• Title/Summary/Keyword: high quality care

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Fear of dentist care and quality of life in dental health in male high school students (일부 남자 고등학생의 치과치료 공포감과 구강건강 삶의 질에 관한 연구)

  • Lee, Jung-Hwa;Lee, Yeong-Ae;Kim, Young-Sun
    • Journal of Korean society of Dental Hygiene
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    • v.14 no.6
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    • pp.951-959
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    • 2014
  • Objectives: The purpose of this study was to find out the fear of dentist care, subjective recognition of dental health, and quality of life in the male high school students and to analyze the influencing factors on dental health care. Methods: A self-reported questionnaire was filled out by 243 special high-school in Deagu province from March 3 to March 14, 2014. The questionnaire consisted of general characteristics of the subjects(5 questions), subjective recognition of health and activities to improve health(6 questions), dental fear(20 questions), oral health related quality of life(16 questions). The instrument for dental fear was adapted from measured by Berggren Dental Fear Survey(DFS). A total of 20 DFS questions included treatment avoidance(8 questions), stimulus reaction(6 questions), and physiological reaction(5 questions) and score by Likert 5 scale. Cronbach alpha was 0.974 in the study. Oral health related quality of life was measured by 16 questions of CPQ11-14 for the adolescents by Lau. CPQ11-14 consisted of oral symptoms(4 questions), functional restriction(4 questions), and emotional wellbeing(4 questions). The instrument was score by Likert 5 scale and Cronbach alpha was 0.9354 in the study. Data were analyzed using SPSS 18.0 program for ANOVA and multiple regression analysis. Results: Fear of dentist care showed significant differences in treatment avoidance factor(p<0.001), stimulus reaction factor (p<0.05), and physiological reaction factor(p<0.001). The factors depended on subjective recognition of health and health-improving activities and differences in treatment avoidance factor(p<0.05) and physiological reaction factor(p<0.01). The dental symptoms factors showed significant differences in health recognition(p<0.001), interest in health(p<0.001), alcohol drinking status(p<0.001) and regular meal(p<0.001). While function limit factors showed differences in health recognition (p<0.001), interest in health(p<0.001), smoking(p<0.001), alcohol drinking(p<0.001) and regular meal(p<0.001). Mental and social stabilities factors showed significant differences in health recognition(p<0.001), interest in health(p<0.001) and alcohol drinking status(p<0.001). Among the factors influencing on the quality of life in dental health, interest in health(p<0.005), alcohol drinking(p<0.005) and physiological reaction in the midst of fear of dentist care(p<0.001) were the significant impact factor. Conclusions: It is necessary to develop a continuous and systematical program of dental health and dental care by experts so that the students can reduce the fear of dentist care by regular dental checkup and preventive treatment and care.

Association Between Unplanned and Planned Readmissions in an University Hospital (비예정과 예정된 재입원 환자들간의 관련 요인 분석)

  • Oh, Hyonh-Joo;Yu, Seung Hum
    • Quality Improvement in Health Care
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    • v.4 no.2
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    • pp.242-259
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    • 1997
  • This study describes associated factors of readmission of 213 inpatients from an university hospital in Seoul. This retrospective study reviewed medical records of patients who discharged from a hospital stay for general diseases between 1 August 1995 and 31 October 1995, Cases were 68 discharge patients with an unplanned readmission within 30 days of discharge from an index stay. And the other cases are 145 patients who had more than two discharges and didn't have an unplanned readmission within 30 days. Logistic regression model was analyzed and the results were as follows; 1. duration of readmission, rate of unpayed, room, path, and risk of disease were more likely to be readmitted unexpectedly than the expected readmission patients. 2. early readmission, low risk condition group, and inadquateness of discharge plann for patients had unplanned radmissions rather than planned readmissions. Therefore, discharge planning education to health care provider is required and assessement of discharge planning should be evaluated. Readmissions are usually for related problems that arose during the original hopitaliztion and caused cost problems. Especially the unplanned readmissions are frequently preventable. Ultimately, models for readmissions can serve as a valuable clinical tool for target high-risk patients and older patients and with this kind of tools we can reduce hospital readmissions and maintain high-quality of inpatient care.

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Cardiopulmonary Resuscitation: New Concept

  • Lee, Kwang-Ha
    • Tuberculosis and Respiratory Diseases
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    • v.72 no.5
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    • pp.401-408
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    • 2012
  • Cardiopulmonary resuscitation (CPR) is a series of life-saving actions that improve the chances of survival, following cardiac arrest. Successful resuscitation, following cardiac arrest, requires an integrated set of coordinated actions represented by the links in the Chain of Survival. The links include the following: immediate recognition of cardiac arrest and activation of the emergency response system, early CPR with an emphasis on chest compressions, rapid defibrillation, effective advanced life support, and integrated post-cardiac arrest care. The newest development in the CPR guideline is a change in the basic life support sequence of steps from "A-B-C" (Airway, Breathing, Chest compressions) to "C-A-B" (Chest compressions, Airway, Breathing) for adults. Also, "Hands-Only (compression only) CPR" is emphasized for the untrained lay rescuer. On the basis of the strength of the available evidence, there was unanimous support for continuous emphasis on high-quality CPR with compressions of adequate rate and depth, which allows for complete chest recoil, minimizing interruptions in chest compressions and avoiding excessive ventilation. High-quality CPR is the cornerstone of a system of care that can optimize outcomes beyond return of spontaneous circulation (ROSC). There is an increased emphasis on physiologic monitoring to optimize CPR quality, and to detect ROSC. A comprehensive, structured, integrated, multidisciplinary system of care should be implemented in a consistent manner for the treatment of post-cardiac arrest care patients. The return to a prior quality and functional state of health is the ultimate goal of a resuscitation system of care.

Feasibility to Expand Complex Wards for Efficient Hospital Management and Quality Improvement

  • CHOI, Eun-Mee;JUNG, Yong-Sik;KWON, Lee-Seung;KO, Sang-Kyun;LEE, Jae-Young;KIM, Myeong-Jong
    • The Journal of Industrial Distribution & Business
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    • v.11 no.12
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    • pp.7-15
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    • 2020
  • Purpose: This study aims to explore the feasibility of expanding complex wards to provide efficient hospital management and high-quality medical services to local residents of Gangneung Medical Center (GMC). Research Design, Data and Methodology: There are four research designs to achieve the research objectives. We analyzed Big Data for 3 months on Social Network Services (SNS). A questionnaire survey conducted on 219 patients visiting the GMC. Surveys of 20 employees of the GMC applied. The feasibility to expand the GMC ward measured through Focus Group Interview by 12 internal and external experts. Data analysis methods derived from various surveys applied with data mining technique, frequency analysis, and Importance-Performance Analysis methods, and IBM SPSS statistical package program applied for data processing. Results: In the result of the big data analysis, the GMC's recognition on SNS is high. 95.9% of the residents and 100.0% of the employees required the need for the complex ward extension. In the analysis of expert opinion, in the future functions of GMC, specialized care (△3.3) and public medicine (△1.4) increased significantly. Conclusion: GMC's complex ward extension is an urgent and indispensable project to provide efficient hospital management and service quality.

Perceptions of Quality of Patient-Centered Nursing Care among Women with Breast Cancer (유방암 여성이 인식한 환자중심 간호의 질)

  • Kang, Jiyoung;Suh, Eunyoung E
    • Perspectives in Nursing Science
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    • v.12 no.2
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    • pp.115-123
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    • 2015
  • Purpose: This study aimed to investigate the quality of patient-centered nursing care (PCNC) among women with breast cancer at a cancer center in Seoul, Korea. Methods: In a cross-sectional survey design, 223 women with breast cancer were recruited from the oncology surgery unit. The Korean version of the oncology patients' perceptions of the quality of nursing care scale, which is conceptualized in four sub-dimensions (individualization, proficiency, responsiveness, and coordination) was used for measurement. Data were analyzed using descriptive statistics and ANOVA. Results: The participants were all women, with a mean age of 51.3 years. The mean score of PCNC was high and significantly different from each other according to age group. Breast cancer women, who had mastectomy, were satisfied highly in terms of proficiency and responsiveness care, but less satisfied with individualization and coordination care than those of other women. Conclusion: The findings of this study show the quality of cancer nursing care, especially focusing on patient-centeredness, can be measured from the patients'perspective. The individualized and coordinated nursing care is considered to be the core of quality cancer care implying patient-centeredness. Based on the findings of this study, more research is necessary to explore the patients' view of quality cancer care and to test the effects of PCNC within the context of comparative effectiveness.

시설 호스피스에 있어서 가족지지가 말기 암 환자의 삶의 질에 미치는 영향

  • Gang Seung-Gye;kim Su-Ho;kim Sin-Su;park Hui-Myeong;song Geun-Ok;Won Ju-Hui;Lee Myeong-Suk;Lee Seong-Ok;Lee Eun-Ui;Lee Chae-Yeong;Lee Hyeon-Mi
    • Korean Journal of Hospice Care
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    • v.3 no.1
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    • pp.31-41
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    • 2003
  • Background: The purpose of this study is to assess the effectiveness of family support on the quality of life in patients admitted to the hospice facility at Saemmul Hospice. Method: The subjects of this study were 152 terminal cancer patients that were admitted to the hospice facility at Saemmul hospice between January 2002 and February 2003. Their each quality of life were assessed at admission, one, three, five and seven weeks at Saemmul Hospice using a questionnaire prepared by the Saemmul hospice and were anlalyzed by means of T-test. Result: There was no difference in the quality of life score between patients with family support and patients without family support in terms of physical, psychosocial, and spiritual aspects in the admission. There was no difference in the quality of life score between the patients with frequent family member's visit(>=8) and less frequent family visit(<=7), and between the patients whose family members stayed at the facility for 24hrs and the patients without staying family members. There was no difference in the quality of life score between the patients in low-middle and low-high class among 9 classes of familial economic status(high-high, high-middle, high-low, middle-high, middle-middle, middle-low, low-high, low-middle, low-low). There was no difference in the quality of life score between the patients whose familial religion were Christianity and the patients with other religions. After 1, 3, 5, 7 weeks assessment, the scores in the physical, psychosocial, spiritual aspect of quality of life were increased. Conclusion: The results suggest that family support is important to improve the quality of life in hospice patients and hospice care team is needed to replace 24 hours of family care. There is a urgent need of trained hospice care teams, so training programs for physicians, nurses, clergies, social workers, and volunteers are necessary.

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Practical Considerations in Providing End-of-Life Care for Dying Patients and Their Family in the Era of COVID-19

  • Kim, Yejin;Yoo, Shin Hye;Shin, Jeong Mi;Han, Hyoung Suk;Hong, Jinui;Kim, Hyun Jee;Choi, Wonho;Kim, Min Sun;Park, Hye Yoon;Keam, Bhumsuk
    • Journal of Hospice and Palliative Care
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    • v.24 no.2
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    • pp.130-134
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    • 2021
  • In the era of coronavirus disease 2019 (COVID-19), social distancing and strict visitation policies at hospitals have made it difficult for medical staff to provide high-quality end-of-life (EOL) care to dying patients and their families. There are various issues related to EOL care, including psychological problems of patients and their families, difficulties in EOL decision-making, the complicated grief of the bereaved family, moral distress, and exhaustion of medical staff. In relation to these issues, we aimed to discuss practical considerations in providing high-quality EOL care in the COVID-19 pandemic. First, medical staff should discuss advance care planning as early as possible and use the parallel planning strategy. Second, medical staff should play a role in facilitating patient-family communication. Third, medical staff should actively and proactively evaluate and alleviate dying patients' symptoms using non-verbal communication. Lastly, medical staff should provide care for family members of the dying patient, who may be particularly vulnerable to post-bereavement problems in the COVID-19 era. Establishing a system of screening high-risk individuals for complicated grief and connecting them to bereavement support services might be considered. Despite the challenging and limited environment, providing EOL care is essential for patients to die with dignity in peace and for the remaining family to return to life after the loved one's death. Efforts considering the practical issues faced by all medical staff and healthcare institutions caring for dying patients should be made.

The Principles of Total Quality Management(TQM) and Its Implementation. (총체적 질관리(Total Quality Management)의 이론적 배경과 그 적용실태)

  • Kang, So-Young
    • Journal of Korean Academy of Nursing Administration
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    • v.1 no.2
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    • pp.388-407
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    • 1995
  • This study is (a) to describe the history of Total Quality Management (TQM) generated in the industry, health care service, and nursing society ; (b) to define the concept, total quality management including the definition of quality ; (C) to explain the each principle of TQM theory developed by main theorists, E. Deming, J. Juran, and B. Crosby ; (d) to give the examples related to TQM implementation at the health care organization ; and (e) to mention the extent to which the health care organizations are able to evaluate their cultural organization toward TQM and have had the way to measure the effect of TQM implementation. TQM referred to Continuous Quality Improvement(CQI), Quality Improvement(QI), and Total Quality Improvement(TQI), was not recognized by experts in the United States industry, but by economists in Japan until the end of the 1970's. However, the United States' government led to introduce the principles of TQM to general industry as well as health care service area so that TQM became a main philosophy to manage the organizations in health care service. TQM is a structured, systematic process for creating organization-wide participation in planning and implementing continuous improvement in quality. E. Deming established the "Chain reaction in Quality" and the fourteen point of TQM. The Chain reaction in quality is to describe the relationship among the reduction of waste, rework, and delay, quality improvement, customer satisfaction, and productivity. There are fourteen points to explain the principles of TQM by E. Deming. Juran defined the "Quality Trilogy" to improve the level of quality in any organization. Quality Trilogy has three steps such as quality planning, quality control, and quality improvement for implementing the TQM projects. Crosby describes his TQM theory by establishing "Four Absolutes" and "Fourteen steps in TQM" implementation. Until now, most healthcare organizations have made efforts to organize the TQM task team and to implement TQM principles with various issues. There are three priorities to select the TQM issues : High-volume, High-risk, and Problem-prone. However, there is no absolute, credible measurement yet to evaluate the effects of TQM implementation in health care organization regardless of the classification of health care organizations, geographical background, and social influence. Thus, developing the evaluation way in terms of TQM is the foremost task in health service area. The most important thing for TQM implementation in the organization is to settle up the concept, cultural transformation from traditional management toward quality.

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Foreign Residents' Experience of Korean Health Care Services (한국 거주 외국인의 의료서비스 경험)

  • Lee, Byoung-Sook;Oh, Ick-Keun;Lee, Eun-Mi
    • Journal of Korean Academy of Nursing Administration
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    • v.17 no.2
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    • pp.226-237
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    • 2011
  • Purpose: This study was done to identify the experience of health care services by foreign residents in Korea. Method: Participants were 12 foreigners from China, North America, and Japan. Qualitative data were collected using three focus group interviews and analyzed with qualitative content analysis. Results: The participants' experience of health services was categorized as 21 sub-categories, 11 categories and three main categories. The main categories were 'Quality of health care', 'Health care personnel', and 'Health care system and infrastructure'. The main category of 'Quality of health care' included three categories, 'Health care personnel' included another four categories, and 'Health care system and infrastructure' included the remaining four categories. The participants reported positive experiences such as favorable feelings and satisfaction particularly, with the high quality of health care but also negative experiences such as apprehension, distrust, difficulties, and inconvenience in the health care service in Korea. Conclusions: The results of this study can be helpful in the development of strategies to improve health care services for foreigners by providing fundamental information about the foreign residents' experience of health care services in Korea from their perspectives.

The Effects of the Perception of Quality Improvement in Health Care and Operational Performance on Customer Orientation and Job Performance after Healthcare Accreditation (의료기관인증제 시행 후 의료 질 향상과 운영성과에 대한 인식이 고객지향성 및 직무성과에 미치는 영향)

  • Jang, Won-Hyuk;Lee, Seung-Jae;Yi, Sun-Chan;Ryu, Hwang-Gun
    • The Korean Journal of Health Service Management
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    • v.11 no.2
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    • pp.1-15
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    • 2017
  • Objectives : This study aimed to identify the perception of quality improvement in health care and operational performance after the implementation of the Healthcare Accreditation. Methods : Data were collected from 5 hospitals that have experienced the 2th Healthcare Accreditation in Busan, South Korea. A Likert 5-point scale was used to measure the research variables and a structured questionnaire was used. Finally, 206 valid cases were analyzed using SPSS win 18.0. For hypothesis testing, hierarchical multiple regression analysis were performed. Results : The perception of quality improvement in health care after the implementation of the Healthcare Accreditation was higher than the operational performance. In the customer orientation and job performance, the perception of quality improvement in health care and operational performance had a significant influence. Conclusions : It is necessary to use the Healthcare Accreditation as a virtuous cycle of management that can ensure enforcement of workplace regulations and improve the members'ability to provide high quality medical services.