• Journal of Digital Convergence
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• v.21 no.1
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• pp.19-27
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• 2023

This is an implementation study towards the development of a strategy to improve the pneumonia adequacy evaluation index of regional public hospital and to confirm its effectiveness. One physician, eight nurses, one computer room staff, and one nursing professor working at a regional base public hospital located in N city participated in this study from March to October 2021. An implementation study was conducted based on the conceptual model of Zuber-Skerritt & Fletcher. The stages of planning, implementation, evaluation, and reflection were operated in two cycles, and the effectiveness was evaluated in the second and third quarters. Compared to the pneumonia adequacy evaluation index in 2019, all indicators reached 100% of the standard target in 2021. The results of this study therefore infer that to provide higher quality medical services in the future, it is necessary to apply medical quality improvement activities through practical research under multidisciplinary participation and cooperation and to review the applicability of clinical sites.

• The Journal of Asian Finance, Economics and Business
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• v.9 no.1
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• pp.93-103
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• 2022

The main purpose of this study was to gauge the patient satisfaction index and subsequently discuss the Importance-Performance (IP) matrix analysis of the inpatient services in the context of the private hospital setting. The Malaysian Customer Satisfaction Index Model was employed as the theoretical framework for the above purposes. This study involving 242 patients in Malaysian's private healthcare sector used a Web-based survey as the main method of data collection. Partial least square structural equation modeling (PLS-SEM) was utilized for data analysis. Using Fornell et al. (1996)'s formula, the resulting patient satisfaction index was slightly lower than the "very satisfied" category, the target level required for positioning as one of the world's premier medical tourism players. The IP matrix showed that medical quality is the main competitive advantage of the private hospitals that can propel their growth in the global healthcare marketplace. The results also indicate that outcome quality, patient rights, and privacy, and service quality are the three quality domains that need to be prioritized for further improvement. On the other hand, the servicescape quality domain needs to be strategized as the unique selling proposition as the performance of the private hospitals in this regard is already extremely good.

• Korean Journal of Radiology
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• v.23 no.9
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• pp.878-888
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• 2022

Objective: To investigate the clinical impact of a quality improvement program including dedicated emergency radiology personnel (QIP-DERP) on the management of emergency surgical patients in the emergency department (ED). Materials and Methods: This retrospective study identified all adult patients (n = 3667) who underwent preoperative body CT, for which written radiology reports were generated, and who subsequently underwent non-elective surgery between 2007 and 2018 in the ED of a single urban academic tertiary medical institution. The study cohort was divided into periods before and after the initiation of QIP-DERP. We matched the control group patients (i.e., before QIP-DERP) to the QIP-DERP group patients using propensity score (PS), with a 1:2 matching ratio for the main analysis and a 1:1 ratio for sub-analyses separately for daytime (8:00 AM to 5:00 PM on weekdays) and after-hours. The primary outcome was timing of emergency surgery (TES), which was defined as the time from ED arrival to surgical intervention. The secondary outcomes included ED length of stay (LOS) and intensive care unit (ICU) admission rate. Results: According to the PS-matched analysis, compared with the control group, QIP-DERP significantly decreased the median TES from 16.7 hours (interquartile range, 9.4-27.5 hours) to 11.6 hours (6.6-21.9 hours) (p < 0.001) and the ICU admission rate from 33.3% (205/616) to 23.9% (295/1232) (p < 0.001). During after-hours, the QIP-DERP significantly reduced median TES from 19.9 hours (12.5-30.1 hours) to 9.6 hours (5.7-19.1 hours) (p < 0.001), median ED LOS from 9.1 hours (5.6-16.5 hours) to 6.7 hours (4.9-11.3 hours) (p < 0.001), and ICU admission rate from 35.5% (108/304) to 22.0% (67/304) (p < 0.001). Conclusion: QIP-DERP implementation improved the quality of emergency surgical management in the ED by reducing TES, ED LOS, and ICU admission rate, particularly during after-hours.

• Quality Improvement in Health Care
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• v.17 no.1
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• pp.89-105
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• 2011

Background : The purpose of study in to grasp the level of perception of hospital workers on the patient safety culture, consider the difference in perception of patients safety culture according to medical service and finally find out a way to establish patient safety culture in hospital. Methods : As for the data, the analysis on frequency, t-test, ANOVA and tukey test were carried out by using SPSS 12.0. Result : The results of comparison among the positive response ratios on the patients culture of hospital workers showed that the subjects had perceived the teamwork within units most positively(74.1%), and perceived most negatively on the non-punitive response to error(16.2%)and the staffing(26.2%). 68.6% of subjects answered that the medical error were mostly of always reported. when daytime working hours are longer, perception of patient safety culture ranked low. In general, departments for direct medical service than departments for indirect medical service assessed patient safety culture high. Conclusion : Organizational learning and teamwork within units, communication openness, active support of hospital management for patient safety, and cooperation across the units would be crucial to promote the overall perceptions of patients safety of hospital workers and the level of patients safety in the units and to improve the quality of the event reporting system.

• The Korean Journal of Emergency Medical Services
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• v.16 no.3
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• pp.29-43
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• 2012

Purpose : The goal of the present study is to provide the basic information to medical control which is the most important improving factor of pre-hospital medical treatment. Method : A total of 749 records of direct medical control were collected from 119 EMTs in emergency medical information center of Daejeon, Chungcheongnam-do and Chungcheongbuk-do from March 1, 2010 to February 28, 2011. Results : The 119 EMTs should record the level of qualification of EMT and general patient history taking precisely when they receive direct medical controls. The doctors should take medical controls within the task range of qualification of EMTs. Conclusion : It is necessary to establish the guideline of medical direction and protocol of prehospital emergency care. The quality improvement of pre-hospital emergency services will be possible by the guideline and protocol.

• Quality Improvement in Health Care
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• v.26 no.2
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• pp.104-112
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• 2020

This study was done to investigate the independent organizations established for patient safety, related policies, and the duties of experts in other countries. Australia established an organization called the Commission in 2006, the United Kingdom established the National Patients Safety Agency in 2001, and the United States assigned its work to the Agency for Healthcare Research and Quality in 2005. This was done by law in all three countries. The experts for patient safety were mainly called the "patent safety and quality coordinator", and although there was no qualification system for carrying out patient safety work, all three countries had licenses in the health care field or required more than 4-5 years of practical experience. The main duties were planning on patient safety and quality of healthcare service, data collection and analysis, and education, etc. and for this, competencies such as communication, leadership, and teamwork were required.

• Journal of Audiology & Otology
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• v.24 no.2
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• pp.91-98
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• 2020

Background and Objectives: This study aimed to compare functional hearing with the use of a personal sound amplification product (PSAP) or a basic hearing aid (HA) among sensorineural hearing impaired listeners. Subjects and Methods: Nineteen participants with mild-to-moderate sensorineural hearing loss (SNHL) (26-55 dB HL; pure-tone average, 0.5-4 kHz) were prospectively included. No participants had prior experience with HAs or PSAPs. Audiograms, speech intelligibility in both quiet and noisy environments, speech quality, and preference were assessed in three different listening conditions: unaided, with the HA, and with the PSAP. Results: The use of PSAP was associated with significant improvement in pure-tone thresholds at 1, 2, and 4 kHz compared to the unaided condition (all p<0.01). In the quiet environment, speech intelligibility was significantly improved after wearing a PSAP compared to the unaided condition (p<0.001), and this improvement was better than the result obtained with the HA. The PSAP also demonstrated similar improvement in the most comfortable levels compared to those obtained with the HA (p<0.05). However, there was no significant improvement of speech intelligibility in a noisy environment when wearing the PSAP (p=0.160). There was no significant difference in the reported speech quality produced by either device or in participant preference for the PSAP or HA. Conclusions: The current result suggests that PSAPs provide considerable benefits to speech intelligibility in a quiet environment and can be a good alternative to compensate for mild-to-moderate SNHL.

• Korean Journal of Audiology
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• v.24 no.2
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• pp.91-98
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• 2020

Background and Objectives: This study aimed to compare functional hearing with the use of a personal sound amplification product (PSAP) or a basic hearing aid (HA) among sensorineural hearing impaired listeners. Subjects and Methods: Nineteen participants with mild-to-moderate sensorineural hearing loss (SNHL) (26-55 dB HL; pure-tone average, 0.5-4 kHz) were prospectively included. No participants had prior experience with HAs or PSAPs. Audiograms, speech intelligibility in both quiet and noisy environments, speech quality, and preference were assessed in three different listening conditions: unaided, with the HA, and with the PSAP. Results: The use of PSAP was associated with significant improvement in pure-tone thresholds at 1, 2, and 4 kHz compared to the unaided condition (all p<0.01). In the quiet environment, speech intelligibility was significantly improved after wearing a PSAP compared to the unaided condition (p<0.001), and this improvement was better than the result obtained with the HA. The PSAP also demonstrated similar improvement in the most comfortable levels compared to those obtained with the HA (p<0.05). However, there was no significant improvement of speech intelligibility in a noisy environment when wearing the PSAP (p=0.160). There was no significant difference in the reported speech quality produced by either device or in participant preference for the PSAP or HA. Conclusions: The current result suggests that PSAPs provide considerable benefits to speech intelligibility in a quiet environment and can be a good alternative to compensate for mild-to-moderate SNHL.

• Journal of Korean Medical Science
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• v.33 no.48
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• pp.305.1-305.5
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• 2018

Background: In 1997 the Korean Association of Medical Journal Editors (KAMJE) instituted a program to evaluate member journals. Journals that passed the initial evaluation were indexed in the KoreaMed. Here, we report changes in measures of quality of the KAMJE member journals during the last 20 years. Methods: Quality measures used in the study comprised 3 assessment categories; self-assessment by journal editors, assessment of the journals by KAMJE reviewers, and by Korean health science librarians. Each used detailed criteria to score the journals on a scale of 0 to 5 or 6 in multiple dimensions. We compared scores at baseline evaluation and those after 7 years for 129 journals and compared improvements in journals indexed vs. not-indexed by the Web of Science (Science Citation Index Expanded; SCIE). Results: Among 251 KAMJE member journals at the end of 2015, 227 passed evaluation criteria and 129 (56%) had both baseline and 7-year follow-up assessment data. The journals showed improvement overall (increase in median [interquartile range; IQR] score from baseline, 0.47 [0.64]; 95% confidence interval [CI], 0.44-0.61; P < 0.001) and within each category (median [IQR] increase by editor's assessment, 0.17 [0.83]; 95% CI, 0.04-0.26; P = 0.007; by reviewer's, 0.45 [1.00]; 95% CI, 0.29-0.57; P < 0.001; by librarian's, 1.75 [1.08]; 95% CI, 1.77-2.18, P < 0.001). Before the foundation of KAMJE in 1996, there were only 5 Korean medical journals indexed in the MEDLINE and none in SCIE, but 24 journals in the MEDLINE and 34 journals in SCIE were indexed by 2016. Conclusion: The KAMJE journal evaluation program successfully contributes improving the quality of the member journals.

• Tuberculosis and Respiratory Diseases
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• v.81 no.3
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• pp.175-186
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• 2018

Pneumonia is an important cause of morbidity and mortality. Since 2014, the Health Insurance Review and Assessment Service (HIRA) has assessed the overall quality of care among hospitalized adult patients with community-acquired pneumonia (CAP) provided by all medical institutions in Korea. A committee of the Korea Academy of Tuberculosis and Respiratory Diseases developed the hospital inpatient quality measures set for CAP consisting of eight core measures and five monitoring measures. The composite measure score was calculated. The medical records of hospitalized adult patients ages 18 years or more with CAP from October to December 2014 were evaluated. The data of 523 hospitals (42 tertiary hospitals [8.0%], 256 general hospitals [49%], and 225 hospitals [43.0%]) and 15,432 cases (tertiary hospitals, 1,673 cases [10.8%]; general hospitals, 8,803 cases [57.1%]; hospitals, 4,956 cases [32.1%]) were analyzed. We found large variations among institutions in terms of performance of care measures for CAP. For the composite measure score, the mean value was 66.7 (tertiary hospitals, 98.5; general hospitals, 79.2; hospitals, 43.8). Despite significant differences in measure scores between tertiary, general hospitals and hospitals, no significant differences were found in mortality between hospitals. Further studies are needed to determine the care measures appropriate for CAP.