• Korea Journal of Hospital Management
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• v.18 no.1
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• pp.70-87
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• 2013

This study investigated contents of mission statements for Strategic Management of hospitals in Korea and Japan. For the study, 44 tertiary care hospitals in korea, which were accredited by the Ministry of Health and Welfare, were selected. And 83 special functioning hospitals in Japan, which were approved by the Minister of Health, Labour and Welfare, were included. Both quantitative and qualitative analyses were conducted by classifying 5 components of the mission statement; market, service, philosophy, image, contribution. Findings from this study are as follow. First, hospitals in Korea emphasized image(93.2%) and philosophy(81.8%) components in their mission statements, whereas hospitals in Japan highlighted components of service(89.2%) and market(72.3%). In detail, mission statements of Korean tertiary care hospitals describe the components of hospital's image (93.2%), philosophy(81.8%), contribution(56.8%), market(22.7%) and service (18.2%) in order. On the other hand, mission statements of Japanese special functioning hospitals describe hospital's service(89.2%), market(72.3%), contribution(61.4%), image (49.4%) and philosophy(34.9%), respectively. Second, as results of Content analysis, there were some differences in mission statements of hospitals between two countries, and it is mainly from the divergences of standards for recognition of medical institutions, environmental factors, and different ways of mission statement description. For strategic hospital management, carrying out innovative restructuring organization or promoting of research and training for medical development is considered as a desirable approach. However, clear description of mission statement is more important and it is required for effective control and managing organization. And then the mission should be communicated within an organization so all internal members understand it and put their efforts to achieve the mission of organization. In conclusion, it is recommended that a leader and senior managers should re-evaluate its mission statement whether it reflects characteristics of an organization. In addition, a mission statement should be created or improved based on critical decision, as well as it should be clearly shared within an organization in order to become a future oriented organizations.

• Clinical and Experimental Pediatrics
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• v.65 no.3
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• pp.150-151
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• 2022

• Asian Pacific Journal of Cancer Prevention
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• v.14 no.6
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• pp.3541-3547
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• 2013

Background: This cross-sectional observational study was undertaken to establish clinico-pathological characteristics of patients with gynecological malignancies, focusing mainly on symptoms, histological type and stage of the disease at presentation, in a tertiary care setting in Eastern India. Materials and Methods: In the gynecology out-patient clinic of a tertiary care hospital in Kolkata, India, the patients with suggestive symptoms of gynecological malignancies were screened. Their diagnoses were confirmed by histopathology. One hundred thirteen patients with histopathologically confirmed gynecological malignancies were interviewed. Results: The most frequently reported symptoms by the patients with histopathologically confirmed gynecological malignancies were excessive, offensive with or without blood stained vaginal discharge (69.0%), irregular, heavy or prolonged vaginal bleeding (36.3%) and postmenopausal bleeding (31.9%). The majority of the patients (61.0%) had squamous cell carcinoma on histopathological examination, followed by adenocarcinoma (30.1%). Nearly half of the patients (48.7%) were suffering from the Federation Internationale des Gynaecologistes et Obstetristes (FIGO) stage III, followed by stage II (40.7%) malignancy. Conclusions: This study highlights that most of the patients with gynecological malignancies present late at an appropriate health care facility. Ovarian cancer may often have non-specific or misleading symptomatic presentation, whereas cervical cancer often presents with some specific symptoms. These observations point to the need for increasing awareness about gynecological malignancies in the community and providing easily accessible adequate facilities for early detection and treatment of the disease by optimal use of available resources, i.e. strengthening the primary health care system.

• Archives of Plastic Surgery
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• v.47 no.5
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• pp.473-477
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• 2020

Superficial inferior epigastric artery (SIEA) flaps represent a useful option in autologous breast reconstruction. However, the short-fixed pedicle can limit flap inset options. We present a challenging flap inset successfully addressed by de-epithelialization, turnover, and counterintuitive rotation. A 47-year-old woman underwent left tertiary breast reconstruction with stacked free flaps using right deep inferior epigastric perforator and left SIEA vessels. Antegrade and retrograde anastomoses to the internal mammary (IM) vessels were preferred; additionally, the thoracodorsal vessels were unavailable due to previous latissimus dorsi breast reconstruction. Optimal shaping required repositioning of the lateral ends of the flaps superiorly, which would position the ipsilateral SIEA hemi-flap pedicle lateral to and out of reach of the IM vessels. This problem was overcome by turning the SIEA flap on its long axis, allowing the pedicle to sit medially with the lateral end of the flap positioned superiorly. The de-epithelialized SIEA flap dermis was in direct contact with the chest wall, enabling its fixation. This method of flap inset provides a valuable solution for medializing the SIEA pedicle while maintaining an aesthetically satisfactory orientation. This technique could be used in ipsilateral SIEA flap breast reconstructions that do not require a skin paddle, as with stacked flaps or following nipple-sparing mastectomy.

• Korea Journal of Hospital Management
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• v.19 no.2
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• pp.66-72
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• 2014

Although stress has been implicated to be a risk factor that can threaten physical and mental health, there have been no sufficient studies that analyze the different levels of stress among employees working in the different levels of the hospitals. We aim to identify the general characteristics of hospitals at different levels, to compare the stress levels among customer service representatives working in the tertiary care hospitals as well as acute general hospitals. In addition, we also wanted to analyze the relationship between the types of hospitals and the stress level. The work stress was measured using the Korean Occupational Stress scale. Study subjects' demographic characteristics and lifestyle factors were analyzed using analysis of frequency and multiple regression analysis. Our study revealed that the levels of medical facility were significantly associated with the levels of job stress(P=0.043), and the stress levels of employees working in the acute general hospital's medical facilities were higher than those who were working in tertiary care facilities. We also found that those with higher depression level tended to have higher job stress (P<0.001). Therefore, it is urgent to implement some kind of job stress interventions, especially in the acute general hospital's medical facilities. Moreover, further studies including social and policy research are necessary in order to analyze the overall impact of stress on physical and mental health and to reduce health inequalities among healthcare workers.

• Journal of Trauma and Injury
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• v.25 no.4
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• pp.145-151
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• 2012

Purpose: The objective of this study was to determine the appropriateness of Emergency Medical Service's (EMS's) triage and transport of severely injured patients in Busan and Kyungnam, Korea. Methods: The medical records of the Emergency Medical Information Center were retrospectively reviewed from January 1, 2010 to December 31, 2010. We identified the number of patients that should have been transferred from a secondary to a tertiary hospital according to the EMS field triage protocol. Results: In a total of 472 cases requests to be transferred to a third hospital were made through the Emergency Medical Information Center. Of these, 207 patients(43.9%) should have been transferred to a tertiary hospital according to the EMS field triage protocol. Among them, thirty-three(15.9%) patients satisfied step 1, 15(7.0%) satisfied step 2, and 117(56.5%) satisfied step 3. Twenty-three(11.1%) patients satisfied both steps 1 and 3. Conclusion: We found the triage by the EMS in the transfer of severely injured patients to a tertiary hospital to be inappropriate and re-education of EMS personnel regarding the EMS field triage protocol is needed. Because many patients are transferred from a secondary to a third hospital, we suggest changing the EMS field triage protocol to expand the severe injury criteria. A need exists to authorize secondary hospitals to transfer severely injured patients directly because there are no trauma centers in Korea.

• Journal of Korean Clinical Nursing Research
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• v.26 no.3
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• pp.374-384
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• 2020

Purpose: To explore the scope and method of applying standardized nursing terminologies to nursing diagnosis and problems used in nursing practice. Methods: A descriptive study was done with a retrospective analysis of the nursing records of 141,420 patients that were hospitalized in 4 tertiary hospitals. The nursing diagnosis and problems collected from the records were standardized, and the standardized nursing diagnosis and problems cross mapped with NANDA-I, confirmed in a nursing focus group. Results: 65 (67.7%) of the 96 standardized nursing diagnosis and problems were equal with NANDA-I and included in the 10 domains of NANDA-I. Among 86 nursing diagnosis and problems excluded from the cross mapping with NANDA-I, the 63 terms (73.3%) related to surgery/procedure were the most common. Conclusion: It is meaningful that multi-tertiary hospital nursing diagnosis and problems were standardized and cross mapping with standard nursing terminologies was performed. As for the method of applying standardized nursing terminologies in nursing practice, it is appropriate to use several standardized nursing terminologies complementarily.

• Journal of Korean Clinical Nursing Research
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• v.29 no.2
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• pp.149-162
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• 2023

Purpose: This study was to investigate the belief in evidence-based practice, awareness of importance and performance of intravenous infusion and pressure ulcer evidence-based practice guidelines among nurses in a tertiary general hospital. Methods: The subjects of this study were 217 nurses working in a tertiary general hospital. Data collection was performed between February 11 and February 25, 2022. Data analysis was conducted descriptive statistics, t-test, hierarchical regression analysis, and Importance-Performance Analysis. Results: The mean score of belief for evidence-based practice among novice nurses was 3.34 out of 5, while preceptor nurses scored a mean of 3.41 out of 5. There was no significant difference in belief scores between novice nurses and preceptor nurses (t=-1.21, p=.227). The factors influencing the performance of evidence-based practice guidelines for intravenous infusion were belief in evidence-based practice (β=.14, p=.009) and importance of intravenous infusion (β=.51, p<.001), and the factors influencing the performance of evidence-based practice guidelines for pressure ulcer were belief in evidence-based practice (β=.15, p=.002) and importance of pressure ulcer (β=.65, p<.001). Importance-Performance Analysis of the evidence-based practice guidelines of two groups were used to identify common and different items. Conclusion: To improve the performance of evidence-based practice guidelines, it is necessary to enhance the evidence-based practice belief and importance of evidence-based practice guidelines. In particular, evidence-based practice should be provided to improve nursing quality through education on items of low-importance and low-performance and items of high-importance but low-performance guidelines identified through Importance-Performance Analysis.

• Journal of Genetic Medicine
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• v.18 no.1
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• pp.31-37
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• 2021

Purpose: To summarize the results of chromosomal microarray analysis (CMA) for copy number variants (CNVs) detection and clinical utility in a single tertiary hospital. Materials and Methods: We performed CMA in 46 patients over the course of two years. Detected CNVs were classified into five categories according to the American College of Medical Genetics and Genomics guidelines and correlated with clinical manifestations. Results: A total of 31 CNVs were detected in 19 patients, with a median CNV number per patient of two CNVs. Among these, 16 CNVs were classified as pathogenic (n=3) or likely pathogenic (LP) (n=11) or variant of uncertain significance (n=4). The 16p11.2 deletion and 16p13.11 deletion classified as LP were most often detected in 6.5% (3/46), retrospectively. CMA diagnostic yield was 24.3% (9/37 patients) for symptomatic patients. The CNVs results of the commercial newborn screening test using next generation sequencing platforms showed high concordance with CMA results. Conclusion: CMA seems useful as a first-tier test for developmental delay with or without congenital anomalies. However, the classification and interpretation of CMA still remained a challenge. Further research is needed for evidence-based interpretation.

• Journal of Korean Clinical Nursing Research
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• v.28 no.2
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• pp.157-166
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• 2022

Purpose: The purpose of this study was to investigate hospital nurses' delirium screening for postoperative delirium, delirium knowledge, and delirium care using case scenarios at a tertiary hospital in Seoul. Methods: A total of 235 nurses working at surgical units participated in this questionnaire-based study. Five cases scenarios were developed based on diagnosed postoperative delirium cases. Data were collected from April 1 to May 1, 2021. Results: The delirium screening score was 4.20±1.17 out of 5. The delirium knowledge score was 34.35±4.57 out of 47. The delirium care score was 67.61±9.26 out of 92. The correlation between the delirium screening and delirium knowledge was statistically significant (r=.18, p=.005). The correlation between the delirium knowledge and delirium care was statistically significant (r=.25, p<.001). Conclusion: The findings showed that the continuing educations of delirium for hospital nurses and the development of a delirium education programs were important to improve delirium screening and care.