• Title/Summary/Keyword: hospital operations

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Crisis Management System in Hospitals (병원의 위기관리 시스템)

  • Kim, Hyeongjin
    • Korea Journal of Hospital Management
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    • no.spc
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    • pp.85-95
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    • 2016
  • This study is to introduce a comprehensive framework of a crisis management system developed at a prominent hospital in South Korea. Throughout recent decades, especially in the recent years, the way in which to cope with both internal and external challenges has been one of the most critical issues. Since the incident management system in the U.S. is acknowledged as the most advanced crisis management model in the world, a portion of this study refers to the Hospital Incident Command System(HICS) provided by the California Emergency Medical Services Authority(EMSA). Nevertheless, the framework suggested in this article was designed based on a distinctive Korean hospital setting. The main contents of this study are as follows; categorization of each type of crisis, organization of a crisis management team in a non-crisis or crisis state, crisis assessment by life cycle stage, and establishment of crisis management protocol. Even though many types of crises are unspecified, those can be categorized into external crisis, medical crisis, and utility & activity failure. A crisis management organization should be operated and consisted differently- depending on a crisis or non-crisis situation. From a life-cycle perspective, the range by which the crisis should be managed extends from pre-stage to post-stage of the crisis. It is important to set proper scenarios and manuals by crisis type to develop a crisis management framework of high quality. With continuous efforts, hospitals can prepare for the uncertainty to better concentrate on core business operations.

A comparison of Wilson and Chevron osteotomy in the Treatment of Hallux valgus (무지 외반증에서 Chevron 술식과 Wilson 술식의 결과 비교)

  • Park, Seong-Jin;Lee, In-Ju;Choi, Nam-Yong;Han, Suk-Gu;Choo, In-Tak;Kang, Yong-Mok
    • Journal of Korean Foot and Ankle Society
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    • v.2 no.1
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    • pp.1-5
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    • 1998
  • In a retrospective study, we compared the results of 24 cases of Chevron osteotomies with those of 17cases of Wilsons osteotomies in the treatment of hallux valgus. We used FFSS(Fore Foot Scoring System) and radiographic findings. There were no differences between the two operations in terms of pain relief and appearance. All patients in the Chevron and Wilsons osteotomy group had good functional results and were more satisfied with the appearance of the foot. We conclude Wilsons osteotomy is useful method for correction of hallux valgus.

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Extraskeletal Calcifications in Children with Maintenance Peritoneal Dialysis

  • Oh, Eunhye;Min, Jeesu;Lim, Seon Hee;Kim, Ji Hyun;Ha, Il-Soo;Kang, Hee Gyung;Ahn, Yo Han
    • Childhood Kidney Diseases
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    • v.25 no.2
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    • pp.117-121
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    • 2021
  • Chronic kidney disease (CKD)-mineral and bone disorder (CKD-MBD) is a common complication of CKD, often accompanied by extra-skeletal calcification in adult patients. As increased vascular calcification is predicted to increase cardiovascular mortality and morbidity, the revised Kidney Disease: Improving Global Outcomes guidelines recommend avoiding calcium-containing phosphate chelators. However, extra-skeletal calcification is less commonly noticed in pediatric patients. Here, we report our experience of such a complication in pediatric patients receiving maintenance peritoneal dialysis. Extra-skeletal calcification was noticed at the corneas, pelvic cavity, and soft tissues of the lower leg in 4 out of 32 patients on maintenance peritoneal dialysis. These patients experienced the aggravation of extra-skeletal calcifications during peritoneal dialysis, and 2 of them underwent excisional operations. It is required to monitor extra-skeletal calcifications in children on kidney replacement therapy.

A Study on the Medical Program and Space Configuration for Veterinary Medical Teaching Hospital - Focused on the Analysis of Veterinary Medical Teaching Hospital built in the last ten years of Korea (수의과대학 반려동물병원의 프로그램 및 공간구성에 관한 연구 - 최근 10년 내에 준공 된 국내 수의과대학 동물병원 분석을 중심으로)

  • Kim, Dohyeon
    • Journal of The Korea Institute of Healthcare Architecture
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    • v.23 no.3
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    • pp.71-80
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    • 2017
  • Purpose: At the moment prevention and treatment of animal related diseases is becoming a social concern as the demand for animal increases. Furthermore, The design of the veterinary medical teaching hospital are even more complex because they have to accommodate medical program for animal and education and research program for students. However, there are a few experience and useful guidelines for the planning of the veterinary medical teaching hospital. So it is not easy for the regional hub universities to work out the proper plan for the construction of the veterinary medical teaching hospital for their own. This study has been started in order to provide basic informations for the planning of Korean veterinary medical teaching hospital. Methods: Interview to veterinarian, intern and employee of the veterinary medical teaching hospital and Field surveys to veterinary medical teaching hospital in Korea have been conducted for the data collection. The drawings of three universities of veterinary medical teaching hospital have been analysed and diagramed. Results: The result of this study can be summarized into three points. The first one is that the veterinary medical teaching hospital spaces are divided into five areas (ambulatory care, central medical care, hospitalization, education and research, operations and support) and each area is divided independently and connected properly. The second one is that the veterinary medical teaching hospital differs from hospital in the detailed space plan in the sense that the animal is a patient. The third one is that each hospital has different operating practices and programs according to local conditions Implications: It is meaningful as a basic source of veterinary medical teaching hospital design in the future.

Importance-Performance Analysis of Evaluation Indicators in Hospital Nutrition Department (병원 영양부서 평가지표에 대한 중요도-수행도 분석)

  • Lee, Joo-Eun
    • Journal of the Korean Dietetic Association
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    • v.18 no.4
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    • pp.326-343
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    • 2012
  • This study has attempted to collect actual spot's opinions and analyze importance-performance of indicators for the evaluation of hospital nutrition department. The results of this research were as follows: first, the average score of self-estimated performance was 3.75 based on a 5-point scale. The degrees of importance of hospital foodservice and nutrition department management were in the range of 3.71~4.85 out of 5.0 and the mean importance degree score was 4.37. Second, the average score of self-estimated performance in each category was significantly higher in the case of general special hospital compared to general hospital. Especially average performance score of nutrition management in the general special hospital was higher than that of general hospital (P<0.001). The average performance score of the hospital with more beds was significantly higher than that with less beds. Contract managed hospital's score was significantly higher than that of self-operated hospital in two categories, "facilities management" and "nutrition management" (P<0.05, P<0.01). In foodservice and nutrition management of task-separated hospitals, the average performance scores were significantly higher than those of not-separated hospitals (P<0.01, P<0.001). Third, according to the importance-performance analysis of recognition about indicators for the hospital nutrition department's operations evaluation, 'foodservice facilities management' and 'foodservice sanitation management' were in 'doing great', 'nutritional management' and 'operational management' were in 'low priority', and 'other foodservice management' was in 'overdone'. In conclusion, there's a need for institutional specific standards of sanitation for Korean hospital foodservice.

Descended Mouth Corner: An Ignored but Needed Feature of Facial Rejuvenation

  • Vidal, Pedro;Berner, Juan Enrique;Castillo, Pablo;Rochefort, Gunther;Loubies, Rodrigo
    • Archives of Plastic Surgery
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    • v.40 no.6
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    • pp.783-786
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    • 2013
  • For years, the gold standard in facial rejuvenation has been the face lift. However, exploring new, less complex procedures for achieving the same goal is currently drawing interest. Rejuvenation of the perioral area is a difficult task for plastic surgeons because of the minimal effect that face lift procedures have over this region and the lack of published material on the subject. In this article, the descended mouth corner anguloplasty technique is presented. It is a 20-minutes lift technique that can correct this typical feature of the ageing mouth. The authors have treated 71 patients using the technique with consistently good results, with just one requiring revision. They conclude that this procedure by itself and in combination with other small operations or even a full face lift can rejuvenate the ageing face.

Infection of Cranioplasty Seen Twenty Years Later

  • Gurbuz, Mehmet Sabri;Celik, Ozgur;Berkman, Mehmet Zafer
    • Journal of Korean Neurosurgical Society
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    • v.52 no.5
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    • pp.498-500
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    • 2012
  • Cranioplasty is performed using autograft and allograft materials on patients to whom craniectomy was applied previously due to the facts that, this region is open to trauma and the scalp makes irritation and pressure onto the brain paranchyma causing brain atrophy and convulsions. Dramatical improvement of neurological deficits, control of convulsions and partial prevention of cerebral atrophy are achieved after these operations. One of the most important complications of cranioplasty is late infection. Here, we report a 43-year-old male patient admitted with the history of purulant discharge from the right temporal incission site for one year to whom cranioplasty had been performed with allograft material 20 days after craniectomy which had been performed in 1989. Allograft cranioplasty material was removed and cranioplasty was performed using new allograft material with the diagnosis of late cranioplasty infection.

Laparoscopic Surgery for Removal of the Multiple Large Gastric Bezoars

  • Hong, Tae-Ho;Kim, Jin-Jo;Park, Seung-Man
    • Journal of Gastric Cancer
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    • v.10 no.2
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    • pp.84-86
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    • 2010
  • Bezoars are retained concretions of undigested animal or vegetable material that can produce gastrointestinal obstruction, ulceration, and bleeding. Therapeutic options for gastric bezoars include enzyme therapy (papain, cellulase, or acetylcysteine), endoscopic disruption and removal, and surgical removal. Multiple large gastric bezoars generally require conventional surgical management through an upper abdominal incision. With the recent improvement of laparoscopy, a lot of portions of abdominal operations have been performed laparoscopically. We successfully removed multiple large gastric phytobezoars in a 52-year-old female completely through laparoscopy. This supported the feasibility of laparoscopic surgery for patients with gastric bezoars.

The Treatment of Neuroma-in-Continuity with Interpositional Nerve Graft and Vein Wrapping - A Case Report - (신경 이식과 정맥 포장을 이용한 연속성 신경종의 치료 - 1예 보고 -)

  • Kwon, Boo-Kyung;Baek, Jong-Ryoon;Kim, Dong-Hwan
    • Archives of Reconstructive Microsurgery
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    • v.19 no.2
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    • pp.93-96
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    • 2010
  • We report a case of 44 years old male patient with neuroma-in-continuity of ulna nerve. In the patient's past history, he had received operative treatment for the open supracondylar fracture of right distal humerus and ulnar nerve injury at 10 years ago, and neurolysis was tried 2 times due to severe neuropathic pain. Despite of these operations, the symptom was not improved. In operative field, we noticed neuroma-in-continuity and decided to resect the neuroma until normal nerve fascicle was noted. The nerve cable graft was done with auto sural nerve on the defect site and the nerve was wrapped with small saphenous vein. At post operative 7 months, pain was markedly decreased and sensory recovery was slightly improved and patient was satisfied with the result.

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Traumatic Disc Injuries and the Iatrogenic Spinal Disability (외상성 추간판 손상과 의원성 척추장애인 만들기)

  • Lee, Kyeong-Seok;Doh, Jae-Won;Yoon, Seok-Mann;Bae, Hack-Gun;Yun, Il-Gyu
    • Journal of Korean Neurosurgical Society
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    • v.29 no.7
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    • pp.935-939
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    • 2000
  • Objective : Traumatic disc lesion is a lesion with tremendous controversies. The causal relationships of this lesion are not established along with pathogenesis, diagnostic criteria, methods of treatment and the outcome. However, a significant number of patients with back pain after a trauma underwent spinal operations under the diagnosis of traumatic disc lesions. Such an ill-directed operation eventually produce a person with an iatrogenic disability. We present two illustrative cases, and tried to make a preventive method. Methods : We examined the path from mild trauma after a road traffic accident into the iatrogenic disability in two illustrative cases, who requested disability assessment and medical appraisement. We evaluated the reason and background for such an unwanted outcome and tried to find a method to reduce or prevent it by a literature review. Results : These two patients were admitted to the hospital with the diagnosis of lumbar sprain after a road traffic accidents. They eventually underwent spinal surgery under another diagnosis such as traumatic disc herniation or internal disc disruption. They stayed at the hospital for more than six months and finally lost their jobs. They became the disabled at last. Although they complained back pain, they never insisted by themselves that their symptoms were due to the traumatic disc lesion. To prevent such an iatrogenic disability, the doctors should assist them to go-back to the workplace promptly instead of a reckless extension of the treatment period. It may be necessary to evaluate the certificates to extend the treatment period with an additional diagnosis by a medical expert. To reduce the unnecessary long-term admission, a new billing system such as a partial share for the high cost of the treatment by the patients may be needed. Conclusion : It is not the patient but the doctors, who has the responsibility to avoid the unnecessary operations. All treating doctors should try to reduce or prevent such an iatrogenic complication caused by ourselves before we are forced to do so.

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