• 의학교육논단
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• 제21권2호
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• pp.80-91
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• 2019

The tripartite mission of 'academic medicine' is education, research, and patient care. Academic medical centers (AMCs) are carrying out the mission and ultimately aiming to improve the health of people and communities. Globally, AMCs are facing a tremendous financial risk stemming from the changes in health insurance reimbursement plans and a shortage of human resources. Innovative AMCs in the United States are trying to transform their physician-centered, and siloed structure into a patient-centered, and integrated structure. They are also building integrated systems with primary healthcare groups to provide continuous patient care from primary to tertiary levels and making strategic networks based on value-based payment and the patient-centered model. These changes have been proven to improve outcomes of patient care and increase fiscal revenues, which are both crucial in supporting education and research. To address the shortage of human resources, programs are being built to develop newly appointed faculty for the future. AMCs have different approaches to bringing changes into their organizations; however, there is a common emphasis on 'a patient-centered approach,' which helps them set more explicit organizational values and make strategic decisions based on their values. Korean AMCs are facing similar challenges to AMCs in the United States in spite of many differences between the countries' healthcare systems. The innovative efforts of AMCs in the United States to address the challenges will be helpful, well-worked examples for Korean AMCs with similar challenges.

• 디지털융복합연구
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• 제19권7호
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• pp.419-426
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• 2021

정보통신기술이 발달함에 따라 스마트병원은 헬스케어 산업에서 새로운 트렌드가 되고 있다. 본 논문에서는 문헌고찰을 통해 스마트병원의 개념, 주요 기술, 적용분야, 직면과제 및 사용자 중심의 스마트병원 구축 전략에 대해 살펴본다. 스마트병원에서는 상호연결된 디지털 네트워크 안에서 임상가들이 환자중심의 통합적 의료서비스를 효율적으로 제공하도록 함으로써 보다 나은 환자결과에 도달할 수 있게 될 것이다. 그러나 향후 보다 성공적인 환자중심 스마트병원을 위해서는 비용이나 기술, 보안, 표준 등과 관련된 여러 장애요소들이 극복되어야 하며, 디지털 솔루션의 최종 사용자인 환자와 의료인의 참여가 요구된다.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제28권4호
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• pp.7-20
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• 2022

Purpose: The main purpose of this paper is to assess a body of research evidence that articulates the impact of environment-related factors on behavioral health and quality of life for people with dementia who reside in long-term care facilities. The study also aims at identifying design implications that can be incorporated into design process and design decisions to improve behavioral health and quality of life for people with dementia. Methods: Comprehensive literature review has been conducted to identify empirical studies and that link the design of dementia care facilities to health- and QOL-related outcomes and scrutinized peer-reviewed articles published in many different fields including architecture, psychology, to nursing. Results: The review identified a growing body of literature that articulates environment-related factors that improve health and quality of life for people with dementia living long-term care facilities Implications: The findings of the review can be translated to design decisions to promote psychological and behavioral health and quality of life of people with dementia in long-term care facilities.

• Journal of Dental Anesthesia and Pain Medicine
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• 제22권3호
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• pp.161-174
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• 2022

Foreign body aspiration can produce a medical emergency. Obstruction of the airways can be life-threatening, and complications may develop in less-severe cases if it is left untreated. Although it is more prevalent in children by approximately three times, adults can still experience it, and it is more frequently related to healthcare in adults. Objects used in dental treatment are usually placed in the oral cavity and can be ingested or inhaled by accident. Dental treatment has been identified as an important cause of the misplacement of foreign bodies in the airway. However, few reports have been published on dentistry-related foreign body aspiration. This paper discusses the disease course, management, and clinical outcomes of foreign body aspiration, especially those associated with dentistry. The patient must be examined for respiratory distress. If the patient is unstable, urgent airway management and the maneuvers for removal should be performed. Radiographs and computed tomography can help identify and locate the object. The treatment of choice is often bronchoscopy, and both flexible and rigid endoscopes can be used depending on the situation. Preventive measures need to be implemented to avoid inhalation accidents given the potential consequences. Though the incidence is rare, healthcare levels need to be enhanced to avert morbidity and mortality. Radiological evaluation and bronchoscopy are vital for management.

• 대한방사선기술학회지:방사선기술과학
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• 제47권2호
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• pp.97-105
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• 2024

The examination needle used in ultrasound biopsy is a medical device used to determine whether there is an abnormality in the tissue. Typically, stainless steel is the standard material used for such needles; however, this study wanted to identify a material that could better enhance sound compared to traditional stainless steel. In this study, six types of needle materials available with the biopsy gun were inserted into pork and ultrasound images according to the curved probe and linear probe were evaluated using ultrasound equipment. The findings revealed significant improvements in ultrasound acoustic enhancement with alternative materials compared to stainless steel (p<0.05). The results regarding the depth of each ultrasound image using the curved probe showed that tungsten and brass had high sound enhancement(p<0.05), while with the linear probe, sound enhancement was high in brass, pla, aluminum, and copper(p<0.05). Due to these results, the previously used stainless needle showed lower ultrasound acoustic enhancement than the five types of materials being compared. Consequently, the outcomes of this study provide valuable insights for the development of new needle technologies aimed at minimizing patient risks and improving diagnostic accuracy.

• 대한예방한의학회지
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• 제28권1호
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• pp.59-67
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• 2024

Objectives : This study aims to systematically examine the determinants of the intention to take herbal medicine among individuals with experience in Korean medicine. Methods : This study utilized the 3,245 respondents from the 2020 Korean Medicine Utilization and Herbal Medicine Consumption Survey who reported having used Korean medical services; the responses were selected through a complex sample analysis, and analytics techniques including frequency analysis, Rao-scott chisquare test, and logistic regression were used to analyze the responses. Results : The results of data analysis reveal that the intention to take herbal medicine in the future among these individuals was significantly influenced by factors such as enrollment in private health insurance, the facility environment of Korean medical institutions, and treatment outcomes. Conclusions : Therefore, it is imperative for Korean medical institutions to continuously try reasonable action strategies, including improving medical facilities/environments and building institutional mechanisms among medical staff and members to enhance the quality of Korean medical services. Additionally, the Ministry of Health and Welfare needs to make policy efforts to reduce patients' medical expenses, such as reducing the co-insurance rate in the pilot project of applying health insurance to herbal medicine.

• Journal of Korean Biological Nursing Science
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• 제26권2호
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• pp.83-98
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• 2024

Purpose: This study investigated how interprofessional education (IPE) related to medication for undergraduate healthcare students, including nursing students, has been designed and conducted. Furthermore, the outcomes of these IPE programs were evaluated. Methods: A scoping review was performed to understand the content and methods of IPE on medication for undergraduate healthcare students, including nursing students. A literature search was done using PubMed, Cumulative Index to Nursing and Allied Health Literature, Embase, Research Information Sharing Service, and Korean Nursing Database in English between January 2000 and December 2022. In total, 14 papers were selected and reviewed. Results: Eleven research studies were conducted on the implementation of one-time IPE on medication safety or errors. Among them, six studies focused on providing IPE to nursing students alongside medical and pharmacy students, while three studies targeted nursing and medical students, and two studies focused on nursing and pharmacy students. The most commonly employed educational method was simulation, which was utilized in 12 studies. All studies consistently reported a positive impact on attitudes toward IPE and effective communication. Additionally, five studies evaluating medication knowledge reported improvements in participants' understanding of drugs. Conclusion: The effects of IPE related to medication for undergraduate nursing students have been confirmed. It is necessary to introduce IPE in the field of pharmacology.

• Korean Circulation Journal
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• 제53권9호
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• pp.594-605
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• 2023

Acute myocardial infarction (AMI) is a major cause of morbidity and mortality in the Asia-Pacific region, and mortality rates differ between countries in the region. Systems of care have been shown to play a major role in determining AMI outcomes, and this review aims to highlight pre-hospital and in-hospital system deficiencies and suggest possible improvements to enhance quality of care, focusing on Korea, Japan, Singapore and Malaysia as representative countries. Time to first medical contact can be shortened by improving patient awareness of AMI symptoms and the need to activate emergency medical services (EMS), as well as by developing robust, well-coordinated and centralized EMS systems. Additionally, performing and transmitting pre-hospital electrocardiograms, algorithmically identifying patients with high risk AMI and developing hospital networks that appropriately divert such patients to percutaneous coronary intervention-capable hospitals have been shown to be beneficial. Within the hospital environment, developing and following clinical practice guidelines ensures that treatment plans can be standardised, whilst integrated care pathways can aid in coordinating care within the healthcare institution and can guide care even after discharge. Prescription of guideline directed medical therapy for secondary prevention and patient compliance to medications can be further optimised. Finally, the authors advocate for the establishment of more regional, national and international AMI registries for the formal collection of data to facilitate audit and clinical improvement.

• 치위생과학회지
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• 제17권1호
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• pp.30-37
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• 2017

The purpose of this study was to reveal analyze the relationship between status of participation in an oral health care program and oral health outcomes among patients in Korea, and to evaluate the results to provide evidence regarding the feasibility of widespread implementation of the program. Patients were designated as either cooperative or non-cooperative with the oral health care program and were assigned to each group accordingly. Modified dental hygiene process (M-DHP) of the oral healthcare program was modified to form the dental hygiene process. The study included 48 patients at a dental clinic in Busan, Korea. Questionnaires were used to collect information on oral health behavior (OHB), clinical examination was used to record bleeding on probing (BOP) and O'Leary index, and phase microscopy was used to identify microorganisms. Differences between groups were evaluated using repeated measures ANOVA. Our results showed that the group cooperative with the oral health care program showed greater improvement in OHB, BOP, and O'Leary index than the non-cooperative group. Second, patient satisfaction with the M-DHP was very high, particularly for content and the friendly nature of the staff. The cooperative group showed greater improvement in oral health than the non-cooperative group for all metrics. Our results suggest that this low-coste program, if implemented, would be actively accepted and utilized in dental clinics.

• Tuberculosis and Respiratory Diseases
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• 제67권6호
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• pp.491-498
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• 2009

Severe sepsis and septic shock are major healthcare problems with high mortality, ranging from 20% to 60%, affecting millions of individuals around the world each year. The speed and appropriateness of therapy administered in the initial hours after severe sepsis develops have an important impact on the outcome. In 2004, an international guideline that the bedside clinician could use to improve the outcomes in severe cases of sepsis and septic shock was published. Several landmark studies recently demonstrated that therapeutic strategies may reduce mortality substantially. The "Surviving Sepsis Campaign guidelines for management of severe sepsis and septic shock: 2008", using a new evidence-based methodology system for assessing the quality of evidence and the strength of the recommendations, was updated. The revised version is based on an updated search into 2007. Evidenced-based recommendations regarding the acute management of sepsis and septic shock are the first step toward improving the outcomes of critically ill patients. We review the treatment guidelines of sepsis and septic shock.