The objective was to analyze the radiotherapy (RT) practice at the cancer centre of a tertiary academic medical institution in Delhi. This audit from an Indian public institution covered patient care processes related to cancer diagnosis, integration of RT with other anti-cancer modalities, waiting time, overall treatment time, and compliance with RT. Over a period of one year, all consecutively registered patients in radiotherapy were analyzed for the audit cycle. Analysis of 1,030 patients showed median age of 49.6 years, with presentation as stage I and II in 14.2%, stage III and IV in 71.2% and unknown stage in 14.6%. A total of 974 (95%) were advised for RT appointment; 669 (68.6%) for curative intent and 31.4% for palliation. Mean times for diagnostic workup and from registration at cancer centre to radiotherapy referral were 33 and 31 days respectively. Median waiting time to start of RT course was 41 days. Overall RT compliance was 75% and overall duration for a curative RT course ranged from 50 days to 61 days. Non-completion and interruption of RT course were observed in 12% and 13% respectively. Radiotherapy machine burden in a public cancer hospital in India increases the waiting time and 25% of advised patients do not comply with the prescribed treatment. Infrastructure, machine and manpower constraints lead to more patients being treated on cobalt (74%) and by two-dimensional (78%) techniques.
In this study, we explored the potential of integrating interactive AI callbot technology into the medical consultation domain as part of a broader service development initiative. Aimed at enhancing patient satisfaction, the AI callbot was designed to efficiently address queries from hospitals' primary users, especially the elderly and those using phone services. By incorporating an AI-driven callbot into the hospital's customer service center, routine tasks such as appointment modifications and cancellations were efficiently managed by the AI Callbot Agent. On the other hand, tasks requiring more detailed attention or specialization were addressed by Human Agents, ensuring a balanced and collaborative approach. The deep learning model for voice recognition for this study was based on the Transformer model and fine-tuned to fit the medical field using a pre-trained model. Existing recording files were converted into learning data to perform SSL(self-supervised learning) Model was implemented. The ANN (Artificial neural network) neural network model was used to analyze voice signals and interpret them as text, and after actual application, the intent was enriched through reinforcement learning to continuously improve accuracy. In the case of TTS(Text To Speech), the Transformer model was applied to Text Analysis, Acoustic model, and Vocoder, and Google's Natural Language API was applied to recognize intent. As the research progresses, there are challenges to solve, such as interconnection issues between various EMR providers, problems with doctor's time slots, problems with two or more hospital appointments, and problems with patient use. However, there are specialized problems that are easy to make reservations. Implementation of the callbot service in hospitals appears to be applicable immediately.
Doyoung Kwon;Kee-Tae Kweon;Young-Jin Hur;Dongsu Kim;Seung-Hun Cho
Journal of Oriental Neuropsychiatry
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v.34
no.4
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pp.359-368
/
2023
Objectives: This study aims to establish a Korean medicine doctor's range of services in the dementia relief primary care system based on the previously developed dementia clinical practice guidelines (CPGs). Developing a dementia relief primary care Clinical Pathway (CP) can aid clinically when the Korean medicine primary care doctor conducts treatment. Methods: We analyzed Dementia Korean Medicine Primary Care Model Data and then applied CP Methodology to develop the configuration of the Korean Medicine Primary Care Model. For patients with Alzheimer's dementia (AD), vascular dementia (VD), and mild cognitive impairment (MCI), the Korean Medicine Primary Care Model focuses on improving cognitive function, everyday living abilities and easing symptoms through interventions described in CPGs. The contents of the draft model later include references to already-existing CPs. Results: The study sites were chosen as Korean medical clinics connected to primary care physicians in the dementia-friendly model. The CP used a time task matrix version to arrange the clinical chronology, which included all examinations, diagnoses, and treatment procedures, from the initial appointment to follow-ups and the end of therapy. Conclusions: It anticipates that Korean primary care doctors familiar with dementia can use the offered therapies for the first time by creating the dementia Korean medicine primary care model in this study. This is expected to maximize the range of medical services provided by Korean medicine and improve the standard of medical treatment.
To be an adjunct professor(gyeomgyosu) literally means to act as an instructor while also holding a different position. Adjunct professors were initially introduced under Confucianism. Gradually, technical offices also appointed adjunct professors using Confucian-educated bureaucrats for the purpose of educating lower-level technical officials and cadets. This paper examines the history of the civil service system related to adjunct professors through the Code of Laws, and examines those who have been appointed to the public office described in various documents. This paper argues that changes in the medical office's adjunct professor system reflect changes in the national medical talent training policy. The main basis of specific recognizing medical personnel is to decouple the appointment of Confucian scholars from that of full-time doctors. The replacement of the role of medical educators from Confucian scholars to full-time doctors was largely accomplished during the reign of King Jungjong(中宗) and was completed during the period of King Injo(仁祖). The time when Euiyakdongcham was created and the Office of Euiyakdongcham was established coincided with the period when the adjunct professor was disrupted in the medical office. However, this change in the adjunct professor system of medical authorities is in contrast to interpretation, which is a representative technical field. In the case of interpretation, Moonshin's sayeogwon position as adjunct professor was maintained even in the late Joseon Dynasty, and apart from this, there was a hanhagmunsin in Seungmunwon. Interpreter families had institutional arrangements that prevented them from making interpretation their own monopoly. Therefore, families of medical bureaucrats had more room for institutional growth than those of bureaucratic interpreters. Of course, these institutional devices did not prevent the growth of interpreting bureaucratic families in the late Joseon Dynasty. However, the situation in which medicine was accepted only as a kind of knowledge, not as an object of full-time work for sadaebue, would have been an opportunity to rise for those in technical jobs who were full-time medicine. As medicine became more differentiated and developed in the late Joseon Dynasty, medical knowledge and the knowledge about the medical profession became more important. The politicians could not avoid the use of a philosophically oriented system in which a confucian-educated bureaucrat equipped with only Confucian knowledge might replace a full-time doctor. Thus, the contradiction between the reality and the ideal of ignoring or denying reality was reproduced like other Confucian-centered societies. These contradictions have implications for us living in the modern age. Establishing the relationship between philosophy (or belief) and technology should not end with the superiority of one side or the other.
The purpose of this study was to determine factors influencing patient satisfaction with medical services in hospital, which is classified into environmental aspect, human services and procedural services. Based on the results of literature review, the study focused on effects of social-demographical factors on patient satisfaction. The environmental aspect of medical care services included medical equipment and facilities, hygiene, ventilation, heating and air-conditioning, waiting and resting space, ward space and parking facilities. Procedural service included registration process, bill payment, waiting time after registration, examination and prescription as well as appointment process. Human services consisted of physicians listening to stories of patients, examination duration, physicians' explanation and physicians' service. As for nurses, explanation about disease, examination procedure and results, kindness and nursing care were evaluated. Services provided by other staff members were also evaluated. Patient satisfaction, defined as individual attitude toward medical service as a whole, was measured using a questionnaire. A total of 700 in-or out-patients were surveyed in 6 hospitals with more than 300 beds in North Gyeongbuk Province. 1. The level of patient satisfaction varied with characteristics of patients. Male patients and those in their 30s had a low level of satisfaction. Dissatisfaction level was positively related to education level but negatively related to economic condition. 2. As for patient satisfaction with medical service providers and other employees in hospital, satisfaction level with physician's explanation about treatment was higher. But dissatisfaction levels with treatment duration and the lack of explanation about examination procedures were high, calling for improvement. Dissatisfaction level with nursing care was high, calling for training of nurses for better service. Given the low level of satisfaction with human services, hospital employees need to be trained to improve their service. 3. It Was found that administrative service was also a significant factor influencing patient satisfaction in addition to medical service. It is therefore important for hospitals to provide patients with prompt and convenient procedural service. 4. Environmental factors such as medical equipment and amenity facilities also affected patient satisfaction. Thus environmental condition, procedural service and human service are all important to improve medical service in hospital. In summary, procedural service was the most significant factor for patient satisfaction. The level of satisfaction in patients was also affected by human service and environmental condition. It is therefore necessary to take patient-oriented approach in providing medical service in an effort to improve patient satisfaction. The finding of a lower level of satisfaction with human service signifies the need for training of healthcare providers and other hospital employees for better services. The introduction of advanced management programs is also needed to improve procedures that patients go through in hospitals.
Journal of Korean Academy of Nursing Administration
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v.15
no.4
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pp.601-609
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2009
Purpose: This study aimed to investigate and analyze the state of the relationship among nurse-doctor collaboration, job autonomy and organizational commitment. Method: The 304 participants were obtained who were working at a General ward, Intensive care unit and Operation room in three university hospitals located in Seoul and Kyunggi-do. The data were collected using a structured questionnaire from March 2d to April 10th, 2009. The collected data were analyzed with t-test, ANOVA, Scheff$\acute{e}$ test and Pearson's correlation on SPSS Win 16.0. Result: There was a significant relationship among nurse-doctor collaboration, job autonomy and organizational commitment. The level of appointment, clinical experience and current hospital experience of nurses affected significantly nurse-doctor collaboration, job autonomy and organizational commitment. The age of nurse had the relation nurse-doctor collaboration and organizational commitment. The relationship between the nurse's working area and job autonomy had positive correlation. Conclusions: The findings of study suggest that the program enhancing the collaborated relationship between nurses and doctors is important to improve nurse's job autonomy and organizational commitment under the situation of citizen's demanding more advanced medical service.
The purpose of this study is to describe the health care status of Korean Immigrants in New Zealand. The sample consisted of 155 Koreans who were randomly selected from the Korean Immigrants telephone book in Auckland, N.Z. They had health problems that required health management both physically (50.3%) and psychologically(70.3%). During the previous year, the average rate of medical contact with a general practitioner was 1$\pm$1.29 times. Korean immigrants who had health problems first attempted to resolve the problem through self medication rather than utilize health care services. They would only visit a general practitioner if they had severe subjective symptoms or no relief from self medication. Even if they think they need to visit the health care service, 41.9% of the subjects did not go back for follow-up care. Generally, the person who demonstrated positive health care behaviors was male, a college level graduate or higher, lived in N.Z. longer than 2 years, had a high score on health status by self assessment, and he placed few demands on health care services. Barriers to a healthy lifestyle are communication difficulties in expressing subjective symptoms, understanding the physician's treatment and medication plans, difficulty in accessing the appointment system and the high cost of service.
This paper examines the positions and personnel of the Naeui system in the late Joseon Dynasty. First, the regulations of the Naeui system were investigated through the literature related to Naeuiwon. Next, the operation of the regulations, changes in the system, and causes were analyzed through the Seungjeongwon Diary (承政院日記). We discovered: 1) Naeuiwon's medical bureaucracy originally did not have a fixed number of positions, but gradually came into being with a quota regulation. Uiyagdongcham-ui (議藥同參醫) and Naechim-ui (內鍼醫) did not have a quota, but was initially set at 10 people, then expanded to 12 people. Originally, the royal physician had no fixed number, and in 1864 the first quota was 7 people. 2) 'Gyeom-eoui' and 'gachanaeui' served to expand Naeui's quota. After the mid-17th century, 'Gyeom-eoui' expanded the quota of royal physicians to secure a position for the medical bureaucracy of Naeuiwon. 'Gachanae' after King Jeongjo serves to add to the quota while obeying the provisions of the law. 3) The customary promotion of Naeuiwon's medical bureaucracy expanded and became stricter after the mid-19th century, during which special promotions became more frequent than in previous periods. As for the provision of appointment to the 6th class after 30 months, Uiyagdongcham-ui was established in 1686 and Naechim-ui was established in 1718, increasing the chance for customary promotion. In the case of Naeui, the regulation for the Secretary General to raise the degree of official rank has been strengthened since the Cheoljong era. However, special promotions were frequent in the mid-19th century because the number of high-ranking officers increased compared to the previous period. In conclusion, the Naeui system in the late Joseon Dynasty changed in the direction of strengthening their own privileges. The Naeuiwon's quota was increased and promotion was guaranteed through the system and customs. Since the mid-18th century, there have been some regulatory restrictions, but the framework has not changed. This is confirmed not only in the regulations of the documents related to the Naeuiwon, but also in the Seungjeongwon Diary. Naeuiwon's medical bureaucracy enjoyed superiority in promotion and status compared to other forms of technical bureaucracy.
Journal of the Korean Society of Hazard Mitigation
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v.8
no.6
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pp.81-92
/
2008
As the process of the Korea is highly industrialization and knowledge information the extent of fire fighting business is getting wide with the development and change. But work environment is not improved much compared with the past. For the situation that threaten life is exposed greatly, compared with the other profession there are also much stress. Moreover, the professional stress of fire official influence not only the safety of fire official. In this paper based on the reduction countermeasure for professional stress of fire official the following are proposed: Lively communication activity between constituents, application of people system as a result work field, improvement of treatment and welfare institution, safety of fire official and health rule enactment, the establishment of specialty hospital for fire fighting and appointment of fire medical specialist.
Kim, Sung Cheol;Kim, Tae Kyung;Kim, Tae Hyun;Park, So Hee;Lee, Sang Gyu
Korea Journal of Hospital Management
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v.21
no.1
/
pp.51-61
/
2016
This study attempted to investigate how mass media marketing of a hospital influences patient volume. Additionally, the association of patient volume with exposure time and the type of mass media was examined. Data from a university hospital in Bundang (from January 2014 to November 2014) were used. Degree of physicians' mass media marketing was measured by the number of media exposure. Linear mixed model for repeated measures data was run to identify the associations between the number of media exposure and patient volume. First, the number of hospital physician's mass media exposure and new patients and the first visit patients were positively associated. Second, broadcasting media which has relatively significant in patient volume is TV programs such as cultural programs and news. Third, hospital physicians with higher ranks who were exposed to press media receive more patient appointment. Also, nonsurgical hospital physicians who were exposed to press media receive more patients. Fourth, medical treatment activities for hospital staff who hold the rank of Professor in case of making an appearance at press media have relatively increased. Hospital physician's media exposure, particularly TV programs, was significantly related to patient volume for outpatients.
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