• 제목/요약/키워드: Triage System

검색결과 54건 처리시간 0.029초

Forecast Driven Simulation Model for Service Quality Improvement of the Emergency Department in the Moses H. Cone Memorial Hospital

  • Park, Eui-H.;Park, Jin-Suh;Ntuen, Celestine;Kim, Dae-Beom;Johnson, Kendall
    • International Journal of Quality Innovation
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    • 제9권3호
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    • pp.1-14
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    • 2008
  • Patient satisfaction with the Emergency Department(ED) in a hospital is related to the length of stay, and especially to the amount of waiting time for medical treatments. ED overcrowding decreases quality and efficiency, therefore affecting hospitals' profitability. This paper presents a forecasting and simulation model for resource management of the ED at Moses H. Cone Memorial Hospital. A linear regression forecasting model is proposed to predict the number of ED patient arrivals, and then a simulation model is provided to estimate the length of stay of ED patients, system throughput, and the utilization of resources such as triage nurses, patient beds, registered nurses, and medical doctors. The near future load level of each resource is presented using the proposed models.

응급의학은 어떤 의학분야이며 그 미래는? (What is Emergency Medicine and Its Agenda for Future)

  • 도병수;이삼범
    • Journal of Yeungnam Medical Science
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    • 제19권2호
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    • pp.92-98
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    • 2002
  • Emergency medicine(EM) is the specialty of evaluating, stabilizing and initiating treatment for patients with life or limb-threatening illnesses or injuries. Techniques unique to the specialty of EM are the triage systems, quick stabilization methods, and emergency surgery procedures. The field of EM encompasses areas such as emergency department management, disaster planning and management, the management of emergency medical service(EMS) systems, research into such areas as brain and heart resuscitation, trauma and disaster management, survival medicine, and environmental emergencies(cold and heat injuries, poisioning, decompression sickness and barotrauma). Today, in addition to providing emergency care, the emergency specialists have moral and legal obligations to assess and report probable cases of child and spouse abuse, sexual assault, and alcohol and drug abuse. Future, the EM should provide surveillance, identification, intervention, and evaluation of injury and disease, therefore EM will remain as a key component of evolving community health care system.

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Paradigm Shift in Prostate Cancer Diagnosis: Pre-Biopsy Prostate Magnetic Resonance Imaging and Targeted Biopsy

  • Jung Jae Park;Chan Kyo Kim
    • Korean Journal of Radiology
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    • 제23권6호
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    • pp.625-637
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    • 2022
  • With regard to the indolent clinical characteristics of prostate cancer (PCa), the more selective detection of clinically significant PCa (CSC) has been emphasized in its diagnosis and management. Magnetic resonance imaging (MRI) has advanced technically, and recent international cooperation has provided a standardized imaging and reporting system for prostate MRI. Accordingly, prostate MRI has recently been investigated and utilized as a triage tool before biopsy to guide tissue sampling to increase the detection rate of CSC beyond the staging tool for patients in whom PCa was already confirmed on conventional systematic biopsy. Radiologists must understand the current paradigm shift for better PCa diagnosis and management. This article reviewed the recent literature, demonstrating the diagnostic value of pre-biopsy prostate MRI with targeted biopsy and discussed unsolved issues regarding the paradigm shift in the diagnosis of PCa.

의료분쟁에 관한 보건정책학적 고찰 -응급의료종사자를 중심으로- (The Legal Consideration in Emergency Medical Service System)

  • 강병우
    • 한국응급구조학회지
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    • 제3권1호
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    • pp.91-101
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    • 1999
  • The medicolegal problem can be occurred in all medical field. Especially pre-hospital stage can be more exposed to the legal claims due to the very nature of EMT business and characteristics of ER patient or their family member. All Emergency Medical Technician should be concerned about the law associated with emergency care for handling the medicolegal problem, so the legally risky situations that may be occurred in pre-hospital stage and ER practice. This study reviewed malpractice claim of emergency patients filed in at Association of malpractice patients' family and two tertiary level hospitals. Problems related to treatment and misdiagnosis. Especially issues concerning emergency medical service system including of inadequate transport, delay in triage and transport accounted for many cases of all claims. This alerts us to the seriousness of medical accidents of emergency patient. This paper suggests several items that all E.M.T and every member of ED health care team always have to remember the medicolegally risk situations, must be trained in understanding the patients' wants and desires and should have the knowledge of the law associated with emergency health care. Develop the system that can share the informations about the medicolegal events which were experienced by each ED health care institutes.

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개발자 별 버그 해결 유형을 고려한 자동적 개발자 추천 접근법 (A Technique to Recommend Appropriate Developers for Reported Bugs Based on Term Similarity and Bug Resolution History)

  • 박성훈;김정일;이은주
    • 정보처리학회논문지:소프트웨어 및 데이터공학
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    • 제3권12호
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    • pp.511-522
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    • 2014
  • 소프트웨어 개발 및 유지보수 과정에서 여러 종류의 버그가 발생된다. 버그는 소프트웨어의 개발 및 유지 보수 시간을 증가시키는 주요원인으로 소프트웨어의 품질 저하를 초래한다. 버그의 발생을 사전에 완벽하게 방지하는 것은 불가능하다. 대신 버그 질라(Bugzilla), 멘티스BT(MantisGBT), 트랙 (Trac), 질라 (JIRA)와 같은 버그 트래킹 시스템을 이용하여 버그를 효과적으로 관리하는 것이 가능하다. 개발자 또는 사용자가 발생된 버그를 버그 트래킹 시스템에 보고하면, 프로젝트 매니저에 의해서 보고된 버그는 버그 해결에 적합한 개발자에게 전달되어 해결될 때까지 버그 트래킹 시스템에 의해서 추척된다. 여기서 프로젝트 매니저가 버그 해결에 적합한 개발자를 선별하는 것을 버그 분류 작업 (Bug triaging)이라고 하며, 대량으로 발생되는 버그 리포트들을 수동으로 분류하는 것은 프로젝트 매니저에게 있어서 매우 어려운 문제가 된다. 본 논문에서는 버그 트래킹 시스템에 저장된 과거에 해결된 버그 리포트에서 개발자 별 버그 해결 유형을 추출하고, 이를 활용한 버그 분류 작업, 즉 개발자 추천 방법을 제안한다. 먼저 버그 트래킹 시스템에서 각 개발자가 해결한 버그 리포트들을 분류한 후, 자연 언어 처리 알고리즘과 TF-IDF (Term frequency-Inverse document frequency)를 활용하여 각 개발자 별 단어 리스트를 생성한다. 그 후, 새로운 버그가 발생되었을 때 코사인 유사도를 통해서 생성된 개발자 별 단어 리스트와 새로운 버그 리포트의 단어 리스트를 비교하여 가장 유사한 단어 리스트를 가지는 개발자를 추천하는 방법이다. 두 오픈 소스 프로젝트인 이클립스 JDT.UI와 CDT.CORE를 대상으로 수행한 개발자 추천 실험에서 기계 학습 모델 기반의 추천 방법보다 제안하는 방법이 더 우수한 결과를 얻은 것을 확인하였다.

간호강도에 의한 환자분류도구의 신뢰도 및 타당도 검증 (Reliability and Validity Tests of Patient Classification System Based on Nursing Intensity)

  • 박정호;김은혜
    • 간호행정학회지
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    • 제13권1호
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    • pp.5-16
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    • 2007
  • Purpose: This study is to verify the validity and reliability of classified items and criteria of the patient classification system(PCS) based on Park's definition of nursing intensity. Methods: An expert group of 8 persons verified the content validity of the tools. The 1817 inpatients at a tertiary hospital in Seoul, Korea were classified into 4 groups according to two tools for verifying concurrent validity and interraters' reliability. These verifications were performed from September to October, 2004. Results: Nursing domains of the tools have been divided into 12 items: hygiene, nutrition, elimination, exercise & activity, education & counseling, emotional support, communication & consciousness, treatment & examination, medication, measurement & observation, coordination of multidisciplinary team, admission & discharge & transfer management. Content validity was verified by the content validity index(above 0.75 in all 12 areas). Interraters' reliability was no significant difference in the results of the patient classification between the two raters(A group 93.75%. B group 88.24%). Concurrent validity was also verified by the agreement of two tools(73.7%). Conclusion: These results showed that the reliability and validity of the PCS based on the nursing intensity were verified. These will use an data for nursing productivity in the future.

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재난발생 시 일반응급의료체계에 관한 연구 (A Study for General Emergency Medical Service Systems in Disaster)

  • 이마리아
    • 한국응급구조학회지
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    • 제10권1호
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    • pp.23-39
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    • 2006
  • In Korea, There are many disasters, like the collapse of Sampung department store, the strike of severe typhoon 'Rusa' and the subway tragedy in Taegu, because of global warming, urbanization, high-density and high-rise of buildings. So, the government made 'The Framework Act' on the safe and management of disaster and 'The National Emergency Management Agency' was established. But emergency medical service systems in Korea is not growing so much. The purpose of this research is to give basic data for the development of emergency medical service systems in Disaster by comparing of disaster management systems and emergency medical systems among the nations of the world, analysing emergency medical systems in disaster in Korea and suggesting some improvement methods. The improvment methods are like this ; First, establishing the National Disaster Medical System in Korea, making the good triage by EMT, expansion of EMT's working area, developing protocols and framing of medical director increasing the working force of EMT, broad inner cavity of ambulance for treatment of patientent, supplement of professional equipments, active using of helicopters are needed in prehospital are. Second, equal establishment of emergency medical center and increase of working force of emergency medical team are needed in hospital area. Finally, enforcement of the dispatcher's qualification, smooth communication among EMSS systems and actualization of medical direction through screen are needed in the Telecommunication system.

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지상무기효과분석모델(AWAM)을 활용한 워리어 플랫폼 지능형 조절 시스템 생존 효과도에 관한 연구 (Study on Survival Effectiveness of Intelligent System for Warrior Platform by using AWAM)

  • 권영진;김태양;채제욱;김주희
    • 한국군사과학기술학회지
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    • 제23권3호
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    • pp.277-285
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    • 2020
  • Survivability in a battle field is the most important aspect to the warriors. To analyze the survival effectiveness of warrior platform, the simulation via war-game model is an essential step in advance to the development of platform. In this study, Army Weapon effectiveness Analysis Model(AWAM) was utilized for analysis. Several weapon parameters were adjusted to apply the characteristics of warrior platform in some cases of the defense and survival system. Especially, adjusted triage possibility, probability of kill, fatality and accuracy were employed as parameters in the simulation program to evaluate the survival effectiveness of intelligent system based on the previous researches. In the future battle field or virtual space in the AWAM, the warrior platform intelligent system could react emergency treatment on time by expoiting the bio-information of man at arms. Considering the order of supply priority, special force was selected as operating troops and battle scenario without engagement was selected to measure accurate survival effectiveness. In conclusion, the survivability of defence and survival system of the warrior platform was about 1.47 times higher than that of current system.

Validation of the Korean criteria for trauma team activation

  • Bang, Minhyuk;Kim, Yong Won;Kim, Oh Hyun;Lee, Kang Hyun;Jung, Woo Jin;Cha, Yong Sung;Kim, Hyun;Hwang, Sung Oh;Cha, Kyoung-Chul
    • Clinical and Experimental Emergency Medicine
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    • 제5권4호
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    • pp.256-263
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    • 2018
  • Objective We conducted a study to validate the effectiveness of the Korean criteria for trauma team activation (TTA) and compared its results with a two-tiered system. Methods This observational study was based on data from the Korean Trauma Data Bank. Within the study period, 1,628 trauma patients visited our emergency department, and 739 satisfied the criteria for TTA. The rates of overtriage and undertriage in the Korean one-tiered system were compared with the two-tiered system recommended by the American College of Surgery-Committee on Trauma. Results Most of the patient's physiologic factors reflected trauma severity levels, but anatomical factors and mechanism of injury did not show consistent results. In addition, while the rate of overtriage (64.4%) was above the recommended range according to the Korean criteria, the rate of undertriage (4.0%) was within the recommended range. In the simulated two-tiered system, the rate of overtriage was reduced by 5.5%, while undertriage was increased by 1.8% compared to the Korean activation system. Conclusion The Korean criteria for TTA showed higher rates of overtriage and similar undertriage rates compared to the simulated two-tier system. Modification of the current criteria to a twotier system with special considerations would be more effective for providing optimum patient care and medical resource utilization.

응급실 체류 중에 의식이 저하된 환자의 특성: 의식명료 환자와의 비교연구 (Characteristics of patients with decreased mental status while staying in an emergency department: Comparative study with alert patients)

  • 문선희
    • 한국산학기술학회논문지
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    • 제19권10호
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    • pp.222-230
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    • 2018
  • 본 연구는 내원 당시에는 의식이 명료했으나 응급실 체류 중에 의식이 저하된 환자의 특성을 의식이 명료한 환자와 비교하여 파악하기 위한 후향적 조사연구이다. 연구대상은 일개 응급실에 방문한 응급환자 중 내원 당시에는 의식이 명료했으나 내원 후 의식저하를 보인 환자 90명과 내원당시 의식이 명료했으며 응급실 체류 중에도 의식저하가 없는 환자 중 무작위 추출한 100명이었다. 연구결과 의식저하 군은 의식명료 군에 비해 뇌혈관 질환, 간질환, 당뇨, 고혈압의 기저질환이 많았다(p=.001, p=.003, p<.001, and p=.002, respectively). 중증도 분류 결과 의식저하 군은 의식명료 군에 비해 중증도가 높았다(p<.001). 의식저하 군의 최종 진단명은 신경계 질환 64.9%, 소화기계 질환 63.3%로 의식명료 군과 차이가 있었다(p<.001). 의식저하 군 중 56명(62.2%)은 응급실 간호사에 의해 의식저하 상태가 발견되었다. 의식저하 군 중 9명은 심정지가 발생하여 심폐소생술을 받았다. 본 연구결과 응급실 간호사는 응급실 내원 당시 의식이 명료하더라도 중증도가 높고, 신경계 질환이나 소화기계 질환이 의심되는 환자는 의식수준을 자주 사정해야 함을 시사한다.