• Journal of the Korea Society for Simulation
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• v.27 no.1
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• pp.75-90
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• 2018

Generally, solutions that can increase patients' satisfaction are in conflict with the solutions that can increase the satisfaction and profitability of the medical personnels. In this paper, we compare appointment patterns using multiple performance measures that take into account both hospital's position and customers' position, and propose the best appointment pattern especially for an efficient scheduling in a plastic surgery clinic. A simulation model using ARENA is designed based on real hospital data. Based on this model, we compare 5 appointment patterns. To check the robustness of the appointment patterns, we have experimented on various appointment situations by considering peak, extreme peak seasons, and peak, off-peak days. We found that Triangle-like pattern turned out to be most efficient regardless of appointment situations.

• Journal of Biomedical Engineering Research
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• v.41 no.6
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• pp.256-263
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• 2020

The importance of quality control has been emphasized to maintain safety of patients and satisfaction of medical service with medical devices used in clinic. Accordingly, objective evaluation method and standards consistently has been brought up for demand to replace outdated medical devices in appropriate time and to maintain the quality of medical service. Though many studies made suggestions methods to determine what medical devices to be replaced first, these methods were difficult in practice for its complex evaluation criteria and long time to evaluate. Therefore, in this study, a simple evaluation method is developed to identify and prioritize medical devices that are ought to be replaced. For the development of this simple evaluation method, four major characteristics of technology, safety, finance, and user satisfaction, which are considered in clinics to evaluate medical device replacement, and 14 minor attributes are distinctively selected. Each characteristic is assessed in binary form of "YES" or "NO" to minimize its subjective nature. Using this method to evaluate sampled medical devices belonging to four different characteristics, devices are suggested to be replaced in the current financial year or in the following financial year, or re-evaluated by the end of this financial year. Such results of evaluation can amend the subjective nature of existing evaluation method and give objective standards more promptly.

• Journal of Biomedical Engineering Research
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• v.43 no.5
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• pp.361-368
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• 2022

The purpose of this study was to develop a hand rehabilitation training system for hemiplegic patients. We also tried to find out five hand postures (WF: Wrist Flexion, WE: Wrist Extension, BG: Ball Grip, HG: Hook Grip, RE: Rest) in real-time using multi-channel EMG-based deep learning. We performed a pre-processing method that converts to Spider Chart image data for the classification of hand movement from five test subjects (total 1,500 data sets) using Convolution Neural Networks (CNN) deep learning with an 8-channel armband. As a result of this study, the recognition accuracy was 92% for WF, 94% for WE, 76% for BG, 82% for HG, and 88% for RE. Also, ten physical therapists participated for the usability evaluation. The questionnaire consisted of 7 items of acceptance, interest, and satisfaction, and the mean and standard deviation were calculated by dividing each into a 5-point scale. As a result, high scores were obtained in immersion and interest in game (4.6±0.43), convenience of the device (4.9±0.30), and satisfaction after treatment (4.1±0.48). On the other hand, Conformity of intention for treatment (3.90±0.49) was relatively low. This is thought to be because the game play may be difficult depending on the degree of spasticity of the hemiplegic patient, and compensation may occur in patient with weakened target muscles. Therefore, it is necessary to develop a rehabilitation program suitable for the degree of disability of the patient.

• KSII Transactions on Internet and Information Systems (TIIS)
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• v.16 no.10
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• pp.3313-3332
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• 2022

This study is an investigation into the factors affecting patient dissatisfaction among Saudi hospitals. The selected factors considered for analysis are security of information sharing, operational practices, disruptive technologies, and the ease of use of EHR patient information management systems. From the literature review section, it was clear that hardly any other studies have embraced these concepts in one as was intended by this study. The theories that the study heavily draws from are the service dominant logic and the feature integration theory. The study surveyed 350 respondents from three large major hospitals in three different metropolitan cities in the Kingdom of Saudi Arabia. This sample came from members of the three hospitals that were willing to participate in the study. The number 350 represents those that successfully completed the online questionnaire or the limited physical questionnaires in time. The study employed the structural equation modelling technique to analyze the associations. Findings suggested that security of information sharing had a significant direct effect on patient satisfaction. Operational practice positively mediated the effect of security of information sharing on patient dissatisfaction. However, ease of use failed to significant impact this association. The study concluded that to improve patient satisfaction, Saudi hospitals must work on their systems to reinforce them against the active threats on the privacy of patients' data by leveraging disruptive technology. They should also improve their operational practices by embracing quality management techniques relevant to the healthcare sector.

• PNF and Movement
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• v.21 no.1
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• pp.129-137
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• 2023

Purpose: The physical therapy diagnosis process requires high-level background knowledge, the ability to obtain added information from patients, accurate examination skills, and a framework for transforming thoughts into a diagnostic decision. Thus, the physical therapy diagnostic process is highly complicated and difficult work. To function as autonomous professionals, physical therapists must develop effective clinical diagnosis skills. As such, mobile application aids can help with accurate and scientific diagnoses. Therefore, this study aims to develop and evaluate the usability of a mobile application for physical therapy diagnoses. Methods: In this study, a diagnostic application was developed using App Inventor, the development environment was the Chrome web browser for Windows 10, and the mobile application was run on a Google Pixel 5. The developed application was evaluated for usability by 20 physical therapists with more than 5 years of clinical experience in the musculoskeletal physical therapy field, and a usability evaluation was conducted using a 5-point Likert scale for accuracy, convenience, satisfaction, and usability. The collected Likert scores were converted into percentages and analyzed as descriptive statistics. Results: The graphical user interface consisted of an initial screen with program guidance, 18 screens presenting the algorithm, and 12 screens presenting the estimated diagnosis based on the algorithm. As such, the usability evaluation of the developed application was as follows: accuracy 100%, convenience 90%, satisfaction 91%, and usability 88%. Conclusion: The newly developed mobile application for physical therapeutic diagnoses has a high accuracy, and it will aid in building an easy and reliable physical therapy diagnosis system.

• Journal of Yeungnam Medical Science
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• v.41 no.3
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• pp.207-212
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• 2024

Background: Myringotomy with tympanostomy tube insertion (MTI) is a superficial surgical procedure used to prevent hearing loss in children with serous otitis media. Intravenous anesthesia, often ketamine, is preferred for this procedure because of its ability to induce sedation without compromising airway reflexes. However, ketamine alone may be insufficient and potentially lead to spontaneous movement during surgery. This study evaluated the effectiveness of midazolam and fentanyl as adjuvants to ketamine in reducing spontaneous movement during MTI and enhancing the quality of recovery. Methods: This study involved two groups of 30 patients each: one group received intravenous ketamine (1.5 mg/kg) with an equal volume of normal saline (K group), while the other received a combination of midazolam, fentanyl, and ketamine (0.05 mg/kg, 1 ㎍/kg, and 1.5 mg/kg, respectively; MFK group). We assessed side effects, intraoperative patient movement, surgeon satisfaction, and emergence agitation scores. Results: The MFK group exhibited significantly lower scores for patient movement (p<0.01) and emergence agitation (p<0.01) and markedly higher surgeon satisfaction scores (p<0.01) than the K group. Conclusion: Administering a midazolam-fentanyl-ketamine combination effectively reduced spontaneous movement during surgery and emergence agitation during recovery without prolonging discharge times in children undergoing MTI.

• The Korean Journal of Nuclear Medicine Technology
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• v.14 no.2
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• pp.41-44
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• 2010

Purpose: Along with recent advances in PET/CT instrumentation and imaging technology, the number of patients has also been steadily increasing. This resulted in the increased radiation exposure to radiation workers in PET/CT rooms. In this study, we installed a radiation shield and investigated whether it could reduce radiation exposure to the workers and thus enhance job satisfaction. Materials and Methods: A radiation shield is composed of 5 cm thick lead and has a structure in which a radiation worker sits and watches a patient through lead glass while injecting radiopharmaceutical to the patient. Quarterly absorbed dose of radiation workers was measured using thermoluminescence dosimeters (TLD) and the results were compared for six months each before and after installation of the radiation shield. Exposure dose was also measured using a pocket dosimeter placed at the same location in the front and the back of the radiation shield. In addition, frequency of use of the shield and job satisfaction of radiation workers were investigated using a survey. Results: Quarterly absorbed dose of radiation workers was 2.70 mSv on average before installation of new radiation shield, whereas that dropped to 2.13 mSv after installation of radiation shield, reducing radiation exposure dose by 21%. Exposure dose on the front side of the shield was 61.2 R, whereas that on the back side of shield was 2.8 R. According to the survey, 85% of workers used the shield and were satisfied with the outcome: each radiation worker made injections to patients average of 6.5 times/day and preferred sitting to standing while injecting radiopharmaceutical to patients. Conclusion: Use of radiation shield reduced the exposure dose of radiation workers, which is the ultimate goal of radiation protection to minimize radiation exposure and is an appropriate method for the improvement of hospital working environment. Furthermore, we found that use of radiation shield not only relieves physical and psychological burden of radiation workers but also enhances job satisfaction. This result indicates that use of radiation shield is important for improvement of the radiation workers' job environment in terms of radiation protection.

• Journal of the Korean Orthopaedic Association
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• v.52 no.1
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• pp.49-58
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• 2017

Purpose: To compare clinical outcome of Sanders type IV intra-articular calcaneal fracture treated with open reduction and internal fixation (ORIF) versus ORIF and primary subtalar arthrodesis (PSTA). Materials and Methods: Between March 2003 and November 2013, 22 patients with 22 Sanders type 4 intra-articular calcaneal fractures were included in this study. Of these, 11 were treated with ORIF (ORIF group), and 11 were treated with ORIF and PSTA (PSTA group). The mean follow-up period was 34.6 months (range, 18-72 months). Clinical outcomes were assessed along with the American Orthopedic Foot and Ankle Society's ankle-hindfoot scale (AOFAS score), and the visual analogue scale pain score (VAS score) at 6-month, 12-month, and last follow-up. Patient satisfaction, return to previous occupation and postoperative complications were also investigated. Results: The results for ORIF did not differ from those for PSTA based on the last follow-up AOFAS scores or the VAS scores (p>0.05). However, patient satisfaction was significantly higher in the PSTA group (p=0.008). Secondary subtalar arthrodesis was conducted in five patients (45.5%) of the ORIF group within 2 years postoperatively. Conclusion: We were unable to demonstrate a significant difference in clinical outcomes between ORIF and PSTA; however, the patient satisfaction was higher in the PSTA group. PSTA may be a suitable choice for patients who need fast recovery to daily activity and to prevent the need for secondary subtalar arthrodesis.

• The Korean Journal of Pain
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• v.33 no.4
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• pp.378-385
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• 2020

Background: The thoracic paravertebral block is an effective analgesic technique for postoperative pain management after breast surgery. The ultrasound-guided retrolaminar block (RLB) is a safer alternative to conventional paravertebral block. Thus, we assessed the analgesic efficacy of ultrasound-guided RLB for postoperative pain management after breast surgery. Methods: Patients requiring breast surgery were randomly allocated to group C (retrolaminar injection with saline) and group R (RLB with local anesthetic mixture). The RLB was performed at the level of T3 with local anesthetic mixture (0.75% ropivacaine 20 mL + 2% lidocaine 10 mL) under general anesthesia before the skin incision. The primary outcome was cumulative morphine consumption using intravenous patient-controlled analgesia (IV-PCA) at 24 hour postoperatively. The secondary outcomes were the visual analogue scale (VAS) scores at 1, 6, 24, and 48 hour postoperatively and the occurrence of adverse events and patient satisfaction after the surgery. Results: Forty-six patients were included, 24 in group C and 22 in group R. The cumulative morphine consumption using IV-PCA did not differ between the two groups (P = 0.631). The intraoperative use of remifentanil was higher in group C than in group R (P = 0.025). The resting and coughing VAS scores at 1 hour postoperatively were higher in group R than in group C (P = 0.011, P = 0.004). The incidence of adverse events and patient satisfaction was not significantly different between the two groups. Conclusions: A single injection of ultrasound-guided RLB did not reduce postoperative analgesic requirements following breast surgery.

• Health Policy and Management
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• v.27 no.1
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• pp.39-46
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• 2017

Background: We evaluated new patient's satisfactory consultation time (SCT) and their willingness to pay additional costs (WPAC) for their SCT. Methods: We surveyed medical service satisfaction, SCT, WPAC for their SCT, and payable amount to 612 new patients of single general hospital and measured their real consultation time (RCT). To compare WPAC and payable amount, we divided RCT into 4 groups (${\leq}3$ minutes, 3-5 minutes, 5-10 minutes, and > 10 minutes), and SCT into 3 groups (${\leq}5$ minutes, 5-10 minutes, and > 10 minutes). On the basis of WPAC, we estimated new patient's SCT. Results: RCT was 6.2 minutes, SCT was 8.9 minutes, and medical service satisfaction score was 4.3 (out of 5). The number of patients having WPAC (payable group) was 381 (62.3%) and the amount was 5,853 Korean won. Their RCT and SCT were longer than non-payable group (6.4 minutes vs. 5.7 minutes, 9.3 minutes vs. 8.2 minutes). From multiple logistic regression analysis, WPAC of RCT 5-10 minutes was higher than that RCT ${\leq}3$ minutes (odds ratio= 1.78). Payable amount was highest in RCT > 10 minutes (6,950 Korea won) and SCT > 10 minutes (7,458 Korean won). Intuitively we suggest 10 minutes as SCT, based on payable group's SCT (9.3 minutes) and cut-off time differentiating payable group with non-payable group (10 minutes). Conclusion: We found that new patient had WPAC for their SCT and the longer the SCT, the greater the amount. From this, we hope that current simplified new patient consultation fee calculating system should be modified combining the consultation time factor.