• Quality Improvement in Health Care
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• v.7 no.1
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• pp.118-131
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• 2000

Background : A continuous healthcare quality improvement is needed to provide high quality healthcare service as well as to maintain trust in terms of satisfying the needs of the patients. Recently it also became an essential issue. in hospital management, recognized for it's competitive potentiality among healthcare organization groups. This study was conducted to analyze patient complaints and issues received by the Quality Improvement Department. Its purpose is to improve healthcare qualities within the hospital, as well as establish policies and appropriate strategies in hospital management. Method : From July 1st to September 30th of the year 1999, we analyzed all complaints and issues made by various patients and their families, which were received through 24 hour phone consultation, numerous suggestion boxes, letters and E-mails, The issues were classified into 16 different categories based on a Patient Satisfaction Assessment Tool. All data were segregated according to the departmental frequencies and their contents. To come up with for environmental and patient satisfaction improvement, all complaints or issues were communicated with hospital administrators, medical and nursing staff and employees. Comprehensive customer satisfaction activities including improving phone etiquette were discussed in Customer Satisfaction Team, CQI Team and each Department. All opportunities for improvement were implemented. Feedback actions were discussed. Results : A total of 317 cases were collected. Issues regarding parking and other accommodation facilities were most common complaints that were 14.5% of total. Issues regarding admission rooms (10.7%), admission procedures (10.7%), waiting room environment (8.8%), nurses and nurse assistants (7.6%), physicians (6.6%) and others (23%) followed. Thirteen of 45 departments received more than 8 complaints. The Nursing Department had the most complaint, receiving 9.8% of total complaints. Complaints regarding the Nursing Department were predominantly related to the environment of patient rooms. The Department of Psychiatry for phone etiquette (4.7%), Department of Otolaryngology for the nursing staff's attitude and phone etiquette (4.4%), and the Admission Department followed. As a part of efforts to improve patient satisfaction, a new parking structure was built and reallocation of the parking space was done. Renovation of other accommodation facilities were carried out by hospital administration, Monthly phone call and answering attitude survey was done by QI Department. Based on this survey we made a phone etiquette manual and distributed throughout the hospital. Compare to the last year, Patient Satisfaction Index measured by Korea Productivity Center using National Customer Satisfaction Index was improved 7 points. According to our organization's own study, we confirmed the phone etiquette was improved 11% than last year. Conclusions : Issues related to parking and other accommodation facilities ranked first followed by complaints made regarding the patient care area, the admission and cashier process, and nurses' and doctors' attitude. The Nursing and Psychiatry Departments need improvement regarding phone etiquette. Results were shared and played a vital role in policymaking and strategic planning of the hospital. It is imperative that we keep our database updated by listening to and solving the needs of each patient. The CQI activities can be achieved only by full commitment of the hospital top management supported by related personal.

• Journal of Korean Academy of Nursing
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• v.30 no.6
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• pp.1455-1466
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• 2000

The purpose of this study was to develop the framework of community-based home care nursing delivery system, and to demonstrate and evaluate the efficiency of it. The study was carned out over a period of 3years from September 1996 to August 1999. The researchers developed Standards for operations, this was all aimed toward a home care recording system, and an assessment intervention algorithm for various diseases quality control and standardization. In the center, 185 patients enrolled, and of the enrollments cerebrovascular disorder and cancer were the most prevailment diseases. Also, a home care nursing activity classification was developed in six domains. Those domains were assessment, medication, treatment, education and consultation, emotional care, and referral or follow-up care. Ten sub-domains were divided according to the systematic needs. Among these nursing activities, treatment, assessment, and education and consultation were frequently performed. In sub-domain classification, skin integrity, respiration, circulation, and immobility related care were provided most frequently. The cost of home care nursing per visit was also suggested. The cost include direct and indirect nursing care, management, and transportation cost. Also, the researchers tried to overcome the limitations of hospital-based home care to provide more accessible, efficient, safe, and stable home care nursing. Therefore, clients were referred from other patients, families, public health care centers, industries, and even hospitals. As a result of this study, several limitations of operation were found. First, it was difficult to manage and communicate with doctor in the emergency situations. Second, there was too much time spent for transportation. This was because they are only five nurses, who cover all of the areas of Seoul and nearby cities. Third, preparation for special care of home care nurses was lacking. Fourth, criteria for the termination of care and the frequency of home visits were ambiguous. Finally, interconnection with home care machinery company was so yely needed. New paragraphs' strategies for solving these problems were suggested. This study will be the basis of community-based home care nursing, and the computerized information delivery system for home care nursing in Korea.

• Journal of Nutrition and Health
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• v.40 no.1
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• pp.78-88
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• 2007

The purpose of this study was to investigate dietary fat and individual fatty acids intake pattern of 174 college women living in Seoul and Gyong-gi province through internet nutritional assessment system. Each of the subjects was required to input their own food intake for three days, which included two days during the week and one day of the weekend, on the web program directly and all of the data collected were used for statistical analysis. The mean daily caloric intake of the subjects was 1,500.9 kcal which was at 71.5% of Estimated Energy Requirement (EER). Dietary fat contributed 27.6% of the total caloric intake which was slightly higher than the recommended limit of 25%. Daily cholesterol intake was 310.0 mg, which was also high to some degree. Mean daily N6 and N3 fatty acid intake was 6.1 g and 0.9 g, respectively, and calory % calculated from each were 3.63% and 0.53%. This result showed the intake of N3 fatty acid fell in Acceptable Macronutrient Distribution Ranges (AMR) $0.5\sim1.0%$ but that of N6 fatty acid was somewhat lower than the AMDR $4\sim8%$. N6/N3 ratio 8.5/l, however, was within the desirable range $4\sim10/1$. Considering overall dietary fatty acids intake, oleic acid was the most abundant, followed by linoleic and palmitic acid. And among polyunsaturated fatty acids intake, linoleic acid was exclusively high, accounting for 97.4% of total N6 fatty acid intake. On the contrary, three fatty acids, linolenic (67.3%), DHA (21.1%) and EPA (10.0%), together supplied 98.4% of total N3 fatty acid intake. Mean P/M/S was 0.9/l.1/1.0. The subjects' intake of fat, many fatty acids and cholesterol came from diverse food groups including meats, fats and oils, milk and milk products, eggs, fish, and soybean products. Nevertheless, the subjects tended to show unfavorable fat and fatty acids intake pattern in terms of quantity and quality. Based on these results, it is important to monitor dietary fat intake pattern of the general population continuously and an internet program such as the one used for this study would be valuable, especially for assessing dietary patterns in the younger generation.

• Korean Journal of Psychosomatic Medicine
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• v.29 no.2
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• pp.77-85
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• 2021

Breast cancer is the most prevalent oncological disease among women. Various psychosocial distress is common at the diagnosis, treatment, and posttreatment phase of breast cancer. For the treatment of breast cancer, not only medical treatment but also psychosomatic integrative care will be needed. Patients with breast cancer may lead to increased vulnerability to stress, adjustment disorder, anxiety disorder, and depressive disorder, and these psychiatric diseases and conditions are associated with recurrence or exacerbation of breast cancer. Psychosocial treatment of anxiety and depression could increase the quality of life of patients and decrease the recurrence and progression of breast cancer. In this article, we reviewed 5 clinical breast cancer survivorship guidelines focused on psychosomatic integrative care including psychosocial treatment and alternative treatment for psychosocial distress. Because 5 treatment guidelines were using various definitions of evidence, we confirmed evidence of various psychosocial treatments for patients with breast cancer based on the definition of evidence by the US Preventive Service Task Force (USPSTF) guideline. We also reviewed the effect size of psychosocial treatment for anxiety, depression, mood, and quality of life in patients with breast cancer. This article discusses the barrier to the delivery of psychosomatic integrative care and suggests integrative care planning for breast cancer. Multi-disciplinary teams, patient's needs assessment, information technology support, patient and caregiver engagement, planned periodic monitoring of psychosocial distress by a psychosomatic specialist or consultation-liaison psychiatrist are recommended as key features of a psychosomatic integrated care plan.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.16 no.6
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• pp.4031-4039
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• 2015

The problems related with blood supply shortage and the stability of blood transfusion are on the rise, as it is expected that the blood doners will decrease but the blood use amount for aged population will increase, owing to low birth and aged population increase. The purpose of this study is to analyze the hospital characteristics which affect patients receiving and non-receiving blood transfusion for the knee and hip total replacement arthroplasty. Data were collected from Health Insurance Review and Assessment Service's 2011 sample data, and 5,370 inpatients were abstracted from them. Logistic regression analysis was performed, using SPSS 20. Independent variables used are hospital characteristics variables and patient characteristics variables. Hospital characteristics variables are hospital type, ownership, residence and the number of usable beds, and patient characteristics variables are gender, age, severity, type of anesthesia, main diagnosis, whether or not of anemia and insurance class. At the result of this study, it was found that hospital type, region, gender, age, severity, main diagnosis and whether or not of anemia were the factors that mostly affected the blood transfusion for knee arthroplasty. And hospital type, residence, gender, age, severity, type of anesthesia and whether of not of anemia were the factors that mostly affected the blood transfusion for hip arthroplasty. In addition to that, it is expected that this research which analyzed the present state of blood transfusion and its influence factors are cost effective, and would make a good use of preliminary data for good quality of medical service.

• Journal of the Korean Society of Food Science and Nutrition
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• v.29 no.4
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• pp.701-711
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• 2000

To provide the baseline information for establishing community based nutritional service system in the context of health promotion, we conducted nutrition survey for 196 adults (male ; 99, female ; 97) in Kyungpook area. Individual food intake was measured by 24-hour recall method, and then diet quality was evaluated by Index of Nutritional Quality (INQ) and Mean Adequacy Ratio (MAR). Average dietary intake of Ca and Vit A of total subjects were lower than Korean Recommended Dietary Allowances (Ca; 83% of RDA, Vit A; 77% of RDA). On the whole, mean nutrients intake of male subjects were higher than that of female subjects. It also appeared that overall nutrients intake of younger women (20~29 yr) were lower than that of other age group. When we evaluated the nutrients intake of the subjects by INQ, Vit C (=2.39) showed the highest score. Ca (=0.89) and Vit A (=0.84) were revealed to be concerned nutrients in both quantity and quality. There was almost no difference in MAR between men and women (Men ; 0.88, Women ; 0.86). MAR showed significantrly positive correlation with age (p<0.05), meal frequency (p<0.001) and negative correlation with education level (p<0.01) in women, whereas no statistically significant relationship among these variables was observed in men. Age and meal frequency showed significantly positive correlation with most nutrients intakes among women. In conclusion, nutrition education strategies for sound food choice and regular meals need to be developed to improve the nutritional adequacy of female adults in the 20's.

• Journal of Digital Convergence
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• v.12 no.10
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• pp.455-466
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• 2014

This study has been implemented to improve the quality in geriatric hospital through the Hospital Accreditation. So research a change in the perception and attitude of the Patient Safety, Organizational Culture, Job Satisfaction, Financial Performance of hospital staff after the Hospital Accreditation. For this, a survay was conducted from April 1 to July 20, 2014 to targeting staffs of eight geriatric hospital in the Busan city. Thus, a total of 283 questionnaires were used in the study. Firstly, It was found that change in the perception and attitude of the Patient Safety, Organizational Culture, Job Satisfaction, Financial Performance of hospital staff after the the Hospital Accreditation. Secondly, It was found that a statistical correlation among variables such as Patient Safety, Organizational Culture, Job Satisfaction, Financial Performance. Thirdly, Organizational Culture, Job Satisfaction, Financial Performance had a positive effect on Patient Safety. Therefore, we should develop the Hospital Accreditation program with the internal assessment to implement health care quality and patient safety to ensure a complete job satisfaction of hospital staffs in the Hospital Accreditation program further improve the evaluation process of hospital care.

• Journal of Korean Academy of Nursing Administration
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• v.6 no.1
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• pp.123-134
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• 2000

This study intended to analyze the effectiveness to obtain by developing the critical pathway presented as the method to improve the quality-betterment and cost effectiveness the through the continuous and consistent patient management for the hysterectomy patient and applying it to the real practice. This study was designed to develop and effect the critical pathway for hysterectomy patients in the way to be possible the intergrated in patient management. It was adopted the process of seven phase to develop a critical pathway. To analyze the application effect of the developed critical pathway, this author offered health care service applying the critical pathway to the hysterectomy patient from July. 20 to Oct. 19. 1999. The study method had been done by investigating the experimental group and control group through the questionnaire on 40 patients who had been inpatient hysterectomy. Dependent variables were measured by modified from satisfaction, and cost and length of hospital stay. The data anlyzed by frequency, x2-test, t-test. The results of this study was as follows; 1. It was decided that the vertical line of the critical pathway was made up of eight items such as monitoring/assessment, treatment, activity, medication, consult. Lab test, diet, patient teaching and horizontal line was 7days from admission to discharge. 2. After the verifying the validity of the expert group about the critical pathway, the horizontal line was amended from hospitalization to five postoperative days and taking their consensus, some contents of the horizontal line was amended and deleted. 3. There was no significant differences in the experimental group and control group in the satisfaction, and significant differences in the cost, the length of hospital stay.

• YAKHAK HOEJI
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• v.54 no.6
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• pp.507-521
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• 2010

Training for asthma patients by professionals has been highly emphasized for patients' self-management. In the present study, three standardized training sessions targeting hospital pharmacists were performed. On the basis of the number of training sessions taken, a non-educated group (CG), an once-educated group (NG), and a twice more-educated group (IG) were allocated. The most frequent errors of using an inhalant were shaking before the use in MDI while taking breathe out before inhaling in the case of DPI, and the total average number of errors were the biggest for CG and the smallest in IG. On comparison in the number of the four symptoms of asthma according to the level of seriousness, it was revealed that the total average number was the biggest in CG and the smallest in IG. In the level of awareness regarding the contents of training for patients, patients over 50 tended to answer that they were aware of education contents, and particularly in mouth rinsing and the use before/after a meal, significant similarity was examined. Regular asthma patient training performed by hospital pharmacists appeared to reduce errors in the inhaler usage, increase the quality of life of an patient, and help a patient remember the contents of the training. Especially among patients over 50, it was found to be more effective and retraining of more than two sessions was requisite.

• Journal of the East Asian Society of Dietary Life
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• v.24 no.4
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• pp.481-487
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• 2014

This study examined microbiological contamination of street foods(kimbab, fish cake, Korean sausage) by microbiological analysis. A collection of 360 samples of street foods was obtained seasonally in four major cities(Seoul, Daejeon, Busan, Gwangju) in Korea. Aerobic mesophilic counts ranged between 1.0 and 9.9 log CFU/g, with the highest count recorded from Kimbab. Counts of psychrotrophic microorganisms were as high as those of mesophilic microorganisms. Total coliform populations between <1.0 and 7.5 log CFU/g were found in 53.6% of samples. Escherichia coli 4.4%, Staphylococcus aureus 7.8% and Clostridium perfringens 3.3%. Salmonella spp. and Listeria monocytogenes were not detected in any of the samples. Kimbab purchased in spring and summer showed higher S. aureus and Cl. perfringens contamination rates. Microbial contamination levels determined in the present study may be used as the primary data to execute microbial risk assessment of street foods.