• Title/Summary/Keyword: Patient Waiting Time

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Needs of Home Care Services for the Arthritic Patients of One Hospital (일개 병원에 내원하는 관절염 환자의 가정간호 요구)

  • Lee, Eun-Ok;Yoo, Kyung-Hee
    • Journal of muscle and joint health
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    • v.1 no.1
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    • pp.88-96
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    • 1994
  • Treatment for the arthritic is mostly on the out-patient basis. The present rheumatologists practicing in Korea do not cover the total number of the patients. Also patients with arthritis need medical treatment for long period of time. Therefore, the number of patients waiting for the treatment is huge in number. This vicious cycle need to be broken in some way. Purpose of this study is to identify the need for home care of the arthritic patients. Nineteen hundred and sixty two subjects were interviewed in one hospital for one month. The following findings were observed : 1. The rates for demanding home care were from 60% to 100% depending on the areas. 2. Reasons for no need of home care were mainly credibility and short distance from the hospital. 3. Time spent for one way transportation was more than 3.3 hours except from Seoul and Kyungki area. The longer they spend time for transportation, the more they want home care services. 4. The number of patients who asked other persons to travel for prescription was 446(22.73%) and average number was 3.26 per year in those 446 cases. 5. Average expenses for transportation and other cost for each time of hospital visit were 21,073won ranged from 8,373 won to 132,571 won. The more spend money for visiting the hospital, the more they want home care services. In order to reduce the physical and economical burden of the arthritic patients living in remote areas, hospital-based home care services are justified on the bases of patients' demand and legislative support.

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Effect of Work Improvement for Promotion of Outpatient Satisfaction on CT scan (CT 외래환자의 만족도 향상을 위한 업무개선 연구)

  • Han, Man-Seok;Lee, Seung-Youl;Lee, Myeong-Goo;Jeon, Min-Cheol;Cho, Jae-Hwan;Kim, Tae-Hyung
    • 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.

Evaluation of Proper Image Acquisition Time by Change of Infusion dose in PET/CT (PET/CT 검사에서 주입선량의 변화에 따른 적정한 영상획득시간의 평가)

  • Kim, Chang Hyeon;Lee, Hyun Kuk;Song, Chi Ok;Lee, Gi Heun
    • The Korean Journal of Nuclear Medicine Technology
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    • v.18 no.2
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    • pp.22-27
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    • 2014
  • Purpose There is the recent PET/CT scan in tendency that use low dose to reduce patient's exposure along with development of equipments. We diminished $^{18}F$-FDG dose of patient to reduce patient's exposure after setting up GE Discovery 690 PET/CT scanner (GE Healthcare, Milwaukee, USA) establishment at this hospital in 2011. Accordingly, We evaluate acquisition time per proper bed by change of infusion dose to maintain quality of image of PET/CT scanner. Materials and Methods We inserted Air, Teflon, hot cylinder in NEMA NU2-1994 phantom and maintained radioactivity concentration based on the ratio 4:1 of hot cylinder and back ground activity and increased hot cylinder's concentration to 3, 4.3, 5.5, 6.7 MBq/kg, after acquisition image as increase acquisition time per bed to 30 seconds, 1 minute, 1 minute 30 seconds, 2 minute, 2 minutes 30 seconds, 3 minutes, 3 minutes 30 seconds, 4 minutes, 4 minutes 30 seconds, 5 minutes, 5 minutes 30 seconds, 10 minutes, 20 minutes, and 30 minutes, ROI was set up on hot cylinder and back radioactivity region. We computated standard deviation of Signal to Noise Ratio (SNR) and BKG (Background), compared with hot cylinder's concentration and change by acquisition time per bed, after measured Standard Uptake Value maximum ($SUV_{max}$). Also, we compared each standard deviation of $SUV_{max}$, SNR, BKG following in change of inspection waiting time (15minutes and 1 hour) by using 4.3 MBq phantom. Results The radioactive concentration per unit mass was increased to 3, 4.3, 5.5, 6.7 MBqs. And when we increased time/bed of each concentration from 1 minute 30 seconds to 30 minutes, we found that the $SUV_{max}$ of hot cylinder acquisition time per bed changed seriously according to each radioactive concentration in up to 18.3 to at least 7.3 from 30 seconds to 2 minutes. On the other side, that displayed changelessly at least 5.6 in up to 8 from 2 minutes 30 seconds to 30 minutes. SNR by radioactive change per unit mass was fixed to up to 0.49 in at least 0.41 in 3 MBqs and accroding as acquisition time per bed increased, rose to up to 0.59, 0.54 in each at least 0.23, 0.39 in 4.3 MBqs and in 5.5 MBqs. It was high to up to 0.59 from 30 seconds in radioactivity concentration 6.7 MBqs, but kept fixed from 0.43 to 0.53. Standard deviation of BKG (Background) was low from 0.38 to 0.06 in 3 MBqs and from 2 minutes 30 seconds after, low from 0.38 to 0 in 4.3 MBqs and 5.5 MBqs from 1 minute 30 seconds after, low from 0.33 to 0.05 in 6.7 MBqs at all section from 30 seconds to 30 minutes. In result that was changed the inspection waiting time to 15 minutes and 1 hour by 4.3 MBq phantoms, $SUV_{max}$ represented each other fixed values from 2 minutes 30 seconds of acquisition time per bed and SNR shown similar values from 1 minute 30 seconds. Conclusion As shown in the above, when we increased radioactive concentration per unit mass by 3, 4.3, 5.5, 6.7 MBqs, the values of $SUV_{max}$ and SNR was kept changelessly each other more than 2 minutes 30 seconds of acquisition time per bed. In the same way, in the change of inspection waiting time (15 minutes and 1 hour), we could find that the values of $SUV_{max}$ and SNR was kept changelessly each other more than 2 minutes 30 seconds of acquisition time per bed. In the result of this NEMA NU2-1994 phantom experiment, we found that the minimum acquisition time per bed was 2 minutes 30 seconds for evaluating values of fixed $SUV_{max}$ and SNR even in change of inserting radioactive concentration. However, this acquisition time can be different according to features and qualities of equipment.

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The Study on Impact of Introduction Characteristics Factor of EMR System on Perceived Usefulness and Ease of Use and Behavioral Intention to Use (EMR시스템의 도입 특성요인이 지각된 유용성, 편이성 및 사용의도에 미치는 영향에 관한 연구)

  • Im, Hyung-Joo;Shim, Jeong-Taek;Lee, Sang-Shik
    • Journal of Korea Society of Industrial Information Systems
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    • v.14 no.2
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    • pp.32-50
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    • 2009
  • Since 1990 when order communication system(OCS) was first introduced, the use of information technology in medical service has been widely accepted in order to enhance quality and customer relationship as well as to increase managerial efficiency. Medical information system is rapidly increasing and is trying to make ubiquitous healthcare environment through telemedicine system. Especially, medical profession and government have taken interest in electronic medical record (EMR) system which can digitalize and manage all medical records in hospitals. By recording patient's medical information in real time, EMR system can improve service efficiency and customer service quality including short waiting time, various utilization of clinic information, and reduced cost.

Comparison of Effectiveness about Image Quality and Scan Time According to Reconstruction Method in Bone SPECT (영상 재구성 방법에 따른 Bone SPECT 영상의 질과 검사시간에 대한 실효성 비교)

  • Kim, Woo-Hyun;Jung, Woo-Young;Lee, Ju-Young;Ryu, Jae-Kwang
    • The Korean Journal of Nuclear Medicine Technology
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    • v.13 no.1
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    • pp.9-14
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    • 2009
  • Purpose: Nowadays in the nuclear medicine, many studies and efforts are being made to reduce the scan time, as well as the waiting time to be needed to execute exams after injection of radionuclide medicines. Several methods are being used in clinic, such as developing new radionuclide compounds that enable to be absorbed into target organs more quickly and reducing acquisition scan time by increase the number of Gamma Camera detectors to examine. Each medical equipment manufacturer has improved the imaging process techniques to reduce scan time. In this paper, we tried to analyze the difference of image quality between FBP, 3D OSEM reconstruction methods that commercialized and being clinically applied, and Astonish reconstruction method (A kind of Iterative fast reconstruction method of Philips), also difference of image quality on scan time. Material and Methods: We investigated in 32 patients that examined the Bone SPECT from June to July 2008 at department of nuclear medicine, ASAN Medical Center in Seoul. 40sec/frame and 20sec/frame images were acquired that using Philips‘ PRECEDENCE 16 Gamma Camera and then reconstructed those images by using the Astonish (Philips’ Reconstruction Method), 3D OSEM and FBP methods. The blinded test was performed to the clinical interpreting physicians with all images analyzed by each reconstruction method for qualitative analysis. And we analyzed target to non target ratio by draws lesions as the center of disease for quantitative analysis. At this time, each image was analyzed with same location and size of ROI. Results: In a qualitative analysis, there was no significant difference by acquisition time changes in image quality. In a quantitative analysis, the images reconstructed Astonish method showed good quality due to better sharpness and distinguish sharply between lesions and peripheral lesions. After measuring each mean value and standard deviation value of target to non target ratio with 40 sec/frame and 20sec/frame images, those values are Astonish (40 sec-$13.91{\pm}5.62$ : 20 sec-$13.88{\pm}5.92$), 3D OSEM (40 sec-$10.60{\pm}3.55$ : 20 sec-$10.55{\pm}3.64$), FBP (40 sec-$8.30{\pm}4.44$ : 20 sec-$8.19{\pm}4.20$). We analyzed target to non target ratio from 20 sec and 40 sec images. And we analyzed the result, In Astonish (t=0.16, p=0.872), 3D OSEM (t=0.51, p=0.610), FBP (t=0.73, p=0.469) methods, there was no significant difference statistically by acquisition time change in image quality. But FBP indicates no statistical differences while some images indicate difference between 40 sec/frame and 20 sec/frame images by various factors. Conclusions: In the circumstance, try to find a solution to reduce nuclear medicine scan time, the development of nuclear medicine equipment hardware has decreased while software has marched forward at a relentless. Due to development of computer hardware, the image reconstruction time was reduced and the expanded capacity to restore enables iterative methods that couldn't be performed before due to technical limits. As imaging process technique developed, it reduced scan time and we could observe that image quality keep similar level. While keeping exam quality and reducing scan time can induce the reduction of patient's pain and sensory waiting time, also accessibility of nuclear medicine exam will be improved and it provide better service to patients and clinical physician who order exams. Consequently, those things make the image of department of nuclear medicine be improved. Concurrent Imaging - A new function that setting up each image acquisition parameter and enables to acquire images simultaneously with various parameters to once examine.

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A new protocol of the sliding mechanics with Micro-Implant Anchorage(M.I.A.) (Micro-Implant Anchorage(MIA)를 이용한 Sliding mechancis)

  • Park, Hyo-Sang
    • The korean journal of orthodontics
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    • v.30 no.6 s.83
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    • pp.677-685
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    • 2000
  • Anchorage plays an important role in orthodontic treatment. Because of limited anchorage Potential and acceptance problems of intra- or extraoral anchorage aids, endosseous implants have been suggested and used. However, clinicians have hesitated to use endosseous implants as orthodontic anchorage because of limited implantation space, high cost, and long waiting period for osseointegration. Titanium miniscrews and microscrews were introduced as orthodontic anchorage due to their many advantages such as ease of insertion and removal, low cost, immediate loading, and their ability to be placed in any area of the alveolar bone. In this study, a skeletal Class II Patient was treated with sliding mechanics using M.I.A.(micro-implant anchorage). The maxillary micro-implants provide anchorage for retraction of the upper anterior teeth. The mandibular micro-implants induced uprighting and intrusion of the lower molars. The upward and forward movement of the chin followed. This resulted in an increase of the SNB angle, and a decrease of the ANB angle. The micro-implants remained firm and stable throughout treatment. This new approach to the treatment of skeletal Class II malocclusion has the following characteristics . Independent of Patient cooperation. . Shorter treatment time due to the simultaneous retraction of the six anterior teeth . Early change of facial Profile motivating greater cooperation from patients These results indicate that the M.I.A. can be used as anchorage for orthodontic treatment. The use of M.I.A. with sliding mechanics in the treatment of skeletal Class II malocclusion increases the treatment simplicity and efficiency.

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A Study on the Experience of Fundamental Nursing Practice (간호 대학생의 기본 간호 실습 경험에 대한 연구)

  • 한경순;조주연
    • Journal of Korean Academy of Nursing
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    • v.29 no.2
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    • pp.293-303
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    • 1999
  • The purpose of this study was to understand and to explain how were nursing students experienced and accepted the fundemental nursing practice. In addition to, the results of this study are attempted to contribute for offer of basic data in projecting and accomplishing to promote quality practice education. The participants were 79 freshmen of S College of Nursing in kyungi-do. They presented record of feeling and thinking on their the fundemental nursing practice experience. The data were collected from 29, J une to 10, July in 1998. Collected data was analyzed by means of Van Kaam's phenomenological method. The results of this study was founded 423 descriptive expression and they were grouped under 42 common factors and they were grouped under 9 categories. By means of the frequency on the categories. the higher category is Anxiety. next Solemn. Flutter. Pride. Usefulness, Recognition of reality in nursing-system. Lack of practice environment. Self-accusation. Comprehension of nursing spirit were founded. 5 common factors. Tension. Difficulty, Dread. Apprehension, Burden were grouped under Anxiety. 7 common factors, Pledge, Memory, Importance of practice, Sincerity, Restriction of dress, Acceptance, Active attitude were grouped under solemn. 5 common factors, Interest, Strange, Beanimated, Waiting, Curiosity were grouped under Flutter. 5 common factors, Conceit, Self-confidence, Skilled, Worth, Accomplishment were grouped under Pride. 6 common factors, Acknowledge of nursing affairs, Expectation of furture, Fascination of nursing. Acquirement of disposition of nurse, Association of injection, Actual feeling of dept. of nursing were grouped under Recognition of reality in nursing-system. 4 common factors, Lack of practice time, Many persons of practice, Lack of practice instrument, Lack of reality were grouped under Lack of practice envirnment. 5 common factors, Inconvenient, Reflection, Loss of pride, Shyness, Feeling sorry were grouped under Self-accusation. 3 common factors, Utility, Connection of practice and theory, Various experience were grouped under Usefulness. 2 common factors, Comprehension on the dignity of human, Comprehension on a point of view of patient were grouped under Comprehension of nursing spirit. In conclusion, the following recommendation should be necessary a supplementary study to approach on the type of students that has a firm view and care about client prior to clinical nursing practice.

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Development of Information Architecture for User-centered Hospital Kiosk (사용자 중심의 병원용 키오스크 정보구조 제안)

  • Park, Min-Hee;Song, Dae-Sik;Kim, Hyun-Jeong
    • The Journal of the Korea Contents Association
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    • v.11 no.7
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    • pp.248-258
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    • 2011
  • Hospital Kiosk is a useful means to decrease human resources and to extend service hour to non-working hour for the stance of hospital and to obtain useful services without time loss in waiting in lines for the stance of user. However, various kinds of information kiosks are respectively installed with independent functions, and they have bad usability due to complexity in manipulate and unclear information architecture. In this paper, we tried to analyze usability and respective functions of each kiosk and aimed to suggest alternative information architecture for the integrated hospital kiosk. We categorized users as patient, guardian and visitor and we conducted usability test and in-depth interview with each group of users. based on result analysis from the research, we could suggest proper information architecture for the integrated user centered hospital kiosk. The new information architecture for the integrated hospital kiosk has better accessibility to the menus which reflects users's preemptive needs and it includes more specific information that can support user tasks.

Computerized Order Communication System for Out-patient's Clinic Using Personal Computer and Local Area Network (PC 및 LAN을 이용한 외래처방 전달 시스템)

  • 김남현;김원기
    • Journal of Biomedical Engineering Research
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    • v.14 no.4
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    • pp.321-326
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    • 1993
  • Recently, microcomputer technology has been developed rapidly and it provides not only graphic user interface that can be fraendly accessable but also large storage capacity to han- dle much hospital information. Almost all the order communication system for hospital has been developed under the concept of host and terminal environment since last 20 years. However, host-terminal system has not been successful in korea simply because most of physicians prescibe for rrlany patients a day(sometimes more than 150 patients a day). Also, under the host-terminal environment, programs are not friendly implemented for users. Since March 1991, we had developed order communication system for out-patients(named YONSEI-PC) using personal computer(PC) and local area network(LAN) . Since September 1992, we has applied succesfully in the Yonsei Cardiovascular Center, Sevrance Hospital, Yonsei University College of Medicine. This system consisted with Server and Clients which is communicated through LAN(Ethernet). The system also use the Host computer(IBM 9221 170) as a data bank and communicates to the Server with emulation card(3270 emulator, Interlink Inc., Korea) . After introducing this system, it enables patients to receive drugs witllin 20 minutes after prescription of 300-400 patients per day and it seemed to be effective system not to reduce waiting time for the patients but also to remove charge-troubling(due to His-entry of prescription) . This system also seems to be effective in terms of office automatism for hospital management. However users, usually physitions, required more friendly and easy system to operate and we thought that the most important one to successfully introduce order communication computer system in the hospital is user interface.

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Comparison of Conventional and Hypofractionated Radiotherapy in Breast Cancer Patients in Terms of 5-Year Survival, Locoregional Recurrence, Late Skin Complications and Cosmetic Results

  • Hashemi, Farnaz Amouzegar;Barzegartahamtan, Mohammadreza;Mohammadpour, Reza Ali;Sebzari, Ahmadreza;Kalaghchi, Bita;Haddad, Peiman
    • Asian Pacific Journal of Cancer Prevention
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    • v.17 no.11
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    • pp.4819-4823
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    • 2016
  • Bckground: Adjuvant radiation therapy is commonly administered following breast-conserving surgery for breast cancer patients. Hypofractionated radiotherapy can significantly reduce the waiting time for radiotherapy, working load on machines, patient visits to radiotherapy departments and medical costs. Material/Methods: Fifty-two patients with operable breast cancer (pT1-3pN0M0) who underwent breast conservation surgery in Tehran Cancer Institute during January 2011 to January 2012, were randomly assigned to undergo radiotherapy in two arms (hypofractionated radiotherapy arm with 30 patients, dose 42.5 Gy in 16 fractions; and conventional radiotherapy arm with 22 patients, dose 50 Gy in 25 fractions). W compared these two groups in terms of overall survival, locoregional control, late skin complications and cosmetic results. Results: At a median follow-up of 52.4 months (range: 0-64 months), the follow-up rate was 82.6%. Overall, after 60 months, there was no detectable significant differences between groups regarding cosmetic results (p = 0.857), locoregional control or survival. Conclusions: The results confirm that hypofractionated radiotherapy with a subsequent boost is as effective as conventional radiotherapy, is well-tolerated and can be used as an alternative treatment method following breast conservation surgery.