• Quality Improvement in Health Care
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• v.3 no.1
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• pp.104-124
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• 1996

Background : In these days, the health care organizations have concerned about customer-centered care in order to empower the competitiveness on the health care markets. The departments working for quality management of the hospitals have used health care quality indicators in terms of medical areas as well as service areas of the hospitals. However, there were insufficient efforts to develop the credible measurement to seek the customers' needs, their expectations and their satisfaction levels related to health care services because various kinds of challenges were in the process of scale development to measure customers' satisfaction in health care. The purpose of this study was to develop the satisfaction scale to health care services in a Korea health care organization and to test its tool with validity and reliability. Method : The concept of this tool was acceptability that one of the components of health care quality defined by Donabedian. Acceptability has the five dimensions of concept: Accessibility; Patient-Practitioner Relations; Amenities; Patient Preferences as to the effects of care; and Patient Preferences as to the costs of care. The Satisfaction Tool to Health Care Services was reviewed by expert panel with five researchers, including hospital managers and a professor related to quality management of the hospitals. As a result, the content validity index was .84 in the outpatient satisfaction tool. The inpatient satisfaction tool had .87 of the content validity index. The Satisfaction Tools to Health Care Services finally consisted of 44 items for outpatients/their families and of 60 items for inpatients/their families. Study subjects of the construct validity test were 479 outpatients/their families and 561 inpatients/their families who visited or admitted at a University hospital from July 1, 1996 through August 10, 1996. The data were examined by Factor Analysis with SPSS. Result : The items of Satisfaction tools for outpatients/their families were categorized by eleven factors with eigenvalue greater than 1.0 accounting for 64.2 percent of the variation in item scores. Also, the items of inpatient tool had eleven factors with eigenvalue greater than 1.0 accounting for 60.3 percent of the variation in item scores. The reliability of overall scale were .95 and .96 for the outpatients/their families satisfaction scores and inpatient/their families satisfaction scores. The internal consistency reliability with eleven factors was ranged from .30 to .94 for inpatients/their families. The Satisfaction Tool with eleven factors for inpatients/their families had internal consistency reliability ranged from .53 to .89. Conclusion : The Satisfaction Tools to Health Care Services focused on outpatients/their families and inpatients/their families developed in this study had a high reliability and the strong evidence of content validity and construct validity based on quality concept. Therefore, this tool would be utilized as a credible quality indicator of health care services to assess the quality problems and to monitor the quality improvement activities in Korean Health Care Organizations.

• Health Policy and Management
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• v.33 no.2
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• pp.185-193
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• 2023

Background: This study focuses on the establishment and operation of a stroke patient hotline program to help patients and their caregivers determine when acute neurological changes require emergency attention. Method: The stroke hotline was established at the Gyeonggi Regional Cerebrovascular Center, Seoul National University Bundang Hospital, in June 2016. Patients diagnosed with stroke during admission or in outpatient clinics were registered and provided with stroke education. Consulting nurses managed hotline calls and made decisions about outpatient schedules or emergency room referrals, consulting physicians when necessary. The study analyzed consultation records from June 2016 to December 2020, assessing consultation volumes and types. Outcomes and hotline satisfaction were also evaluated. Results: Over this period, 6,851 patients were registered, with 1,173 patients (18%) undergoing 3,356 hotline consultations. The average monthly consultation volume increased from 29.2 cases in 2016 to 92.3 cases in 2020. Common consultation types included stroke symptoms (22.3%), blood pressure/glucose inquiries (12.8%), and surgery/procedure questions (12.6%). Unexpected outpatient visits decreased from 103 cases before the hotline to 81 cases after. Among the 2,244 consultations between January 2019 and December 2020, 9.6% were recommended hospital visits, with two cases requiring intra-arterial thrombectomy. Patient satisfaction ratings of 9-10 points increased from 64% in 2019 to 69% in 2020. Conclusion: The stroke hotline program effectively reduced unexpected outpatient visits and achieved high patient satisfaction. Expanding the program could enhance the management of stroke-related neurological symptoms and minimize unnecessary healthcare resource utilization.

• Quality Improvement in Health Care
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• v.20 no.1
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• pp.28-40
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• 2014

Objectives: Prescriptions for Parkinson's can be dispensed at the outpatient pharmacy. In general, the treatment of Parkinson's disease requires a multitude of drugs, sometimes taken 4 to 6 times a day at specific times as prescribed by the medical practitioner. Said "time-specific therapy" is one of the major reasons of dispensing delay observed at the outpatient pharmacy. Because our establishment lacked a computerized system to support time-specific prescriptions, they were not recognized electronically. They had to be issued and dispensed manually, which required a greater amount of time than the automated process. To solve the problem, a new sig code was developed to handle time-specific prescriptions with a comprehensive automated dispensing system to support it. This study aims to create electronic programs and streamline the process to increase dispensing performance. And thus, ensure greater patient safety and dispensing accuracy within a shorter dispensing time and also increase employee satisfaction through a decreased workload. Methods: After identifying the problems caused by non-electronic prescriptions an automated system that allowed the issuance of time-specific prescriptions was developed. A new sig code was created that could be recognized by the Pharmacy electronic medical program, the label printer to group medications by administration times and the Automatic Tablet Counter(ATC) to count the grouped drugs accordingly. Result: With the new sig code, the practitioner became able to electronically select the times of drug administration while issuing the prescription. This 'time-specific prescription' can now be recognized by the pharmacy electronic medical program, the label printer and the ATC like any other prescription. Conclusion: The developed program started operating on September 2013. Although not all Parkinson's patients have been issued with the new electronic 'time-specific prescription', the overall dispensing process has become more streamlined and accurate. As the medical team continues to integrate the new system in their practice an additional decrease of the dispensing time is predicted. Future program upgrades and other new time-saving approaches are scheduled, which are expected to further increase the service quality of our outpatient pharmacy.

• Maxillofacial Plastic and Reconstructive Surgery
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• v.31 no.5
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• pp.394-400
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• 2009

Purpose : On outpatient facilities, our sedation protocol focuses on the intermittent bolus injections of midazolam intravenously, according to patient's and operator's needs during the dental treatment. This multicenter retrospective study was aimed to prove the efficiency and safety of our sedation protocol. Patients and Methods : In three centers using the same outpatient sedation protocol for dental treatment (Division of Oral and Maxillofacial Surgery/Department of Dentistry in Hanyang University Medical Center, S-plant Dental Hospital. and Grand Oral and Maxillofacial Surgery), total 937 patients had various dental treatments under intravenous conscious sedations with independent patient monitoring from March 2006 to March 2009. By reviewing charts, we analyzed the results of sedation and dental treatment, retrospectively. Results : Our sedation protocol had no severe postoperative complications requiring admission. while showing good compatibility with almost all dental treatments, with acceptable satisfaction of both patients and operators. Conclusion : We assure that our sedation protocol can be used efficiently and safely on routine outpatient basis. We also hope that this study will provide the concrete concepts to common dental practitioners, who desire to perform sedation for dental treatment.

• Korea Journal of Hospital Management
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• v.8 no.3
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• pp.49-71
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• 2003

The purpose of the study is exploring the relationship among patient perceived quality of dental care, satisfaction, and royalty in dental clinics and hospitals. The observation of the study is outpatient visiting dental clinics and hospitals located in Seoul and Kyung-Gi Do area, and surveyed the outpatients. The contents of the survey are consisted with questions including quality of care perceived by the patients, costumer satisfaction, and royalty, and measurement for each question is using five point Likert scale. According to result of bi-variate analysis, there was the significant relationship among specialized care, value of the care, and kindness in quality of dental services, level of care in dentists significantly influenced on costumer satisfaction and costumer royalty, and there was the significant relationship between costumer satisfaction and royalty. According to result of regression analysis on the costumer satisfaction, the costumer satisfaction positively related with the convenience of facility, specialized care, value of care, patient age, number of visit, and spend time for treatment, and housewives and self-employees were likely to satisfy on care than regular employees. By result of full regression model and reduced model on costumer royalty, satisfaction could explain 86% on the costumer royalty such as re-visit and promoting other people, and increase of explain power is not significant when other independent variables joined model (full model). Considering efficiency of model, costumer royalty could be explained by satisfaction only rather than other independent variables used. Finally, This study shows that the social-demographic variables of patient influenced the patient satisfaction, and the patient satisfaction influenced patient royalty directly.

• The Journal of Korean Medicine
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• v.43 no.2
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• pp.8-26
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• 2022

Objectives: This study is designed to statistically analyze characteristics, treatment effect and prognosis of patients who were treated for the recurrent Bell's palsy Methods: This study retrospectively analyzed the medical records and telephone questionnaire of 82 patients treated with the recurrent Bell's palsy at the OO Korean Medicine hospital from August 01, 2018 to July 31, 2021. Results: The lower the EQ-VAS^® and HB scale before and after treatment, the higher the satisfaction with the treatment. The average of the number of days and duration of outpatient treatment for male was longer than that for female. The average number of days and duration of outpatient treatment in the group that received combined treatment was longer than that of patients who received Korean Medicine only. The higher the satisfaction of treatment, the higher the willingness to receive treatment in the event of recurrent facial palsy. HB scale after treatment was the lowest in their 40s, and the average value of HB scale after treatment tended to increase as age increased except for those in their 40s. Conclusion: This study showed that the lower the HB scale after treatment, the lower the EQ-VAS®, the higher the treatment satisfaction, and the higher the probability receiving treatment if the facial paralysis recurs. Those in their 10s to 40s showed excellent results after treatment. Comparatively, those in their 50s and above showed a little effect after treatment. Gender, affected side, history of facial palsy, season of onset, age, hypertension and diabetes had no statistically significance with recurrent Bell's palsy prognosis.

• Health Policy and Management
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• v.18 no.3
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• pp.41-57
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• 2008

To examine the gap between physician's perceived importance and performance of care and to identify factors associated with the gap. A self-administered questionnaire survey was conducted with 91 physicians working in a University hospital in Seoul. The respondents were asked about their perceived importance and actual performance of interpersonal care on a 5-point Likert-type scale, indicating a higher score as higher importance and performance. Interpersonal care was measured by questions modified from the Korean Standard Service Quality Index, which are grouped into 6 categories: basic services, extra services, reliability, courtesy, convenience, and tangibles. Multiple regression analysis was conducted to find out physician characteristics associated with the gap. All of the 6 interpersonal care categories showed lower performance than perceived importance. The respondents tended to have a worse performance than perceived importance as the number of patients per outpatient care session ($\beta$=-0.0204, p<0.05) and the need for customer satisfaction education increase ($\beta$=-0.2226, p<0.05). Female physicians ($\beta$=0.2336, p<0.05) and those with higher job satisfaction($\beta$=0.0096, p<0.05) showed a better performance than perception. Overall, it appears that lower quality of interpersonal care was delivered to patients than the desired level considered by the responding physicians. Based on the regression analysis results, it is suggested that reducing patient volume per session, fulfilling education need for customer satisfaction, and improving job satisfaction may contribute to reduce the gap between physician's perceived importance and performance of interpersonal care.

• Korea Journal of Hospital Management
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• v.4 no.2
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• pp.41-59
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• 1999

Objectives: This study was done to compare patient satisfaction and hospital charges of surgery performed in an outpatient basis(ambulatory surgical procedures). Methods : This retrospective study was performed in 20(vitrectomy 11, tonsillectomy 9) randomly selected ambulatory surgical procedures patients and 50(vitrectomy 26, tonsillectomy 24) inpatients who. received the same procedure at a general hospital in Seoul since January 1, 1998 to October 31, 1998. The operative procedures were vitrectomy and tonsilletomy which could be performed on a ambulatory surgical procedures basis or on an inpatient basis. Results: The results of this study shows that the patients thought the expenses and the surgical operative time was an important factor in a ambulatory surgical procedures but there were no differences in the patient satisfaction by the method of surgery. The charges of vitrectomy and tonsilletomy were reduced up to 495,000 won and 380,000 won from l,589,000 won 842,000 won inpatient surgery respectively. Conclusions: This study focused only on the charges of the surgical procedures and did not include the cost of patient helper, the lost salary due to missing days of work to care for a member of the family, transportation costs, and other indirect costs. Therefore, if those fees were included, ambulatory surgical procedures would be more economical. Therefore, by giving incentives at the fee schedule, the government health policies it would reduce the total hospital charges.

• Journal of East-West Nursing Research
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• v.30 no.1
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• pp.51-59
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• 2024

Purpose: The purpose of this study was to determine the effect of preoperative guidance and operating room environment experience using virtual reality on increasing satisfaction with information and reducing anxiety in preoperative patients undergoing general anesthesia and local anesthesia. Methods: A non-equivalent control group quasi-experimental design was employed. The participants were 80 surgical patients from 4 wards (40 experimental group and 40 control group) of the general hospital located in Gyeonggi-do. Data collection was conducted from June to November 2023 after completing the control group survey in January 2023. Data were analyzed using Chi-square, t-test, and Mann-Whitney U test using SPSS 23.0 program. Results: Satisfaction with preoperative information was higher in the experimental group than that of the control group. Additionally, anxiety related to surgery in the experimental group was significantly lower than that of the control group. The preoperative state anxiety score in the experimental group was not significantly lower than that of the control group. Conclusions: These results suggest that providing patient education and information using virtual reality technology can not only alleviate patients' anxiety related to surgery, but also have the potential to be used as an effective intervention to improve positive patient experiences.

• Korean Journal of Adult Nursing
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• v.19 no.4
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• pp.670-681
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• 2007

Purpose: The purpose of this study was to identify the influencing factors on postpartum fatigue in the parturient women. Methods: The data were collected from July to September, 2006 using self-report questionnaires. The sample was 143 healthy parturient women who visited the outpatient clinic at 2 hospitals for a routine follow up after childbirth. The data were analyzed by using SPSS 12.0 Win program. Results: There were significant differences in the postpartum fatigue by age, religion, sleep hour, and complaint of perceived health problem. The postpartum fatigue were significantly correlated with infant care stress(p<0.001), sleep satisfaction(p<0.001), and feeding difficulty(p=0.016). The multiple regression analysis showed that the postpartum fatigue were significantly predicted by the infant care stress, sleep satisfaction and complaint of perceived health problem. These variables explained 31.8% of the variance of postpartum fatigue. The infant care stress was the main predictor of postpartum fatigue. Conclusions: It could be concluded that the nursing intervention for reducing the infant care stress should be developed to manage the postpartum fatigue for parturient women. Prospective studies are needed to be conducted to verify the causal relationship between infant care stress and postpartum fatigue.