• Radiation Oncology Journal
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• v.20 no.1
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• pp.81-90
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• 2002

Purpose : To establish and verify the proper and the practical IMRT (Intensity--modulated radiation therapy) patient QA (Quality Assurance). Materials and Methods : An IMRT QA which consists of 3 steps and 16 items were designed and examined the validity of the program by applying to 9 patients, 12 IMRT cases of various sites. The three step OA program consists of RTP related QA, treatment information flow QA, and a treatment delivery QA procedure. The evaluation of organ constraints, the validity of the point dose, and the dose distribution are major issues in the RTP related QA procedure. The leaf sequence file generation, the evaluation of the MLC control file, the comparison of the dry run film, and the IMRT field simulate image were included in the treatment information flow procedure QA. The patient setup QA, the verification of the IMRT treatment fields to the patients, and the examination of the data in the Record & Verify system make up the treatment delivery QA procedure. Results : The point dose measurement results of 10 cases showed good agreement with the RTP calculation within $3\%$. One case showed more than a $3\%$ difference and the other case showed more than $5\%$, which was out side the tolerance level. We could not find any differences of more than 2 mm between the RTP leaf sequence and the dry run film. Film dosimetry and the dose distribution from the phantom plan showed the same tendency, but quantitative analysis was not possible because of the film dosimetry nature. No error had been found from the MLC control file and one mis-registration case was found before treatment. Conclusion : This study shows the usefulness and the necessity of the IMRT patient QA program. The whole procedure of this program should be peformed, especially by institutions that have just started to accumulate experience. But, the program is too complex and time consuming. Therefore, we propose practical and essential QA items for institutions in which the IMRT is performed as a routine procedure.

• 한국노년학
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• v.32 no.2
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• pp.467-485
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• 2012

National Health Insurance Corporation initiated Home and Community Long-term care Agency Quality Assessment(HCLA-QA) program in 2010. This study aims to explore long-term care agencies' perceptions and attitudes toward HCLA-QA program, focused on the home-visit care agencies. Total 473 agencies completed the questionnaires(response rate 13.6%), using the e-mail and fax survey methods with high-capacity web-fax server of NHIC. On the results of this study, we found the agencies' different perceptions and attitudes on HCLA-QA program according to their quality ratings as QA results. Compared to the agencies with low quality ratings, the agencies with high quality ratings tend to have more time for preparation, better understandings about HCLA-QA program, more positive perceptions that quality indicators generally are valid, and more affirmative attitudes that the notifications of QA results are helpful for agencies. Our findings can be very useful for establishing strategies for improving the HCLA-QA program. The policy makers, the insurer, and the agencies need to consider the opinions of the agencies with high quality ratings as well as the ones with low quality ratings.

• The Journal of Information Systems
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• v.12 no.1
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• pp.159-175
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• 2003

During the early stage of radioactive disposal programs, important issues related with quality assurance of data sets, methodologies, R&D procedures are recognized as important ones. This paper focused on the development of web-based workflow standards for the QA procedures of the radioactive waste disposal programs. The flow of process was analyzed based on workflow concepts proposed by the Workflow Management Coalition (WfMC). QA system is based on the principles of T2R3. T2R3 Workflow was used to standardize and restructure the business and/or work process in the industry or organization. The WfMC has identified five functional interfaces to a workflow service as part of its standardization program. They are composed of process definition interface, worklist handler, application program interface, interface between workflows, and system management. The task flow and QA program were defined based on the workflow ideas. QA procedures for the R&D results of radiation disoposal were analyzed following the reference model of workflow. In addition, six program run list were created and implemented. The creation, revision, and approval of the test data were designed to be inplemented on the web environment. Through this system, R&D procedures such as planning, research, documentation, internal review and future independent peer review processes could be well organized and stored more systematically on the database and knowledge base. This will encourage the usage and data sharing between interested parties through it's clear and transparent workflow standards.

• Proceedings of the Korean Society of Medical Physics Conference
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• 2002.09a
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• pp.17-18
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• 2002

Last year, a three-year research program was started in order to establish an external audit system to radiotherapy QA in Japan. It consists of questionnaire surveys, mailed (off-site) dosimetry and visited (on-site) dosimetry at radiotherapy facilities in Japan. The first questionnaire was sent to all Japanese radiotherapy facilities in October 2001, surveying basic QA procedures at each facility. 628 answers were returned with the return rate of 87%. In February 2002, the second questionnaire was sent. Off-site and on-site dosimetry have been tested in several facilities, and will be started soon. We anticipates that this program will gradually grow to a radiotherapy quality control center similar to Radiological Physics Center at MD Anderson Hospital.

• Proceedings of the Korean Society of Medical Physics Conference
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• 2002.09a
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• pp.19-22
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• 2002

The importance of accurate dose delivery in radiotherapy is well documented. Studies have shown that a mere 5% deviation of the prescribed dose can produce an undesirable treatment outcome. Uncertainties in the dose delivery can arise at different stages of the radiotherapy process. Therefore, a good quality assurance programme will ensure the best possible results and consistency of the radiotherapeutic treatment. Quality assurance in any radiotherapy department involves the responsibility of a multi-disciplinary team of radiation oncologists, medical physicists and radiation technologists. This paper will focus on the physical and technical aspects of QA. The organizational structure and responsibility of the physics QA team is outlined and also included the types and frequencies of QA checks. For a QA program to be effective, action levels should be clearly defined and understood by all staff concerned. Data of the Singapore National Cancer Centre's participation over the last ten years with the IAEA / WHO Postal TLD Dose Inter-comparison programme is presented. The data obtained were within the international criteria. For a QA program to be successfully implemented, there must be a commitment by management to provide adequate staff, test equipment, machine time as well as continual training and education. This is in addition to the positive attitudes of all the staff. A quality audit is also necessary to serve as a check and balance to ensure that the QA is in order.

• The Journal of Korean Academic Society of Nursing Education
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• v.5 no.1
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• pp.133-141
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• 1999

Recently there are increasing concerns on quality improvement activities related to difficult economic situations, more competitive environment, health professional's emphasis on quality, and customer's needs in health care. The purpose of this study was to identify educational needs in the quality improvement for staff nurses. Study setting was an acute care hospital having more than 1000 bed in Seoul, Korea. The subjects were 40 staff nurses who participated in the first Quality Assurance(QA) inservice education. Data were collected by self-administered questionnaire which consisted of four parts : QA knowledge and attitude(ten items, by five Likert scale), contents of QA education(ten items, by setting the priority), evaluation of the program(structure, time allocation, place, educational method), and general characteristics of respondents (age, duration to work for hospitals etc.) The response rate was 85%(34/40), Most had positive perspective and attitude about QI/QA activities, but 9% had negative impression and knowledge about this activities. Also they'd like to know the plan of hospital-level QI/QA activities, QI/QA current practice, general hospital system, the role of QA specialist and so on. Consequently, for building the quality improvement activities that is customer-focused, coordinated, outcome-oriented, resource-efficient, collaborative in Korea, at first the education about philosophy, theory, and implementation process of QI/QA should be conducted, and then that on QI/QA terminology, quality indicators development, the analysis and presentation of quality-related data and so forth be followed.

• Journal of Construction Engineering and Project Management
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• v.8 no.1
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• pp.1-9
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• 2018

US transportation agencies are dealing with shrinking budgets, limited work forces, and deteriorating infrastructure. In order to cope with funding uncertainty, state highway agencies are now looking into their own organizations and identifying programs, practices, and processes that have potential for cost saving. A quality assurance (QA) program is an integral part of highway construction and ensures a project's contracted level of quality. The cost of quality (conforming and nonconforming) can constitute a sizable part of total construction cost. As the quality assurance programs evolved, various practices and processes were developed over time and later adopted by state highway agencies. These practices and processes include different QA standards and specifications, varying testing methods, central testing lab vs. on site testing, performance based vs. prescribed quality assurance practices, implementation of innovative quality assurance practices, etc. Therefore, there is an opportunity to assess different QA strategies and recommend those practices that are effective and cost efficient. A national survey was conducted by the authors, which provided a detailed mapping of various QA practices and processes used as part of QA programs and identified areas where agencies can focus on for cost savings. The survey found that QA sampling and testing plans, optimization of sampling plans, optimization of QA standards and specifications, and implementation of innovative test methods and processes are the main areas the agencies should focus to lean the current QA programs.

• Radiation Oncology Journal
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• v.24 no.3
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• pp.185-191
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• 2006

[ $\underline{Purpose}$ ]: Standardization quality assurance (QA) program of CyberKnife for suitable circumstances in Korea has not been established. In this research, we investigated the development of QA program for CyberKnife and evaluation of the feasibility under applications. $\underline{Materials\;and\;Methods}$: Considering the feature of constitution for systems and the therapeutic methodology of CyberKnife, the list of quality control (QC) was established and divided dependent on the each period of operations. And then all these developed QC lists were categorized into three groups such as basic QC, delivery specific QC, and patient specific QC based on the each purpose of QA. In order to verify the validity of the established QA program, this QC lists was applied to two CyberKnife centers. The acceptable tolerance was based on the undertaking inspection list from the CyberKnife manufacturer and the QC results during last three years of two CyberKnife centers in Korea. The acquired measurement results were evaluated for the analysis of the current QA status and the verification of the propriety for the developed QA program. $\underline{Results}$: The current QA status of two CyberKnife centers was evaluated from the accuracy of all measurements in relation with application of the established QA program. Each measurement result was verified having a good agreement within the acceptable tolerance limit of the developed QA program. $\underline{Conclusion}$: It is considered that the developed QA program in this research could be established the standardization of QC methods for CyberKnife and confirmed the accuracy and stability for the image-guided stereotactic radiotherapy.

• The Journal of Korean Society for Radiation Therapy
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• v.10 no.1
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• pp.30-44
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• 1998

Accurate delivery of doses using a high dose rate(HDR) brachytherapy, remote afterloading system(RALS) depends on knowing the strength of the radioactive source at the time of treatment, the precision and consistency of the timer, and the ability of the unit to position the source at the proper dwell location along the applicator. Periodic Quality Assurance(QA) on HDR machines is a part of the standard protocol of any user. The safety of the patient & staff, positional accuracy, temporal accuracy, and dose delivery accuracy are periodically(weekly, quarterly, monthly) estimated using HDR source(Ir-192), treatment planning devices, measurement devices, and overall treatment devices with regard to treatment delivery. The overall measurement results are estimated successfully and assessed its clinical significance. As a result, our HDR brachytherapy units has been very accurate until now. The QA program protocol permits routine clinical use and provides a high confidence level in the accurate operation of HDR units. Therefore, regular QA of HDR brachytherapy is essential for successful treatment.

• Proceedings of the Safety Management and Science Conference
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• 2004.11a
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• pp.277-287
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• 2004

This study presents a method of quality category classification by safety, maturity, complexity, and what types and extent of controls and verifications are applied to specific products and services during the various stages of a nuclear facility life cycle. All products, services and processes have various controls and verifications built in to ensure they perform their functions satisfactorily. The highest grade should require the most stringent application of the quality assurance requirements ; while, the lowest grade should require the least stringent. When products or services are modified, the assigned grade of quality assurance requirements could become more stringent or less stringent depending on the significance in nuclear safety. Applying QA program always costs money, and they should be applied and focused to the extent where necessary and not applied or applied to a lesser degree for less important activities. An efficient QA program should be developed to satisfy the necessary requirements and to ensure the required confidence in quality, but without unnecessary stipulations. Not all the requirements of QA standard must be applied identically to all products and services which are to be provided.