• Quality Improvement in Health Care
• /
• v.18 no.1
• /
• pp.37-55
• /
• 2012

Objectives : This study was conducted to evaluate the effect of fixed critical pathway with emr (electronic medical record) on the length of hospital stay, the cost and quality of care provided to gastrectomy patients in a university hospital and to develop flexible critical pathway with emr which can be used excluded or drop-out patients. Methods : Thirty-eight patients with gastrectomy were included as case group and Thirty-four patients included as control group. The comparison between control and case with using fixed critical pathway were done. To develop and to evaluate usefulness of flexible critical pathway with flexible data base, simulation was done for flexible critical pathway with drop-out patients. Result : The major results of this study were as follows: There were no significant differences in patient clinical conditions and no sign of deterioration of quality from critical pathway. The length of hospital stay was 11 days in control group, 8 days in path group(P<0.01). The total costs during the hospital stay were reduced in path group. However the cost per day was significantly increased from reduction of hospital stay(554,352 won in control, 645,669 won in path group). One hundred percentage of drop out patients(60) in the simulation of flexible critical pathway was successful. Conclusion : Computerized critical pathway reduced the length of hospital stay, total hospital costs and resource utilization without harming quality of patient care. The flexible critical pathway program can be used as one of the powerful management tools for reducing the practice variations and increasing the efficiency of care process and decreasing the workload of doctors and nurses in Korean hospital settings.

• Archives of Craniofacial Surgery
• /
• v.14 no.1
• /
• pp.24-29
• /
• 2013

Background: The incidence of blow out fractures is increasing and the techniques of diagnosis and treatment have been recently evolving. Despite its clinical significance, there has been no study on orbital inferiomedial blow out fractures. Therefore, this study was designed to investigate the clinical significance of treatment of orbital inferiomedial blow out fractures. Methods: A retrospective review of fifty-seven patients who could be followed up for at least 1 year after surgical reconstruction of pure inferiomedial blow out fracture was undertaken. The transconjunctival approach was performed in all cases. The onlay technique was used in 32 patients and the inlay/sheet method was used in 25 patients. We evaluated the clinical outcomes using the chi-square test. Results: In the group using the onlay technique, postoperative diplopia and enophthalmos were observed in 14 cases and 3 cases, respectively. Of these, 5 cases and 3 cases lasted for more than 6 months, respectively. In the group using the inlay/sheet method, postoperative diplopia was observed in 9 cases, but there were no cases of enophthalmos. Among the 9 diplopia cases, 4 lasted for more than 6 months. Conclusion: Postoperative diplopia and enophthalmos were increased after treatment of inferiomedial blow out fractures compared to isolated medial (0.6%, 0.3%) or inferior (1.8%, 0.6%) blow out fractures. Therefore, careful dissection is necessary not to injure the inferior oblique muscle to decrease the incidence of postoperative diplopia. Moreover, the inlay/sheet method is an effective option for reconstruction of inferiomedial blow out fractures.

• Journal of Society of Preventive Korean Medicine
• /
• v.15 no.3
• /
• pp.101-114
• /
• 2011

The purpose of this study was to analyze of Hospital Coordinator based on the DACUM(Developing A Curriculum) method. The contents of this study were to extract the duties, tasks consisting of job of Hospital Coordinator and to investigate levels of importance, difficulty, frequency and entry level on each task, and to make out a job model of Hospital coordinator. A DACUM committee was composed to analyze job of Hospital Coordinator and the committee members were total 17, a facilitator, 15 hospital administrator and a recorder. The major findings of this study were as the followings ; first, duties in job of Hospital Coordinator were total 10, which were organization of Hospital Coordinator affairs, customerfacing services, consultation support, customer counsel, customer management, financial management, medical service planning, medical service marketing, organizational management, image making management, and self-development. And total tasks in job of Hospital coordinator were 76. Second, the tasks which were important, difficult, frequent and essential in entry step of occupation were counseling before consultation, explaining treatment plan after consultation, checking progress of consultation, answering teleconsultation, and finding out customer's consultation information. Third, a job model of Hospital Coordinator was constructed based on the results of DACUM job analysis.

• Journal of Acupuncture Research
• /
• v.19 no.4
• /
• pp.112-123
• /
• 2002

Objective : This study was designed to find out the effects of Carthami-Flos herbal acupuncture theraphy on neck pain due to soft tissue damage. Methods : This study was carried out for 34 patients who had neither structural defectiveness of cervical spine nor neural injury but simple soft tissue damage among poeple who visited Hye-dang Oriental Hospital from December 1, 2001 to June 15, 2002. Group A of 17 patients was taken Carthami-Flos herbal acupuncture treatment. Group B of 17 patients was taken common acpuncture treatment. Results : We have found out the good effects of Cathami-Flos herbal acupuncture on the patients due to soft tissue damage. Conclusion : The Carthami-Flos herbal acupuncture treatment is useful on the patients of neck pain due to soft tissue damage.

• Journal of The Korean Society of Emergency Medicine
• /
• v.29 no.5
• /
• pp.493-499
• /
• 2018

Objective: This study aimed to identify the effects of serum potassium and lactate on neurologic outcomes in out-of-hospital post-cardiac arrest adult patients. Methods: This study was a single center, retrospective observational study. We recruited out-of-hospital post-cardiac arrest adult patients admitted to an intensive care unit from 2011 to 2017. Primary outcome was good neurologic outcome at discharge. To evaluate the prognostic impact of serum potassium and lactate, univariate and multivariate logistic regression analyses were performed. Results: A total of 57 patients were included in this study. The number of patients with good neurologic outcome was 19 (33.3%). In the univariate analysis, good neurologic outcome patients showed a higher smoking rate, shorter pre-hospital transportation time, higher rate of percutaneous coronary intervention, and lower severity score (all P<0.05). The good neurologic outcome patients also presented higher pH, lower partial pressure of carbon dioxide, and lower potassium regarding laboratory findings on the first hospital day (all P<0.05). In the multivariate analysis, the independent factors favoring good neurologic outcome were pre-hospital transportation time (adjusted odds ratio [aOR], 0.82; 95% confidence interval [CI], 0.69-0.97; P=0.019) and lower partial pressure of carbon dioxide on the first hospital day (aOR, 0.95; 95% CI, 0.91-0.99; P=0.034). Conclusion: Serum potassium and lactate were not significantly associated with good neurologic outcome in out-of-hospital post-cardiac arrest adult patients. The prognostic factors for good neurologic outcome were pre-hospital transportation time and initial partial pressure of carbon dioxide.

• Quality Improvement in Health Care
• /
• v.2 no.2
• /
• pp.130-145
• /
• 1996

Purpose : the management of University Hospital is being challenged in maintenance of reasonable level of income and high ranked reputation by domestic competition with each other and emergence of enterprised owned hospitals. It is imperative that University Hospitals have to make management for patient satisfaction. Furthermore, increased patient's requirement for qualified hospital services (quality assurance) and low-estimated service fee also repress the hospital management condition as well as medical markets open following with Urguay Connection. Due to these unforable conditions surrounding hospital management, -University Hospitals are being pressed to seek improved management strategies. To develope the strategies, we need to have basic understanding about the problems on hospital management and detail information for various patient's requirement. Methods: For this study, we have analysed out-patients from five different University Hospitals located in Seoul, Korea. To obtain the data, we have carried out personal interviews with patients who patients who visit the Out-Patient Clinics of five different University Hospitals using a previously prepared questionnaire. Result: Around 65.7 percent of the visits to University Hospitals were indwelt in the vicinity of 1 hour and motuvation of visiting University Hospital was expending high wuality medical csre in 49.3 percent. The 79.3 percent of the patients have experienced inconvenience during medical care in University Hospital. The most inconvenient condition was waiting for doctors. The 57.2 percent of total patient have experienced rudness. The most rudness condition was registration and receipt desk in 44.4 percent. Patient expect that doctors working in University Hospitals as professors have high and updated medical knowledge(50.4%) and University Hospitals have a high quality medical care system(79.4%). The patient satisfaction was relatively low in 61.1 percent of total patient and revealed high frequency of again visit University Hospital in satisfaction group. Comparison of interhospital analytical study showed quite difference on various problems. Conclusion: Almost patients who visit to Out-Patient Clinic of University Hospital havevisiting motivation to high quality medical care. University Hospitals have several different unsatisfactorial factors and revealed different degree of patient satisfaction. In a future day, University Hospitals have to make use of another University Hospital's merits for approach of Benchmarking and also should be studied decision factors of patient satisfaction and interhospital difference of them.

• Journal of Korean Clinical Nursing Research
• /
• v.28 no.2
• /
• pp.157-166
• /
• 2022

Purpose: The purpose of this study was to investigate hospital nurses' delirium screening for postoperative delirium, delirium knowledge, and delirium care using case scenarios at a tertiary hospital in Seoul. Methods: A total of 235 nurses working at surgical units participated in this questionnaire-based study. Five cases scenarios were developed based on diagnosed postoperative delirium cases. Data were collected from April 1 to May 1, 2021. Results: The delirium screening score was 4.20±1.17 out of 5. The delirium knowledge score was 34.35±4.57 out of 47. The delirium care score was 67.61±9.26 out of 92. The correlation between the delirium screening and delirium knowledge was statistically significant (r=.18, p=.005). The correlation between the delirium knowledge and delirium care was statistically significant (r=.25, p<.001). Conclusion: The findings showed that the continuing educations of delirium for hospital nurses and the development of a delirium education programs were important to improve delirium screening and care.

• Medical Lasers
• /
• v.10 no.4
• /
• pp.246-249
• /
• 2021

The carbon dioxide (CO₂) laser is one of the treatment options used for xanthelasma palpebrarum. However, even if the full dermal layer is removed, the lesion can recur due to the residual lipid deposits. A 44-year-old male patient with xanthelasma on both upper eyelids was treated with a pulsed dye CO₂ laser. On the right upper eyelid, we carried out a CO₂ laser treatment until the yellowish plaque was almost invisible and the full thickness of the dermal layer was removed. On the left upper eyelid, the dermal layer was partially removed and an additional squeezing out of yellowish particles was done. The lesion treated by the squeezing out of lipid droplets showed better long-term results than the lesion treated up to the deeper dermal layer.

• The Korean Journal of Health Service Management
• /
• v.5 no.4
• /
• pp.15-26
• /
• 2011

This study assessed and compared the expectation levels of in- and out-patients at hospitals of different size in relation to patients' view of their rights. A survey of out-patients visiting university hospitals (204 patients) and small to mid size community hospitals (215 patients) in Seoul and Kyeongki Province was conducted, where the respondents reported their perceptions of patient rights. Based on the survey, their respective expectation levels for the medical services that they would receive was assessed and analyzed for exploring possible factors for their selecting small to mid sized hospitals over larger hospitals. The results showed difference in perceptions between patients visiting or staying in lager and smaller hospitals. Namely, for out-patients, those at university hospitals had higher perceptions only about their rights to privacy while in hospital, whereas in the case of in-patients, those at small to mid size hospitals had higher perceptions only about their rights to access to inspection information. With respect to the results from analysis of difference in the expectation level for medical services between university and non-university hospital patients, it was found that in-patients at university hospitals had higher perceptions about their rights to choose to see hospital visitors while in hospital and rights to access to religious facilities.

• Korean Journal of Occupational Health Nursing
• /
• v.19 no.1
• /
• pp.50-59
• /
• 2010

This study was done to examine ER nurses' burn-out, as an understanding in the relationship of nursing performance and professional identity. The subjects of the study were nurses working in the emergency room of the general hospital with over 300 beds, located in D metropolitan city and C city. The self-report questionnaires were administered and 120 were collected. For the data analysis, SPSS WIN 12.0 was used. ER nurses' burn-out was 2.99, the mean of nursing performance was 3.69, and professional identity was 3.51. The extent of ER nurses' burn-out showed significantly negative correlation with the extent of nursing performance(r=-.257), along with professional identity(r=-.192). While ER nurses' nursing performance showed significantly positive correlation with professional identity(r=.696). In conclusion, the higher professional identity, the fewer ER nurses experienced burn-out, and the higher extent of nursing performance was obtained. It is necessary to create activities and programs to reduce and prevent burn-out.