Purpose: The objectives of this study were to understand and compare perception and experience between clinical staffs(nurses and pharmacists) and Quality Improvement managers. Method: A qualitative study was conducted with 14 clinical staffs and QI managers who are working at tertiary hospitals in Korea. Interviews were recorded and transcribed for systematic analyses of qualitative data. Results: Most critically, while QI managers acknowledged that establishment of the patient safety culture and reduction of medical errors are urgent tasks for QI effort, clinical staffs don't seem to share such perceptions. All participants agree that staff shortage and no compliance to safety procedures were major reasons for medical error occurrences. Many suggested that an organizational culture where errors were perceived as a systematic problems rather than individual failures or carelessness should be formed to promote voluntary reporting of medical errors. Conclusion: A more systematic effort and attention at the hospital leadership and public policy level should be promoted to constitute societal consensus on the urgence of promoting patient safety culture and more specific approaches to tackle the patient safety problems.
Kim, Chul Eung;Ko, Young-Mi;Lee, Sang-Uk;Choi, SungKu;Han, Kiwan;Park, Se Jin;Jo, MinKyung;Park, Yu Kyong;Lee, Hye Young;Park, Subin
Osong Public Health and Research Perspectives
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제9권6호
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pp.314-324
/
2018
Objectives: The aim of this study was to analyze research and development projects in mental health services in Korea, using priority evaluation of mental health promotion policies to determine direction of the service. Methods: An online survey was conducted that targeted experts in the mental health service regarding promotion of mental health in Korea in 2016. The survey was based on 32 policy projects that resulted from 12 strategies according to 4 policy objectives. Results: Analysis of 32 mental health projects were assessed regarding the possibility of technology development success, magnitude of the ripple effect, and necessity of a national response. It was observed that 3 policy projects relevant to suicide, had a high relative priority. This was followed by policies for improvement of health insurance and the medical benefit cost system, and policies for reinforcement of crisis psychological support such as those for disaster victims. Conclusion: The prioritization of mental health services should place an emphasis on promotion of a healthy mental lifestyle, rehabilitation support for patients with serious mental illness, and reinforcement of social safety networks for suicide prevention.
Background & Objectives : Korea is face with the social need for health care technology assessment so that it is urgently needed to found principles and methodology in technology assessment in health care. As a groundwork for health care technology assessment, we tried to prioritize medical technology for assessment. Among medical technologies, procedure is somewhat difficult to assess, compared to drug or equipment. In this study, we aimed at the prioritisation of medical procedure to be assessed, in terms of efficay, safety, and adequacy. Method : For the standardized classification of medical procedure, ICD-9-CM(International Classification of Diseases 9th edition - Clinical Modification) was used. Among the list the procedures coming under otorhinolaringjology and thoracic surgery were selected by three family physicians. The list of procedure was mailed to the board certified surgeons of both disciplines, with the question asking about the necessity for assessment in terms of efficay, safety, and adequacy. Replied questionnaires were analyzed in each procedure. Results : Of 560 otorhinolaryngologist and 480 thoracic surgeon, 114 surgeons replied. Of otorhinolaryngological procedure, incision, excision, and destruction of inner ear : fenestration of inner ear : stapedectomy and its revision were the most urgent technology to assess in the aspect of safety. For adequacy, operations on Eustachian tube: fenestration of inner ear: incision, excision, and destruction of inner ear were highly ranked in necessity, and for efficary, operations on Eustachian tube; external maxillary antrotomy; fenestration of inner ear. Thoracic surgeons replied thoracic procedures, lung transplantation; heart transplantation; implantation of heart assist system [pump] are most important for evaluation in terms of safety; and heart transplantation; Lung transplantation; Implantation of heart assist system [pump] in terms of adequacy, and surgical collapse of lung [Artificia니 pnemothorax or pnuexoperitoeum]; lung transplantation; periarterial sympathectomy in terms of efficacy. As a whole, surgeons regard safety evaluation is more urgent than adequacy or efficary. In addition, otorhinolaryngological surgeons regard evaluation of their procedures more urgent than thoracic surgeons regard theirs. Conclusion : By the questionnaire to board certified physicians, we get some preliminary data for prioritisation of technologies to assess. Through the questionnaire like this, much information would be gathered for technology assessment, especially for medical procedure, if not enough. In the near future, well structured expert opinion gathering research, such as modified Delphi or nominal group technique, should be done succeedingly.
Objectives : Aim of this study is to contribute to establishment of the Traditional Korean Medicine (TKM) policies in the future. Final assessment for 12 of the forecasting projects was carried out on the TKM policies that deduced by professionals in 1996 whether or not to realize in 2013. Methods : We investigated governmental and private research projects, reports and papers, and laws and systems on the forecasting projects. We reviewed them through the Traditional Korean Medicine Information Portal OASIS (http://oasis.kiom.re.kr), Korean studies Information Service System (KISS) (http://kiss.kstudy.com/) and DBpia (http://www.dbpia.co.kr/), Akomnews(http://www.akomnews.com/), THE MINJOK MEDICINE NEWS(http://www.mjmedi.com/), Ministry of Government Legislation(http://www.law.go.kr/). Results : Of the 12 forecasting projects, five were judged as 'realization', four were as 'partial realization' and three were as 'un-realization', The realization rate was 75.0%. Three un-realized projects included the TKM insurance coverage for various herbal medicines, leadership secure on medical technicians and commercialization of the TKM managing system on senior medicare policy. Realization of the future forecasting TKM policy projects was decided depending on conditions such as the importance, domestic capability levels, principal agents, methods and restrains. Conclusions : Continuous studies and new developed forecasting projects for the TKM policies will be required to realize the projects in the future.
Objectives: To investigate the use frequency and amount of food sources of sodium and knowledge requirement, and job satisfaction with school food services according to the school types in Busan. Methods: A total of 98 schools were surveyed and knowledge requirement and job satisfaction were assessed using a questionnaire. In addition, the use frequency and amount of food sources of sodium for 10 school days were examined. Results: The response rate of the most difficult area among dietitians' tasks was significantly high in 'nutrition education and counseling' for elementary schools and 'hygiene management' for high schools (p < .05). The response rate of the factors to be considered in meal planning was significantly high in 'energy and nutrients requirement' for elementary schools and 'menu/taste preference of students' for middle and high schools (p < .05). The response rate of whether school food services affect health and eating habits of students or not was significant high in 'very helpful' for elementary schools (p < .001). The average sodium contents in the meals of elementary, middle and high schools was 1981.4 mg/meal/person/day, 1867.3 mg/meal/person/day and 1,329.9 mg/meal/person/day, respectively. For foods in highest sodium, Kimchi, Oribulgogi, and Kare rice were ranked 1st, 2nd and 3rd respectively. The main reason for not providing the fruits was 'price' among all groups. The knowledge requirement such as 'nutrition and menu management', 'nutrition education', and 'nutrition counseling' was significantly higher in elementary school compared with middle and high school (p < .001, p < .01, and p < .01 respectively). The dietitians and nutrition teachers of elementary schools have a higher job satisfaction compared with those of middle schools (p < .01). The job satisfaction was positively correlated with knowledge requirement of dietitians and nutrition teachers of elementary and middle schools. Conclusions: The results suggest that developing dietitians' education program about knowledge requirement contribute to increasing the school food service and job satisfaction in elementary and middle schools.
BACKGROUND/OBJECTIVES: The current South Korean government policy on food irradiation technology should be reformed based on an in-depth investigation of the communications aspect, because the issue is no longer of a technological nature, given the proven safety and efficacy of the processes. SUBJECTS/METHODS: The target population of the education program consisted of elementary, middle, and high school students attending 310 schools in South Korea (2013: 63 schools, 2014: 104 schools, 2015: 143 schools). Data subjected to analysis were 13,327 pre-education and 12,641 post-education questionnaires received from 7,582 elementary, 2,671 middle, and 3,249 high school students who participated in the education program from May 2012 to April 2015 (n = 12,831), after the exclusion of inadequately filled-in questionnaires. RESULTS: Analysis of the three-year educational effect trend was conducted by comparing levels of variables before and after food radiation education. The analysis yielded the finding that the post-education levels were significantly higher for all variables. That is, for interest in education, perception (necessity, safety, subjective knowledge, and information acquisition), objective knowledge, and attitude, with the sole exception of objective knowledge in 2013. CONCLUSIONS: Given that post-education levels of perception, knowledge, and attitude concerning irradiated foods increased considerably compared to pre-education levels, behavior change should be induced by providing continuous education to enhance, these primary variables.
RAMS is becoming increasingly important in the decision making process for the rolling stock projects in order to improve competitiveness by reducing system life cycle cost while improving reliability, availability, maintainability and safety. In order to apply and manage RAMS of rolling stock systems effectively in the operator perspective, it is essential to integrate and control RAMS systematically from the early stage of rolling stock projects. RAMS management is to implement a RAMS system into rolling stock projects in terms of a rolling stock operator, which presents the strategic directions of RAMS policy, objectives, requirements, control, analysis, measurement and improvement throughout life cycle of rolling stock projects. This article presents a new framework of RAMS management that provides an effective and efficient way for managing RAMS in rolling stock systems in the railway industry.
Objectives: This study examined the status of children's favorite foods intake and the relationship with the policy environment based on the Special Act on Safety Control of Children's Dietary Life for suggesting a supportive policy strategy. Methods: The subjects were 4th grade students (n=1,638) in elementary school from 45 schools collected from seven areas (Seoul, Daegu, Daejeon, Gyeonggi, Chungnam, Jeonbuk, and Gyeongnam). The children participated in a self-administered questionnaire survey in class under the supervision of the teacher. The questionnaire consisted of items, such as social demographic characteristics, frequency of intake of the children's favorite foods, and policy cognition. A t-test and ANOVA were applied to explore the relationship between the frequency of children's favorite foods intake and policy cognition. The survey was implemented from August 2016 to September 2016. Results: For the boys, the frequency of 'high-calorie low nutrient foods intake' (HCLN) was significantly higher than that of the girls (p<0.01). For the children who received information on their favorite foods from the internet, the frequency of HCLN was higher than the other sources (p<0.01). The time of TV viewing and computer usage, and smartphone usage was associated with a higher frequency of HCLN, and a lower healthy favorite food intake (all p<0.001). The intake frequency of healthy favorite foods indicated a positive correlation with the policy cognition, including policy perception, usefulness, necessity and buying intention, and educational experience. Conclusions: This study showed a correlation with the frequency of children's favorite foods intake and policy. In particular, the frequency of children's healthy favorite foods intake indicated a meaningful relationship with the policy than the frequency of HCLN. This study also found that the consumption of children's healthy favorite foods was positively correlated with the educational experience. To develop a supportive policy for a good dietary environment for children, there is a need to focus on how to collaborate with multiple levels of influences, such as the national level, school level, and family.
Objectives : A safety culture is the bedrock for all patient safety improvement initiatives; thus, many resources have been invested in measuring hospital culture. However, many of these endeavors have failed to yield meaningful results. This article proposes a practical checklist to ensure successful administration of a safety culture survey and describes current methodologies for analyzing survey results to develop safety improvement programs. Methods : We reviewed currently used safety culture surveys and summarized their strengths and weaknesses. We also reviewed studies using safety culture surveys and found several pitfalls leading to failure in survey administration. With this information, we developed a checklist that covers critical items in the survey process. We also reviewed newly developed methodologies for survey results analysis and application and described them using the Korean version of the Safety Attitudes Questionnaire as an example. Results : The checklist consists of three steps: survey preparation, administration, and analysis and application. Each step contains clear action items. The content even describes how to get buy-in from hospital executives and manage communication channels with them. Also, common misunderstandings regarding survey scores are described and possible solutions are suggested. In the analysis section, we demonstrate new methods for obtaining more accurate survey results and how to utilize these methods to develop and implement hospital-wide safety improvement programs. Conclusion : A successful safety culture survey is the foundation of all future safety improvement projects. This review is intended to guide hospitals in enhancing safety.
Kim, Jihyun;Yon, Miyong;Kim, Cho-il;Lee, Yoonna;Moon, Gui-Im;Hong, Jinhwan;Hyun, Taisun
Nutrition Research and Practice
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제11권3호
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pp.240-246
/
2017
BACKGROUND/OBJECTIVES: Folic acid supplementation before pregnancy is known to significantly reduce the risk of having a baby with neural tube defects (NTDs). Therefore, it is important for women to be aware of the effects of folic acid supplementation before pregnancy. The purpose of this study was to investigate the awareness and preconceptional use of folic acid and to assess the current knowledge about folic acid among low-income pregnant women in Korea. SUBJECTS/METHODS: A questionnaire survey was conducted in 2012. Five hundred pregnant women were selected from the waiting list for the Nutriplus program implemented in public health centers using a multistage clustered probability sampling design. Data from 439 women were analyzed after excluding ones with incomplete answers. RESULTS: Among women who responded to the questionnaire, 65.6% had heard of folic acid before pregnancy, and 26.4% reported on the preconceptional use of folic acid. Women with a university degree or higher education were more likely to be aware of folic acid and to take folic acid in the preconception period. In a multivariate logistic regression, when age, education level, household income, employment status, gravidity, parity, and folic acid awareness were included in the model, folic acid awareness was a strong predictor of preconceptional folic acid use. As of interview, 85.4% and 77.7% of women were aware of the NTD-preventive role of folic acid and the appropriate time to take folic acid, respectively. The main sources of information on folic acid were healthcare professionals (41.2%), friends and family members (31.2%), and the media (26.5%). CONCLUSIONS: Our results suggest that public health strategies are needed to increase the preconceptional use of folic acid among Korean women.
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