• Journal of Korean society of Dental Hygiene
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• v.8 no.1
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• pp.93-105
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• 2008

In order to provide basic information to help dental medical service with supplying gratifying service for patients. the survey is conducted on the patients who frequently visited dental clinics located in the areas such as Seoul, Kyoungi, and Incheon from May of 2006 to June. The survey results are as following : 1. Judged from the factors to make patients choose one dental clinic over another. the low cost of treatment accounts for 32.8%. and followed by physician's academic background / career experiences with 20.5%. In case of recommending to their acquaintances, physician's proficiency in treatment is ranked high as 56.7%. 2. For most desirable facilities for dental hospitals. the results indicate that cutting-edge medical equipment holds 46.7% and followed by a comfortable waiting room with 32.8%. 3. Examined the questions of what patients are most satisfied with dental clinics. 43.1% of respondents point out kind and detailed explanation. 14.1% also responds to constant care after the treatment. This result suggests that after-care and detailed explanation also play an important role in dental care as well as the treatment itself. 4. For desirable services in the waiting room. 28.5% of the respondents choose a selection of magazines and newspaper and 18.7% say that they want to converse with the staff. As to how long can wait with patience. 38.2% of the participants agree on as long as 20 minutes. 5. Among unsatisfactory sources against dental clinics while visiting, the high cost of the treatment is scored high as 34.1% and followed by a long waiting time with 22.1%. The figure points to the fact that dental medical clinics should consider these two factors to solve in the future. In case where patients find the treatment discontent and they are asked what to do, 36.4% of the respondents respond that they go to a different hospital without saying anything. As to the enquiry about how the complains should be dealt, 46.% wishes that the matter should be taken care immediately upon complaining, 21.8% suggests that they like to feel understood and acceptable when presenting complaints.

• The Korean Journal of Nuclear Medicine Technology
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• v.21 no.1
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• pp.60-64
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• 2017

Purpose Westgard multi-rules application based on test quality improvement and commercialized international standard has been widely used in quality control. However, it is difficult to applicate the Westgard multi-rules in nuclear medicine in vitro tests due to the larger sample sizes and the simultaneous measurement of quality control material and patient sample. This study investigated the usefulness of Westgard multi-rules application in nuclear medicine in vitro tests. Materials and Methods A total of 282 systematic error multi-rules (22s, 101s) recorded in the samsung medical center computer system from January 2013 to June 2016 along with 117 cases of corrective measure record was analyzed. The Quality control implementation is recorded in Hospital information system were divided into 4 high-level areas including quality control material error, experimental procedural error, Kit lot number management error, and others. To prevent quality control material error, the existing method that each staff used their own method was changed. The staff who in charge of managing the quality control material was designated and daily consumption amount of every test was strictly controlled by one person. To prevent other errors, every test step was standardized so that the entire test procedures are identically implemented. Results The total quality control implementation was 117 cases; As a result, 62 quality control material errors were 62 cases, experimental process errors were 24 cases, Kit lot number control errors were 18 cases, and other errors were 13 cases. The quality control material error was corrected and could be used fresh materials within 2 days after thawing. The cases of systemic error were decreased to causes as quality control material error. The quality control materials were reduced above 10 vials to a monthly average. In addition, these errors of experimental processing and Kit lot number were improved by test standardization. Consequently, the cases of 101s and 22s in systematic error rules decreased at least 2 cases to a monthly average. Conclusion To confirm of systematic error through multi-rules application quickly, it is necessary to base on management of the QC material, target values and standard deviation. Moreover, in the event of a systematic error, it was found important to record measures based on test cause analysis. The experiment results are expected to contribute to internal quality control improvement and prompt and accurate result reporting through error recording and causal analysis based on Westgard multi-rules analysis.

• Journal of radiological science and technology
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• v.35 no.1
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• pp.45-50
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• 2012

Nowadays, most of the hospital serves "one stop service" for CT scan. The patients could be taken the CT scan in the day they register for scan. On the contrary to the time convenience, patients are not satisfied with long waiting time and unkindness of staff. The objective of this study is to improve the patient's satisfaction for the CT scan, by analyzing inconvenience factors and improving the service qualities. From April 1 to August 30 in 2011, we investigated the satisfaction of patients who did examined abdomen CT scan with contrast media. We analyzed the 89 questionnaires before and after the service improvements from them. The worker's kindness, the environment of CT room and understanding about CT scan were answered by questionnaire and the waiting time of a day CT scan was drawn by medical information statistics. Also, the period before improvement was from April to June and the period after improvement was from July to September. And these questionnaire was analyzed through SPSS V. 15.0. In this study, kindness of staff, environment of CT room, intelligibility for CT scan and waiting time was explored and analyzed by SPSS V.15.0. The score of kindness was improved by 32%, satisfaction level of the environment was improved by 52.54%. The understanding level about CT scan was improved by 52.36% and the wating time of a day CT was shortened by 21% through our service enhancement programs. Consequentially, it is considered that these efforts would contribute to increase the revenue of hospital.

• Quality Improvement in Health Care
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• v.7 no.1
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• pp.32-45
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• 2000

Background : Critical pathway is an optional sequencing and timing of interventions by physicians, nurses, and other staff for a particular diagnosis or procedure, designed to minimize delays and resource utilization, and to maximize quality of care; abbreviated versions of case management plans that show critical outcome and key incidents that occur in a predictable and timely fashion to achieve an appropriate length of stay. This study is to develop a critical pathway for vaginal delivery and cesarean section to assess the degree of contentment of the patients and medical personnel and to implement clinical application to see how we could meet the need to guide patients to achieve continuum of care. Method : Critical pathways were developed for normal vaginal delivery and casarean section. LOS(length of stay) target for vaginal delivery was 1 day after delivery & 5 days after C-section. It was distributed to the mother at the OPD and explained thoroughly. It was applied when patients got into the Labor & Delivery Floor. We applied total of 42 patients (30 normal deliveries & 12 C-sections) from February to March, 2000. We performed patient satisfaction survey to all 42 patients, 24 nurses, and 7 residents for internal customer satisfaction. Results : Twenty six patients out of 42 responded to the survey. Twenty one patients out of 26 answered satisfactory. Eighty four percent of 21 respondents replied Critical pathway worked very well. Treatment column got the most compliance. Eleven out of 31 employees thought critical pathway is very helpful for the patient care. Eighteen people didn't see any difference. In their opinion, treatment got the least compliance, which is the contrary to patients opinion. Fifty eight percent of respondents thought that critical pathway can expedite early discharge. Conclusion : Patient satisfaction was higher than we expected but we still need to revise the form. It is recommended to analyze the cost and variance check in the future.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.19 no.5
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• pp.89-97
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• 2018

In the past, hospitals were planned with a minimum of public space for the sole purpose of treatment. On the other hand, modern hospitals have more public space as the importance of the healing environment increases and are planned taking into consideration the patients, guardians, and medical staff. In addition, the lobby shape is developed from a HALL type and planned as a STREET type or CONCOURSE type, increasing the public area. Unlike past hospitals, which were used as reception, waiting, and procedure spaces, modern hospitals are used as commercial, hobby, and cultural space. The purpose of the study was to evaluate the healing environment of the hospital lobby based on the shape of the plane surface by deducting the elements of general hospitals' healing environment from preceding studies as a framework. The hospital lobby is an important place where many actions occur. Therefore, 3 types of cases were evaluated based on the plane form. As a result of the study, the STREET type showed a better healing environment than the HALL type, but the accessibility, roof garden, and resting place showed similar results. Because the case was based on a large general hospital, which had sufficient planned space, the factor has little to do with the style of the lobby. Among the STREET types, the linear atrium showed a better result in terms of the sense of space and inflow effect of natural lighting than the four-sided atrium because the linear atrium has large open volume ratio. When the lobby plane is the HALL type, a cross section of the courtyard had a large open volume ratio. Therefore, the shape of the cross section is as important as the plane form of the lobby.

• Journal of Korean Academy of Nursing
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• v.1 no.1
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• pp.111-132
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• 1970

An analysis of nursing activities in a in-patient ward and its management was observed in order to assess necessary number of nursing hands and find out reasonable work management with them. The study was performed with two wards of St. Mary′s Hospital, Catholic Medical Center, for the period from July to December 1970. The results and conclusions were as the following 1. The role of the nurses are determined by doctor′s order in 57.7% in kind, 80.0% in amount. and by nurses decision 20.0% in amount. 2. Works related to patient care are found to be 20.6% in the internal medicine ward and 20.4% in the surgical ward while works related to treatment are 4.7% in the former and 27.2% in the letter. Medication occupies 40.0% in the internal medical ward while 26.6% in the surgery ward, and observation occupies 34.7% in the former while 25.8% in the letter. These can be said to reflect characteristic differences bet ween the two wards. 3. When nursing functions were evaluated by importance "A" level in the amount of works to be done occupied 67.6% in the surgical ward and 62.8% in the internal medical ward. In the kind of the important works, "B"level is found to be most frequent with 50% while "A"level 43%. When evaluated by difficulty, "B"level was found to be most frequent in amount in both internal medicine and surgical wards (52.6%, 38.2%). 4. Works needing professional knowledge and skills occupied 92% in the both wards while unprofessional works 2.8% and 4.2% respectively. There are indications, however, that unprofessional works have an increasing tendency. 5. When evaluated by the amount of works, the surgical ward has 11 nurses less and the internal medicine ward 3 nurses less then the necessary number of nursing staffs. There are shortage of 12 and 6 nurses respectively when evaluated by the number of patients and 18 nurses in the both wards when evaluated by the medical regulations of the Government. 6. The ratio of the nursing staff to patient was found to be 1:11.5, 1:23.0 and 1:34.5 in the morning, evening and night turn in the surgical ward. In the medical word the ratio was 1:9.4, 1:22.0 and 1:33.0. 7. The deficiency of necessary equipment and tension accompanying management of those equipment were found to lower the effective functioning of the head nurse who is a junior manager of the ward. They also consume much of the time and energy of the nurses at work who are over burdened in most of the cases. 8. The high rate of the number of nurses who leave the job impairs the functioning of team work which is considered to be most important in the effective performance of nursing activities and thus contributes to lower the efficiency of nursing functions.

• Korean Journal of Clinical Laboratory Science
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• v.50 no.1
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• pp.54-62
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• 2018

In the 2000's, due to a change in hospital management strategy, the organizational structure shifted from a hierarchical system to a team system. While the hierarchical system is characterized by being activity centered, job title linked, and vertically managed, the team system is characterized by being competency centered, job title segregated, and horizontally managed. The job titles of medical technologist manager was surveyed three times in 1997, 2007, and 2017. It has been confirmed through staff members working at 24 hospitals in more than 500 beds in the metropolitan area. The results of job titles follow are as follow: "Team Leader; Part Leader" 14/24 (59%), "Chief Technologist; Area Head Technologist" 7/24 (29%), and "Chief" 3/24 (12%). The present authors propose an alternative name based on the team system to refine the three job titles currently used by medical technologists. First, the Chief Technologist is unclear if it refers to the Technologist General Manager or Technologist Manager. The Chief Technologist should be changed to "Team Leader". Second, given that Area Head Technologist or Section Chief are on the same position as Head Nurse, we suggest that Area Head Technologist or Section Chief should be changed to "Part Leader". Third, while the organization regulation is marked merely as Department of Laboratory Medicine according to the hierarchical system, it is marked as Laboratory Medicine Team according to the team system. Medical technologists come to have more belongingness, feeling of solidarity, and intimacy under the team system.

• Journal of Hospice and Palliative Care
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• v.1 no.1
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• pp.56-64
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• 1998

Purpose : Seoul National University Hospital developed a group counseling program for the terminal cancer patients and their family members. This program consists of each of doctor, nutritionist, nurse, pharmacist, and social worker to provide them with the information and to enhance their ability to cope with terminal cancer. This research aims to introduce this new program per se, and to appreciate its validity and applicability to the terminal cancer patients and their family members by analyzing the concerns and specific questions of the participants. Methods : The methodological approach employed in this research is 1996 content analysis of the group counseling reports, and interview of the 312 participants. The analysis includes the general characteristics of the subjects, family relationship to the patients, times of attendance to the group session, source of information to the program. Results : The participants consist of 261 family members(84%) and 51 patients(16%). Majority responded to the program with a single-attendance. Diagnosis are mainly lung cancer, stomach cancer, liver cancer. The ratio of participants by family members is decreased in the order of spouse, children, daughter-in-law, brothers and sisters, and parents. The source of information to the program is largely through medical staff(69%) as compared with posters in the hospital (26%). The participants are interested primarily in the medical information. Their interests are various, such as pain control, patient care, nutrition, psychosocial problem and etc. Conclusion : This program is characterized largely as a family-supporting program which primarily offers information for terminal cancer. This program is a sort of a hospice program, which maximizes the present quality of living of the terminal cancer patients as long as life continues by encouraging them to live with terminal cancer. Thus, this group program can be employed as an active support network for the patients and their family. In order to develop comprehensive care-giving services, it is required to have 24-hour telephone service, hospice facilities, home care service, and communication between the referral hospitals and the primary care physicians, in particular. Such a development of services is the ultimate goal for improving care. But the immediate goal of the program is to make possible better education for the patients and their family to live with terminal cancer.

• Korea Journal of Hospital Management
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• v.9 no.1
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• pp.66-94
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• 2004

The objective of this study is to examine how to maximize the efficiency of hospital management by minimizing the unit cost of hospital operation. For this purpose, this paper proposes to develop a model of the profit maximization based on the cost minimization dictum using the statistical tools of arriving at the maximum likelihood values. The preliminary survey data are collected from the annual statistics and their analyses published by Korea Health Industry Development Institute and Korean Hospital Association. The maximum likelihood value statistical analyses are conducted from the information on the cost (function) of each of 36 hospitals selected by the random stratified sampling method according to the size and location (urban or rural) of hospitals. We believe that, although the size of sample is relatively small, because of the sampling method used and the high response rate, the power of estimation of the results of the statistical analyses of the sample hospitals is acceptable. The conceptual framework of analyses is adopted from the various models of the determinants of hospital costs used by the previous studies. According to this framework, the study postulates that the unit cost of hospital operation is determined by the size, scope of service, technology (production function) as measured by capacity utilization, labor capital ratio and labor input-mix variables, and by exogeneous variables. The variables to represent the above cost determinants are selected by using the step-wise regression so that only the statistically significant variables may be utilized in analyzing how these variables impact on the hospital unit cost. The results of the analyses show that the models of hospital cost determinants adopted are well chosen. The various models analyzed have the (goodness of fit) overall determination (R2) which all turned out to be significant, regardless of the variables put in to represent the cost determinants. Specifically, the size and scope of service, no matter how it is measured, i. e., number of admissions per bed, number of ambulatory visits per bed, adjusted inpatient days and adjusted outpatients, have overall effects of reducing the hospital unit costs as measured by the cost per admission, per inpatient day, or office visit implying the existence of the economy of scale in the hospital operation. Thirdly, the technology used in operating a hospital has turned out to have its ramifications on the hospital unit cost similar to those postulated in the static theory of the firm. For example, the capacity utilization as represented by the inpatient days per employee tuned out to have statistically significant negative impacts on the unit cost of hospital operation, while payroll expenses per inpatient cost has a positive effect. The input-mix of hospital operation, as represented by the ratio of the number of doctor, nurse or medical staff per general employee, supports the known thesis that the specialized manpower costs more than the general employees. The labor/capital ratio as represented by the employees per 100 beds is shown to have a positive effect on the cost as expected. As for the exogeneous variable's impacts on the cost, when this variable is represented by the percent of urban 100 population at the location where the hospital is located, the regression analysis shows that the hospitals located in the urban area have a higher cost than those in the rural area. Finally, the case study of the sample hospitals offers a specific information to hospital administrators about how they share in terms of the cost they are incurring in comparison to other hospitals. For example, if his/her hospital is of small size and located in a city, he/she can compare the various costs of his/her hospital operation with those of other similar hospitals. Therefore, he/she may be able to find the reasons why the cost of his/her hospital operation has a higher or lower cost than other similar hospitals in what factors of the hospital cost determinants.

• Journal of the Korea Academia-Industrial cooperation Society
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• v.20 no.2
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• pp.294-299
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• 2019

Korean hospitals implement external quality assessment (EQA) schemes to improve the quality of clinical tests. However, smaller hospital do not implement EQA due to lack of appreciation and cost burdens. The purpose of this study was to analyze the results of EQA from the perspective of clinical chemistry carried out at a small-to-medium sized hospital (SMH) and to investigate factors influencing quality control. The medical institution concerned had performed EQA on 21 items annually for three years and had analyzed measurement methods, variation coefficients, and anomalous results as defined by the SMH. No significant change in test methods or variation coefficients, which exhibited a high level of variation, were observed for any test item over the 3-year period. The results obtained showed that anomalous test results were significantly more frequent when EQA was not conducted (p<0.05), internal quality control was not conducted daily (p<0.01), and when tests were less frequently performed (p<0.01). Small-to-medium sized hospitals need to be more aware of the benefits of EQA and provide tailored education to staff.