• 한국병원경영학회지
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• 제22권3호
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• pp.74-87
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• 2017

Purposes: The purpose is to establish the direction of healthcare R&D through private nonprofit organization. Methodology: The data is divided into two groups: 12 physicians and pharmacists, and 16 persons including professors related to university donation, non-profit foundation executives. Each group was subjected to two Delphi surveys. To analyze the validity of the opinion, the content validity ratio and the consensus of experts were verified. Findings: Funding should be invested in 'development research' and 'application research'. The factors that hinder the donation culture are 'donation prevention system such as tax imposition system and rebate double penalty system', 'insufficient motivation of fund raising person', and 'lack of fund specializing specialist'. The fund raising strategy should be centered on a small number of large donors or a balance between large and small donors. The fund raising target should be effective to raise funds for corporate and individual donors. It is necessary to clarify the purpose of the social problem to be solved by the campaign strategy for promoting donation, to announce the validity of the trust and transparency of the institution, and to emphasize the social investment by the private sector. Practical Implications: It is necessary to present directions through private nonprofit organizations for the future development of healthcare R&D. The legal and institutional deficiencies of the domestic nonprofit organization fundraising infrastructure should be improved. In order to create a social investment climate, it is necessary to improve the awareness of donations and develop various donation programs for the private sector.

• Journal of Preventive Medicine and Public Health
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• 제50권2호
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• pp.68-82
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• 2017

Objectives: We performed a systematic review to assess and aggregate the available evidence on the frequency, expected effects, obstacles, and facilitators of disclosure of patient safety incidents (DPSI). Methods: We used the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines for this systematic review and searched PubMed, Scopus, and the Cochrane Library for English articles published between 1990 and 2014. Two authors independently conducted the title screening and abstract review. Ninety-nine articles were selected for full-text reviews. One author extracted the data and another verified them. Results: There was considerable variation in the reported frequency of DPSI among medical professionals. The main expected effects of DPSI were decreased intention of the general public to file medical lawsuits and punish medical professionals, increased credibility of medical professionals, increased intention of patients to revisit and recommend physicians or hospitals, higher ratings of quality of care, and alleviation of feelings of guilt among medical professionals. The obstacles to DPSI were fear of medical lawsuits and punishment, fear of a damaged professional reputation among colleagues and patients, diminished patient trust, the complexity of the situation, and the absence of a patient safety culture. However, the factors facilitating DPSI included the creation of a safe environment for reporting patient safety incidents, as well as guidelines and education for DPSI. Conclusions: The reported frequency of the experience of the general public with DPSI was somewhat lower than the reported frequency of DPSI among medical professionals. Although we identified various expected effects of DPSI, more empirical evidence from real cases is required.

• 대한간호학회지
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• 제27권1호
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• pp.178-188
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• 1997

As a descriptive survey, this study was attempted to get basic data necessary to recognize the factors that disturb the therapeutic atmosphere of hospital wards as perceived by nurses and hospitalized patients, to identify differences between the perceptions of the nurses and of patients. The subjects, 159 patients in Pusan National Hospital and 68 nurses working there were sampled between March 18 and April 13, 1996. The tool used to measure the disturbing factors was an amended form of the one developed by Kim, Mae Ja(1983). The differences between each subject's score for each factor were analyzed using means & SD. and the highest 3 items above the mean score for each factor were collected and compared. The results are described below : 1. Subject's perception of main disturbing factors : patients reported that the main factors were 'loss of role & economic trouble', 'the prognosis of disease', 'the change of daily life' but nurses replied that the main factors were' the prognosis of disease', 'the communication trouble with the medical team & interpersonal relationships'. 'The change of daily life' was not a perceved factor by nurses, but ranked third by the patients. 2. Subject's perception degree of each disturbing factor : (1) among the items related to interpersonal relationship. the patient group reported that the worst disturbance was dur to severely ill patients in the same room' but the nurse group regarded 'greed to monopolize wheelchairs or other supplies' as the worst disturbance. (2) among the items related to physical factors. the patient group regarded 'limitations to wash their body, physical pain and limitations in physical activity' as the worst disturbance, but the nurse group regarded' physical pain', and 'limitations to activity or change of appearance' as the worst disturbance. (3) among the items related to the change of daily activity, the patient group regarded 'the boredom of hospitalization or infavorable diet' as the worst disturbance, but the nurse group regarded 'too much noise or unclean room' as the worst disturbance. (4) among the items related to the communication trouble with medical team, the patient group regarded 'the ignorance of their disease due to poor information. the inability to understand the language of the medical team or the difficulty in seeing physician in time' as the worst disturbance, but the nurse group regarded 'the inability to trust physicians and physician's poor attention to patients' as the worst disturbance.

• 핵의학기술
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• 제12권3호
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• pp.214-221
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• 2008

목적 : 융합 SPECT/CT가 기존 SPECT에 비해 병소의 해부학적 위치를 정확히 판단할 수 있는지 정성 평가하고, CT 감쇠 보정이 SPECT 영상에 미치는 효과를 알아보아 SPECT/CT의 유용성을 제시하고자 한다. 실험재료 및 방법 : 1. 융합 영상의 평가 : 2008년 1월(月)부터 8월(月)까지 Precedence 16 혹은 Symbia T2에서 $^{131}I$-MIBG, Bone, $^{111}In$-Octreotide, Meckel 게실, Parathyroid MIBI 등을 SPECT/CT 시행한 환자를 대상으로 하였고, SPECT/CT영상을 융합한 것과 하지 않은 것을 비교하여 정성 평가하였다. 2. 감쇠보정의 평가 : Symbia T2로 2008년 6월에서 8월까지 $^{201}Tl$ 심근 검사를 한 환자 38명을 대상으로 Cedars-Sinai의 QPS를 이용하여 산출하였다. Ant, Inf, Lat, Septum, Apex로 5개부분으로 분류하고, 각 부분에 대한 관류의 상태를 백분율로 산출했다. CT AC와 Non AC를 평균${\pm}$표준편차로 각 부분에 대한 관류 상태를 비교하고 차이를 분석하였다. 결과 : 1. 융합 영상의 평가 : 에너지가 높은 $^{131}I$ SPECT의 경우 병소와 주위 조직 간의 섭취율 차이로 인해 (주위 조직이 saturation 됨) 병소의 위치 파악이 어려웠으나 CT로 융합한 결과 해부학적 위치를 정확히 평가할 수 있었다. 또한 멕켈게실이나 $^{111}In$과 같이 장이나 장기쪽에 질환을 찾는 경우에는 그 우수성이 더욱 뛰어 났다. Bone SPECT/CT는 척추간의 구별을 확실히 할 수 있어 임상의가 정확한 결과를 제시하는데 도움을 준다. 2. 감쇠 보정의 평가 : 감쇠 보정 전후의 관류 백분율의 차이가 Ant, Lat에서는 통계적으로 유의한 차이가 없었으나(p>0.05), Inferior, Apex, Septum에서는 유의한 차이가 있었다(p<0.05). 차이를 보이는 값 중 Inferior Wall에서 CT AC perfusion : $76.84{\pm}6.52%$, Non AC perfusion : $68.58{\pm}7.55%$로 CT 보정에 의한 차이가 $8.26{\pm}4.95%$로 가장 크게 측정되었다(t=10.29, p<0.01). 결론 : SPECT에 CT가 부착되면서 병변의 기능적 활성도를 나타내는 분자학적 영상은 물론 병변의 해부학적 위치 정보를 보다 정확하게 확인할 수 있게 되었다. 이것은 비정상적 부위를 찾아내는 것에 그치지 않고 복잡한 인체 부위에서 정상군과 비정상군을 분리하는데 많은 도움을 주게 되었다. 따라서 임상의는 하나의 검사 영상으로 진단과 치료계획을 동시에 시행할 수 있을 것이다. 또한 감쇠가 잘 되는 흉곽 부위 안에 있는 심근 검사에는, CT로 보다 정확한 감쇠 보정을 할 수 있기 때문에 SPECT 검사 시 관심부위의 관류 상태를 더욱 신뢰할 수 있어 치료 예후의 정당성을 입증할 수 있을 것으로 판단된다.

• 한국의료질향상학회지
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• 제7권1호
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• pp.118-131
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• 2000

Background : A continuous healthcare quality improvement is needed to provide high quality healthcare service as well as to maintain trust in terms of satisfying the needs of the patients. Recently it also became an essential issue. in hospital management, recognized for it's competitive potentiality among healthcare organization groups. This study was conducted to analyze patient complaints and issues received by the Quality Improvement Department. Its purpose is to improve healthcare qualities within the hospital, as well as establish policies and appropriate strategies in hospital management. Method : From July 1st to September 30th of the year 1999, we analyzed all complaints and issues made by various patients and their families, which were received through 24 hour phone consultation, numerous suggestion boxes, letters and E-mails, The issues were classified into 16 different categories based on a Patient Satisfaction Assessment Tool. All data were segregated according to the departmental frequencies and their contents. To come up with for environmental and patient satisfaction improvement, all complaints or issues were communicated with hospital administrators, medical and nursing staff and employees. Comprehensive customer satisfaction activities including improving phone etiquette were discussed in Customer Satisfaction Team, CQI Team and each Department. All opportunities for improvement were implemented. Feedback actions were discussed. Results : A total of 317 cases were collected. Issues regarding parking and other accommodation facilities were most common complaints that were 14.5% of total. Issues regarding admission rooms (10.7%), admission procedures (10.7%), waiting room environment (8.8%), nurses and nurse assistants (7.6%), physicians (6.6%) and others (23%) followed. Thirteen of 45 departments received more than 8 complaints. The Nursing Department had the most complaint, receiving 9.8% of total complaints. Complaints regarding the Nursing Department were predominantly related to the environment of patient rooms. The Department of Psychiatry for phone etiquette (4.7%), Department of Otolaryngology for the nursing staff's attitude and phone etiquette (4.4%), and the Admission Department followed. As a part of efforts to improve patient satisfaction, a new parking structure was built and reallocation of the parking space was done. Renovation of other accommodation facilities were carried out by hospital administration, Monthly phone call and answering attitude survey was done by QI Department. Based on this survey we made a phone etiquette manual and distributed throughout the hospital. Compare to the last year, Patient Satisfaction Index measured by Korea Productivity Center using National Customer Satisfaction Index was improved 7 points. According to our organization's own study, we confirmed the phone etiquette was improved 11% than last year. Conclusions : Issues related to parking and other accommodation facilities ranked first followed by complaints made regarding the patient care area, the admission and cashier process, and nurses' and doctors' attitude. The Nursing and Psychiatry Departments need improvement regarding phone etiquette. Results were shared and played a vital role in policymaking and strategic planning of the hospital. It is imperative that we keep our database updated by listening to and solving the needs of each patient. The CQI activities can be achieved only by full commitment of the hospital top management supported by related personal.