• 한국의료질향상학회지
• /
• 제21권1호
• /
• pp.52-61
• /
• 2015

Objectives: Because recently hospital had to faced with financial hardship, we have to have more effective hospital management. The purpose of this study was to reduce loss costs of the hospital through the systematic management of medical supplies and increase operational efficiency. Methods: The team was composed of outpatient nursing staff, medical record administrator, nurses in medical insurance, medical computer center, dermatologists for this study. We surveyed for 114 people including outpatient nursing staff, nurse aids, medical assistant, physician assistant. Pre-survey period was 2013.03.11 ~ 03.30(2 weeks), and post-survey period was 2013.09.03 ~ 09.17(2 weeks). Result: We improved this way through the computational improvement, conservation campaigns, inventory management, staff training, replaced by low-cost medical supplies. The finding of this study were as follows: Comparing before and after the activity of outpatient nursing staff's degree of knowledge, performance, economic consciousness, the degree of knowledge, performance was increased, but there was no significant change in economic consciousness. Performance of Married person is higher than the unmarried, In addition, the high-position people were more the degree of knowleage, economic consciousness. After activity, correlation of goods and treatment, examinations is increasing, but statistically there was no mean. Conclusion: This study revealed that knowledge in a short period of activity, but also can improve, perform the same change in behavior is not easy. This one shows the intensive training required to sustained and systematic behavioral changes, such as changes in behavior, perform rituals to help the economy. Expensive medical supplies to replace a similar effect as the cost of materials just to have a lot of cost savings. Therefore, more medical supplies change is necessary to develop alternative treatment and cost cutting.

• 한국의료질향상학회지
• /
• 제10권1호
• /
• pp.28-41
• /
• 2003

Background : Because unplanned readmissions to intensive care unit(ICU)might be related with undesirable patient outcomes, we investigated the pattern of and reason for unplanned ICU readmission to provide baseline data for reducing unplanned returns to ICU. Methods : The subjects included all patients who readmitted to ICU during the same hospitalization at a tertiary referral hospital between January 1st and June 30th 2002. Quality improvement(QI) nurse collected the data through medical records and a medical director reviewed the data collected. Results : 1) The average unplanned ICU readmission rate was 5.6%(gastroenterology 14.6%, pediatrics 12.7%, pulmonology 11.9%, neurosurgery 6.3%, general surgery 5.3%, chest surgery 3.9%, and cardiology 3.3%). 2) Among the unplanned readmissions, more than 50% of cases were from patients older than 60 years, and the main categories of diagnose at hospital admission were neurologic disease(29.9%) and cardiovascular disease(27.6%). 3) Of unplanned ICU readmissions, 41.8% had recurrence of the initial problems, 44.8% had occurrence of new problems. And 9.7% required post-operative care after unplanned operations. 4) The most common cause responsible for unplanned ICU readmission were respiratory problem(38.3%) and cardiovascular problem(14.3%). 5) About 40% of unplanned ICU readmission occurred within 3 days after ICU discharge. 6) Average length of stay of the readmitted patients to ICUs were much longer than that of non-readmitted patients. 7) Hospital mortality rate was much higher for unplanned ICU readmitted patients(23.6%) than for non-readmitted patients(1.5%) (P<0.001). Conclusions : This study showed that the unplanned ICU readmitted patients had poor outcomes(high morality and increased length of stay). In addition study results suggest that more attention should be paid to patients in ICU with poor respiratory function or elderly patients, and careful clinical decisions are required at discharged from ICU to general ward.

• 한국의료질향상학회지
• /
• 제8권2호
• /
• 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.

• 한국엔터테인먼트산업학회논문지
• /
• 제14권7호
• /
• pp.559-570
• /
• 2020

본 연구는 의료기관 인증 제도를 받은 요양병원과 양방병원의 내부구성원을 구분하여 인증이 구성원만족도, 직무 스트레스, 병원운영 효과, 의료서비스 향상에 미치는 영향을 파악하고자 하였다. 요양병원이 양방병원보다 인증제도가 구성원만족도, 병원운영효과, 의료서비스 효과에서 높게 나타났으며, 양방병원 구성원이 직무 스트레스에 대해선 높게 나타났다. 요양병원 및 양방병원 모두 인증에 따른 구성원 만족도, 병원 운영효과, 의료서비스 효과는 정(+)적인 결과를 나타났다. 요양병원은 2013년부터 의무적 인증으로 인증제의 효과가 실증적으로 높게 나타났을 것으로 사료된다. 따라서 본 연구는 인증제가 의료서비스 향상에 미치는 영향을 분석함으로써 꾸준한 의료의 질 관리가 병원경영 효율화 및 환자의 만족도 향상에 기여하고자 한다.

• 한국품질경영학회:학술대회논문집
• /
• 한국품질경영학회 2006년도 춘계학술대회
• /
• pp.54-65
• /
• 2006

Since the ending of the IMF period, the Korean health industry has experienced a number of changes in its environment such as hospital bankruptcy, enforcement of SDF(Separation of Dispensing and Prescription), opening of the medical market by WHO, evaluation of medical institutions with more than 100 sick beds, and limited approval for medical service advertisement. Furthermore, the concept of medical service has changed from a beneficent and vortical one to a hi lateral and righteous one. These changes in medical service have required medical institutions to provide customers with medical service options and adopt market principles actively, while considering customer satisfaction. Thus, this paper aims to investigate the service quality and service value of medical institutions, to understand the mutual relationship between customer satisfaction and repeat visits, and to suggest better solutions for the improvement of service quality. For future studies, It will be necessary to overcome the limitations of this research and develop proper measurement tools on service quality in the Korean medical system.

• 대한세포병리학회지
• /
• 제9권2호
• /
• pp.129-137
• /
• 1998

Although the success of the Papanicolaou test as a screening tool of cervical cancer is evident, there still exists $2{\sim}5%$ of discrepancy rate by both human and machine. To improve the qualilty of cervico-vaginal cytology, the authors compared cervicovaginal smear with cervical biopsy diagnoses, and analysed the causes of discrepancies. Among 30,922 cervicovaginal smears from June 1996 to April 1997 at our hospital, there were 271 cases of cervicovaginal smear with subsequent cervical punch or LEEP cone biopsies within several months. The biopsies and smears from a total of 98 discordant cases were reviewed. The discrepancy was attributed to sampling errors in 43 cases(43.9%), and to cytologic diagnosis in 49 cases(50.0%). Among these, 43 cases were interpretative errors(categories A;19, B;16 and C;8) whereas six cases were screening errors(categories B:2 and C:4). Among cervical biopsy cases, errors were present in four. As for 10% random rescreening, cytotechnologists reviewed 3,196 of 30,922 smears during the same period, There were 43 cases of screening error(categories A;27, B;16). Cytologic/histologic correlation was superior to 10% random rescreening of negative cases. The most effective method for quality improvement in cervicovaginal cytology was to implement both quality control(rescreening) and qualify assurance(cytologic/histologic correlation) programs.

• 한국방사선학회논문지
• /
• 제17권4호
• /
• pp.565-572
• /
• 2023

본 연구에서는 국내 공공 부문에서 실시하고 있는 의료기관 평가 중 영상검사와 관련된 현황을 살펴보고 개선 방향을 제시하고자 하였다. 의료기관 평가 중 영상검사와 관련된 주요 평가는 의료기관 인증평가와 영상검사 적정성 평가가 있으며, 의료기관 인증평가에서는 영상검사 운영과정, 정확한 결과 제공, 안전관리 절차 준수 등을 평가하고 있다. 영상검사 적정성 평가에서는 인력, 장비와 관련된 구조 지표, 환자평가 실시율, 피폭 저감 프로그램 등이 포함되어 있었다. 하지만 좀 더 안전하고 질 높은 영상검사를 위해서는 의료기관의 인증평가 참여율을 높이는 방안 마련이 필요하며, 영상검사 적정성 평가의 인력지표 개선과 인센티브 지급에 대한 고려도 필요하다. 마지막으로 국가 차원의 방사선 노출 통합관리도 함께 병행되어야 할 것이다.

• 동의신경정신과학회지
• /
• 제21권2호
• /
• pp.17-28
• /
• 2010

Objectives : This study is to evaluate the quality of life and amount of stress after the treatment among the patients who visited hospital due to traffic accident. Methods : We evaluated 40 patients who have been treated by western medicine for 3 months but showed no improvements. We surveyed VNRS, SF-36 and IES-R-K scores before treatment began and treated patients twice a week for 4 weeks with acupuncture, chuna theraphy, herbal medicine. After 4 weeks of treatment, we surveyed VNRS, SF-36 and IES-R-K scores again and compared with the scores of before treatment. Results : VNRS score and SF-36 scale and IES-R-K scale showed significant improvement after the treatment, compared to the treatment before. Conclusions : The amount of pain and stress, physical condition, all showed improvement among the patients who came to Oriental medicine hospital due to traffic accident.

• Journal of Acupuncture Research
• /
• 제24권1호
• /
• pp.79-98
• /
• 2007

Objectives : The study of Traditional Korean medical therapy has recently become a popular academic field as proven to be an great alternative to the limitation of Western medical treatment. However, there has been little study examining the Quality of life to investigate the Effectiveness of Recent Traditional Korean Medical Therapy on Treating Allergic Rhinitis. Thus, this study aims to reveal the characteristics of Allergic Rhinitis patients, their clinical symptoms, and other accompanying diseases. Moreover, it attempts to investigate the sense of improvement and satisfaction from the Allergic Rhinitis patients treated with Traditional Korean Medical therapy by examining Quality of Life Questionnaires. Subject and Method : A total of 380 subjects that consists of allergic rhinitis patients and non patients were participated in this study. 330 allergic rhinitis patients were divided into two groups; the experimental group (230 subjects) was treated with Traditional Korean Medical therapy, and the control group (100 subjects) was not treated with any other therapy. Also, the normal control group (50 subjects) who had no symptoms of the allergic rhinitis was participated in this study as well. All the subjects were asked to answer to the questionaries that consist of two parts such as recalling the symptoms that they had 3 month ago, and describing the current symptoms that they had the present. The experimental group also was asked to answer the quality of life questionnaire before and after the therapy. Results: The results of investigating recent Traditional Korean therapy are as follows: 1. The reservoir rate of other disease was 39.0% in the control group and 34.8% in the experimental group. These were higher than the rate of the normal control (10.0%), which reveals the clinical characteristics of allergic rhinitis patients. 2. The symptoms of Allergic Rhinitis showed improvement after Traditional Korean medical therapy, which can be shown by its statistical significance. (p=.000<.001). 3. 97.0% of the Allergic Rhinitis patients treated with the Korean Therapy answered the improvement of symptom within 4 weeks, and 88.3% of the patients were satisfied with the Traditional Korean medical therapy. 4. The Nasal symptoms had prominently positive effect at the most as the symptoms significantly affect sleep disturbances, ocular symptoms, activity limitation, and emotional problems.

• 한국병원경영학회지
• /
• 제20권2호
• /
• pp.39-56
• /
• 2015

This study calculated the potential customer satisfaction improvement index (PCSI index) and average satisfaction coefficient (ASC) by categorizing quality attributes based on the Kano analysis for medical service quality. This study seeks to suggest ways to increase the efficiency of medical business management by determining priority to improve after applying the indexes to IPA. To achieve such purposes, this study conducted a survey on 150 outpatients of a premium general hospital and 200 workers in four different sections in the same hospital. As a result of the analysis, there was a difference in the awareness of service quality to improve patient satisfaction between the outpatients and workers. Therefore, the focus should be put on those items deemed important by the patients rather than those that the workers called attention to in order to effectively improve service quality. Along with efforts to alleviate or eliminate inconveniences experienced by patients, it is necessary to provide training programs for workers on customer reception and management such as delivering services with a kind manner and giving explanations in a proper and professional manner and exhibiting the right attitude.