• Korean Journal of Occupational Health Nursing
• /
• v.29 no.4
• /
• pp.219-227
• /
• 2020

Purpose: Regarding workers' health promotion and disease prevention, the law on the health management system has been enacted and implemented since 1961. However, regulations related to health managers do not meet recent demands for changes in fields such as industrial structure, occupational health problems, or the improvement of occupational health skills. This study aimed to suggest improvement strategies regarding the health management system in the workplace. Methods: We summarized past empirical or theoretical literature. Results: This study summarized the overview and history of the Korean occupational health management system, advanced foreign occupational health management system, and the effectiveness of the health management at workplace. Further, this study proposed various strategies to improve the occupational health management system in Korea. Method: We summarized past empirical or theoretical literature. Conclusion: The effective operation of the health management system in the workplace would improve workers' health, in addition to enhancing national competitiveness through securing a healthy workforce.

• Quality Improvement in Health Care
• /
• v.14 no.1
• /
• pp.61-68
• /
• 2008

• Quality Improvement in Health Care
• /
• v.19 no.2
• /
• pp.14-34
• /
• 2013

Objectives: The purpose of this study is to provide comprehensive information of qualification systems of developed countries needed to establish our national system for QI(Quality improvement) specialists. Methods: All articles related to any applicable domestic or foreign countries' laws, operational status, and detailed programs for professional qualification system of QI were reviewed. Result: In the United States, a non-profit organization, Healthcare Quality Certification Commission (HQCC) has set the policies, procedures and standards in the field of health care quality. And qualification system of CPHQ (certified professional in healthcare quality) has been operated in order to authenticate the qualifications in the field of quality management. IBQH(international Board for quality in healthcare), a qualification system of experts in the United Kingdom, was designed to assist the qualification of professionals to improve the quality of healthcare. In addition, Health Research Center of Feinberg School of Medicine in Northwestern University has been operating Master's and doctoral degree programs in the field of the quality of care and patient safety and IHI (institute for healthcare improvement) open school was operating a professional training course related to the quality of care and patient safety. Conclusion: Quantity and complexity of information of the quality of care and patient safety have been increased. For reform of the health care system, a special training course of the expertise and leadership are needed. So far, there is no national professional certification courses in our nation. Therefore essential job skill should be acquired individually. For systematic and effective quality improvement activities, the educational and certification system with professional development model are needed.

• Pediatric Gastroenterology, Hepatology & Nutrition
• /
• v.25 no.1
• /
• pp.70-78
• /
• 2022

Purpose: Cholestasis resulting from cytomegalovirus (CMV)-induced hepatitis manifests in 40% of patients with a CMV infection. Ganciclovir treatment in children with CMV infections has proven to be highly effective. Until now, there are very few studies have identified predictive factors for liver biochemistry improvement after ganciclovir therapy. This study aimed to identify the predictors of liver biochemistry improvement in patients with CMV cholestasis after ganciclovir treatment. Methods: A retrospective cohort study was conducted using medical records from Dr. Sardjito General Hospital Yogyakarta, Indonesia from 2013 to 2018. CMV cholestasis was confirmed based on serum CMV IgG and IgM positivity and/or blood and urine CMV antigenemia positivity. Incomplete medical records and other etiologies for cholestasis, such as biliary atresia, choledochal cyst, metabolic diseases, and Alagille syndrome, were excluded. Patient age at cholestasis diagnosis and ganciclovir treatment, duration of CMV cholestasis, history of prematurity, central nervous system involvement, and nutritional status were analyzed and presented as an odds ratio (OR) with a 95% confidence interval (95% CI). Results: CMV cholestasis with ganciclovir therapy was found in 41 of 54 patients. Multivariate analysis showed that a shorter duration of CMV cholestasis (OR: 4.6, 95% CI: 1.00-21.07, p=0.04) was statistically significant for liver biochemistry improvement after 1 month of ganciclovir treatment. The remaining factors that were analyzed were not significant predictors of liver biochemistry improvement in patients with CMV cholestasis after ganciclovir treatment. Conclusion: A shorter duration of CMV cholestasis is the predictor of liver biochemistry improvement after 1 month gancyclovir treatment.

• The Journal of Korean Obstetrics and Gynecology
• /
• v.35 no.4
• /
• pp.105-120
• /
• 2022

Objectives: The purpose of this study is to investigate the perception of Korean Medicine (KM) doctors toward infertility treatment evaluation tools and develop a standard evaluation tool for mental and physical function improvement following Korean medicine treatment. Methods: An online survey (Moaform) was conducted, and responses were analyzed for members of the Society of Korean Medicine Obstetrics and Gynecology and KM doctors who participated in the 2021-2022 traditional Korean medicine treatment infertility support program in Gyeonggi-do. Results: In fertility treatment, the most effective indicators that KM doctors wanted to evaluate other than pregnancy and childbirth were reproductive health indicators, overall health improvement, and stress improvement (33.1%, 21.2%, 18.9%). Furthermore, 45.1% of the respondents had experience using the presented infertility stress evaluation tools. For each evaluation tool, 52.1% and 54.6% of the respondents answered that it 'does not reflect the changing circumstances of the times' and that there were 'too many questions'. As for the developing a standard evaluation tool for infertility treatment in KM, KM doctors expected a simple and clear tool focusing on the pregnancy rate. They also wanted the tool to include a reproductive health index, overall function improvement and stress improvements. Conclusions: The survey confirmed the need to evaluate indicators for reproductive health, mental health, and infertility stress in addition to pregnancy rate to assess the effectiveness of KM infertility treatment. It also confirms the necessity of developing an infertility stress evaluation tool with simplified questions that reflects the changing time.

• Quality Improvement in Health Care
• /
• v.8 no.2
• /
• pp.186-207
• /
• 2001

Background : This study presented an analysis of healthcare quality indicators using data mining and a development of decision support system for quality improvement. Method : Specifically, important factors influencing the key quality indicators were identified using a decision tree method for data mining based on 8,405 patients who discharged from a medical center during the period between December 1, 2000 and January 31, 2001. In addition, a decision support system was developed to analyze and monitor trends of these quality indicators using a Visual Basic 6.0. Guidelines and tutorial for quality improvement activities were also included in the system. Result : Among 12 selected quality indicators, decision tree analysis was performed for 3 indicators ; unscheduled readmission due to the same or related condition, unscheduled return to intensive care unit, and inpatient mortality which have a volume bigger than 100 cases during the period. The optimum range of target group in healthcare quality indicators were identified from the gain chart. Important influencing factors for these 3 indicators were: diagnosis, attribute of the disease, and age of the patient in unscheduled returns to ICU group ; and length of stay, diagnosis, and belonging department in inpatient mortality group. Conclusion : We developed a decision support system through analysis of healthcare quality indicators and data mining technique which can be effectively implemented for utilization review and quality management in a healthcare organization. In the future, further number of quality indicators should be developed to effectively support a hospital-wide Continuous Quality Improvement activity. Through these endevours, a decision support system can be developed and the newly developed decision support system should be well integrated with the hospital Order Communication System to support concurrent review, utilization review, quality and risk management.

• Journal of Environmental Impact Assessment
• /
• v.29 no.6
• /
• pp.453-466
• /
• 2020

The addition and evaluation of health impact items in Environmental Impact Assessment document are written in hygiene and public health items only for specific development projects and are being reviewed. However, after the publication of the evaluation manual on the addition and evaluation of health impact items in 2011, there is a demand for continuous methodology and improvement plans despite partial improvement. Therefore, in order to propose a methodological improvement of the evaluation manual, this technical paper identified detailed improvement requirements based on the consultation opinions on hygiene and public health items, and investigated and suggested ways to solve this problem by reviewing the contents of the research so far. As for the improvement requirements, the contents related to mitigation plan, post management, effect prediction, assessment, and present-condition investigation were presented in Environmental Impact Assessment documents for the entire development project at a frequency of 93%, 85%, 80%, 74%, and 67%, respectively. Particularly, the detailed improvement requirements related to mitigation plan consisted of an establishment direction and a management of development project. Considering the current evaluation manual and the frequency of improvement requirements, this paper proposed concrete methods or improvement plans for major methodologies for each classification of hygiene and public health items. Furthermore, a comprehensive evaluation methodology related to whether a project is implemented was proposed, which is not provided in the current assessment manual.

• Journal of the Korean Society of Safety
• /
• v.29 no.3
• /
• pp.46-55
• /
• 2014

With regard to the basic safety and health education in construction industry issued on January, 26, 2012 by Occupation Safety And Health Acts, this study conducted a survey with self-administered questions for workers in the construction field in order to comprehend the problems since introduction of basic safety and health education. By analyzing the effectiveness of the safety and health activities, this study sought to reduce the trials and errors as well as to secure the improvement toward the early settlement of the basic safety and health education in construction industry. As a result of the question investigation, the survey respondents in the field sites who finished the basic safety and health education showed positive attitudes toward the improvement of safety awareness and the prevention of accidents. They also needed constant implementation of the education. At the same time, the government should improve the education program with strong policies to secure the effectiveness of the basic safety and health education in construction industry.

• Quality Improvement in Health Care
• /
• v.5 no.1
• /
• pp.120-127
• /
• 1998

Background : This study is to identify preoperative patient characteristics associated with a lack of improvement on one or more measures peri operatively, postoperative 3-4 months, and postoperative 12 months. Methods : For the assessment, prospective study was performed with 92 patients who had undergone either one eye or both eye cataract surgery by 3 ophthalmologists practicing at a university hospital. The criteria of improvement were (1) Snellen visual acuity, (2) a cataract-related symptom score(possible range: 0, 0 of 6 symptoms present or bothersome, to 18, all 6 symptoms very bothersome), and (3) VF-14 score - a measure of functional impairment in patient with cataract - (possible range: 0, inability to perform any of the applicable activities, to 100, no difficulty in performing any of the applicable activities). Results : Although 14 patients (15.2%) failed to improve on one or more of the outcome measures assessed, no one failed to improve on all three measures. Both eyes of surgery than one eye, preoperative cataract symptom score of 1-4, 5 or higher than 0 were associated independently with the increased likelihood of improvement (odds ratio 8.95, 7.16, 8.87 respectively). And the preoperative level of Snellen visual acuity was not associated with the likelihood of improvement Conclusion : We conclude that specific preoperative characteristics (both eyes, cataract symptom score) are independent predictors of patient outcome after cataract surgery.

• Health Policy and Management
• /
• v.27 no.4
• /
• pp.347-358
• /
• 2017

Background: The recent revision of South Korea's Mental Health Law emphasizes the role of the Mental Health Review Board. For this study, we examined the current status of continuing hospitalization judgement in Mental Health Review Board at the national level and aimed to determine the directions of improvement. Methods: Using a qualitative case study as the research method, we interviewed 30 Mental Health Review Board members and analyzed the results. Results: Each municipality had very different continuing hospitalization judgement methods. In our systematic review, which consisted of document inspection, we identified reliability problems due to limitations in Mental Health Review Board's operating systems, discharge orders, etc. Additionally, continuing hospitalization judgement needs to improve the objectivity, fairness, and effectiveness of their screening examinations. Conclusion: Based on the results of this study, we suggest policy proposals to improve these systems, such as standardizing examination processes, strengthening on-site inspections, increasing the independence and neutrality of judgment in Mental Health Review Board, building community mental health infrastructures, and establishing integrated management systems.