• 제목/요약/키워드: healthcare outcomes

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대화 공간을 제공하는 마을 같은 도시형 공공병원의 건축공간 구성방식과 설계적용 연구 (A Study of Architectural Space Organization for the Promotion of Interactive Conversations and the Design Application for a Public Hospital Project)

  • 이영진;이정만
    • 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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    • 제21권3호
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    • pp.47-55
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    • 2015
  • Purpose: While medical standard is rapidly improved, welfare of users and employees in hospitals is not treated correspondingly. Intercommunication of hospital users is thought to be very important for their welfare, and provision of conversation spaces within hospital environment needs to be expanded by architectural design. Space organization methods for the design of conversation space is to be embellished. Methods: Literature and hospital designs are analysed in order to develop the basis of argumentation for the hospital conversation space. 15 hospitals are reviewed and designed spaces for the intercommunication of the users are examined, Space organization efforts and design experiments are identified, and 6 organizational methods are proposed such as: 1) reducing territoriality 2) flowing space 3) categorizing and separating spaces 4) height variation 5) contact with outside and 6) Sun-lighted space. Results: 6 organization methods are confirmed in precedent hospital cases, and these proposed methods are applied in a new hospital design project to verify their usefulness. Implications: A hospital design project is presented based on these proposed methods of organization for the conversation space. Outcomes of this study can be applied for the formulation of human intercommunication spaces in other facilities.

요양병원 인증 2주기 당면과제 및 해결방안 (Urgent problems and solution strategies in 2nd cycle of long-term care hospital accreditation)

  • 김경숙
    • 한국병원경영학회지
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    • 제21권3호
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    • pp.65-70
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    • 2016
  • The Long-Term Care Hospital (LTCH) accreditation system was initiated in 2013 in the form of mandatory accreditation system in order to improve patient safety and the quality of medical service at LTCHs. By June 2016, the accredited LTCHs were 76.2%. This research was conducted to review the implementation process in the first cycle and to promote development of the second cycle of LTCH accreditation system. There are some changes which reinforced the accreditation standards, accreditation survey, and public access to accreditation results in order to strengthen patient safety in the first cycle LTCH accreditation system. LTCHs which participated in the accreditation system achieved certain outcomes in respect to patient safety and employee satisfaction. However, there are several urgent problems in placement criteria of night duty health care providers, reinforcement plans in the accreditation system, and incentives for accredited hospitals. In order to solve these problems, the most important thing is to clearly recognize the fact that the healthcare accreditation system is not the means for control and regulate hospitals but a system to induce hospitals to continue to strive for improvements in patient safety and medical service quality. In addition, it is required that LTCHs, accrediting agency and the Ministry of Health and Welfare compromise and cooperate to seek solutions every time issues related to the accreditation system arise.

Factors Influencing the Motor Development of Children with Cerebral Palsy: Differences in Pediatric Physical Therapists' Perceptions

  • 김장곤
    • The Journal of Korean Physical Therapy
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    • 제23권4호
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    • pp.7-13
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    • 2011
  • Purpose: The purpose of this article is to identify whether the physical therapists perceive the important factors influencing the motor development in children with cerebral palsy differently. Methods: Study participants included 58 pediatric physical therapists. They were recruited from the internet communities for physical therapists. The data was collected through a web-based questionnaire using Google Documents tool. Questionnaire was focused on the importance (10-point scale) of each factor influencing the motor development in children with cerebral palsy. The mean scale of each factor was compared by itself and according to the participants' career characteristics. Results: The personality characteristics received the least importance rating (6.77) in comparison with other domains (healthcare service: 7.70, family ecology: 7.53, secondary impairment: 7.53, primary impairment: 7.45). In the detailed items, home exercise (8.33) received the highest mean importance rating, while sociability (6.03) received the lowest mean importance rating. Comparing the importance of factors by the type of work institution, subjects working in the welfare institutions perceived the contextual factors (personality characteristics, family ecology, healthcare service) as more important than those working in the medical institutions. Conclusion: The authorsuggests that pediatric physical therapists should try to have an identical approach by reaching a consensus. Also, the support for family-centered service to children with cerebral palsy should be strengthened.

생물안전 4등급(BL4) 실험시설의 동선계획에 관한 연구 (A Study on the Circulation System of Biosafety Level 4 Laboratory Facilities)

  • 권순정;최홍빈
    • 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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    • 제17권1호
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    • pp.23-32
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    • 2011
  • Recently, with the advent of high risk infectious agent such as the Ebola virus, SARS, special research facilities dealing with such dangerous pathogenic are drawing attention gradually. Especially, this kind of facilities can be called BL4(Biosafety Level 4) facility. At the moment, Korean government is going to construct BL4 institute in order to handle efficiently such kind of pathogen. However, there are no proper design guidelines for BL4 facility. This paper proposes circulation system of BL4 facility on the basis of analysis of existing BL4 guidelines of Canada, and Korean BL3 facilities. The outcomes of this study are as follows. At first, functional areas of BL4 facilities have been divided into three categories according to the hazard level ; dangerous area, transitional area, and ordinary area. Secondly, circulation system of BL4 facility has been explored as a form of diagram according to the circulating subjects. These include human, laboratory animals, hazardous pathogen, equipments and cloth. This study has some limitations in that it lacks empirical evidences and concrete SOPs(Standard Operating Procedure). Despite of some weaknesses, it is expected to give some preliminary guidelines for the design of circulation system in BL4 facilities.

노인환자의 안전, 삶의 질, 건강향상을 위한 치유환경요소에 관한 연구 - 노인전문병원 및 노인요양시설 배경 외국연구문헌을 중심으로 (A Study on Healing Environmental Factors that Promote Safety, Quality of Life, and Health of Elderly Patients - Focused on Studies Published in English in the Context of Geriatric Hospitals or Elderly Care Facilities)

  • 최영선
    • 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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    • 제19권3호
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    • pp.7-19
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    • 2013
  • Purpose: The main objective of this paper is, first, to assess a body of research evidence that articulates the impact of environmental and design factors on safety, quality of life, and health of the elderly who reside in geriatric hospitals or other elderly care facilities and, second, to draw out design implications that can be incorporated into design process and design decisions to help create healing environments for the elderly. Methods: Extensive literature review has been conducted to identify rigorous empirical studies that link the design of elderly care facilities to health-related outcomes and scrutinized peer-reviewed articles published in many different fields including architecture, psychology, nursing to gerontology. Results: The review found a growing body of rigorous studies that identified physical environmental and design factors that improve safety, quality of life, and health of the elderly in geriatric hospitals or other elderly care facilities. Implications: The findings of the review can be translated to design decisions to promote safety, quality of life, and health of the elderly in geriatric hospitals or other elderly care facilities.

근거기반 임상실무지침: 장루간호 (Evidence-Based Nursing Practice Guideline: Ostomy Care)

  • 이윤진;박현숙;김민경;서희원;이미주;원은애;조가나
    • 임상간호연구
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    • 제26권2호
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    • pp.154-163
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    • 2020
  • Purpose: The aim of this study was to develop an evidence-based guideline for stoma management providing institutional policy, assessment, complications and follow-up care. Methods: The guideline adaptation manual consisting of 23 steps developed by the National Evidence-Based Healthcare Collaborating Agency was used for this study. It presents an overview of the process used to develop the guideline and lists specific recommendations from the guideline. Results: It provides 55 recommendations that include the following 8 topics: 1) Organization and policy recommendations, 2) Preoperative nursing; Ostomy education, stoma site marking, 3) Ostomy formation, 4) Postpoperative nursing; education, assessment, high output stoma management, 5) Selection of ostomy products, 6) Colostomy irrigation, 7) Stomal and peristomal complications, 8) Follow-up care after discharge. Conclusion: The guideline can be used to address stoma management in hospital settings. The intent of the guideline is to provide information that will assist healthcare providers to manage adult patients with ostomies, prevent or decrease complications, and improve patients' outcomes.

Academic Medicine은 환자 중심 의료이다 (Academic Medicine Is Patient-Centered Medicine)

  • 안신기
    • 의학교육논단
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    • 제21권2호
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    • pp.80-91
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    • 2019
  • The tripartite mission of 'academic medicine' is education, research, and patient care. Academic medical centers (AMCs) are carrying out the mission and ultimately aiming to improve the health of people and communities. Globally, AMCs are facing a tremendous financial risk stemming from the changes in health insurance reimbursement plans and a shortage of human resources. Innovative AMCs in the United States are trying to transform their physician-centered, and siloed structure into a patient-centered, and integrated structure. They are also building integrated systems with primary healthcare groups to provide continuous patient care from primary to tertiary levels and making strategic networks based on value-based payment and the patient-centered model. These changes have been proven to improve outcomes of patient care and increase fiscal revenues, which are both crucial in supporting education and research. To address the shortage of human resources, programs are being built to develop newly appointed faculty for the future. AMCs have different approaches to bringing changes into their organizations; however, there is a common emphasis on 'a patient-centered approach,' which helps them set more explicit organizational values and make strategic decisions based on their values. Korean AMCs are facing similar challenges to AMCs in the United States in spite of many differences between the countries' healthcare systems. The innovative efforts of AMCs in the United States to address the challenges will be helpful, well-worked examples for Korean AMCs with similar challenges.

환자중심 스마트병원의 개요와 전망 (Overview and Prospects of Patient Centered-Smart Hospitals)

  • 박현영;조용진
    • 디지털융복합연구
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    • 제19권7호
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    • pp.419-426
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    • 2021
  • 정보통신기술이 발달함에 따라 스마트병원은 헬스케어 산업에서 새로운 트렌드가 되고 있다. 본 논문에서는 문헌고찰을 통해 스마트병원의 개념, 주요 기술, 적용분야, 직면과제 및 사용자 중심의 스마트병원 구축 전략에 대해 살펴본다. 스마트병원에서는 상호연결된 디지털 네트워크 안에서 임상가들이 환자중심의 통합적 의료서비스를 효율적으로 제공하도록 함으로써 보다 나은 환자결과에 도달할 수 있게 될 것이다. 그러나 향후 보다 성공적인 환자중심 스마트병원을 위해서는 비용이나 기술, 보안, 표준 등과 관련된 여러 장애요소들이 극복되어야 하며, 디지털 솔루션의 최종 사용자인 환자와 의료인의 참여가 요구된다.

치매 환자의 건강과 삶의 질 향상을 위한 치유환경 요소에 관한 연구 - 치매 환자를 위한 노인요양시설을 중심으로 (A Study on Environment-related Factors that Promote Psychological·Behavioral Health and Quality of Life for People with Dementia - Focused on the Context of Long-term Care Facilities for People with Dementia)

  • 최영선
    • 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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    • 제28권4호
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    • pp.7-20
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    • 2022
  • Purpose: The main purpose of this paper is to assess a body of research evidence that articulates the impact of environment-related factors on behavioral health and quality of life for people with dementia who reside in long-term care facilities. The study also aims at identifying design implications that can be incorporated into design process and design decisions to improve behavioral health and quality of life for people with dementia. Methods: Comprehensive literature review has been conducted to identify empirical studies and that link the design of dementia care facilities to health- and QOL-related outcomes and scrutinized peer-reviewed articles published in many different fields including architecture, psychology, to nursing. Results: The review identified a growing body of literature that articulates environment-related factors that improve health and quality of life for people with dementia living long-term care facilities Implications: The findings of the review can be translated to design decisions to promote psychological and behavioral health and quality of life of people with dementia in long-term care facilities.

Foreign body aspirations in dental clinics: a narrative review

  • Huh, Jin-Young
    • Journal of Dental Anesthesia and Pain Medicine
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    • 제22권3호
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    • pp.161-174
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    • 2022
  • Foreign body aspiration can produce a medical emergency. Obstruction of the airways can be life-threatening, and complications may develop in less-severe cases if it is left untreated. Although it is more prevalent in children by approximately three times, adults can still experience it, and it is more frequently related to healthcare in adults. Objects used in dental treatment are usually placed in the oral cavity and can be ingested or inhaled by accident. Dental treatment has been identified as an important cause of the misplacement of foreign bodies in the airway. However, few reports have been published on dentistry-related foreign body aspiration. This paper discusses the disease course, management, and clinical outcomes of foreign body aspiration, especially those associated with dentistry. The patient must be examined for respiratory distress. If the patient is unstable, urgent airway management and the maneuvers for removal should be performed. Radiographs and computed tomography can help identify and locate the object. The treatment of choice is often bronchoscopy, and both flexible and rigid endoscopes can be used depending on the situation. Preventive measures need to be implemented to avoid inhalation accidents given the potential consequences. Though the incidence is rare, healthcare levels need to be enhanced to avert morbidity and mortality. Radiological evaluation and bronchoscopy are vital for management.