulance should be arranged with each and every fire station. 3) Communication net work. The head office of emergency commumication network should be arranged with the head office of fire station in community. It is proposed that Hot-line system for emergency care should be introduce. High controlled ambulance and thirtial emergency center should simultaneously equip critical-line in order to communication with each other. Ordinary ambulance and secondary emergency facility should also simultaneously equip emergency-line in order to communication with each other. 4) Emergency care facilities. Primary emergency care facilities should be covered with the ambulatory emergency patients-minor illness and injuires. Secondary emergency care facilities should be covered with the emergency admission patients. Third emergency care center should be covered with the critical patients who need special treatments and operation. Secondary and third emergency care facilities should employ emergency medical doctor and emergency nurse specialist to treat in-patients with severe and acute illness and multiple injuires. It should be fashioned for a system of emergency facilities that meets emergency patients needs. Provide incentives for increased number of emergency care facilities with traning in personal/clinical emergency care. 5) Finance It is recommended to put the finance of a emergency care on a firm basis. The emergency care delivery system should be managed by the government or accreditted organizations. In order to facilitate this relevant program the fund is needed for more efficient and effective emergency researchs, service, programs, and policy. 6) Gaining understanding and co-operation of pubic It is also important to undertake pubic education to improve understanding of first aids and C. P. R of individuals, communities and business. It is proposed that teachers and health officers be certified in C. P. R. The C. P. R education can be powerful influence save lives. Lastly appropriate emergency care information must be provided to the pubic for assisting them in choosing emergency care.

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A Comparative Study on Awareness the Dental Coordinator between Dental Hygienists and Dental Hygiene Students (치과위생사와 치위생과 학생의 치과코디네이터 인식 비교)

  • Park, Il-Soon;Lee, Kyeong-Hee;Youn, Hye-Jeong
    • Journal of dental hygiene science
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    • v.10 no.2
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    • pp.63-69
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    • 2010
  • The purpose of this study was to examine the business awareness of dental coordinators and preferred working condition according to educational period, to suggest what improvements should be made. A survey was conducted for a year and four months from March 2007 to June 2008, and the collected data were analyzed, which made use of ${\chi}^2$(Chi-square) test, t-test. The findings of the study were as follows: 1. In regard to preferred conditions of employment, a dental hospital (42.0%) was most preferred by the incumbent dental hygienists investigated, followed by a dental clinic(29.4%). The largest number of the students who took dental coordinator courses had a liking for a dental hospital(41.9%), followed by university hospital and general hospital(29.0%)(p<0.001). 2. As for perception of dental coordinator, all the dental hygienists were aware of that occupation, and most of the students(81.9%) were cognizant of it(p<0.001). Concerning the necessity of that occupation, the students who felt the need for that(94.8%) outnumbered the dental hygienists who did(85.2%)(p<0.05). 65.9 percent of the dental hygienists and 84.5 percent of the students looked upon a dental hygienist as the best occupation that also could serve as a dental coordinator(p<0.01). 3. Concerning a favorite type of work including an official title, the dental hygienists wanted to work as the chief of counseling section the most(34.1%), and the largest group of the students hoped to become a section chief or team leader(35.2%). In regard to the most integral field of work, the dental coordinators(51.1%) and students(65.8%) attached the most importance to counseling(p<0.05). 4. The dental hygienists were better gratified than the students in every regard(p<0.001). The former($4.00{\pm}0.41$) looked at that occupation in a better way than the students($3.81{\pm}0.50$) as well(p<0.01). The abovementioned findings suggested that it would be advisable to provide dental hygienists with a certain level of a clinical career with education in order to ensure the success of dental coordinator education.

Task Analysis of Paramedics of Korea Based on DACUM Method (DACUM 기법에 의한 1급 응급구조사의 직무분석)

  • Bae, Ki-Sook;Koh, Bong-Yeun;Lee, Jung-Eun;Lee, In-Mo;Choi, Keun-Myoung;Kim, Soo-Tae
    • The Korean Journal of Emergency Medical Services
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    • v.15 no.1
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    • pp.5-23
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    • 2011
  • Objective : This study grasps specific task on paramedics who plays a great role in the emergency scene, thereby eliciting definition of job called paramedics and analyzing occupation by DACUM method. Thus, the aim is to suggest working-level guidelines on the task of paramedics. Methods : It targeted paramedics who are working at hospitals, fire stations, and industries in Seoul and Gyeonggi area from Oct. 11, 2010 to Nov. 30. A total of 608 copies of questionnaire were analyzed by DACUM method. A research tool on occupational analysis consisted of 8 pieces for duty, 43 pieces for task, and 149 pieces for task elements. In order to survey performance frequency, importance, and difficulty by element, each task was developed by this research team, and each task was analyzed and finally elicited through workshop of DACUM method. Results : The occupational definition of paramedics, which was defined through this DACUM, was elicited as 'professional job of performing emergency medical care on the scene, during transferring, or within medical institution in order to maintain life and prevent wound deterioration, targeting a person who is put in emergency situation.' Task element, whose performance frequency was indicated to be the highest, was in order of checking mental status($2.76{\pm}0.497$), checking vital signs($2.70{\pm}0.578$), and airway/c-spine immobilization($2.69{\pm}.546$). Especially, defibrillation stood at $2.23{\pm}.655$ points. Task element, whose performance frequency was low, was in order of caring sexual abuse victims($1.32{\pm}0.563$), performing cricothyrotomy($1.36{\pm}0.618$), and caring cardiac arrest victims($1.40{\pm}0.636$). Importance of task was in order of airway/c-spine immobilization ($2.88{\pm}0.338$), maintenance of respiration($2.88{\pm}0.351$), caring cardiac arrest victims($2.87{\pm}0.349$), and performing CPR($2.87{\pm}0.361$). Task element, whose importance is low, was indicated to be in order of enema($2.29{\pm}0.736$), urinary catheterization($2.35{\pm}0.664$), and nasogastric intubation($2.35{\pm}0.667$). Task element, whose difficulty was shown to be the highest, was indicated to be in order of caring cardiac arrest victims during pregnancy ($2.60{\pm}0.559$), caring cardiovascular injury($2.59{\pm}0.546$), and labor management($2.53{\pm}0.533$). Conclusion : Based on the results of this study, the job performance work table(Dacom chart) of paramedics is suggested to be used, thereby being applied to development in education and curriculum of paramedics. It is necessary to evaluate usefulness of the job performance work table by estimating effect of education for paramedics based on the job performance work table of paramedics.

Microbiological Safety Assessment of a Perilla Leaf Postharvest Facility for Application of a Good Agricultural Practices (GAP) System (농산물우수관리제도(GAP system) 적용을 위한 깻잎의 수확 후 관리시설(APC)에 대한 미생물학적 안전성 평가)

  • Kim, Kyeong-Yeol;Nam, Min-Ji;Lee, Hyo-Won;Shim, Won-Bo;Yoon, Yo-Han;Kim, Se-Ri;Kim, Doo-Ho;Ryu, Jae-Gee;Hong, Moo-Ki;You, Oh-Jong;Chung, Duck-Hwa
    • Korean Journal of Food Science and Technology
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    • v.41 no.4
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    • pp.392-398
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    • 2009
  • This study identified risk factors of cross-contamination of foodborne pathogens and established a good agricultural practice (GAP) system for an agricultural products processing center (APC) for perilla leaves. All samples were collected before and after a standard work shift at the APC, while perilla leaves were also collected after each step in the APC. In addition, the workers and their surroundings were sampled by swabbing. The total plate count (TPC) and coliform count in the water samples increased significantly (p<0.05) to 3.36 and 1.73 log CFU/mL after work, respectively. However, no Escherichia coli and Listeria monocytogenes were detected. The bacterial populations of the workers and their surroundings did not differ significantly (p${\geq}$0.05) before and after work. However, Staphylococcus aureus (<1.66 log CFU) was detected at a high rate (13-50%) in the basket, packing table, gloves and cloth. Although perilla leaves passed through the washing steps, the TPC and coliform bacterial populations on the final products were higher (p${\geq}$0.05) than those of unwashed perilla leaves, which indicates that the washing system was not functioning properly. Accordingly, a GAP system with a better washing system should be employed at this facility.

Research on Making a Disaster Situation Management Intelligent Based on User Demand (사용자 수요 기반의 재난 상황관리 지능화에 관한 연구)

  • Seon-Hwa Choi;Jong-Yeong Son;Mi-Song Kim;Heewon Yoon;Shin-Hye Ryu;Sang Hoon Yoon
    • Korean Journal of Remote Sensing
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    • v.39 no.5_2
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    • pp.811-825
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    • 2023
  • In accordance with the government's stance of actively promoting intelligent administrative service policies through data utilization, in the disaster and safety management field, it also is proceeding with disaster and safety management policies utilizing data and constructing systems for responding efficiently to new and complex disasters and establishing scientific and systematic safety policies. However, it is difficult to quickly and accurately grasp the on-site situation in the event of a disaster, and there are still limitations in providing information necessary for situation judgment and response only by displaying vast data. This paper focuses on deriving specific needs to make disaster situation management work more intelligent and efficient by utilizing intelligent information technology. Through individual interviews with workers at the Central Disaster and Safety Status Control Center, we investigated the scope of disaster situation management work and the main functions and usability of the geographic information system (GIS)-based integrated situation management system by practitioners in this process. In addition, the data built in the system was reclassified according to purpose and characteristics to check the status of data in the GIS-based integrated situation management system. To derive needed to make disaster situation management more intelligent and efficient by utilizing intelligent information technology, 3 strategies were established to quickly and accurately identify on-site situations, make data-based situation judgments, and support efficient situation management tasks, and implementation tasks were defined and task priorities were determined based on the importance of implementation tasks through analytic hierarchy process (AHP) analysis. As a result, 24 implementation tasks were derived, and to make situation management efficient, it is analyzed that the use of intelligent information technology is necessary for collecting, analyzing, and managing video and sensor data and tasks that can take a lot of time of be prone to errors when performed by humans, that is, collecting situation-related data and reporting tasks. We have a conclusion that among situation management intelligence strategies, we can perform to develop technologies for strategies being high important score, that is, quickly and accurately identifying on-site situations and efficient situation management work support.