The main Purpose of this survey was to identify for elements of an effective hospital infection control program for Korea. Nurses and doctors who had participated in an education program for infection control or were re s ponsible for hospital infection control were selected as data informers. The data were collected from 51 subjects by employing a Delphi technique in a series of three rounds from september 1, 1987, to March 31, 1988. IN each round the responses to questionaires were analyzed and the results were communicated back to the individuals. Finally 32 elements of effective hospital infection control program were reduced to 10 elements. 10 elements are as follows ; 1) Hospital administrator's knowledge of importance and necessity for HIC(hospital infection control) 2) Supporting HIC administratively 3) Constituting infection control committee and role of ICC 4) Developing an eductional program and providing a work manual for the hospital infection control staff 5) Educating and informing medical staff about hospital infection 6) Surveillance for hospital infection 7) Developing patient care technique 8) Controlling the hospital environment 9) Executing regular health examination of all medical staff 10) Recruiting the medical staff sufficiently Three rankings of response rate about 32 elements are as follows ; 1) Hiring a full tim staff member for the HIC(66%) 2) Establishing a hospital policy and standards for the HIC(66%) 3) Activating the infection control committee and taking administrative action to support the ICC(63%) In addition the rankings of importance score by Likert 5 scale are as follows ; 1) Washing hands scrupulously(4.88) 2) Nurses participation as key members of the ICC(4.75) 3) Reviewing and evaluating all ongoing aseptic techniques (4.69) In conclusion, first of all, administrative support must be given to hiring a full time staff member and to organization of infection control committee for the HIC in Korea.
Community mental health management system emphasizing on the rehabilitation and the return to the community has been established and carried out for many years. The study has been demanded to prove that the decreasing rate of the recurrence of the mentally ill resulted to lower their medical costs, to enrich the quality of life, and to reduce the psychological burden of their family. This study tried to prove that the mental health services to the mentally ill which were registered in community mental health center of A city have an influence on the medical cost, the quality of their lives. the family burden. The subject group of this study were 39 home-based mentally ill patients and their 37 family members, totally 76 people registered in mental health center of A city and participated in its program. This research had been measured twice, the first before the intervention and the second after at least a year. The measuring tools in the research were the medical cost measurment tools developed by the researcher, the quality of life index by Yoo ja, Noh(1988) and the family burden by Montgonery(1985). The methods were modified and supplemented in this study. This research made use of SPSS Win 10.0. The results of this study are the same as followings. 1) There were the significant difference in the medical cost before and after the mental health service delivery. 2) The quality of lives of the mentally ill, after the mental health services delivered were significantly higher than before. 3) The family burden were significantly reduced after the delivery of community mental health services. Community mental health services brought out efficient results to the social return and rehabilitation. And these results means that the mentally ill changed highly the quality of life and their burden of family and medical cost were reduced. So the public organization and the private society should help positively the mentally ill and their family through mental health policy and social service agency to live healthy lives and to be valuable member of society.
The purpose of this study was to identify the relationship between organizational culture based on the competing values approach, human resource management practices and organizational performance at a hospital. Participants were 138 employee in a general hospital. Data were collected during May, 2003 using four structured instruments. The data were analyzed using Chi-square test, One-way ANOVA, $scheff{\acute{e}}$ test and Cluster analysis. Three clusters were derived from cluster analysis. The first cluster consisted of cultures which were mixed developmental, consensual, hierarchial and rational culture equivalently. The second cluster consisted of the weak cultures, which was lower score than other clusters. The third cluster consisted of strong comprehensive cultures, which had higher score than other clusters. In the three clusters, hierarchial and rational culture were superior. The difference between human resource management practices and organizational commitment in organizational performance according to organizational culture clusters was found to be statistically significant. The cluster which had strong comprehensive cultures, in contrast to other clusters, more significantly affects on human resource management practices and organizational commitment. However, the strength of organizational culture does not have a significant effect on customer oriented service performance in organizational performance. These results showed that types of organizational culture were significantly related to human resource management practices and organizational commitment, and understanding the existing culture is essential to develop the organization of hospitals.
Kim, Seung Ju;Jang, Sung-In;Han, Kyu-Tae;Park, Eun-Cheol
Health Policy and Management
/
v.28
no.2
/
pp.186-193
/
2018
Background: The aim of our study was to review the findings of health insurance fraud investigations and to evaluate their impacts on medical costs for target and non-target organizations. An interrupted time series study design using generalized estimation equations was used to evaluate changes in cost following fraud investigations. Methods: We used National Health Insurance claims data from 2009 to 2015, which included 20,625 medical institutions (1,614 target organizations and 19,011 non-target organizations). Outcome variable included cost change after fraud investigation. Results: Following the initiation of fraud investigations, we found statistically significant reductions in cost level for target organizations (-1.40%, p<0.001). In addition, a reduction in cost trend change per month was found for both target organizations and non-target organizations after fraud investigation (target organizations, -0.33%; non-target organizations of same region, -0.19%; non-target organizations of other regions, -0.17%). Conclusion: This study suggested that fraud investigations are associated with cost reduction in target organization. We also found similar effects of fraud investigations on health expenditure for non-target organizations located in the same region and in different regions. Our finding suggests that fraud investigations are important in controlling the growth of health expenditure. To maximize the effects of fraud investigation on the growth of health expenditure, more organizations needed to be considered as target organizations.
Park, Seong-Hi;Hwang, Jeong-Hae;Choi, Yun-Kyoung;Lee, Sun-Gyo
Quality Improvement in Health Care
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v.19
no.2
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pp.14-34
/
2013
Objectives: The purpose of this study is to provide comprehensive information of qualification systems of developed countries needed to establish our national system for QI(Quality improvement) specialists. Methods: All articles related to any applicable domestic or foreign countries' laws, operational status, and detailed programs for professional qualification system of QI were reviewed. Result: In the United States, a non-profit organization, Healthcare Quality Certification Commission (HQCC) has set the policies, procedures and standards in the field of health care quality. And qualification system of CPHQ (certified professional in healthcare quality) has been operated in order to authenticate the qualifications in the field of quality management. IBQH(international Board for quality in healthcare), a qualification system of experts in the United Kingdom, was designed to assist the qualification of professionals to improve the quality of healthcare. In addition, Health Research Center of Feinberg School of Medicine in Northwestern University has been operating Master's and doctoral degree programs in the field of the quality of care and patient safety and IHI (institute for healthcare improvement) open school was operating a professional training course related to the quality of care and patient safety. Conclusion: Quantity and complexity of information of the quality of care and patient safety have been increased. For reform of the health care system, a special training course of the expertise and leadership are needed. So far, there is no national professional certification courses in our nation. Therefore essential job skill should be acquired individually. For systematic and effective quality improvement activities, the educational and certification system with professional development model are needed.
The purpose of this study was to identify caregivers of the elderly, the pattern of the caregivers' caring behaviors, and the cultural principles of patterns of caring behaviors practiced in a Korean minority community, Yanbian. To clarify these, an ethnographic approach was used. The fieldwork for this study was conducted from Aug. 24, 1993 to May 20, 1994. The informants were 16 natives, age 60 or more, who were members of a large family of three generations. The results of the study are as follows. The caregivers for the elderly were family, kinship and community groups. Family caregivers for the elderly were spouses, sons, daughters-in-law, grandchildren, sons of former wives, sons of former husbands, adopted sons. daughters and sons-in-law. The elderly had caregivers who were part of the kinship group. Three community groups provided care for the elderly. The three community groups were Dokbozo. a formal large organization for the elderly. the same age group as an informal small meeting for the elderly, and other community younger groups. The findings of this study indicated that family caregivers, especially spouses and sons, are the significant others of the elderly, and comminuty groups are better caring groups than kinship relatives. This study identified forty-three different kind of caring behaviors. They were divided into fifteen behavior patterns. These patterns integrated into five categories : soo-bal(¼?¹ß), protecting, respect, support, jung(?×). For physical comfort, soo-bal and protecting were conducted. For the comfort of mind, respect. support, and jung were conducted. The comfort of mind are better than physical comfort for the elderly. Cultural principles of caring behaviors were group membership, reciprocity, and harmony. But there was no hierarchy priciple. And these three principles provide best caring together at the same time. This study provides significant data for nursing research, theory and practice.
The purpose of this study was to develop a mentoring program to support the professional growth of new nurses and to check the effectiveness. This mentoring program was developed by research teams and mentoring professionals based on Benner's theory. The data was analyzed using SPSS 18.0 program. The average of satisfaction of mentoring program in the mentees is 4.31 higher than mentor as 3.77. The highest scored item was 'need of mentoring program', the lowest one was 'mentoring program period and number of meetings'. Finally based on the results of the research, the duration of the mentoring program was changed to the six months. A steady support of the organizational policy about mentoring program is required to secure an outstanding nursing workforce.
The role of the neonatal nurse specialist has been well established over the past decade and now reform in 21st century. Neonatal nurse specialists responsibilities in caring for critically and long-term chronically ill infants and their families are very important. Neonatal nurse specialists have a two fold responsibility in caring for these infants. First, through acquiring advanced practice education in complex neonatal care and diagnostic skills, neonatal nurse specialists meet the physiologic needs of the infant. Second, neonatal nurse specialists provide a more holistic approach to their care through evaluating the family in treatment plans and involving the family in discharge planning for the infant. In some institutions, neonatal nurse specialists are directly involved in institutional and/or home follow-up care and case management also. It is the neonatal nurse specialists responsibility to function collaboratively with the multidisciplinary team in managing critically or chronically ill infants from admission to discharge. The role of the neonatal nurse specialist case manager can be described as one that focuses on individualized care of the infant, while providing continuity of care to both the infant and family. The neonatal nurse specialist's role will vary depending on the neonatal intensive care unit(NICU). Therefore, the multidisciplinary collaborative approach to long-term management of infants in the NICU is extremely important to provide successful transition to home or to long-term rehabilitative care facilities because care for the chronically ill infant is complex and multifaceted. I suggest the role of neonatal nurse specialist in 21st century are as follows. 1. Diagnostic/patient assessment 2. Management of patient health/illness 3. Administering/monitoring therapeutic interventions and regimens 4. Monitoring/ensuring quality of health care practices 5. Organization and work role 6. Helping role 7. Teaching/coaching role 8. Management of rapidly changing situations 9. Consulting role The advanced practice nursing model of care delivered by neonatal nurse specialist's in the NICU incorporates medical and nursing role functions and emphasizes holism, caring, and a health perspective for critically and chronically ill neonates and their families.
Background: To evaluate the quality of chronic care provided by public health centers located in a South Korean metropolitan city using a modified Assessment of Chronic Illness Care (ACIC). Methods: We conducted self-evaluation surveys and collected data using a modified ACIC from twenty five public health centers. Cultural validity of the original ACIC was examined by the public health and nursing science experts. Based on expert reviews, cognitive interviews, pre-test results, five items of the original ACIC that were not relevant were deleted. The response scale was changed from twelve-point Likert scale to Guttman scale but its scoring system was maintained. Results: Eighty eight percent of public health centers in this study reported that their overall quality of chronic care was at a limited or basic level. About 68% of the centers reported that the organization was as reasonably good or fully developed to provide chronic care. On the other hand, 96% of the public health centers reported that the clinical information system was at a very limited or basic support level. The decision support, the integration of Chronic Care Model components, the delivery system design, the community linkages, and the self-management support were evaluated as limited or basic level of support by more than half of the public health centers, respectively. Conclusion: In a metropolitan area of South Korea, quality of chronic care in public health centers was not found to reach acceptable levels of services. It is critical to enhance the quality of chronic care in public health centers.
Across sectional study was performed to evaluate the chronic effects on central nerve system(CNS) of cumulative exposure of complex organic solvents, using neurobehavioral test. Subjects were 66 (male) dock yard painters of some large ship industry which is located in Ulsan. The neurobehavioral test battery used in this study was NCTB (Neurabehavioral Core Test Battery recommended by WHO(World Health Organization), which consisted of 7 items-Profile of mood states (POMS), Simple reaction time, Santa Ana dexterity test. Digit span, Digit symbol, Benton visual retention test and Pursuit aiming. The subjects were classified by 3 groups according to duration of employment(group 1 ; less than 9 years, group 2 ; 10-14 years, group 3 ; more than 15 years). The results of performance were analyzed considering of work duration, age, educational level, alcohol drinking, smoking and testing time as confounding factors. Benton visual retention test, pursuit aiming correct dot and sum of dot showed significant differences among the groups, and decreased with increasing work duration. It indicated that the mean scores of performance ability were lowering according to work duration. Besides, the tests that didn't show statistical significances but showed linear trends were depression-dejection, vigor, fatigue of POMS, slowest time of simple reaction time and digit span forward. Most of the neurobehavioral test items were correlated with age and educational level. After controlling of confounding factors-age and educational level, the results followed ; digit span backward was different significantly. Tension-anxiety, depression-dejection, anger-hostility of POMS, SD and slowest time of simple reaction time, Santa Ana dexterity test non-preferred hand, digit span forward, Benton visual retention test and pursuit aiming correct dot decreased with increasing of work duration. The correlation analysis was done in order to find out the relationship between subjective symptom and the scores of neurobehavioral core test battery. According to the results of analysis there were no items that had statistical significant relationship(p<0.05).
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