• Title/Summary/Keyword: quality of medical record

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Study on Development a Personal Health Record Application of Atopic Dermatitis in Korean Medicine (아토피피부염 개인건강기록 앱 개발에 관한 연구)

  • Seo, Jin-Soon;Kim, Young-Eun;Lee, Seung-Ho;Kim, An-Na;Nam, Bo-Ryeong;Jang, Hyun-Chul
    • The Journal of Korean Medicine Ophthalmology and Otolaryngology and Dermatology
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    • v.32 no.1
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    • pp.32-41
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    • 2019
  • Objective : The purpose of this study is to develop a personal health record(PHR) application of atopic dermatitis in Korean Medicine(KM). Methods : We have identified the items necessary to provide an PHR application that helps to record and manage the symptoms of an atopic dermatitis in KM. We also derived the symptom collection process and method and applied it to the application. Results : In this study, the types of symptoms collected for atopic dermatitis were derived. Symptoms include daily check, stool/urine/sleep, daily emotion, meal management, symptom photographs, SCORAD, quality of life, progress check, original symptom, pediatric health check, weakness check, and subjective symptoms. The recording cycle can be divided into the first, daily, weekly, specific day, and subjective. We developed the PHR application of atopic dermatitis in KM by deriving the type of symptoms and symptom recording process. The app organized menus into dashboards, checklists, daily checks, and health records. Conclusions : We developed a PHR application for atopic dermatitis by deriving symptom collection items of atopic dermatitis and developing symptom collection process and collection technique. The app does not make an accurate diagnosis of atopic dermatitis symptoms, but it helps facilitate symptom collection and helps to identify or predict a person's health condition. It can also be used for medical treatment through sharing symptoms with Korean medicine. Patients are able to communicate in both directions on a daily, weekly, self-aware basis, at the request of a doctor, to record their symptoms and use them for medical purposes. If the doctor asks for a progress check to refer to the next examination, it can be written through the system. This manages atopic dermatitis in daily life and can be used in the clinical field.

A Study on the Identification of Risk Factors for unplanned Readmissions in a University Hospital (계획되지 않은 재입원에 대한 위험요인분석)

  • Hwang Jeong Hae;Rhee Seon Ja
    • Journal of Korean Public Health Nursing
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    • v.16 no.1
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    • pp.201-212
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    • 2002
  • This study was designed to identify the risk factors of unplanned readmission in a university hospital. The six-month discharge information from January to June, 2000 in a tertiary university hospital was used as a source of data through the medical record and hospital information system. To increase the effect of comparison. the data were collected by sampling 192 couples (384 patients) of unplanned readmission group through the matching by its disease groups, sex, and age. The accuracy of prediction for unplanned readmission was analyzed by constructing the predicted model of unplanned readmission through the logistic regression. The study results are as follows. The conditional logistic regression analysis was performed with nine variables at the significance level 0.05 through univariate analysis including residence, days after discharge, initial admission route, previous admission, transfer to special care unite, hospital stay days, medical care expenses, special cares, and laboratory and imaging services. As a result, the closer the patients live in Seoul and Gyeong-in area (Odds ratio=2.529, p=0.003), the shorter the days after discharge was (Odds ratio=0.600, p=0.000), and the more frequent admission rate was (Odds ratio=2.317, p=0.004), the more unplanned readmission was resulted. Also, the accuracy of prediction for data classification of this regression model showed $70.3\%$(032+83/306).

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Usefulness and capability of three-dimensional, full high-definition movies for surgical education

  • Takano, M.;Kasahara, K.;Sugahara, K.;Watanabe, A.;Yoshida, S.;Shibahara, T.
    • Maxillofacial Plastic and Reconstructive Surgery
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    • v.39
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    • pp.10.1-10.5
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    • 2017
  • Background: Because of changing surgical procedures in the fields of oral and maxillofacial surgery, new methods for surgical education are needed and could include recent advances in digital technology. Many doctors have attempted to use digital technology as educational tools for surgical training, and movies have played an important role in these attempts. We have been using a 3D full high-definition (full-HD) camcorder to record movies of intraoral surgeries. Method: The subjects were medical students and doctors receiving surgical training who did not have actual surgical experience (n = 67). Participants watched an 8-min, 2D movie of orthognathic surgery and subsequently watched the 3D version. After watching the 3D movie, participants were asked to complete a questionnaire. Result: A lot of participants (84%) felt a 3D movie excellent or good and answered that the advantages of a 3D movie were their appearance of solidity or realism. Almost all participants (99%) answered that 3D movies were quite useful or useful for medical practice. Conclusions: Three-dimensional full-HD movies have the potential to improve the quality of medical education and clinical practice in oral and maxillofacial surgery.

A Study on the Performance and the Importance of Ambulatory Nursing Activities (외래 간호인력 업무활동 수행도와 중요도 분석;종합병원${\cdot}$종합전문요양기관 중심으로)

  • Hwang, Hye-Young;Park, Jeong-Hye;Kim, Ji-Soo;Chen, In-Sug;Bae, Kyung-Ok;Seo, Mi-Sook;Yang, Woo-Jeong;Jung, Moon-Young;Chae, Ji-Sun;Hong, Ji-Yeon;Kim, Moon-Sil
    • Journal of Korean Academy of Nursing Administration
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    • v.13 no.1
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    • pp.109-117
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    • 2007
  • Purpose: This study focused on analysing the performance and the perception of importance about workload of ambulatory nurses and nurse-aides for quality of nursing. Method: The subjects of this study were 126 ambulatory nurses and 117 nurse-aides in 6 secondary and 4 tertiary hospitals. The method of data collection was used the questionnaire. Result: As a result, First, nurses' activities that the performance score is above 3.0 are reception, guidance, reservation, confirm, checking medical record, operating report, explanation of disease, explanation of examination discuss with medical part, discuss with supporting part, solving patient problem environment management, and paper work. And the other side, those of nurse-aides are reception, guidance, reservation, preparation for clinic, assistant for clinic, preparation for examination, material transfer & receipt, confirm, checking medical record, and arrangement. Second, nurses-aids perceive above 3.0 performance score activities to be important for themselves. Finally, nurses perceive three categories of patient education/counselling, patient advocacy and quality improvement to be more important and higher performance when compared with nurse-aides. Conclusions: Ambulatory nurse's important nursing activities are therapeutic care, patient education/counselling, patient advocacy, communication, personal management, quality improvement.

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The Big Data Analysis and Medical Quality Management for Wellness (웰니스를 위한 빅데이터 분석과 의료 질 관리)

  • Cho, Young-Bok;Woo, Sung-Hee;Lee, Sang-Ho
    • Journal of the Korea Society of Computer and Information
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    • v.19 no.12
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    • pp.101-109
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    • 2014
  • Medical technology development and increase the income level of a "Long and healthy Life=Wellness," with the growing interest in actively promoting and maintaining health and wellness has become enlarged. In addition, the demand for personalized health care services is growing and extensive medical moves of big data, disease prevention, too. In this paper, the main interest in the market, highlighting wellness in order to support big data-driven healthcare quality through patient-centered medical services purposes. Patients with drug dependence treatment is not to diet but to improve disease prevention and treatment based on analysis of big data. Analysing your Tweets-daily information and wellness disease prevention and treatment, based on the purpose of the dictionary. Efficient big data analysis for node while increasing processing time experiment. Test result case of total access time efficient 26% of one node to three nodes and case of data storage is 63%, case of data aggregate is 18% efficient of one node to three nodes.

Impact of Health Insurance Type on the Quality of Hemodialysis Services: A Multilevel Analysis (의료보장 형태가 혈액투석 서비스 제공에 미치는 영향에 대한 다수준 분석)

  • Jung, Jin-Hee;Kwon, Soon-Man;Kim, Kyoung-Hoon;Lee, Seon-Kyoung;Kim, Dong-Sook
    • Journal of Preventive Medicine and Public Health
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    • v.43 no.3
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    • pp.245-256
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    • 2010
  • Objectives: This study aims to compare quality indicators for the hemodialysis services between patients with health insurance and those with medical aid. Methods: This study used data from sampled hospitals that provided a hemodialysis service. A total of 2287 patients were selected, and the information for hemodialysis service has been granted from medical record reviews. A multi-level regression analysis was used to examine the differences in process and outcome indicators for hemodialysis between patients with health insurance and those with medical aid. Process indicators were defined as: frequency of hemodialysis, hemodialysis time, erythropoietin (EPO) use, measurement of hemodialysis dose at least once a month, measurement of phosphate at least once every three months, and measurement of albumin at least once every three months. Outcome indicators were defined as: hemodialysis adequacy, anemia management, blood pressure management, and calcium, phosphate and nutrition management. The total scores for outcome indicators ranged from 0 (worst) to 4 (best). Results: There was a significant difference in the measurement of hemodialysis dose at least once a month between patients with health insurance and those with medical aid (OR 0.66, 95% CI = 0.43 - 0.99). However, frequency of hemodialysis, hemodialysis time, EPO use, measurement of phosphate at least once every three months, measurement of albumin at least once every three months, hemodialysis adequacy management, Hb${\geq}$11 g/dL, blood pressure within the range of 100-140 /60-90 mmHg, calcium x phosphate${\leq}$55 $g^2/dL^2$ and albumin${\geq}$4 g/dL were not significantly different between the groups. Conclusions: There were no significant differences in outcome indicators for hemodialysis between the groups. Further studies are warranted into the mechanism that results in no differences in the outcome indicators for hemodialysis.

Development of Performance Measures Based on the Nursing Process for Prevention and Management of Pressure Ulcers, Falls and Pain (욕창, 낙상예방 및 통증간호의 간호과정 적용 평가도구 개발)

  • Kim, Keum Soon;Kim, Jin A;Kim, Moon Sook;Kim, Yu Jeong;Kim, Eul Soon;Park, Kwang Ok;Song, Mal Soon;Yi, Young Hee;Lee, In Ok;Jung, Yoen Yi;Choi, Yun Kyoung
    • Journal of Korean Clinical Nursing Research
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    • v.15 no.1
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    • pp.133-147
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    • 2009
  • Purpose: This study was conducted to construct evidence based clinical guidelines and to develop nursing process based performance measures for prevention and management of pressure ulcers, falls and pain. Method: Clinical guidelines were drafted through a comprehensive review of relevant literature, national guidelines and hospital protocols. The proposed guidelines were reviewed by a panel of experts and 90 hospital nurses, and refined on the basis of their suggestions. Nursing process based performance measures were developed based on the clinical guidelines and content validity was examined by surveys from 90 hospital nurses. Results: All items, except timetable for position change and pressure ulcer nursing record, in the guidelines for prevention and management of pressure ulcer were appropriate. Most items, except fall risk assessment tools, were appropriate for the guidelines of fall prevention. All other items, except the purpose of pain management, were appropriate for the guidelines of pain management. Performance measures developed in this study were acceptable as a tool to evaluate quality of nursing care. Conclusion: Nursing process based performance measures provide important indicators to monitor whether necessary nursing care is implemented and can be used as the primary resources to improve quality of nursing services.

Preliminary Study for Development of System for Oriental Nurse-specialist (한방전문간호사제도를 위한 예비조사)

  • Baek, Ji-Young
    • The Journal of Korean Academic Society of Nursing Education
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    • v.7 no.2
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    • pp.275-284
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    • 2001
  • This study was conducted to examine the nurses' role in Oriental medical hospital and the necessity of Oriental medical nursing system. Data were collected from 194 nurses in 14 Oriental medical hospitals located in Seoul, Busan, Daegu, Kwangju, Kangwon Province, Kyungbuk Province from July 1, 2000 to September 10, 2000. The results of this study are summarized as follows. 1. In nurse's level of knowledge of acupuncture point in current Oriental nursing practice, 28.4% of the respondents did not know acupuncture points at all, while 30.9% knew them a little. 40.7% of them did not almost know them. 2. According to nurses' role in Oriental medical hospital, they did a lot of duty for measurement of vitality, medical record, Dr. notifying, communication with medical team and related departments, and observation of patients' conditions. They did a little duty for handling Oriental medical practice. 3. As the subject of curriculum for Oriental medical nursing, 52.1% chose training course for Oriental medical nursing, while 25.8% chose inclusion of the curriculum in the school of nursing. 39.2% replied that they would take the training course for Oriental medical nursing, while 3.6% answered that they would not take it. 68.6% of them thought that Oriental medical nursing system should be introduced, while 4.1% objected to introducing the system. The nurses in Oriental medical hospitals are working with many problems because of their role confusion and low level of knowledge in Oriental medicine. Therefore, systematic curriculum and research related to Oriental medical nursing are necessary. Oriental medical nursing system must be introduced in order to make nurses have professional knowledge and skill in Oriental medicine. The nurses then can provide services of good quality for the patients.

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Development of customized patient data analysis process for quality of care improvement : focused on foreign patients (진료 품질 향상을 위한 환자 데이터 맞춤형 분석 프로세스 개발: 외국인 환자를 중심으로)

  • Roh, Eul Hee;Kim, Yoo Jung;Park, Sang Chan
    • Journal of Korean Society for Quality Management
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    • v.46 no.3
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    • pp.539-550
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    • 2018
  • Purpose: The purpose of this study was to find meaningful patient groups of disease using foreign patients data and analyze implemented test of the patient groups. Methods: The data was collected by foreign patients' EMR data of K university hospital. The author proposed tree-form patients' characteristic diagram through statistical methods that association rule, proportion test, clustering using prescription information and questionnaire information. Results: This study's analysis process was applied high blood data and diabetes data. Analysis showed other characteristic of meaningful patient groups in high blood and diabetes. In high blood, test implementation rate of patient group showed the differences. And in diabetes, test implementation rate of patient group and implemented test list showed differences. Conclusion: The result of this study can play a role as basic data that can be clinical testing standard in preventive aspect. Eventually, 5 dimensions of SERVQUAL will be improved by this study's process.

Development of Clinical Practice Guidelines in a Hospital (병원단위의 임상진료지침 개발과정)

  • Shin, Youngsoo;Kim, Chang-Yup;Oh, Byung-Hee;Han, Kyou-Sup;Yoon, Byung-Woo;Han, Joon-Koo;Khang, Young-Ho
    • Quality Improvement in Health Care
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    • v.4 no.1
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    • pp.82-103
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    • 1997
  • Background : With increased concerns about variation among physician's practice pattern and their impact on the quality of care, clinical practice guidelines have been developed by many different organizations, with differing aims and incentives. From the same point of view, there is growing interest in the development of clinical practice guidelines in Korea, but with only a few examples. As a result, there is not much exploration on the incentive and barrier to develop guidelines as well as description on the development process. The purposes of this study are to describe the process of the four different clinical practice guidelines in a hospital setting, and to identify incentives and barriers in the development of guidelines. Methods : For this research, a clinical practice guideline development committee and four clinical practice guideline development teams were organized in a university hospital which has more than 1,200 bead. Twenty eight doctors, three nurses, and one technician participated as members of development teams for eight months. Four to six meetings were held, and three to seven departments in the hospital were involved. Results : The topics which developed into clinical practice guidelines were cardiopulmonary resuscitation(CPR), blood transfusion, anticoagulation, and angiography. The main goals set by teams were education(CPR, angiography), risk management(blood transfusion), and to enhance quality of care(anticoagulation). Among four teams, only in the team for anticoagulation guideline medical record review and pilot-testing were performed. Also literature review was not carried out systematically. However, all the guidelines were developed by multidisciplinary be used as standard protocols in the practice. Conclusion : Experience and skill in developing process has to be improved to have a more valid and useful practice guideline. In particular, literature review and problem identification by examining medical record should be emphasized. Also further studies on the clinical outcomes of the guidelines application and changes in physicians' behaviors would be required.

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