• Title/Summary/Keyword: service standardization

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The Effects of Near Miss and Accident Prevention Activities and the Culture of Patient Safety Management for the Patient Safety (Near Miss 사고 예방 활동과 환자안전관리 문화형성이 환자안전에 미치는 영향)

  • Chang, Ho-Suk;Lee, Gui-Won
    • The Korean Journal of Nuclear Medicine Technology
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    • v.14 no.2
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    • pp.138-144
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    • 2010
  • Purpose: Despite the rapidly changing healthcare environment, healthcare organizations have recognized the importance of patient safety management. But patient safety management has the problem of the lack of participation of members due to the process of focusing on the follow-up service and punishment. The department of nuclear medicine in Uijeongbu St. Mary's Hospital started this research to reduce the near miss and prevent patient safety accidents by both initiating the participatory near-miss-proof activities as an advance management and constructing a system without disadvantages of reporting. In addition, this research aims to establish a differentiated patient safety management system in the department of nuclear medicine. Materials and Methods: 1. Colleting cases of team members' past and present near miss and accidents(First data collection). 2. Quantifying the cases of near miss and accidents after identifying the degree of importance and urgency through surveys(Second data collection). 3. Quantifying cases and indentifying important points of contact through data analysis. 4. Making and standardizing a manual for important points of contact, and initiating participatory activities to prevent errors. 5. Activating web-based community for establishing the report system of near miss. 6. Estimating the result of before and after activities through surveys and focus group interviews. Results: 1) Quantified safety accidents and near miss in the department of nuclear medicine. About 50 near misses a month and one safety accident a year. 2) Establishing improvement measurements based on quantified data. About 11 participatory activities, the improvement of process, a manual for standardization. 3) Creating a system of safety culture and high participation rate of team members. Constructing a report system, making a check list and a slogan for safety culture, and establishing assessment index. 4) Activating communities for sharing the information of cases of near misses and accidents. 5) As the result of activities, the rate of near miss occurrence declined by 50% and the safety accident did not happen. Conclusion: The best service in the department of nuclear medicine is to provide patients with safety-guaranteed high-quality examination and cure. This research started from the question, 'what is the most faithful-to-the-basics way to provide the best service for patients?' and team members' common answer for this question was building a system with participation of all members. Building a system through the participatory improvement activities for preventing near miss and creating safety culture resulted in the 50% decline of near miss occurrence and no accident. This is a meaningful result from the perspective of advance management for patient safety. Moreover, this research paved the way for creating a culture to report and admit near miss or accidents by establishing a report system with no disadvantage of reporting. The system which sticks to the basics is the best service for patients and will form a patient safety culture system, which will lead to the customer satisfaction. Therefore, all members of the department of nuclear medicine will develop a differentiated patient safety culture with stabilizing the established system.

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Development of Korean Green Business/IT Strategies Based on Priority Analysis (한국의 그린 비즈니스/IT 실태분석을 통한 추진전략 우선순위 도출에 관한 연구)

  • Kim, Jae-Kyeong;Choi, Ju-Choel;Choi, Il-Young
    • Asia pacific journal of information systems
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    • v.20 no.3
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    • pp.191-204
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    • 2010
  • Recently, the CO2 emission and energy consumption have become critical global issues to decide the future of nations. Especially, the spread of IT products and the increased use of internet and web applications result in the energy consumption and CO2 emission of IT industry though information technologies drive global economic growth. EU, the United States, Japan and other developed countries are using IT related environmental regulations such as WEEE(Waste Electrical and Electronic Equipment), RoHS(Restriction of the use of Certain Hazardous Substance), REACH(Registration, Evaluation, Authorization and Restriction of CHemicals) and EuP(Energy using Product), and have established systematic green business/IT strategies to enhance the competitiveness of IT industry. For example, the Japan government proposed the "Green IT initiative" for being compatible with economic growth and environmental protection. Not only energy saving technologies but energy saving systems have been developed for accomplishing sustainable development. Korea's CO2 emission and energy consumption continuously have grown at comparatively high rates. They are related to its industrial structure depending on high energy-consuming industries such as iron and steel Industry, automotive industry, shipbuilding industry, semiconductor industry, and so on. In particular, export proportion of IT manufacturing is quite high in Korea. For example, the global market share of the semiconductor such as DRAM was about 80% in 2008. Accordingly, Korea needs to establish a systematic strategy to respond to the global environmental regulations and to maintain competitiveness in the IT industry. However, green competitiveness of Korea ranked 11th among 15 major countries and R&D budget for green technology is not large enough to develop energy-saving technologies for infrastructure and value chain of low-carbon society though that grows at high rates. Moreover, there are no concrete action plans in Korea. This research aims to deduce the priorities of the Korean green business/IT strategies to use multi attribute weighted average method. We selected a panel of 19 experts who work at the green business related firms such as HP, IBM, Fujitsu and so on, and selected six assessment indices such as the urgency of the technology development, the technology gap between Korea and the developed countries, the effect of import substitution, the spillover effect of technology, the market growth, and the export potential of the package or stand-alone products by existing literature review. We submitted questionnaires at approximately weekly intervals to them for priorities of the green business/IT strategies. The strategies broadly classify as follows. The first strategy which consists of the green business/IT policy and standardization, process and performance management and IT industry and legislative alignment relates to government's role in the green economy. The second strategy relates to IT to support environment sustainability such as the travel and ways of working management, printer output and recycling, intelligent building, printer rationalization and collaboration and connectivity. The last strategy relates to green IT systems, services and usage such as the data center consolidation and energy management, hardware recycle decommission, server and storage virtualization, device power management, and service supplier management. All the questionnaires were assessed via a five-point Likert scale ranging from "very little" to "very large." Our findings show that the IT to support environment sustainability is prior to the other strategies. In detail, the green business /IT policy and standardization is the most important in the government's role. The strategies of intelligent building and the travel and ways of working management are prior to the others for supporting environment sustainability. Finally, the strategies for the data center consolidation and energy management and server and storage virtualization have the huge influence for green IT systems, services and usage This research results the following implications. The amount of energy consumption and CO2 emissions of IT equipment including electrical business equipment will need to be clearly indicated in order to manage the effect of green business/IT strategy. And it is necessary to develop tools that measure the performance of green business/IT by each step. Additionally, intelligent building could grow up in energy-saving, growth of low carbon and related industries together. It is necessary to expand the affect of virtualization though adjusting and controlling the relationship between the management teams.

2013 Records Regime Issues and Prospects for Public Records Management in Korea (한국 공공기록관리의 쟁점과 전망 2013년 기록관리체제를 위하여)

  • Ahn, Byung-Woo;Lee, Sang-min;Sim, Seong-Bo;Nam, Kyeong-Ho;Kim, Jin-Sung;O, Dong-Seok;Jeong, Tae-Young
    • The Korean Journal of Archival Studies
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    • no.34
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    • pp.3-28
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    • 2012
  • The year of 2013 is the first year that the new president takes the power and administrates the national affairs. In Korea, when the new president comes, the new administration brings big changes in the politics, economy, and society. The government management style has been changed according to the orientation and styles of the new president. Public records management is a critical and effective business tool to establish and carry out the government policies as well as an essential tool for democracy. Modern democracy is based on good governance. Creation and free use of full and accurate public records makes the good communication between the government and the public possible, and people's participation in the policy-making and surveillance of government activities for public good can work. During the present administration, communication between the president and the people was cutoff and people's participation in the national affairs have been further limited. Furthermore, in the present administration, the public records management was not regarded important, Whatever new administration comes, the year of 2013 is the time for the new administration to realize again the importance of the public records management and put it back to the normal track. Here are the major issues in the public records management to be concerned and resolved; (1) to ensure technological and institutional management of the electronic records in the government and safe transfer of the massive electronic records, (2) to establish an independent national records management and archives authority to be based on good governance, (3) to innovate the public records management in the public agencies including their agency records offices (RMO) and records management systems (RMS) (4) to establish local government archives and document local government policies and activities (5) supporting and promotion for documentation of the total society as a public service (6) expanding employment of professional records managers and archivists in the central and local governments, and standardization of professional competency and certification. In this paper, I will introduce the major issues in the public records management and suggest the policies and solutions that the Korean records professionals considered and discussed. This analysis and suggestions are the outcome of our professional considerations and discussions.

Comparison of the Legislation Applicable to Compare the use of Diagnostic Radiation Devices (진단용 방사선발생장치 이용에 적용되는 법제의 비교)

  • Ko, Jong-Kyung;Jeon, Yeo-Ryeong;Han, Eun-Ok;Cho, Pyong-Kon;Kim, Yong-Min
    • Journal of radiological science and technology
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    • v.38 no.3
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    • pp.277-286
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    • 2015
  • Diagnostic radiation devices that is used in the country has reached to 78,000 units. When used for human subjects diagnostic purposes, it is subject to Medical Service Act, when used in diagnostic purposes in animal subjects, the subject to Veterinarians Act. When used for other purposes are subject to the Nuclear Safety Act. Even the same radiation devices varies the legislation that is applied depending on the intended use and object. Diversified been p rovisions a re necessary compared to t he analysis o f l egal content in o rder t o prevent confusion of the legislation is a matter to be applied. It is a qualitative study that Nuclear Safety Act, Medical Service Act and Veterinarians Act administrative procedures for the introduction of the applied diagnostic radiation devices, safety inspection, human resources management, area management and the content related to administrative punishment. The Nuclear Safety Act sub-provisions, the introduction of diagnostic radiation generating devices, there are many complex and complete requirements administrative procedures on the concept of a permit. Inspection of safety associated with the use, would be subject to periodic inspection auditing characteristics over the entire field of radiation safety management. It must receive court regular education for the safety administrator and workers. Unlike the reference of the radiation dose rate to specify the radiation controlled area there is a measurement obligation of radiation dose rate. Unlike the reference of the radiation dose rate to specify the radiation controlled area there is a measurement obligation of radiation dose rate. Quantitative difference of administrative punishment that is imposed when legislation violation has reached up to 10 times, over the entire field, the largest burden of radiation safety management at the time of application of the Nuclear Safety Act sub provisions. And it is applied differently depending on the purpose and the imaging target using the same diagnostic radiation devices. Depending on the use mainly under the current legal system, radiation can be lacking in fairness of the contents of the legislation for safety management, there is a risk of confusion. Alternatives such as centralized and standardization of legislation by diagnostic radiation devices use is expected to be necessary.

Overlay Multicast Network for IPTV Service using Bandwidth Adaptive Distributed Streaming Scheme (대역폭 적응형 분산 스트리밍 기법을 이용한 IPTV 서비스용 오버레이 멀티캐스트 네트워크)

  • Park, Eun-Yong;Liu, Jing;Han, Sun-Young;Kim, Chin-Chol;Kang, Sang-Ug
    • Journal of KIISE:Computing Practices and Letters
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    • v.16 no.12
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    • pp.1141-1153
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    • 2010
  • This paper introduces ONLIS(Overlay Multicast Network for Live IPTV Service), a novel overlay multicast network optimized to deliver live broadcast IPTV stream. We analyzed IPTV reference model of ITU-T IPTV standardization group in terms of network and stream delivery from the source networks to the customer networks. Based on the analysis, we divide IPTV reference model into 3 networks; source network, core network and access network, ION(Infrastructure-based Overlay Multicast Network) is employed for the source and core networks and PON(P2P-based Overlay Multicast Network) is applied to the access networks. ION provides an efficient, reliable and stable stream distribution with very negligible delay while PON provides bandwidth efficient and cost effective streaming with a little tolerable delay. The most important challenge in live P2P streaming is to reduce end-to-end delay without sacrificing stream quality. Actually, there is always a trade-off between delay & stream quality in conventional live P2P streaming system. To solve this problem, we propose two approaches. Firstly, we propose DSPT(Distributed Streaming P2P Tree) which takes advantage of combinational overlay multicasting. In DSPT, a peer doesn't fully rely on SP(Supplying Peer) to get the live stream, but it cooperates with its local ANR(Access Network Relay) to reduce delay and improve stream quality. When RP detects bandwidth drop in SP, it immediately switches the connection from SP to ANR and continues to receive stream without any packet loss. DSPT uses distributed P2P streaming technique to let the peer share the stream to the extent of its available bandwidth. This means, if RP can't receive the whole stream from SP due to lack of SP's uploading bandwidth, then it receives only partial stream from SP and the rest from the ANR. The proposed distributed P2P streaming improves P2P networking efficiency.

Summary and Conclusion Title :Oriental Nursing Management System (한방간호 관리체계 연구)

  • Moon, Heui-Ja
    • Journal of East-West Nursing Research
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    • v.10 no.1
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    • pp.11-26
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    • 2004
  • The purpose of this study is to investigate the present conditions of nursing investment contents, its conversion process, and output in Oriental University Medical Center, Korea to get good qualified Oriental nursing result which is the ultimate purpose of the Oriental nursing management, and to develope a matrix of Oriental nursing management system on the basis of that project. The subjects for nursing investment and output contents were eighteen nursing directors in eleven Oriental University Medical Center and two hundred thirty-nine nurses with three years and over experience in Oriental medical center. The subjects for Oriental nursing organization, human affair management, and control function were nineteen Oriental medical center in Oriental University Medical Center, Korea. Data were collected from November, 2002 to February, 2003 with questionnaire. Data analysis was done by SPSS PC+ 12 program. Frequency, percentage, and minimum/maximum values were used for investment contents, and frequency and percentage were used for conversion process and output contents. 1. The input factors of oriental nursing management system The objective's western hospital career was over five years of one hundred and seventy-five(73.2%) persons. Nursing in-service education was performed in fourteen hospitals(77.8%). Two hundreds(83.7%) were pro to oriental nurse system. Only four hospitals(22.2%) had independent budget in nursing division. Nursing staff allocation to the bed was from 2.8:1 to 9.06:1 respectively, with a big gap of the rate following the hospitals. 2. The conversion factors of oriental nursing system 1) Oriental nursing system Oriental hospital nursing system was organized independently in ten hospitals among eighteen hospitals. The recruitment of nurses which was a vital role of the nursing division of the hospital was mostly(79%) opened. The education to develope nursing personnels was through in-service one in 97.4%. Education for oriental nursing and management was performed in 42.1%(eight hospitals) and that for reserves was done in 36.8%(seven hospitals). Administration for nursing education by nursing division was 68.5%(thirteen hospitals). The post education evaluation was performed by report submission in 36.8%(seven hospitals), by written examination in 26.3%, by questionnaires in 21.1%, and by lecture presentation in 15.8% subsequently. The directorial meeting for the nursing directors was attended by 84.2%(sixteen hospitals), and the meeting type was the medical executive and support division executive meeting in 55.6%(ten hospitals) and the personnel management in 39.6%(seven hospitals). 2) The actual conditions of oriental nursing personnel management The reason of working in oriental hospital was by voluntary in 67.1%(a hundred and sixty persons), by nursing department order in 28.0%(sixty-seven persons), and by others in 5.0%(twelve persons) respectively. The shift form was a three-shifts one in 94.7%(eighteen hospitals), a two-shift one in only one hospital. Duty assignment was functional in 52.6%(ten hospitals), team and functional in 26.3%(five hospitals) and no team alone. Promotion manual was present at 68.4%(thirteen hospitals) and the competency essentials comprised of performance evaluation in 79%, interview, written examination, training result, study result subsequently. No labor union existed in 79%(fifteen hospitals) 3) Oriental nursing preceptor system There were five oriental hospitals(27.7%) administering the preceptor utilization model, which showed lower rate than the twenty-two medical university hospitals in Seoul in which fifteen hospitals (72.7%) were having the system. To the question of necessity of oriental nurse system asked to the objectives of two hundred and thirty-nine with more than three year-experience in oriental hospital, two hundred persons(83.7%) answered positively. 4) The control of oriental nursing The evaluation results from the target hospitals were mostly not opened in 89.4% of oriental hospitals. Thirteen hospitals(68.3%) had evaluation system of direct managers and the next were three hospitals(15.8%) of direct managers and selves. There was one hospital(5.3% each) where fellows and superiors, fellows, and inferiors' evaluation was performed and no hospital where superiors, fellows, inferiors and selves, and superiors, fellows and selves' evaluation was performed. The QI activity of nursing was 42.1%(eight hospitals) for nursing service evaluation, 36.8% for survey of ECSI, 26.3% for survey of ICSI, 15.8% for medical visit rate, 10% for hospital standardization inspection in sequence. 3. The output factors of oriental nursing management system The job satisfaction appeared good in general, indicating very good in thirty-seven persons (15.7%), good in one hundred and fourteen persons (48.3%) and fair in eighty-five persons(36.0%).

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A Study on the Online Newspaper Archive : Focusing on Domestic and International Case Studies (온라인 신문 아카이브 연구 국내외 구축 사례를 중심으로)

  • Song, Zoo Hyung
    • The Korean Journal of Archival Studies
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    • no.48
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    • pp.93-139
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    • 2016
  • Aside from serving as a body that monitors and criticizes the government through reviews and comments on public issues, newspapers can also form and spread public opinion. Metadata contains certain picture records and, in the case of local newspapers, the former is an important means of obtaining locality. Furthermore, advertising in newspapers and the way of editing in newspapers can be viewed as a representation of the times. For the value of archiving in newspapers when a documentation strategy is established, the newspaper is considered as a top priority that should be collected. A newspaper archive that will handle preservation and management carries huge significance in many ways. Journalists use them to write articles while scholars can use a newspaper archive for academic purposes. Also, the NIE is a type of a practical usage of such an archive. In the digital age, the newspaper archive has an important position because it is located in the core of MAM, which integrates and manages the media asset. With this, there are prospects that an online archive will perform a new role in the production of newspapers and the management of publishing companies. Korea Integrated News Database System (KINDS), an integrated article database, began its service in 1991, whereas Naver operates an online newspaper archive called "News Library." Initially, KINDS received an enthusiastic response, but nowadays, the utilization ratio continues to decrease because of the omission of some major newspapers, such as Chosun Ilbo and JoongAng Ilbo, and the numerous user interface problems it poses. Despite these, however, the system still presents several advantages. For example, it is easy to access freely because there is a set budget for the public, and accessibility to local papers is simple. A national library consistently carries out the digitalization of time-honored newspapers. In addition, individual newspaper companies have also started the service, but it is not enough for such to be labeled an archive. In the United States (US), "Chronicling America"-led by the Library of Congress with funding from the National Endowment for the Humanities-is in the process of digitalizing historic newspapers. The universities of each state and historical association provide funds to their public library for the digitalization of local papers. In the United Kingdom, the British Library is constructing an online newspaper archive called "The British Newspaper Archive," but unlike the one in the US, this service charges a usage fee. The Joint Information Systems Committee has also invested in "The British Newspaper Archive," and its construction is still ongoing. ProQuest Archiver and Gale NewsVault are the representative platforms because of their efficiency and how they have established the standardization of newspapers. Now, it is time to change the way we understand things, and a drastic investment is required to improve the domestic and international online newspaper archive.

A Contemplation on Measures to Advance Logistics Centers (물류센터 선진화를 위한 발전 방안에 대한 소고)

  • Sun, Il-Suck;Lee, Won-Dong
    • Journal of Distribution Science
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    • v.9 no.1
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    • pp.17-27
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    • 2011
  • As the world becomes more globalized, business competition becomes fiercer, while consumers' needs for less expensive quality products are on the increase. Business operations make an effort to secure a competitive edge in costs and services, and the logistics industry, that is, the industry operating the storing and transporting of goods, once thought to be an expense, begins to be considered as the third cash cow, a source of new income. Logistics centers are central to storage, loading and unloading of deliveries, packaging operations, and dispensing goods' information. As hubs for various deliveries, they also serve as a core infrastructure to smoothly coordinate manufacturing and selling, using varied information and operation systems. Logistics centers are increasingly on the rise as centers of business supply activities, growing beyond their previous role of primarily storing goods. They are no longer just facilities; they have become logistics strongholds that encompass various features from demand forecast to the regulation of supply, manufacturing, and sales by realizing SCM, taking into account marketability and the operation of service and products. However, despite these changes in logistics operations, some centers have been unable to shed their past roles as warehouses. For the continuous development of logistics centers, various measures would be needed, including a revision of current supporting policies, formulating effective management plans, and establishing systematic standards for founding, managing, and controlling logistics centers. To this end, the research explored previous studies on the use and effectiveness of logistics centers. From a theoretical perspective, an evaluation of the overall introduction, purposes, and transitions in the use of logistics centers found issues to ponder and suggested measures to promote and further advance logistics centers. First, a fact-finding survey to establish demand forecast and standardization is needed. As logistics newspapers predicted that after 2012 supply would exceed demand, causing rents to fall, the business environment for logistics centers has faltered. However, since there is a shortage of fact-finding surveys regarding actual demand for domestic logistic centers, it is hard to predict what the future holds for this industry. Accordingly, the first priority should be to get to the essence of the current market situation by conducting accurate domestic and international fact-finding surveys. Based on those, management and evaluation indicators should be developed to build the foundation for the consistent advancement of logistics centers. Second, many policies for logistics centers should be revised or developed. Above all, a guideline for fair trade between a shipper and a commercial logistics center should be enacted. Since there are no standards for fair trade between them, rampant unfair trades according to market practices have brought chaos to market orders, and now the logistics industry is confronting its own difficulties. Therefore, unfair trade cases that currently plague logistics centers should be gathered by the industry and fair trade guidelines should be established and implemented. In addition, restrictive employment regulations for foreign workers should be eased, and logistics centers should be charged industry rates for the use of electricity. Third, various measures should be taken to improve the management environment. First, we need to find out how to activate value-added logistics. Because the traditional purpose of logistics centers was storage and loading/unloading of goods, their profitability had a limit, and the need arose to find a new angle to create a value added service. Logistic centers have been perceived as support for a company's storage, manufacturing, and sales needs, not as creators of profits. The center's role in the company's economics has been lowering costs. However, as the logistics' management environment spiraled, along with its storage purpose, developing a new feature of profit creation should be a desirable goal, and to achieve that, value added logistics should be promoted. Logistics centers can also be improved through cost estimation. In the meantime, they have achieved some strides in facility development but have still fallen behind in others, particularly in management functioning. Lax management has been rampant because the industry has not developed a concept of cost estimation. The centers have since made an effort toward unification, standardization, and informatization while realizing cost reductions by establishing systems for effective management, but it has been hard to produce profits. Thus, there is an urgent need to estimate costs by determining a basic cost range for each division of work at logistics centers. This undertaking can be the first step to improving the ineffective aspects of how they operate. Ongoing research and constant efforts have been made to improve the level of effectiveness in the manufacturing industry, but studies on resource management in logistics centers are hardly enough. Thus, a plan to calculate the optimal level of resources necessary to operate a logistics center should be developed and implemented in management behavior, for example, by standardizing the hours of operation. If logistics centers, shippers, related trade groups, academic figures, and other experts could launch a committee to work with the government and maintain an ongoing relationship, the constraint and cooperation among members would help lead to coherent development plans for logistics centers. If the government continues its efforts to provide financial support, nurture professional workers, and maintain safety management, we can anticipate the continuous advancement of logistics centers.

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An Application-Independent Multimedia Adaptation framework for the Mobile Web (모바일 웹을 지원하는 응용 독립적 멀티미디어 적응 프레임워크)

  • Chon, Sung-Mi;Lim, Young-Hwan
    • Journal of Internet Computing and Services
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    • v.6 no.6
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    • pp.139-148
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    • 2005
  • The desired level for multimedia services in the mobile web environment, the next generation web environment, is expected to be of PC level quality. And great efforts have been made in the development of hadware technology, communication technology, various kinds of services and standardization to support these services, In the mobile web environment, multimedia contents adaptation services should be available through supporting various kinds of devices, network abilities and users' preferences. It means that due to the variety of both desired devices' hardware specifications, called destinations, and desired QoSes, the QoSes in the destinations are not fixed or defined. If a new user wants to stream multimedia contents in a server through a new kind of terminal device, it should be considered whether the existing transcoders are able to adapt the multimedia contents. However, the existing libraries for multimedia adaptation have heavy transcoder figures which include all adaptive functions in one library, The challenge of universal access is too complex to be solved with these all in one solutions. Therefore, in this paper we propose an application independent multimedia adaptation framework which meets the QoS of new and varied mobile devices. This framework is composed of a group of unit transcoders having only one transcoding function respectively, Instead of heavy transcoders. Also, It includes the transcoder manager supporting the dynamic connections of the unit transcoders in order to satisfy end to end QoS.

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Development and Analysis of Community Based Independent Home Care Nursing Service (지역사회중심의 독립형 가정간호 시범사업소 운영체계 개발 및 운영결과 분석)

  • Park, Jung-Ho;Kim, Mae-Ja;Hong, Kyung-Ja;Han, Kyung-Ja;Park, Sung-Ae;Yun, Soon-Nyoung;Lee, In-Sook;Cho, Hyun;Bang, Kyung-Sook
    • Journal of Korean Academy of Nursing
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    • v.30 no.6
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    • pp.1455-1466
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    • 2000
  • The purpose of this study was to develop the framework of community-based home care nursing delivery system, and to demonstrate and evaluate the efficiency of it. The study was carned out over a period of 3years from September 1996 to August 1999. The researchers developed Standards for operations, this was all aimed toward a home care recording system, and an assessment intervention algorithm for various diseases quality control and standardization. In the center, 185 patients enrolled, and of the enrollments cerebrovascular disorder and cancer were the most prevailment diseases. Also, a home care nursing activity classification was developed in six domains. Those domains were assessment, medication, treatment, education and consultation, emotional care, and referral or follow-up care. Ten sub-domains were divided according to the systematic needs. Among these nursing activities, treatment, assessment, and education and consultation were frequently performed. In sub-domain classification, skin integrity, respiration, circulation, and immobility related care were provided most frequently. The cost of home care nursing per visit was also suggested. The cost include direct and indirect nursing care, management, and transportation cost. Also, the researchers tried to overcome the limitations of hospital-based home care to provide more accessible, efficient, safe, and stable home care nursing. Therefore, clients were referred from other patients, families, public health care centers, industries, and even hospitals. As a result of this study, several limitations of operation were found. First, it was difficult to manage and communicate with doctor in the emergency situations. Second, there was too much time spent for transportation. This was because they are only five nurses, who cover all of the areas of Seoul and nearby cities. Third, preparation for special care of home care nurses was lacking. Fourth, criteria for the termination of care and the frequency of home visits were ambiguous. Finally, interconnection with home care machinery company was so yely needed. New paragraphs' strategies for solving these problems were suggested. This study will be the basis of community-based home care nursing, and the computerized information delivery system for home care nursing in Korea.

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