• Title/Summary/Keyword: Quality of Medical Services

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Activities to Improve the Accessibility to clinical social work for Patients from Vulnerable/Disadvantaged/Marginalized Social Groups (취약계층 환자의 의료사회 복지서비스 접근성 증진 활동)

  • Hur, Lib;Lee, Young-Sook
    • Quality Improvement in Health Care
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    • v.19 no.2
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    • pp.80-88
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    • 2013
  • Objectives: With the increase in the number of people who are marginalized in receiving medical services, the role of Seoul National University Hospital as a public hospital is being emphasized. However, many patients are either experiencing delays in receiving medical services or simply being left out as a result of the inaccessibility to the department of social work on part of both the patients and the medical staff. Methods: In order to increase consultation from other departments and the accessibility to the department of social work for the socially marginalized group through early consultation from other departments, the following steps were taken. First, an orientation program for novice medical residents led by clinical social worker was introduced/implemented. Second, posters and brochures on various financial aids programs were produced and distributed. Third, a system of early screening was built/constructed, and once a week rounds and early screening meeting were executed/carried out. Result: The department of social work's rate of consultation from other departments increased by 4.4% compared to last year, while it showed 61% increase for those wards that had an early screening meeting. In addition, the average time of consultation from other departments was reduced by 3.1 days, securing sufficient amount of time for clinical social work services, both in terms of quality and quantity. Conclusion: It is believed that the various promotional activities, along with the strengthening of accessibility to clinical social work services and early consultation on part of social disadvantaged/marginalized group, would undoubtedly help provide quality services to patients and increase their level of satisfaction. In this way, the wards can effectively reduce the number of unnecessary hospital stay days while the hospital can prevent the accumulation of outstanding bills/fees as well as contribute to the publicness of hospitals. The promotion of clinical social work programs in various ways are crucial to ensuring the satisfaction of patients and hospital staff.

Factors Affecting Quality of Nursing Services and Intention to Revisit as Perceived by Hospitalized Patients and Nurses in Medium Sized Urban Hospitals (일 지역 중소 종합병원 입원환자와 간호사가 지각한 간호서비스 질과 의료기관 재이용 의도에 영향을 미치는 요인)

  • Kim, Ki Sook;Ha, Eun Ho
    • Journal of Korean Clinical Nursing Research
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    • v.15 no.2
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    • pp.103-114
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    • 2009
  • Purpose: The purpose of this study was to investigate factors which affect the quality of nursing services and intention to revisit as perceived by hospitalized patients and nurses in medium sized urban hospitals. Methods: The SERVQUAL scale, a measurement of overall nursing services and intention to revisit a medical institution, was used. The sample consisted of 223 patients and 239 nurses from four medium sized hospitals in I city. Frequencies, t-test, One-way ANOVA, Pearson correlation coefficient and Stepwise method regression were used to analyze the data. Results: For expectation, nurse and patient perceptions were similar, but for performance, patient perception was significantly higher than nurse perception for five factors. The factors affecting intention to revisit the hospital were those recommending, satisfaction with medical and nursing services. Conclusion: The findings indicate that differences between expectations and performance for both patients and nurses need to be reduced in order to elevate patient satisfaction. A precondition for intention to revisit and increased satisfaction is the development of marketing strategies as well as intervention programs in nursing.

A study on the quality of medical social work influenced by organizational culture of hospital (조직문화가 의료사회사업서비스의 질에 미치는 영향에 관한 연구)

  • Kang, Heung-Gu
    • Health Policy and Management
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    • v.12 no.4
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    • pp.34-55
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    • 2002
  • In this study, the impact of organizational culture on the quality of social work services in hospitals were empirically analysed. A mailed questionnaire survey was conducted between February 19 and April 10, 2001. A sample of total 70 hospitals, including general hospitals with one social worker at least and single-department hospital with two social workers or more, were identified nationwide through the registry of Korean Association of Medical Social Workers and Korean Association of Hospitals. According to coping strategy and reacting pattern with the environmental changes, four types of organizational culture in each hospital, classified as group culture, developmental culture, hierarchial culture, and rational culture, were adopted for the independent variables. Three dimensional aspects of quality of social work service - structure, process, and outcome were selected as dependent variables in this study. Also the quality of social work service was distributed into provider-perceiving quality and consumer-perceiving quality The major findings were as following in summary; First, most social workers reported that the characteristic of culture in their hospitals are group culture the first, hierarchial culture the second, developmental culture the third, and rational culture finally in order of comparing the level of quality perceived between social worker's recognition. Second, service provider and consumer, The provider-perceiving quality showed less score than that of consumer, especially the lowest was the score of quality of outcome perceived by provider. Third, according to the types of organizational culture, there were significantly different levels of quality in total social work services, structure dimension and process dimension. The quality of outcome dimension did not show significant differences among the type of organizational culture. Finally, the most influential variables to the quality of social work service ice proved departmental form of social work unit, leader of social work unit, and developmental culture of hospital To assure quality services, accordingly, social work unit in hospital is required to be organized as a single unit, that means to be an independent department of which qualified social worker is supposed to control the unit. It is strongly recommended to develop leadership for the leaders of social work unit.

Choice of Medical Care Institution for Delivery and Evaluation of the Institution after Delivery (분만기관 선택과 이용 후의 평가)

  • 권순호;한달선
    • Health Policy and Management
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    • v.8 no.2
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    • pp.1-24
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    • 1998
  • There exists a general consensus in Korea that patients tend to concentrate in large hospitals and this tendency is partly responsible for inefficiency in health services. The process of choosing a medical care provider for health care services and evaluating the provider after utilization seems to involve many diverse factors to become very complex. Therefore a systemsatic study is needed to achieve sufficient understanding of the proeess. For this point of view, this study investigates patient's selection of medical care institution for delivery care services and their evaluation of the institution after delivery. In more specific, the objectives of the study are twofold: 1) to identify the factors associated with expectant mothers' choice of type of medical care institution for delivery among tertiary hospitals, general hospitals, small hospitals, and clinics: and 2) to understand the factors affecting patient evaluation of the medical care institution after delivery. The data used for the analysis were collected through face-to-face interviews with those women who had childbirth during the period from January 1, 1996 to the date of interview in February 1998. The survey was conducted using preqared structured questionnaire in Seoul. The sample was drawn from each of arbitrarily defined four regions of Seoul, Northeast, Northwest, Southeast and Southwest, in proportion to the number of births reported in 1996 in each of them. The distribution of the interviewed women by educational level was made similar to that of mothers of new babies reported in 1996. The sample size was planned to be about 300, but ended up with analytical sample of 319. Major conclusions emerged from the analysis can be summarized as follows: 1) Large hospitals were evaluated as much better for technical quality than other types of institutions, whereas they were compared similar to or worse for other attributes. And it was found that technical quality of care is considered as the most important condition of medical care institution for delivery, while the amount of direct cost is considered as the least important one. Taken together, the utilization of large hospitals is not likely to decrease even though they cannot give satisfaction to patients in other aspects than technical quality. 2) The activeness in the search for information affected the respondents' evaluation of medical care institutions, which would influence their later decision or recommendation to other persons as to the choice of source of health care services. Therefore, increased efforts should be directed to improving availability of useful and correct information for patients in relation to the utilization of health care services. 3) Since the findings of this study were obtained from the analysis of delivery care services, their applicability to other kinds of services may be limited. Thus it would be useful to conduct a comparative study of several kinds of services explicitly taking into account the characteristics of those services in the analysis.

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Back strength and relevance of CPR chest compression (배근력과 심폐소생술의 가슴압박과의 관련성)

  • Choi, Sung-Soo;Han, Mi-Ah;Yun, Seong-Woo;Ryu, So-Yeon
    • The Korean Journal of Emergency Medical Services
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    • v.17 no.2
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    • pp.57-64
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    • 2013
  • Purpose : The purpose of the study is to investigate the quality and relevance of back strength or chest compression which is applied by isotonic exercise of hip joint. Methods : Subjects were 37 students who participated in the BLS course and accepted the informed consent from December 7 to 8, 2012. During CPR performance, back strength was measured by the researcher. CPR was used the manikin for practical training with using PC, conducted by standard CPR for 2 minutes, Quality of chest compressions included average chest compression depth, rate, and recoil ratio. Results : Back strength (kg) is related to the chest compression depth (mm) (r =.746, p <.001). The high quality CPR is the most important factor so high quality is full chest recoil of chest compression and chest compression depth (mm) (${\beta}$=.831, p <.001). In this study, chest compression rate and recoil ration were not influenced by back muscle strength. Conclusion : It is necessary to implement the CPR program to improve physical strength and effective performance of CPR.

Geospatial Analysis for Oriental Medical Services of Jinju (진주시 한의원 의료서비스 공간특성분석)

  • Kim, Mi Song;Yoo, Hwan Hee
    • Journal of Korean Society for Geospatial Information Science
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    • v.22 no.3
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    • pp.107-112
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    • 2014
  • In keeping with the increasing demand for medical services in accordance with the economic development, the use of oriental medicine is on the rise year by year. In particular, it is a tendency that the elderly over age 65 prefer the oriental medicine to the western medicine in Korea. Under the circumstance, changing into an aging society, the importance of oriental medical services has been growing. In this regard, this study evaluated the quality of medical services by conducting the density analysis and the accessibility analysis of oriental medical clinic targeting Jinju, which is one of local small and medium-sized cities. The study results reveal that oriental medical hospitals accounted for 27% of the entire medical facilities in Jinju, and there was an imbalance in the quality of the oriental medical services according to districts(called dong) because oriental medical hospitals were mainly concentrated in the central commercial areas. In particular, in terms of the analysis on the accessibility of an aging population over age 65 to the oriental medical hospitals, over 50% of the whole districts (dongs) in Jinju were blind spots in medical services, showing a very vulnerable condition. Accordingly, it is judged that systematic measures for improvement in support of the oriental medical services in local small and medium-sized cities should be provided in Korea when we consider the characteristics of Korea where an aging population is rapidly increasing.

Group Antenatal Care: A Paradigm Shift to Explore for Positive Impacts in Resource-poor Settings

  • Gaur, Bhanu Pratap Singh;Vasudevan, Jyothi;Pegu, Bhabani
    • Journal of Preventive Medicine and Public Health
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    • v.54 no.1
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    • pp.81-84
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    • 2021
  • The delivery of high-quality antenatal care is a perennial global concern for improving maternal and neonatal outcomes. Antenatal care is currently provided mainly on a one-to-one basis, but growing evidence has emerged to support the effectiveness of group antenatal care. Providing care in a small group gives expectant mothers the opportunity to have discussions with their peers about certain issues and concerns that are unique to them and to form a support system that will improve the quality and utilization of antenatal care services. The aim of this article is to promote group antenatal care as a means to increase utilization of healthcare.

Effects of job stress and burnout on the quality of life among 119 EMTs (119 구급대원의 직무스트레스, 소진이 삶의 질에 미치는 영향)

  • Yun, Yu-Jin;Hong, Sun-Woo
    • The Korean Journal of Emergency Medical Services
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    • v.22 no.3
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    • pp.131-148
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    • 2018
  • Purpose: This study examined the associations of job stress and burnout with the quality of life (QOL) among 119 emergency medical technicians (EMTs). Methods: Using a descriptive correlational design, 260 EMTs working in D City or S City completed the questionnaires. Hierarchical multiple regression analysis was conducted to determine the predictors of QOL among 119 EMTs. Results: Overall, there was relatively low job stress among 119 EMTs. There were significant differences in job stress and burnout by general characteristics, especially regarding those of gender, service career, job rank, and self-reported health. In a hierarchical multiple regression, general characteristics explained 29% of QOL (Model I, F=16.369, p<.001). The explanatory power for QOL increased to 49% upon adding job stress (Model II, F=18.737, p<.001), and 59% upon adding burnout (Model III, F=22.621, p<.001). In the last model, self-reported health (${\beta}=.316$, p<.001), job demand (${\beta}=-.130$, p=.009), job insecurity (${\beta}=-.136$, p=.010), lack of reward (${\beta}=-.189$, p=.001), emotional exhaustion (${\beta}=-.196$, p=.004) and lack of personal accomplishment (${\beta}=-.334$, p<.001) were significant predictors of QOL among 119 EMTs. Conclusion: Based on the results, it is necessary to assess and manage job stress and burnout systematically among EMTs, and to develop health improvement programs for better QOL.

The Effects of Tele-care Case Management Services for Medical Aid Beneficiaries (일 시범 지역 의료급여수급권자 대상의 텔레케어 사례관리 효과)

  • Ahn, Yang-Heui;Kim, Eui-Sook;Ko, Il-Sun
    • Research in Community and Public Health Nursing
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    • v.21 no.3
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    • pp.351-361
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    • 2010
  • Purpose: This study was done to analyze the effects of tele-care case management services using secondary data. Methods: A descriptive research design was utilized, and the participants were 134 medical aid beneficiaries who were in either the high-risk group or the preventive group. Casemanagement services were delivered by 8 care managers. Data were analyzed using PAWS Statistics 17 through descriptive statistics and paired t-test. Results: After the case management intervention, the participants' health quality of life, self-care competency, and reasonable medical care utilization increased significantly for the high-risk group. However there were no significant changes in the preventive group. Conclusion: The results showed that the tele-care case management services were effective for high-risk medical aid beneficiaries. Further studies with controls for constitutional variables and a comparison group are required to validate the robustness of the effectiveness of the case management program in the present study.

Comparison of chest compression and ventilation volume using LUCAS and manual in virtual reality-based ambulance simulation -A manikin study- (가상실현 기반 구급차에서 루카스와 수기에 의한 가슴압박과 인공호흡 비교 -마네킨 연구-)

  • Lee, Jae-Gook;Kim, Jin-Su;Roh, Sang-Gyun
    • The Korean Journal of Emergency Medical Services
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    • v.22 no.3
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    • pp.67-76
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    • 2018
  • Purpose: The purpose of this study was to evaluate the quality of chest compressions and ventilation when using an mechanical device(LUCAS) and 2-men manual cardiopulmonary resuscitation(CPR) performed on a minikin, as well as to propose a more effective CPR method during transit. Methods: Data were collected by LUCAS and manual virtual reality based ambulance simulation. Analysis was performed using SPSS software 12.0. The average and standard deviation of chest compression depth and ventilation were analyzed using descriptive statistics and t-test. Results: In the virtual reality based LUCAS and manual CPR results, LUCAS showed better chest compression and lower incomplete chest release than manual CPR. During CPR with a chest compression-ventilation ratio of 30:2 in virtual reality ventilation with bag-valve mask was able to deliver an adequate volume of breathing. Conclusion: It is suggested that rescuers on ambulance may consider using LUCAS as an alternative to high-quality chest compression during transit.