• Journal of the Korea Academia-Industrial cooperation Society
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• v.19 no.1
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• pp.466-476
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• 2018

This study was conducted to determine factors affecting professionalism of community health practitioners (CHPs). The participants in this study were 153 community health practitioners working in G province with structured self-report questionnaires from 20 August to 25 September 2017. Data were analyzed by descriptive statistics, t-test, ANONA, Scheffe's test, Pearson's correlation coefficients and stepwise multiple regression using the SPSS 20.0 program. There were statistically significant differences according to income (F=6.951, p<.001), work experience (F=5.245, p=0.002) and motivation for choosing a community health practitioner (F=3.676, p=0.004). The highest related factors were job satisfaction (${\beta}=0.320$, p<0.001), individual disposition (${\beta}=0.291$, p<0.001), income (${\beta}=0.283$, p<0.001) and job continuance (${\beta}=0.176$, p=0.009). These variables explained 49.6% of the total variance in professionalism. These findings suggest that it is necessary to develop a convergence program and policy support at the individual and organizational level to strengthen the professionalism of community health practitioners.

• Quality Improvement in Health Care
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• v.1 no.2
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• pp.44-59
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• 1994

Medical consumers(patients) want evening-clinic because of busy work. For patient's convenience and improving service, hospital should accept it. Considering payment system and patient's demand, personnel expenses, hospital can not accept. The practice of shift system to accept patient's demand and hospital's economic aspect was made. To analysis the effect of the system and probability to alternative to evening clinic this study was done. This study was composed of basal study, intervention, evaluation of effect. The basal study were composed of studying demand on evening clinic, the number of beds, doctors employee, the time table of practice and work, and the number of patients at arrival time. The intervention composed of changing of practice time, changing of working time by the number of patients at arrival time, increasing of employee. The evaluation of effect were composed of evaluating the number of patient at time, the effect of shift system, the comparison of the number of in and out patients and questionnairing the practice of shift system. In the practice time at 2 shift system First team works 7-15 hours and Second team 12-20 hours. there are no lunch and supper time. At 18-20 hours the number of patients were 25-30. The number of patient a depart were 6-7. The number of out-patient increase in 13% and inpatient increase in 10% before the system. Doctors(100%), employee(94.6%), and patients(86.4%) approved this system. The advantage of this system were utilization of surplus time, lengthen the practice time, even distribution of patients and shortening of waiting time, rapid treatment of emergent patients. The disadvantage of this system were shortage of manpower, not all depart practice, continuity of practice, no lunch and supper time, irregular rounding. At present because of small Demanding on evening clinic, this shift system was economical. To succeed this study more effectively all depart in hospital participate. But because of economical reason it is impossible for hospital to do it. If the government assist the economic loss that all depart participate in this system it is very helpful for hospital to succeed in implementing this system more early.

• Journal of Korean Academy of Nursing
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• v.48 no.5
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• pp.554-564
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• 2018

Purpose: This study aimed to construct a management model for patient transfer in a multilevel healthcare system and to predict the effect of counseling with nurses on the patient transfer process. Methods: Data were collected from the electronic medical records of 20,400 patients using the referral system in a tertiary hospital in Seoul from May 2015 to April 2017. The data were analyzed using system dynamics methodology. Results: The rates of patients who were referred to a tertiary hospital, continued treatment, and were terminated treatment at a tertiary hospital were affected by the management fee and nursing staffing in a referral center that provided patient transfer counseling. Nursing staffing in a referral center had direct influence on the range of increase or decrease in the rates, whereas the management fee had direct influence on time. They were nonlinear relations that converged the value within a certain period. Conclusion: The management fee and nursing staffing in a referral center affect patient transfer counseling, and can improve the patient transfer process. Our findings suggest that nurses play an important role in ensuring smooth transitions between clinics and hospitals.

• Journal of the Korea Institute of Information and Communication Engineering
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• v.13 no.6
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• pp.1128-1140
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• 2009

In this paper, we present a patient real-time vital sign information transmission system to effectively support developing real-time communication service by using a real-time object model named TMO (Time-Triggered Message-Triggered Object). Also, we describe the application environment as the ICU(Intensive Care Unit) to guarantee real-time service message with TMO structure in distributed network systems. We have to design to obtain useful vital sign information, which is generated at parsing data receiver modulor of HIS with TMO structure, that is offered by the central monitor. Vital sign informations of central monitor is composed of the raw data of several bedsite patient monitors. We are willing to maintain vital sign information of real time and continuity that is generated from the bedsite patient monitor. It is able to apply to remote medical examination and treatment. we proposed integration method between a vital sign database systems and hospital information systems. In the real time simulation techniques based on TMO object modeling, We have observed several advantages to the TMO structuring scheme. TMO object modeling has a strong traceability between requirement specification and design.

• The Journal of the Convergence on Culture Technology
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• v.1 no.2
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• pp.85-89
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• 2015

It has been reported that cerebral disease is the most leading to death as a single disease even though next to cancer in the most important cause of death in the country. Even if patients maintain a life without death, it will have to suffer from side effects such as hemiplegia and language disorders. In this paper, the symptoms and treatment of cerebral infarction cases are described through the medical dramas (The Third Hospital, The Brain) and movie (Amur). Even if there is the same stroke each drama or movie, depending on the previous history or current physical condition of the patient knew which treatment the law is different.

• The Journal of the Korea institute of electronic communication sciences
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• v.2 no.4
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• pp.244-249
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• 2007

HL7 is well-Known standard protocol for text data generated in hospital information systems. In this paper, we have to design to obtain useful vital sign information, which is generated at data receiver modulor of HIS, that is offered by the central monitor. Vital sign informations of central monitor is composed of the row data of several bedsite patient monitors. We are willing to maintain vital sign information of real time and continuity that is generated from the bedsite patient monitor. It is able to apply to remote medical examination and treatment. we proposed integration method between vital sign database systems and hospital information systems. Through the proper exchange and management of patient vital sign information, real time vital sign information management will offer better workflow to all hospital employee.

• Journal of Yeungnam Medical Science
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• v.14 no.1
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• pp.85-93
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• 1997

Hospital information system has been widely used and increased recently for a variety of many aspects. And Order-Communicating system(OCS), as like as hospital information system, has been used in many medical care facilities, which is simple and easily accessible, useful system. Also then the use of OCS in emergency care center in YUMC has been introduced since 1996. 10, above 70% of availability is noticed at present and increasing in the use rate, is considered that it is very simple and accurate, time-saving, widely applicable system. So authors say that, after the use of OCS in emergency care center, interhospital exchange of the patient's information and also accomplishment of EMSS can be possible.

• Quality Improvement in Health Care
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• v.7 no.2
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• pp.138-155
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• 2000

Background: Factors related to waiting and staying time for patient care in emergency care center (ECC) were examined during 1 month from Apr. 1 to Apr. 30, 1997 at an ECC of Yeungnam university hospital in Taegu metropolitan city, to obtain the baseline data on the strategy of effective management of emergency patients. Method: The study subjects consisted of the 1,742 patients who visited at ECC and the data were obtained from the medical records of ECC and direct surveys. Results: The mean interval between ECC admission time and initial care time by each ECC duty residents was 83.1 minutes for male patients and 84.9 minutes for female patients, and mean ECC staying time (time interval between admission and final disposition from ECC) was 718.0 minutes in men and 670.5 minutes in women. As the results, the mean staying time in ECC was higher in older age, and especially the both of initial care time and staying time were highest in patients of medical aid, and shortest in patients of worker's accident compensation insurance. The on admission or not, previously endotracheal-intubation state of patient. The ECC staying ti initial care time was much more delayed in patients of not having previous medical records and the ECC staying time was higher in referred patients from out-patient department, in transferred patients from the other hospitals and patients having previous records, and in patients partly used the order-communicating system. The factors associated with the initial care time were the numbers of ECC patients and the existence of any true emergent patients, being cardiopulmonary resuscitation (CPR) statusme was much more longer in patients of drug intoxication, in CPR patients, in medical department patients, in transfused patients and in patients related to 3 or more departments. And according to the numbers of duty internships, the ECC staying time for four internships was more longer than for five internships and after admission ordering was done, also-more longer in status being of no available beds. As above mentioned results, the factors for the ECC staying time were thought to be statistically significant (P<0.01) according to the patient's age and the laboratory orders and the X-ray films checked. And also the factor for the ECC staying time were thought to be statistically significant (P<0.01) according to the status being of no available beds, the laboratory orders and/or the special laboratory orders, the X-ray films checked, final disposing department, transferred to other hospital or not, home medication or not, admission or not, the grades of beds, the year grades of residents, the causes of ECC visit, the being CPR status on admission or not, the surgical operation or not, being known personells in our hospital. Conclution: Authors concluded that the relieving method of long-staying time in ECC was being establishing the legally proved apparatus which could differentiate the true emergency or non-emergency patients, and that the methods of shortening ECC staying time were doing definitely necessary laboratory orders and managing beds more flexibly to admit for ECC patients and finally this methods were thought to be a method of unloading for ECC personnels and improving the quality of care in emergency patients.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.13 no.1
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• pp.236-246
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• 2012

Hospital out-shopping by local patients has become more popular. In particular, many cancer patients have visited hospitals in the capital area to get better medical services regardless of how far the hospitals are from their home. However this kind of hospital out-shopping may discontinue medical treatment and cause a waste of medical resources including manpower. In addition, it creates additional economic and social expenses such as caretakers' transportation and lodging expenses. It is necessary to study patients who would take the medical treatment in Busan go to Seoul for better medical services are more satisfied based on objective data. For this, a questionnaire survey has been performed against 223 cancer patients who had a surgery in Busan and 187 patents who had an operation in Seoul. According to the survey, the patients who had an operation in the capital area(Group A) were more satisfied than the patients who had a surgery in Busan(Group B) in terms of convenience facilities, doctors' competence. However the Group A was very dissatisfied in terms of accessibility and satisfaction on overall medical services.

• Journal of Gastric Cancer
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• v.9 no.1
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• pp.18-25
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• 2009

Purpose: The postoperative hospital stay after gastric cancer surgery is usually 8 to 14 days. The main reason for a prolonged hospital stay may be the 3 to 4 day period of postoperative starvation. The aim of this study is to investigate the feasibility of a critical pathway for early recovery after gastric cancer surgery, and this pathway included early postoperative feeding. Materials and Methods: One hundred three consecutive patients who underwent gastric resection and reconstruction for gastric cancer from October 2007 to June 2008 at St. Mary's Hospital were prospectively enrolled in a fast-track critical pathway. The pathway included minimal preoperative procedures, optimal pain relief, proper fluid administration, early mobilization and early enteral nutrition at postoperative 1 day. The exclusion criteria were determined preoperatively, intraoperatively and postoperatively. Results: Of the 103 patients, 19 patients were excluded for preoperative (5), intraoperative (7) and postoperative (7) reasons. Eighty-four patients (81.6%) were included in the fast-track critical pathway. Sixty-eight (88.6%) of 84 patients were discharged at the planned 8 day after surgery during the initial period of the study, and the postoperative hospital stay was shortened up to 6 days during the more recent period. Postoperative complications occurred in 22 patients (26.2%), and these were gastrointestinal track-related complications in 6 cases (3 cases of ileus, 1 case of stasis and 2 cases of leakage) and infection-related complications in 8 cases. There was no statistical difference in the incidence of morbidity according to the clinic-operative features that included age, gender, stomach resection and lymphadenectomy. Conclusion: The fast-track critical pathway with using the available exclusion criteria was a valid option for patients who underwent gastric cancer surgery.