• Journal of Korean Academy of Nursing Administration
• /
• v.23 no.2
• /
• pp.211-222
• /
• 2017

Purpose: To develop staffing levels for nursing personnel (registered nurses and nursing assistants) to provide inpatients with integrated nursing care that includes, in addition to professional nursing care, personal care previously provided by patients' families or private caregivers. Methods: A time & motion study was conducted to observe nursing care activities and the time spent by nursing personnel, families, and private caregivers in 10 medical-surgical units. The Korean Patient Classification System-1 (KPCS-1) was used for the nurse manager survey conducted to measure staffing levels and patient needs for nursing care. Results: Current nurse to patient ratios from the time-motion study and the survey study were 1:10 and 1:11, respectively. Time spent in direct patient care by nursing personnel and family/private caregivers was 51 and 130 minutes per day, respectively. Direct nursing care hours correlated with KPCS-1 scores. Nursing personnel to patient ratio required to provide integrated inpatient care ranged from 1:3.9 to 1:6.1 in tertiary hospitals and from 1:4.4 to 1:6.0 in general hospitals. The functional nursing care delivery system had been implemented in 38.5% of the nursing units. Conclusion: Findings indicate that appropriate nurse staffing and efficient nursing care delivery systems are required to provide integrated inpatient nursing care.

• Korea Journal of Hospital Management
• /
• v.27 no.3
• /
• pp.15-25
• /
• 2022

Purposes: This study aimed to identify the relationships among personal and organizational communication skills, occupational stress, and patient safety activity levels of two nursing workforce groups (nurses and nursing assistants) who provide integrated nursing care services. Methodology: The study design is a cross-sectional study. Seventy-one nurses and forty-three nursing assistants working in the integrated nursing care service wards participated in this study. The data were collected using a self-reported questionnaire from June to July 2021. The relationships among the variables were analyzed using the Pearson correlation coefficient. Findings: Nurses' personal communication skills (r=.294, p=.013), organizational communication skills (r=.408, p<.001), and occupational stress (r=.243, p=.041) were associated with their patient safety activities. However, nursing assistants' personal communication skills, organizational communication, and occupational stress were not correlated with their patient safety activities. Practical Implication: Patient safety activities of nurses were related to their communication skills and occupational stress, but nurse assistants were not. Therefore, nurses should encourage nursing assistants to responsibly engage in patient safety activities and supervise their works appropriately to achieve high-quality care.

• Journal of agricultural medicine and community health
• /
• v.49 no.2
• /
• pp.132-145
• /
• 2024

Objectives: This study compares cases of Dalgubeol Health Care Project, 301 Network Project, and 3 for 1 Project based on program logic models to derive measures for promoting integrated healthcare and welfare services centered around medical institutions. Methods: From January to December 2021, information on the implementation systems and performance of each institution was collected. Data sources included prior academic research, project reports, operational guidelines, official press releases, media articles, and written surveys from project managers. A program logic model analysis framework was applied, structuring the information based on four elements: situation, input, activity, and output. Results: All three projects aimed to address the fragmentation of health and welfare services and medical blind spots. Despite similar multidisciplinary team compositions, differences existed in specific fields, recruitment scale, and employment types. Variations in funding sources led to differences in community collaboration, support methods, and future directions. There were discrepancies in the number of beneficiaries and medical treatments, with different results observed when comparing the actual number of people to input manpower and project cost per beneficiary. Conclusions: To design an integrated health and welfare service provision system centered on medical institutions, securing a stable funding mechanism and establishing an appropriate target population and service delivery system are crucial. Additionally, installing a dedicated department within the medical institution to link activities across various sectors, rather than outsourcing, is necessary. Ensuring appropriate recruitment and stable employment systems is needed. A comprehensive provision system offering services from mild to severe cases through public-private cooperation is suggested.

• Journal of agricultural medicine and community health
• /
• v.32 no.1
• /
• pp.27-39
• /
• 2007

Objectives: The challenge of an increasing elderly population has coupled with everpresent social concerns in Korea. A major problem in health center for the frail older people is that medical, healthcare, and welfare services are often fragmented in terms of providers and settings without appropriate coordination. The purpose of this study was to investigate the need of health center-based integrated healthcare services and its related factors for the elderly. Methods: A total of 110 elderly people who had visited at a county Health Center were interviewed using a self-administered questionnaire from November to December, 2005. The questionnaire consists of five domains according to the Program of All-inclusive Care for the Elderly. Results: Respondents had high need (total mean score with the 5-point Likert-type sacle: 3.67) of health center-based integrated healthcare services including home visiting service (mean: 4.08), chronic disease care service (mean: 4.06), and transportation service (mean 4.05). According to the results of hierarchical multiple regression analysis, among three regression models the magnititude of the variance of full model that is explained by the need of welfare-domain service was significantly larger than two reduced model. Income was a significant variable in increasing the need of health care and welfare services. Conclusions: This study suggests that the health center-based integrated healthcare services for the elderly must be continuously developed and provided for the health promotion and improved the quality of life of the elderly who live in rural area in Korea.

• International Journal of Internet, Broadcasting and Communication
• /
• v.10 no.3
• /
• pp.115-120
• /
• 2018

Current medical tourism is focused on the services of large hospitals and it is hard to find ways to attract the users. Users collect information for medical tourism through various paths in order to receive the medical consultations and customized tour services. To expand medical tourism to small and medium sized hospitals, it is necessary to have the customized medical consultations, tours and interpreter services, which are the key elements of medical tourism. This study suggests ways to provide the services based on information on medical consultations, tours and interpreter services that users had experienced directly, and also based on the platform for the essential items integrated from users, hospitals and guides' viewpoints. With information on hospitals that provide medical consultations and guides who are able to provide professional services in translation, interpretation and customized tour, users may accumulate and share the information about hospitals and customized tours verified by other users from the integrated platform. To match the contents provided by hospitals and guides with information experienced by users into a system, this study suggests the construction plan for the service model that can match the experience information between users and hospitals, between users and guides and between hospitals and guides systematically by operating the data in the universal container.

• The Journal of Korean Institute of Communications and Information Sciences
• /
• v.38B no.11
• /
• pp.870-878
• /
• 2013

The objective of this paper is to develop mobile-based PACS(Picture Archiving Communication System: mPACS) for diagnostic medical image service available via Android-based mobile smartphone. The proposed mPACS provides an integrated platform for mobile application of diagnostic medical images stored in hospital PACS, and allows the smartphone to store, retrieve, manipulate and transfer the diagnostic medical images. Then, the mPACS platform includes the following features for use in the Android framework (i. e., diagnostic medical image processing) : transfer protocols between PACS, mPACS and smartphone, image format converter, JPEG and JPEG2000 coders, text and avatar search, and etc. This mPACS is shown to be useful and effective in providing a solution for mobile-based diagnostic medical image service.

• Journal of Digital Convergence
• /
• v.9 no.5
• /
• pp.65-75
• /
• 2011

For the latest information and communication technology convergence with related technology to integrate all the systems has been developed in the form. In this era as well as the flow of the healthcare industry in recent years many studies on the development and application has been actively. Health IT in healthcare information systems that integrate information systems that have evolved rapidly in the direction to go, and in the future it is expected to do better acceleration. In this paper, state-led ubiquitous environment for building the hospital application system and IT application services are practical and Free in the integrated health information for the patient care service strengthening to integrated medical information system proposal and design do's and At the same time the establishment of integrated health information systems plans and operational challenges presented.

• Health Policy and Management
• /
• v.32 no.2
• /
• pp.154-163
• /
• 2022

Background: The costliness index (CI) is an index that is used in various ways to improve the quality of medical care and the management of appropriate treatment in medical institutions. However, the current calculation method for CI has a limitation in reflecting the actual medical cost of the patient unit because the outpatient and inpatient costs are evaluated separately. It is desirable to calculate the CI by integrating the medical cost into the episode unit. Methods: We developed an episode-based CI method using the episode classification system of the Centers for Medicare and Medicaid Services to the National Inpatient Sample data in Korea, which can integrate the admission and ambulatory care cost to episode unit. Additionally, we compared our new method with the previous method. Results: In some episodes, the correlation between previous and episode-based CI was low, and the proportion of outpatient treatment costs in total cost and readmission rates are high. As a result of regression analysis, it is possible that the level of total medical costs of the patient unit in low volume medical institute and rural area has been underestimated. Conclusion: High proportion of outpatient treatment cost in total medical cost means that some medical institutions may have provided medical services in the ambulatory care that are ancillary to inpatient treatment. In addition, a high readmission rate indicates insufficient treatment service for inpatients, which means that previous CI may not accurately reflect actual patient-based treatment costs. Therefore, an integrated patient-unit classification system which can be used as a more effective CI indicator is needed.

• International Journal of Quality Innovation
• /
• v.10 no.2
• /
• pp.109-126
• /
• 2009

The purpose of this study was to examine overall customer satisfaction associated with medical service quality in Taiwan by integrated Kano's model and customer satisfaction index model. Another purpose was to confirmed nonlinear and asymmetric relationship of Customer Satisfaction and Quality Performance by the research outcome. By analyzing 1,100 patients or their family members, this study used the structural equation model (SEM) with AMOS software for data analysis. The results show that must-be attributes, one-dimensional attributes and attractive attributes had a direct effect on overall customer satisfaction, Surprisingly, overall customer satisfaction had positively influenced customer loyalty customer satisfaction had negatively influenced customer complaints. The study also found that customer complaints have direct effect on customer loyalty. Importantly, the study found out the must-be attributes, the attractive attributes and one-dimensional attributes increased, the level of overall customer satisfaction also increased. The customer satisfaction positively influences customer loyalty in medical service quality in Taiwan. The findings might reveal new insights for researchers dealing with quality of medical service and for hospital managers who devote resources exclusively to achieving highest possible levels of patient satisfaction.

• Journal of the Ergonomics Society of Korea
• /
• v.31 no.1
• /
• pp.93-100
• /
• 2012

Objective: This study is to review the current state of services offered to pharmacy users, and develop a service design converging a prescription service and a smart phone application service in order to enhance patients' experience at pharmacies and home. Background: Under the new medical system; separation of prescribing and dispensing drugs, a doctor writes a prescription to their patients and patients have their prescription filled at the pharmacy. As the number of flue, allergy and atopy patients has increased, waiting lines have been longer at pharmacies. Besides, the current medical service system lacks of providing proper information on prescribed pills to patients. There are already services offered during waiting times such as offering free drinks, magazines or suggesting general drugs which you can buy without prescription, however they neither cover the current medical service's shorts nor shorten the waiting time. Method: I researched objective and perceived waiting times reduction methods, the current service status at pharmacies, and the government's policy direction in a medical service. Also, I observed a patient's journey from the hospital to pharmacy and then home. I examined the circumstance at pharmacies, patients' behaviors and their thoughts during their journey, and extracted three main goals to design a service in order to help patients have positive perception during the waiting time; (1) to reduce the perceived time by the way of visualizing time and offering readings about what patients consider necessary, (2) to educate patients what they are into and how to get through, (3) to establish trust among patients, doctors and pharmacists. Based on three goals, I designed a structure and a wireframe for a new service application of smart phones. Results: With a new service design for pharmacy users, users can track their medical record and visit the information about their current medical treatments anytime. Also the service helps patients build reliable relationships with doctors and pharmacists. Conclusion: Experience is not just an activity but series of multiple activities. The serving range of a medical service should not be determined by stakeholders but user's holistic experience. By approaching a service design with a holistic vision, it can enrich not only a temporary experience but also a whole life well being. Application: Since there are already many service applications advising patients about their illness and finding right doctors, this service design is focused on the experience from getting a prescription till feeling better. The next move is to combine those two parts medical services and design an integrated service application. As a prescription is going to be coded in numbers, we might consider to design an un-attended pharmacy which can shorten huge amount of time for filling prescriptions.