• 한국의료질향상학회지
• /
• 제2권1호
• /
• pp.118-124
• /
• 1995

Background: Clinical indicators are objective measures of process or outcome of patient care in quantitative terms. This study aims to review the medical records of patients who 'return to operating room during the same admission', which is one of the critical clinical outcomes, and describe the result by unplanned reoperation rate. Methods: Computerized patient registry was used for selecting subject conditions. For medical records retrieved, two nurse evaluators identified the presence of explicit reoperation planning in medical records. Results: Overall reoperation rate was 2.8% and unplanned reoperation rate 1.3%. The main category of reoperation cause was the postoperative bleeding. Duration of stay from previous operation to reoperation of the unplanned group, 12.7 days, was shorter than that of the planned(p< .05). The differences did not reach statistical significance in age, sex and length of stay. Conclusion: Results suggested that unplanned reoperation rate was lower than 'threshold' level other institutions had established. However, this result could become comparable only after management of medical records would be improved and risk adjusted.

• 보건행정학회지
• /
• 제15권4호
• /
• pp.26-45
• /
• 2005

The purposes of this study were to Identify the .level of measurement on quality Indicators and evaluate the existing indicators in order to determine the priority of quality indicators' application in Korean general hospitals. A survey was conducted using a questionnaire. The subjects were quality managers working at general hospital having over 300 beds. The criteria were relevance, reliability, precision, impact, application, and preference to evaluate quality indicators. According to these six criteria, each indicator was evaluated on a five point scale(5: excellent, 1: poor). The response rate was $40.4\%$. The hospitals have monitored the average of 3.8 indicators(median 4). The indicators such as return to operating room, unplanned readmission, cancellation of booked operations, death, hospital infection, cesarean section rate, volume per disease or procedure, readmission, re-operation, blood transfusion, and post-procedural complications were frequently measured. The top ten quality indicators in the evaluation by its relevance, validity, reliability, impact, preference and application were decubitus ulcer, clean wound infection, fall, unplanned return to operation room, transfusion reactions, foreign body left In during procedure, unplanned readmission, wound infection after contaminated surgery, postoperative hemorrhage/hematoma, and cesarean section rate in order. The high priority quality indicators frequently measured could be used as primary national indicators. Standardized guidelines about monitoring indicators and the utilization will preliminarily be needed to compare and reuse the data for various purposes and improve the quality of care continuously.

• Archives of Reconstructive Microsurgery
• /
• 제9권1호
• /
• pp.15-22
• /
• 2000

One hundred & seventy four consecutive free-flap transfers were reviewed to analyze distribution of the type of reconstructions, kinds of donor flaps as well incidence of complications. The role of emergent exploration and the effect of preoperative wound conditions in flap survival were evaluated. Free flap transfer for head and neck reconstruction was most common as 93 cases, followed by for upper extremity of 30 cases, for lower extremity 30 cases, 18 penile reconstructions and for trunk & breast 3 cases. Nine flaps exhibited signs of ciruclatory insufficiency between 5 hours and 7 days. Three were managed conservatively with ultimate partial necrosis of the flaps. Eight flaps required return to the operating room. On exploration, early arterial occlusion was revealed in 1 flap, late arterial occlusion in 2 flaps, early venous occlusion in 1 flap, late venous thrombosis in 2 flaps, prolonged venous spasm in 1 and hematoma in 1 flap. The average time from the first abnormal examination to exploration was 2.6 hours. There were no false-positive explorations. Four free flaps failed in spite of the correction of the cause of circulatory compromise. The remaining 4 flaps were salvaged following the correction the casuse. Recipient vessel problems such as irradiation and infection were the most common cause of circulatory crisis. Among the eight flaps requiring return to the operating room, single vein was anastomosed in three flaps and two veins in the remaining five. In the totally failed four flaps only single vein was anastomosed in three cases. The results of this study demonstrate the efficacy of clinical monitoring and the role of early exploration. Precautious selection of recipient vessels and two vein anastomosis are recommended for safe and better prognosis.

• 한국전기전자재료학회논문지
• /
• 제18권8호
• /
• pp.759-765
• /
• 2005

In this paper, developed isolator for gap filler is analyzed and designed using the simulation tool. Using the designed parameters, isolator is fabricated and tested in gap filler band. Temperature characteristics of isolator depend on magnet, YIG ferrite, and conductor etc. These require temperature stability and possible method of compensation for the temperature dependent effects. The temperature stabilization tries to use Ni-alloy. Developed isolator that compare with room temperature and high temperature characteristics has change fewer than 20 MHz. Implemented isolator shows more than 20 dB isolation characteristic at center frequency(2,650 MHz) and has 0.2 dB insertion loss in overall 100 MHz operating bandwidth. Return losses of input and output port are measured below -20 dB.

• 전자공학회논문지A
• /
• 제30A권4호
• /
• pp.1-10
• /
• 1993

This paper presents the designing/manufacturing scheme of the diplexer for satellite transponder which is composed of 2-channel bandpass filters, coupled with E-plane T-junction, having symmetrical waveguide E-plane step discontinuity structures. The 2-channel bandpass filters of the diplexer are designed by the scheme of connecting ${\lambda}_{g}$/2 shunt stub to the waveguide E-plane, playing the role of heat sinks without attaching a special heat sinks and to give the profitable productivity and allow the low-cost manufacturing at mass production, tuning screws are eliminated which have been used to compensate the operating characteristics of manufactured filters. The 2 channel bandpass filters of manufactured 14/12 GHz diplexer for domestic Ku-band satellite transponder have the return loss of 25 dB, insertion loss of 0.3 dB in passband, and below-50 dB of stopband characteristics (T$_{x}$ : f$_{o}{\pm}$250 MHz, R$_{x}$ : f$_{o}{\pm}$220 MHz) at room temperature.

• 한국병원경영학회지
• /
• 제5권1호
• /
• pp.1-23
• /
• 2000

This study was undertaken to develop performance measurement indicators in S Hospital, which is the largest component of Y Medical Center which implemented the Responsible Management System in 1993. To begin, strategic initiatives for S Hospital were reestablished based on Y Medical Center's goals and objectives. The BSC(Balanced Scorecard) was used to develop performance measurement indicators after validity checks by specialists. The results were that total 16 indicators were developed to measure performance for strategic initiatives. Those included the growth rate of patient revenues, operating profit to gross revenues, reduction rate in administrative expenses from a financial perspective; average medical expenses per adjusted patient, patient satisfaction survey for inpatients and outpatients and emergency room patients, return rate for treatment results from the customer's perspective; reduction rate in average length of hospital stay, expenses for lost cases of medical disputes, rate for contracted employees, the number of published reports per faculty member from an internal perspective; educational expenses for training medical staff and full time employees, adjusted patient per medical staff, and the number of cases implemented which were proposed by employees. Any organization needs to have its own explicit objectives to grow and develop and it is absolutely necessary to measure performance to accomplish them. The performance measurement indicators developed by this study are expected to be used as a tool to attain the objectives of S Hospital.

• 한국산학기술학회논문지
• /
• 제12권8호
• /
• pp.3610-3616
• /
• 2011

전기철도는 전차선을 통해 차량을 구동할 수 있는 전력을 공급하며, 공급된 전류는 선로 및 접지망을 통해 변전소로 귀환한다. 전기철도 구간에서 철도차량의 운행에 따라 사용된 부하전류는 귀환회로인 궤도를 통해 변전소로 유입한다. 철도차량에서 사용되고 있는 전력변환장치 때문에 부하전류에는 고조파가 함유되고 이러한 고조파 전류가 열차제어시스템에 영향을 주지 않아야 한다. 본 논문에서는 신규로 건설된 전기철도 구간에서 철도차량 운행에 따라 발생되는 고조파가 연동장치에 영향을 주는 지 확인하기 위하여 시험한 결과를 제시하고 있다. 신호기계실에 설치되는 연동장치에 철도차량 운행에 따라 고조파 영향이 있는 지 확인하기 위하여 본 논문에서의 시험은 철도차량이 운행되는 선로변 설비에서 연동장치로 연결되는 부분에서 수행되었다.

• 유기물자원화
• /
• 제23권3호
• /
• pp.33-41
• /
• 2015

대규모 시설확장 없이 기존하수시설의 운영 방식개선으로 처리효율을 극대화할 수 있는 방법을 찾아보고자 하였다. 충분한 질소제거를 위해 체류시간 79%는 호기조에 할애할 필요가 있었다. 포기시간이 길어질수록 질산화가 많이 진행되었는데 인 농도는 반대의 경향을 보여주었다. 긴 포기시간에서 높은 농도의 인 배출을 보여주고 있었다. 높아진 $NO_3-N$의 방해로 PAOs의 활동이 저하되어 TP 및 $PO_4-P$의 흡수가 저조해지는 현상으로 추정되었다. 충분한 질소제거를 위해 긴 포기시간을 선택해야 하지만 TP 및 $PO_4-P$의 농도를 낮출 수 있는 방법도 강구해야 할 필요성이 생겨 혐기조 체류시간을 가변적으로 확장하는 방법을 고안하였다. 혐기조와 무산소조를 두 칸으로 하지 않고 3등분하여 중앙 칸을 가변적으로 사용하는 경우를 설정해 보았다. 중앙 칸을 무산소 또는 혐기조로 사용하는 경우로 설정한 것이다. TN, $NH_3-N$, $NO_3-N$ 등은 충분히 낮추면서 TP 및 $PO_4-P$의 농도를 더욱 낮출 수 있었다. 혐기조 체류시간이 증가되어 탈질촉진이 생긴 것으로 판단되었다. 중앙 칸을 가변적으로 사용할 수 있는 방법으로는 호기조에서 오는 내부반송수를 두 번째와 세 번째 칸으로 밸브 연결하여 두 번째 칸을 선택적으로 혐기조로 운영하는 방법이다. 이러한 방식은 계절에 따라 수온변화에 대응하는 우수한 대안이 될 것으로 사료되었다.