We sought to derive an overall strategy for green business certification of medical institutions and to propose the improvement directions for green management evaluation systems through applying the criteria to medical institutions. A self-assessment survey was conducted at 44 targeted hospitals across the country, and the 2012 green management evaluation criteria for healthcare services were used as assessment tools. As a result, only 11 of the 44 hospitals were eligible for green business certification. By type, hospitals with more than 400 beds, hospitals in Seoul and the Gyeonggi area (${\geq}$ 400 beds) and private hospitals (${\geq}$ 400 beds) received relatively high scores. In an analysis of the mean score, only the difference between the hospitals with ${\geq}$ 400 beds and < 400 beds was statistically significant. When we analyzed the interviews of the hospitals with lower scores, it is important to change the awareness of executives and employees, to establish vision/strategy/objective, to promote relatively small-scale activities, and to establish long-term plans. To improve green management evaluation systems, it is necessary to reset the assessment area, to control scoring and weights, to create certification grades, and to adjust additional points.
Eun Hye Choi;Jung Hee Cho;Kyoung Eun Yeob;Bo Hui Park;So Young Kim;Jong Hyock Park
Health Policy and Management
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v.34
no.2
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pp.211-221
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2024
Background: The public health crisis caused by coronavirus disease 2019 emphasizes the need to expand and strengthen public hospitals. However, the overall perception of public hospitals remains negative. This negative perception can hinder the roles and functions of public hospitals, so this study aims to analyze the factors affecting negative perceptions of public hospitals. Methods: We used data from a survey on the public healthcare of Chungcheongbuk-do residents conducted by the Chungcheongbuk-do Public Health Policy Institute, and 1,916 adults aged 19 or older who responded to the survey were included in the study. Logistic regression analysis was used to analyze the impact of experiences with public hospitals use and evaluations of public healthcare and public hospital policies on the negative perception of public hospitals. Results: The experience of not using public hospitals (adjusted odds ratio [aOR], 1.69; 95% confidence interval [CI], 1.04-2.74) and negative evaluations of public healthcare and public hospital policies were found to significantly impact negative perceptions of public hospitals. In public healthcare policies, negative evaluations of the provision of essential medical care (aOR, 4.14; 95% CI, 2.59-6.62), regional disparities (aOR, 1.59; 95% CI, 1.02-2.49), coverage (aOR, 1.99; 95% CI, 1.25-3.16), and quality of care (aOR, 2.39; 95% CI, 1.50-3.80) were significantly associated with negative perceptions of public hospitals. In public hospital policies, negative evaluations of facilities and equipment (aOR, 3.74, 95% CI, 2.36-5.94), medical specialties and services (aOR, 1.91; 95% CI, 1.21-3.01), and quality of medical service (aOR, 2.71; 95% CI, 1.72-4.25) were also significantly associated with negative perceptions of public hospitals. Conclusion: This study emphasizes the need to improve perceptions of public hospitals by considering the experience with public hospitals use and evaluation of public healthcare and public hospital policies.
This Study was an attempt to estimate the optimum numbers of Operating Room Nursing Manpower by measuring the amount of service hours required by the patients in Operating Room in relation to the service amount actually provided by the nurses. The major concern of this study was placed on the measurement of Nursing Service Requirements by using the Operating Room (O. R) Patient Acuity System recently developed by M. M. Hart to classify the O. R. patients into four groups according to the degree of the complexity of operative procedure and some other elements which increase nursing activities in respect of patient care; Acuity IV group is the one requires nursing services most, on the other hand Acuity I requires least. nu sing The objectives of this study were as follows; 1. To analyze functions of the nursing personnel in O. R. by time unit and to estimate the average time a nurse can activate for productive functions. 2. To measure the actual amount of nursing times provided by nurses to the surgical patients. 3. To develop a patient classification system in order to measure the amount of Nursing services required by the patients. 4. To calculate an appropriate number of nursing manpower to meet the needs of the patients. In order to conduct the research both selected nurses and patients in 'S' University Hospital were Studied by utilizing the O. R. Patient Acuity System as well as the Classification Chart developed by Association of Operating Room Nurses (A. O. R. N) as a means of classifying functions of O. R. nurses. That is; Functions of the 10 selected O. R. nurses observed during the period of June 30 to July 4, 1986, whereas the amount of nursing services required by or provided to the 974 patients who had received surgeries during the period of June 9 to July 4, 1986. The results of this study were as follows; 1) The actual working hours per a nurse averaged 6.7 hours a day. 2) Each nurse's daily routine schedule consists of $71.4\%$ for Technical Functions, $16.1\%$ for Nonprodective Functions, $6.6\%$ for Assessment and Evaluation, $3.9\%$ for Overseeing and Supervision and the rest $2.0\%$ for Patient Preparation respectively. 3) Preoperative waiting time per a patient was 24.1 minutes on the average; for the first case was 10.7 minutes, whereas for the following cases was 32.0 minutes. 4) Total Operation time for the 974 patients during the period of observation for this study amounted to 2759.6 hours, weekly hour was equivalent to 689.9 hours, Whereas daily operation time averaged 130 hours. Meanwhile the average operation time per patient was 2.8 hours ; for the case of Acuity IV was 5.6 hours, 5. 1 hours for the case of Acuity III, 2.3 hours for Acuity II and 1.1 hours for Acuity I. 5) According to the O. R. Patient Acuity System, $64.5\%$ of the whole patients belonged to Acuity II, $23.7\%$ to Acuity III, 11. $3\%$ to Acuity IV and $0.7\%$ to Acuity I respectively. 6) Required amount of nursing times based on the preoperative waiting time and operation time was 7167.8 person hours, which showed that $5.5\%$ of them needed for preoperative nursing care, whereas the rest $94.5\%$ for intraoperative nursing care. In terms of the O. R. Patient Acuity System, $49.7\%$ of total nursing service requirements was needed for Acuity II patients, $27.4\%$ for Acuity III patients, $17.2\%$ for Acuity IV patients and $0.2\%$ for Acuity I patients. 7) The rate of the nursing services provided against the required nursing times was about $81.4\%$ on the average; some departments, like those of Plastic Surgery, Otolaryngology and Ophthalmology whose patients mostly belonged to Acuity II recorded hegher provision rate than average, whereas other departments of Thoracic Surgery. Neurosurgery and Orthopedic Surgery whose patients belonged to Acuity III and Acuity IV as well as Acuity II recorded lower provision rate than average. 8) Subsequently, required numbers of nursing manpower was 10.7 nurses additionally. Based on the above findings the following recommendations will be made; 1) this study recommends, develops. and adopts an accurate and realistic O. R. Patient Acuity System which can help measure the nursing service requirements objectively to elicit the rationales of allocation of nursing personnels. 2) this study proposes storongly place nurses who take the role of preoperative nursing care exclusively for the waiting patients in O. R. and shortening their waiting time by close communication between the designated O. R. and the ward.
This study was performed to investigate the necessity and the features of adequate services of home visiting physical therapy for chronic ill patients. The study subjects were physical therapist visited in Taejon for Korea Physical Therapy Association Seminar on March 19, 2000. Authors developed questionnaire and distributed it to each physical therapist attended at the Seminar. The number of distributed questionnaire was 1,500, and 487 questionnaire were collected and 388 questionnaire analysed finally. 1. The rate of necessity for home visiting physical therapy by kinds of disease was 70.6% in cerebral palsy, 84.3% in spinal cord injury, 89.7% in cerebral vascular accident and traumatic brain injury, 20.1 % in other diseases. 2. The rate of necessity of education for home visiting physical therapy was 94.5% of men, 97.3% of women. 54.4% of answerer replied that the best education method was that developed clinical program. 3. In the general features of adequate service for home visiting physical therapy, 70.9% of men and 69.1 % of women want special isolated physical therapy center, 61.8% of men and 63.7% of women want distance of 15minutes-29minutes by car. 59.4% of men and 47.5% of women want 3 times per week in frequency(P<0.05), 70.9% of men and 61.0% of women want 30-60minutes in treatment duration. and 47.2% of men and 51.6% of women want to teach only evaluation and treatment method. 4. In the payment of adequate service for home visiting physical therapy, 47.9% of men and 49.3% of women want insurance with private charge (P<0.05), 58.8% of men and 55.2% of women want insurance direct charge and traffic fee and visiting fee for the private charge. 37.0% of men wants 4,000won-4,900won and 32.7% of women wants 2,000won-2,900won for the traffic fee. 43.0% of men wants 5,000won-9,900won and 48.0% of women wants 5,000won-5,900won for the visiting fee. 5. In the qualifications for home visiting physical therapy, 44.8% of men wants to have license and learn home treatment method but 47.1% of women wants to have license and career and learn home treatment method(P<0.05). In the career, 38.8% of men wants above 5 years, 39.5% of women wants above 3 years(P<0.01). 63.0% of men and 66.4% of women answered with unconcern but 18.8% of men wants physical therapist worked in general hospital and 20.6% of women wants in welfare center(P<0.01). 92.7% of men and 92.4% of women answered no interested in physical therapist's gender. The most preferential age of home visiting physical therapist was also no interested in physical therapist's age.
Journal of the Korea Academia-Industrial cooperation Society
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v.18
no.4
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pp.614-623
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2017
The purpose of this study is to analyze the impact of the financial performance of regional public hospitals on their efficiency. In addition, the analysis of their efficiency using environmental factors, such as the market share, operating mode, and size of the regional public hospitals, as well as the factors influencing their efficiency, are selected by selecting the input and output factors of the hospitals and some differences were found between them. The DEA index and financial performance of the 31 regional public hospitals were calculated for the three years from 2012 to 2014. ANOVA and hierarchical regression analysis were used. As a result, there was a significant difference in their efficiency according to the environmental factors, such as the city scale of the regional public hospital, the number of hospital beds, and their business performance, productivity, and publicness. The medical profit margin (p<0.05), labor cost investment efficiency (p<0.05) and HHI (p<0.05) were found to affect the efficiency. In order to identify the inefficiencies of the regional public hospitals and increase their efficiency, it is necessary to measure the efficiency of the input resources and to reduce their cost. In addition, if the regional public hospitals were to provide specialized services, such as specialized functions of medical care that would give them a competitive advantage over private hospitals, their operational efficiency would be enhanced and they would be able to fulfill their role as public medical institutions.
Journal of Korean Academy of Nursing Administration
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v.4
no.2
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pp.387-403
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1998
These days our nation is standing on tiptoe of welfare nation. so hospital in authority have done reformation to provide quality medical services. This effective nursing work to provide quality nursing by keeping pace with the reformation of management of hospital for quality medical function might be well said to be depending on the degree of function of nursing management of nursing department. This essay has been aimed to prepare the data to build the position of nursing organization which can elevate the quality of nursing by clarifying the difference of the degree of the function of nursing management according to the position of nursing department in hospital organization. 135 nurses of 1 general hospital in Seoul which has independent nursing organization of the hospitals of over 600 beds and 155 nurses of 1 general hospital in Seoul which has the nursing organization under the management of medical department have been the objects of this study. The tool of Yoon. Young Ae(1988) has been used by having it amended and complemented and the degree of reliability of the tool was resulted in Cronbach's Alpha .9155. The collected data have been analysed by SPSS program as mean. frequency, chi-square. t-test. F-test(ANOVA) and the results are as the follows; 1. Compared result of general characteristics of the two groups by $x^2$-test showed statistically significant difference between religion ($x^2$=10.375, p=.015) and educational background($x^2$=51.222. p=.000) 2. The t-test aimed to compare the degree of function of nursing management according to the position of nursing department is as the below: Compared result of the degree of the function of nursing management according to the areas has shown higher point in independent type(M=3.22) than in the type under the management of medical department(M=2.85) in the personnel and administrative activities of nursing department. the standard and regulation of nursing duty also showed higher point in independent than in the type under the management of medical department (M=3.37) and the education of nursing showed higher point in independent type(M=3.53) than in the type under the management of medical department(M=3.19) and the evaluation of nursing quality has shown higher point in independent type(M=3.33) than in the type under the management of medical department(M=3.05), The area which showed the highest difference of the degree of the function of nursing management between the two organizations was in the activities of personnel and administration management of nursing department (independent type M=3.22. the type under the management of medical department(M=2.85). The degree of function of general nursing management showed higher in independent type nursing organization than in the type under the management of medical department by 3.41 in independent type and 3.11 in the type under the management of medical department. The items which showed the lowest degree of function of nursing management of both organizations have been suitable nursing man power and distribution and the reflection of the opinion of nursing department. In conclusion. the degree of function of nursing management to be able to provide quality nursing for the hospital goal of quality medical works showed visibly higher in independent nursing organization than in the nursing organization under the management of medical department. Therefore it is desirable for the hospital to operate the nursing department in hospital organization by independent type rather than the type under the management of medical department and the chief of nursing department of the nursing organization of the type under the management of medical department should make effort to reform its structure to be able to establish the position of performing independent nursing management. And also the chief of the nursing organization of independent type should endeavor to build substantial independent type organization more than ever under the viewpoint of securing suitable nursing man power and the low degree of management in the reflection of the opinion of nursing department.
The purpose of this study is to analyze the effects of the simulation-based professional cardiac resuscitation training on the performance of professional cardiac resuscitation performed by paramedics in the pre-hospital stage and to provide basic data for effective cardiac resuscitation. This study is an experimental study of the design before and after the control of non-equality. The subjects of this study were 16 newly recruited paramedics from K firefighting school. The simulation training program and evaluation papers used as the evaluation tool were reviewed and commented by 6 ACLS simulation experts (2 emergency medical doctor, 2 emergency medical professors, 2 KALS instructors)Respectively. The training consisted of 30 minutes of theory and 150 minutes of practical training. The lecturer first demonstrated for 5 minutes, and after training by individual debriefing after individual training, individual and team education was conducted The evaluation scale was given a 5 - point Likert scale. The SPSS 22.0 program for Windows was used. The general characteristics of the subjects were analyzed for frequency, the examination of homogeneity between the experimental group and the control group wasfulfilled by t test, and the difference test between the groups of the two groups was performed using the paired t-test. The homogeneity test was able to confirm the homogeneity between experimental group and control group. In the evaluation of six ACLS techniques, it was proven that the experimental group that received the simulation training had better performance in all aspects than the non - training control group. The following are the technical items to be performed. 1. Electrocardiogram 2. Specialized instrument 3. Treatment of fluid 4. Leadership and teamwork 5. Medical guidance 6. Evaluation during transfer. It was proved that paramedics who received simulation training were improved on their job performance ability than general lecture and training group. Therefore, if simulation training and education are applied to a student in the synthetic course or an emergency resident who is engaged in clinical practice, he / she will be able to perform his / her duties more proficiently. It is expected that emergency services provided to patients with cardiac arrest will be improved.
The purpose of this study was to investigate the quality of life of clients who treated and equipped prosthesis in Eulji University Hospital in Dae-Jun City. The results of this study were as follows. The oral status of Female had more carious tooth than male had. Carious tooth(p<0.05) and losed tooth(p<0.001) was more popular in older female. The frequency of treated tooth was higher under 59 years old female than over 60 years old(p<0.01). In education category, carious tooth(p<0.05) and losed tooth(p<0.000) was more popular in low education than high education In the score of relation of OHIP-14 category and general characteristic, female was significantly higher than male in dysfunction( p<0.05), physical disorder(p<0.001) and activity disorder(p<0.05). The score was significantly higher in older than younger in dysfunction(p<0.05), physical disorder(p<0.001) and activity disorder(p<0.001). The score of education was significantly higher in low education group than high education group in physical pain (p<0.001), mental discomfort (p<0.001). The score of marriage status was significantly higher in marriaged group than other group in dysfunction (p<0.05) and mental discomfort (p<0.05). In the score of relation of OHIP-14 category and oral status, the score of carious tooth group was significantly higher in dysfunction(p<0.05), physical disorder(p<0.05) and activity disorder(p<0.05). The score of losed tooth group was significantly higher in dysfunction(p<0.05), physical pain (p<0.05), mental discomfort(p<0.05), physical disorder(p<0.05) and activity disorder(p<0.01). The score of non treated tooth group was significantly higher in dysfunction(p<0.05), mental discomfort(p<0.05), social disorder(p<0.05) and activity disorder(p<0.05). In the score of relation of OHIP-14 category and the sort of prosthesis, the score of being bridge group was significantly higher than being crown group in activity disorder(p<0.05). The OHIP-14 category and the number of prosthesis was not significant relationship. These results suggest that the information and services of the process of dental prosthesis based on subjective evaluation should be provided to clients rather than based on clinical evaluation. The continued system of oral management should be developed and provided.
Purpose: The aims of this study are to evaluate psychological impact and quality of life according to the cancer diagnosis and mutation status in Korean families with BRCA mutations. Materials and Methods: Seventeen affected carriers (AC), 16 unaffected carriers (UC) and 13 healthy non carriers (NC) from 13 BRCA mutation families were included in the study. Outcomes were compared with regard to depression (Beck Depression Inventory), anxiety (State-Trait Anxiety Inventory, STAI), optimism (Reevaluation of the Life Orientation test, LOT-R), knowledge of hereditary ovarian cancer, and quality of life (QoL) (SF-36v2 Health Survey, physical component score [PCS], mental component score [MCS]) among three groups. Result: Level of depression, optimism, and PCS were similar in AC, UC, and NC. Anxiety score was elevated in all three groups. MCS was significantly low in AC than in UC and NC (P=0.009, P=0.017). Knowledge of hereditary breast and ovarian cancer was high in AC than NC (P=0.001). MCS was significantly related to whether patient was affected by cancer (P=0.043) and has occupation (P=0.008) or not in multivariable analysis. Conclusion: From this cross sectional study, psychological adverse effect was not related to the carrier status of BRCA mutation. Elevated anxiety in BRCA family members was observed but, independent to affection and the type of genetic mutation. AC showed low mental QoL. Further effort to understand psychological impact and QoL of genetic testing in BRCA family members is required for follow-up in clinical aspects.
Purpose: This study was conducted to explore the impact of registered nurse/nurses' aid (RN/NA) staffing and turnover rate on inpatient health outcomes in long term care hospitals. Methods: A secondary analysis was done of national data from the Health Insurance Review and Assessment Services including evaluation of long term care hospitals in October-December 2010 and hospital general characteristics in July-September 2010. Final analysis of data from 610 hospitals included RN/NA staffing, turnover rate of nursing staff and 5 patient health outcome indicators. Results: Finding showed that, when variables of organization and community level were controlled, patients per RN was a significant indicator of decline in ADL for patients with dementia, and new pressure ulcer development in the high risk group and worsening of pressure ulcers. Patients per NA was a significant indicator for new pressure ulcer development in the low risk group. Turnover rate was not significant for any variable. Conclusion: To maintain and improve patient health outcomes of ADL and pressure ulcers, policies should be developed to increase the staffing level of RN. Studies are also needed to examine causal relation of NA staffing level, RN staffing level and patient health outcomes with consideration of the details of nursing practice.
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