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The Development of Korean Rehabilitation Patient Group Version 1.0 (한국형 재활환자분류체계 버전 1.0 개발)

  • Hwang, Soojin;Kim, Aeryun;Moon, Sunhye;Kim, Jihee;Kim, Jinhwi;Ha, Younghea;Yang, Okyoung
    • Health Policy and Management
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    • v.26 no.4
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    • pp.289-304
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    • 2016
  • Background: Rehabilitations in subacute phase are different from acute treatments regarding the characteristics and required resource consumption of the treatments. Lack of accuracy and validity of the Korean Diagnosis Related Group and Korean Out-Patient Group for the acute patients as the case-mix and payment tool for rehabilitation inpatients have been problematic issues. The objective of the study was to develop the Korean Rehabilitation Patient Group (KRPG) reflecting the characteristics of rehabilitation inpatients. Methods: As a retrospective medical record survey regarding rehabilitation inpatients, 4,207 episodes were collected through 42 hospitals. Considering the opinions of clinical experts and the decision-tree analysis, the variables for the KRPG system demonstrating the characteristics of rehabilitation inpatients were derived, and the splitting standards of the relevant variables were also set. Using the derived variables, we have drawn the rehabilitation inpatient classification model reflecting the clinical situation of Korea. The performance evaluation was conducted on the KRPG system. Results: The KRPG was targeted at the inpatients with brain or spinal cord injury. The etiologic disease, functional status (cognitive function, activity of daily living, muscle strength, spasticity, level and grade of spinal cord injury), and the patient's age were the variables in the rehabilitation patients. The algorithm of KRPG system after applying the derived variables and total 204 rehabilitation patient groups were developed. The KRPG explained 11.8% of variance in charge for rehabilitation inpatients. It also explained 13.8% of variance in length of stay for them. Conclusion: The KRPG version 1.0 reflecting the clinical characteristics of rehabilitation inpatients was classified as 204 groups.

Strategies and Experts in Other Countries for Patient Safety and Quality Improvement (환자안전과 질 향상을 위한 다른 나라의 개선 전략과 전담인력)

  • Kwak, Mi-Jeong;Park, Seong-Hi;Kim, Chul-Gyu;Park, TaeZoon;Lee, Sang-Il;Lee, Sun-Gyo;Choi, Yun-Kyoung;Hwang, Jeong-Hae
    • 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.

Identification of Cardiovascular Disease Based on Echocardiography and Electrocardiogram Data Using the Decision Tree Classification Approach

  • Tb Ai Munandar;Sumiati;Vidila Rosalina
    • International Journal of Computer Science & Network Security
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    • v.23 no.9
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    • pp.150-156
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    • 2023
  • For a doctor, diagnosing a patient's heart disease is not easy. It takes the ability and experience with high flying hours to be able to accurately diagnose the type of patient's heart disease based on the existing factors in the patient. Several studies have been carried out to develop tools to identify types of heart disease in patients. However, most only focus on the results of patient answers and lab results, the rest use only echocardiography data or electrocardiogram results. This research was conducted to test how accurate the results of the classification of heart disease by using two medical data, namely echocardiography and electrocardiogram. Three treatments were applied to the two medical data and analyzed using the decision tree approach. The first treatment was to build a classification model for types of heart disease based on echocardiography and electrocardiogram data, the second treatment only used echocardiography data and the third treatment only used electrocardiogram data. The results showed that the classification of types of heart disease in the first treatment had a higher level of accuracy than the second and third treatments. The accuracy level for the first, second and third treatment were 78.95%, 73.69% and 50%, respectively. This shows that in order to diagnose the type of patient's heart disease, it is advisable to look at the records of both the patient's medical data (echocardiography and electrocardiogram) to get an accurate level of diagnosis results that can be accounted for.

A Ethnographic Field Study for a Model Development of the Chronic Bed-ridden Patient s Home-ward (만성 재가 기동장애자의 가정병실 모델 개발을 위한 현장 연구)

  • 김태연;정연강
    • Journal of Korean Academy of Nursing
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    • v.24 no.4
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    • pp.597-615
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    • 1994
  • This study is designed to facilitate the creation of home environment conducive to the family taking care of chronic bed-ridden patients with more effective method. The need for this study has emerged against the background of marked changes in the structure of ailments and causes of death, resulting in the number and plights of chronic bed-ridden patients as well as of a rapid increase in demand for medical care and resulting premature discharge. Keeping these in mind, this study focused on home-wards where the majority of chronic bed-ridden patients are being cared for. Despite. their overriding importance, home-words are less than efficient in caring (or chronic bed-ridden patients. These circumstances require the designing of home-wards that can offer greater comfort to patients and at the same time make things easier for caregivers, on the basis of an overall analysis of patients' life and home - ward situation. According1y this study adopted a Participant Observation Method derived cultural anthropology, Toward this end, 3 patients were chosen as subjects of this study for intensive interviewing and participant observation. In the process of this field re-search efforts were made to collect emprical data, that is, to faithfully record the words of the subjects and their caregivers for analysis and interpretation. The findings of these analyses are as follows. Firstly, the chronic bed-ridden patients are mostly being taken care by close family members. Secondly, a room for the exclusive use of the patient, floor, kitchen, bathroom and multipurpose space were found to be necessary for proper caring of the patient. These spaces were respectively used with a view to 1) accomodating the patient as well as caregivers' activities, 2) keeping general and medical supplies and other appliances for patient's care and drying the patient's washing, 3) preparing and keeping the patient's foods and beverages, 4) keeping the supplies necessary for cleaning the patient's body and treating the patient's eliminations, 5) washing the patient's clothes, underwears and bedclothes. The patient's room in turn is subdivided into six portions in terms of uses : specifically the places for accomodating 1) the patient, 2) medical supplies, 3) medicines, 4) linens St clothes, 5) bedclothes and, 6) diapers. Thirdly, the activities of the caregiver are subdivided into seven key areas : hygiene, exercise, diet, elimination, therapeutic nursing, prevention of sore, and other activities. Each area is further classified into several different activities of caring. These activities we mainly carried out in the patient's room. Fourthly, the supplies for caring the chronic bed-ridden patient is divided into two large domains : medical and general supplies. Finally, three main problems areas were found in this study on the part of caregivers, that is, sore prevention, hygiene problem related frequent urination / defecation, the caregiver's physical, psych ological and emotional burden. In consideration of the aforesaid problem areas, a model home-ward was developed in this study. The newly-developed model has been found to have the following six advantages. Firstly, the time and effort required for maintaining the patient's hygiene are reduced, thus relievins the caregiver's physical and psychological bur-den. Secondly, the patient's hygiene can be maintained in satisfactory conditions, because the patient's eliminations are more easily removed. Thirdly, skin irritations caused by the patient's eliminations were remarkably reduced and so were the patient's sores due to moisture and bacteria. Fourthly, the home-ward have a tilt-table ef-fect thanks to the inclining room floor. This improves the patient's cardiovascular function as well as constantly changes pressed skin areas and thus prevents sores. Fifthly, improved shelf arrangements help make the best use of patient's supplies. Sixthly, the trouble of continuously changing clothes, underwears, diapers & bedclothes is remarkably reduced simply by covering the patient with cotton sheets when laid in bed. This is espected to cut down expenses by reducing the comsumptions of diapers and other disposable supplies.

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A Study on the Perception of the Importance and Performance of Patient Education of the Clinical Nurses (종합병원 간호사가 인식하는 환자교육 중요도와 수행도의 관계연구)

  • Yoo, Eun-Kyung;Suh, Moon-Ja
    • The Journal of Korean Academic Society of Nursing Education
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    • v.6 no.2
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    • pp.287-302
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    • 2000
  • The purpose of the study are to examine the perception of the importance and performance of patient education of the clinical nurse and find out the interfering factors in practicing patient education. The data were collected from convenient sample of 256 clinical nurses working in the nursing units of adult patients except the psychiatric unit, obstetric unit, dental surgical unit and intensive care unit of one University Hospital in Seoul from September 29 to October 2, 1998. Three measurement tools of self-report- questionnaires developed by researcher used. For the content validity of the questionnaires, two sessions of panel discussion and a pilot test were done and finally factor analysis was done with Varimax method. Analysis of data was done with SAS program using frequency, percentage, means, standard deviation, Pearson's Correlation Coefficients, t-test and ANOVA. The obtained results were as follows : 1. The surveyed nurses perceived the importance of patient education at higher level with mean score of 4.08 among 5 point than their perception of practice( mean score : 3.42). 2. There was positive significant correlation(r=.29, p=0.0001)between nurses' perception of the importance of patient education and it's practice 3. Among the teaching contents for patients, 'information of diagnostic procedure and operation' and 'orientation of hospitalization' were perceived most important. And 'preparation for discharge' and 'understanding of disease and health promotion' were perceived least important 4. Among the teaching contents for patients, 'orientation of hospitalization' and 'information of diagnostic procedure and operation' were perceived highly performable. And 'understanding of disease and health promotion' and 'preparation for discharge' were perceived least performable. 5. Three types of interfering factors were identified as patient-factor, situational factor, nurse-factor. The mean degree of impediment with the interfering factors was at average level(3.09 among 5). The patient and situational factors of impediments were more interfering than nurse- factor for teaching patients. 6. In older age(p<.05), married state (p<.05), higher educational status (p<.01), higher clinical experience (p<.01) and higher position(p<.01), the score of perceived importance of patients education was more high. 7. In older age(p<.01), higher clinical experience(p<.001) and surgical unit (p<.01), the score of perceived performance of patients education was more high. In conclusion, in order to activate patient education practice in the clinical setting, the continuing education for patients education should be more emphasized and the effective teaching methods and materials should be developed to help patient teaching. And an organizational support such as budgeting for patient education and reimbursement system should be administrated.

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Association of quality of dental care service on the level of patient satisfaction (치과의료서비스의 질과 환자만족도와의 연관성)

  • Lee, Hyang-Nim;Shim, Hyung-Sun;Kim, Ga-Young
    • Journal of Korean society of Dental Hygiene
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    • v.11 no.3
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    • pp.383-393
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    • 2011
  • Objectives : This study has been undertaken for the purpose of finding out what influence is made by the dental care service provided to patients by the dental clinics to the level of patient satisfaction to provide the base data for developing and improving the dental care service of dental hygienist. Methods : The survey was undertaken for 500 patients visiting 18 dental clinics in City G and the questionnaire was undertaken for two weeks in May 2010, and 473 copies were analyzed with the exception of the questionnaires with many omissions in the response. Results : 1. Distribution of the level of satisfaction for patient had the dentist factor which was highest in the dentist factor for 4.43 at the age of 60s (p<0.05). and in sole proprietorship for 4.49 (p<0.01). treatment procedure factor which was highest in sole proprietorship for 4.16 (p<0.001). environment of dental clinic factor which was highest at the age of 60 years or older for 4.36 (p<0.05) and in sole proprietorship for 4.14 (p<0.01). 2. Evaluation on the quality of the dental care service of dental hygienist had the kindness of dental hygienists which was highest at the age of 60 years or older for 4.40(p<0.001), knowledge factor of dental hygienist which was highest for 4.34 at the age of 60 years or older (p<0.05) and highest 4.27 for visit dentists(p<0.001) and the patient management and other factor was highest at the age of 60s for 4.47 (p<0.05), and in sole proprietorship for 4.28 (p<0.05). 3. Factors influencing on the level of satisfaction for patient. The level of satisfaction for patient was higher for higher evaluation of the dentist quality (p<0.001), for feeling convenient in treatment procedure and use (p<0.01), for feeling kindness of the dental hygienist (p<0.01), and for higher evaluation in patient management and other management activities of the dental hygienist (p<0.001). Conclusions : In order to heighten the level of satisfaction for patient, it would be necessary to strengthen the kindness and patient management aspect on the patients of the dental hygienist, and it would require to heighten the quality of dentist as patients recognize and heighten the treatment procedure and service convenience of dental clinics.

Implementation of Patient Experience Assessment and Subsequent Changes at the Ground Level in Health Care: Patient Experience Employees' Perspective (환자경험 평가와 의료 현장의 변화: 의료기관 환자경험 업무 담당자의 관점)

  • Song, Yeong-Chae;Yoon, Eun-Sil;Han, Se-Young;Tae, Ji-Yeon;You, Soo-Kyeong;Do, Young-Kyung
    • Quality Improvement in Health Care
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    • v.28 no.1
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    • pp.14-33
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    • 2022
  • Purpose: To examine whether the Patient Experience Assessment (PEA) has led to perceptible changes at the ground level of health care, as a way of evaluating PEA as a policy intervention for quality improvement. Methods: Four focus group discussions (FGDs) were conducted, each comprising six to eight participants who were employees responsible for patient experience at their respective hospitals. The primary focus of the FGDs was on questions such as: 1) How do hospitals respond to PEA? 2) What significant changes were observed after the implementation of PEA? 3) What were the unintended consequences of implementing PEA, if any? 4) What areas of improvement have been identified for maximizing the potential of PEA? Results: Two broad themes emerged out of the FGDs: changes observed post implementation of PEA, and areas for improvement of PEA. Four significant changes were reported by participants: changes in perception and attitude regarding patient experience in hospital employees, increased active involvement by the hospital leadership, enhanced efforts to improve patient experience, and increased cooperation between such activities. Furthermore, eight areas of improvement were identified, which have been grouped in three categories: improving the process of data collection for PEA, introducing additional catalysts to facilitate further changes, and paying attention to structure- and patient-level constraints that must be addressed in parallel. Conclusion: The implementation of PEA led to perceptible changes within hospitals, which implies that it can serve as an effective catalyst for improving patient experience. A number of areas of improvement that would aid in maximizing the potential of PEA were also identified.

21) Suppression Technics for Mammography

  • Jang Meoung Mi
    • Journal of The Korean Radiological Technologist Association
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    • v.25 no.1
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    • pp.360-364
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    • 1999
  • There is patient's complain, problem of mammography, with increasing mammography every year. We tried to find out how much the pain can be decreased through power of compression, number of compression and change of study style with having maintain existin

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A Strategic Quality Initiative and Its Opportunities to Improve Healthcare Environment (진료환경개선을 위한 우선적 전략과제 설정 및 그 적용)

  • Tark, Kwan-Chul;Park, Hyun-Ju;Park, Chang-Il;Kang, Jin-Kyung
    • Quality Improvement in Health Care
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    • v.5 no.2
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    • pp.324-334
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    • 1998
  • Background : Strategic planning is an organizationwide or systemwide, ongoing look into the future usually of 2~3 years, based on objective analysis of the current environment and trends, but it can incorporate both short-term and long-term goals. The strategic planning process includes external analysis, internal analysis, issue analysis, development of mission, vision and values, and lastly development of organizational goals and objectives. As a part of the strategic quality planning process, certain service lines, important organizationwide functions, or key processes supporting these functions can be prioritized to expedite and roll out certain strategic goals. This is called strategic quality initiatives. Methods : We organized a quality improvement team, a subgroup of 21st century vision planning corps of our medical center, and pursued QI activities for improvement of healthcare environment, particularly in the admission setting. We developed a strategic quality initiative based on the results of patient satisfaction surveys, and carried out functions of self-directed work team. Results : The strategic goal was to be the benchmark for peer group hospitals in Korea for providing cost-effective best-practice. The QI team included 3 medical doctors, 1 nurse, 1 social worker, and 1 QI consultant as well as many operational members to support services and quality initiatives met every Tuesday for 18 weeks. Outcome objectives were to improve patient satisfaction score. The issues included in the objectives were comfort, temperature, noise, cleanliness of the admission wards, quality and education of patient meals, matters regarding the admission process, and an appurtenant facility such as restaurant or convenience store. Every issue was discussed and recommendations, conclusions and opportunities were implemented. Conclusions : By developing a strategic quality initiative as a part of the strategic quality planning process, and pursuing a self-directed work team, certain sen/ice lines, important organizationwide functions, or key processes supporting these functions can be improved effectively within a short period. Strategic quality initiatives serve to support, or roll out, certain strategic goals that are relevant to performance improvement and development of specific measurable outcome objectives, and associated performance measure for each initiative. Each strategic quality initiative should include a statement of intent outcome objectives, and performance measures. We will come back with follow up of the strategic quality initiative, for improvement of healthcare environment, and results of patient satisfaction re-survey.

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