• Title/Summary/Keyword: medical manager

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Is It Possible to Replace Microendoscopic Discectomy with Percutaneous Transforaminal Discectomy for Treatment of Lumbar Disc Herniation? A Meta-Analysis Based on Recurrence and Revision Rate

  • Zhao, Xiao-ming;Yuan, Qi-ling;Liu, Liang;Shi, Ya-ming;Zhang, Yin-gang
    • Journal of Korean Neurosurgical Society
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    • v.63 no.4
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    • pp.477-486
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    • 2020
  • Objectives : Due to recent developments and the wide application of percutaneous transforaminal discectomy (PTED) in China, we herein compare its clinical effects with microendoscopic discectomy (MED) for the treatment of lumbar disc herniation in terms of recurrence and revision rates. Methods : Six databases, namely, PubMed, EMBASE, Cochrane Library, Ovid, China National Knowledge Infrastructure and Wanfang, were searched by computer. The literature was screened according to inclusion and exclusion criteria, and the quality of the included literature was evaluated. After extracting the data from the papers, Review Manager 5.2 software (Cochrane Collaboration, Oxford, UK) was applied to analyze these data. Finally, sensitivity and publication bias analyses of the results were conducted. Results : A total of 12 studies consisting of 2400 patients were included in this meta-analysis. A comparison of PTED with MED revealed higher postoperative recurrence and postoperative revision rates for PTED (odds ratio [OR] recurrence, 1.60; 95% confidence interval [CI], 1.01 to 2.53; p=0.05 and OR revision, 1.77; 95% CI, 1.18 to 2.64, p=0.006). Conclusion : PTED has a number of advantages because it is a minimally invasive surgery, but its recurrence and revision rates are higher than MED. Therefore, MED should not be completely replaced by PTED.

The results of recognition survey for patient safety culture in a hospital (일개병원의 환자안전문화 인식도 조사결과)

  • Kim, Ki-Young;Han, Hye-Mi;Park, Yu-Ri;Kim, Sun-Ae;Shin, Hyun-Soo
    • Quality Improvement in Health Care
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    • v.22 no.2
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    • pp.75-90
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    • 2016
  • Objectives: This study measures the level of cognition of employee's patient safety culture and evaluates the current level through comparing the results to external levels. Ultimately it is performed to construct a strategic improvement plan through the basic database for patient's safety culture. Methods: A questionnaire survey of self reporting type was carried out using structured questionnaire of the patient's safety culture for employees currently employed in a hospital. Total responders was 1,129 and a response rate was 54.6%. The survey results were calculated with a percent positive response, and the current level was evaluated by comparing with the survey results of a hospital (2009 and 2014) and the survey result of The Agency for Healthcare Research and Quality(2014). Results: Sub-dimension of high percent positive response for each area were 'teamwork within hospital units' (80%), 'feedback & communication about error' (73%) and 'supervisor/manager expectations & actions promoting safety' (67%). Meanwhile, 'teamwork across hospital units' (31%), 'hospital management support for patient safety' (29%), 'staffing' (27%) and 'non-punitive response to error' (17%) were relatively low percent positive response. Compared to the survey results of AHRQ (2014) for each area, 'teamwork within hospital units' (80%), 'feedback & communication about error' (73%), 'frequency of event reporting' (66%) were at the top 50% percentile level and the remaining sub-dimensions showed a very low level in the lower 10% percentile area. Conclusion: In order to establish a system for patient safety culture within the hospital and evaluate the effect on this, it is necessary to periodically evaluate the patient's safety culture and establish regulations on hospital safety culture to comply with this.

A Study on the Current Status and Tasks of Medical Records Management: Focused on Applying the KS X ISO 15489 to the Y Hospital (의무기록관리의 현황과 개선방안: KS X ISO 15489표준의 Y병원 적용 중심으로)

  • Lee, Eun-Mi;Kim, Myeong;Hee, Jin
    • Journal of the Korean Society for information Management
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    • v.29 no.3
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    • pp.257-285
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    • 2012
  • As the electronic medical records systems (EMRs) are introduced into the hospitals in Korea and the needs of chief stakehoders of medical records are changed, the environments related to creating and managing medical records has been changed dynamically. At this moment it might be meaningful to examine medical records based on records management principles rather than information management principles. The purpose of this paper is to apply the KS X ISO 1549 standards, which covers the principles of records management, to hospital medical records management and assess the current quality of medical records management, and define a few tasks of improvement for hospitals. To achieve this goal, this study has performed following activities: Firstly, principles that could be applied to medical records management were prepared for each record management steps described in the standards, such as capture, registration, classification, storage, access, trace and disposition, and 22 principles were selected from those 7 steps of the record management. Secondly, the Y hospital, which is affiliated with a medical school in Seoul, was chosen to evaluate the current situation regarding medical records management. The department head of the medical records management team in Y hospital was interviewed and the present status was evaluated according to each principle. Thirdly, tasks for improvement were suggested, in such stages as access, trace and disposition. With this study as a cornerstone, useful implications are expected to be gathered from future studies that apply standards for metadata of records, management systems for records, and record management systems to medical record management in hospitals.

Effects of Perceived Patient Safety Culture on Safety Nursing Activities in the General Hospital Nurse's (일 지역 종합병원 간호사의 환자안전문화 인식이 안전간호활동에 미치는 영향)

  • Kim, Hwa-Young;Kim, Hye-Sook
    • Journal of Korean Academy of Nursing Administration
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    • v.17 no.4
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    • pp.413-422
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    • 2011
  • Purpose: This descriptive correlation study was done to identify how perception of patient safety culture of general hospital nurses affects safety during nursing activities. Data from this study should provide information on management of patient safety as well as improvement in patient safety. Method: Participants in this study were 357 clinical nurses working in a general hospital in M city which had two medical evaluations. A survey was conducted to gather the data. Results: The score for perception of patient safety culture of the general hospital nurses was 3.42, out of a possible 5 points, and the score for safety care activities was 3.90. There was a statistically significant positive relationship between the nurses' perception of patient safety culture and their safety care activities, Perception of patient safety culture, Supervisor/manager, communication and procedures, and frequency of accident reporting were factors that impacted significantly on safety nursing activity. Conclusion: The results of the study indicate that patient safety cultural perception significantly affects the safety of nursing activities and thus systematic educational strategies to increase perception should be provided to increase the level of patient safety culture. Also, other specific methods that increase the level of patient safety culture should be considered.

Role Identification of Home Health Nursing Specialist (가정전문간호사의 역할 규명)

  • Kim, Hae-Young
    • Journal of Home Health Care Nursing
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    • v.13 no.1
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    • pp.33-45
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    • 2006
  • Purpose : The purpose of this study is to present the desirable level of home health care services by identifying the roles and activities by task of home health nursing specialists as well as to raise the level of professionalism in home health care services. Method : This is a methodological study. The roles and activities by task were identified through a review of literature and a state-of-the-practice survey, and were structured into a questionnaire after being reviewed and modified through a consensus of experts. The field survey was conducted on 136 home health nursing specialists at medical institutions, public health centers. public medical institutions, non-governmental organizations, and religious institutions in Seoul, Gyeonggi Province. Incheon, Busan, Daegu, and Gwanggju from June 4 to August 4. 2004. Seven roles. 34 tasks and 130 activities were identified in association with home health nursing specialists. Result : The roles of home health nursing specialists were identified as professional nursing service provider, advisor, educator, administrator, case manager, researcher and leader. Under these roles. 34 tasks and 134 task-specific activities were identified. Conclusion : The the roles and activities of home health nursing specialist identified in this study can be used in various home health care settings. These the roles and activities should provide the evaluation criteria of home health care services for institutions with existing home health care programs. An evaluation tool should be developed in order to ensure the hish quality of home health care services.

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The Development Job Standards for Advanced Health Insurance Review Nurses (보험심사 전문 간호사의 직무표준 개발)

  • Hwang, Hye-Young
    • Journal of Korean Academy of Nursing Administration
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    • v.15 no.2
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    • pp.264-274
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    • 2009
  • Purpose: This study is to develop job standards in order to propose proper job level of the advanced nurse practitioners and apply the results to the work and enhance the expertism. Method: This study is a methodical study. The validity was examined by using the content validity index(CVI). Result: The pre-items of job standards for advanced health insurance review nurses were established and the final job standards comprising of 12 standards, 46 criteria, 92 indicators, 418 activities were determined after the examination by the advisory group. The validity of the job standards were examined for two times by the seven professionals. The relevance of the modified job standards was examined by the working level employees above the assistant manager position working in the general hospitals and the result was 93.14% relevance. The job standards comprising of 12 standards, 46 criteria, 89 indicator and 409 activities were developed. Conclusions: By the development of the job standards, it is expected to prove that advanced health insurance review nurses are the most suitable professionals for dealing with medical affairs such as management and propriety evaluation of medical expenses while defining the roles of advanced health insurance review nurses.

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Strategic Orientation of Hospitals in Korea and Their Related Characteristics (우리나라 병원들의 전략지향 및 관련 특성 분석)

  • Youn, Hye-Won;Shin, Eui-Chul;Kim, Ye-Soon;Jung, Ki-Taek
    • Journal of the Korean hospital association
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    • v.37 no.3 s.313
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    • pp.74-87
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    • 2008
  • As healthcare environment being more complex and turbulent, strategic approach of hospitals became more important. This study was to investigate strategic orientation of Korean hospitals and their related characteristics. We surveyed managers of 360 hospitals randomly selected from all hospitals in Korea. For typology of strategic orientation, we used that developed by Miles and Snow, and results are as follows. Firstly, major types of organizational strategic orientation of Korean hospitals were analyzer(42.0%) and prospector(34.0%). Secondly, characteristics affecting to hospitals' strategic orientation significantly were hospital ownership and sex of managers. Medical corporation had a high tendency of prospector strategic orientation by 2.7 times compared to personal ownership. Female managers had a low tendency of prospector strategic orientation by 0.2, which was statistically significant. Though 60+ age group (compared to twenties and thirties) and middle managers (compared to CEO) had a tendency of being more prospector strategic orientation, but insignificant. The study result that majority of strategic orientation were prospector and analyzer reflects Korean hospital environment are complex and unstable. Hospital managers need to more focus on environment and boundary spanning function for maintenance and survival of their organizations.

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Evaluation on Fitness between Human Resource Management System and Strategy on Subsidiary Hospitals of Medical Center (일개 의료원 산하 병원간 전략과 HR시스템의 정합성 평가)

  • Kim, Young-Hoon;Kim, Han-Sung;Woo, Jung-Sik;Kim, Hyo-Jung
    • Korea Journal of Hospital Management
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    • v.17 no.1
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    • pp.59-78
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    • 2012
  • The purpose of this study is to evaluate on the fitting with human resource practice and strategic on 6 public hospital in the point of resource based view. At the result of this study, public strategy is not much fitted into HRM(human resource management) system, but it shows positive result of the fitting with efficiency strategy and HRM system. These results were associated with the integration of G Medical Center. Generally 6 public hospitals of the HRM system and the strategy had not been linked. They also did not achieve a great outcome. We suggest that the manager in charge of each hospital make strategies of the hospital, and then evaluates about fitting with HRM system. We hope, hereafter, it applied the analysis methods that evaluates it with financing result and individual non-financial result all together.

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Nursing Organizational Characteristics and Job Satisfaction of Nurses in a general hospital (일 종합병원 간호사의 지각된 간호조직특성과 직무만족)

  • Park, Sung-Ae;Lee, Eun-Joo;Kim, Jeong-Hee
    • Journal of Korean Academy of Nursing Administration
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    • v.6 no.3
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    • pp.347-356
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    • 2000
  • The purpose of this study was to identify the relationship between the nursing organizational characteristics and job satisfaction. Subjects were 362 nurses at a general hospital in Seoul. Data were collected from November 1, 1999 to November 31, 1999 with the structured questionnaires and analyzed by $SPSS-PC^+$ 8.0 for descriptive statistics, ANOVA, Pearson correlation, and stepwise multiple regression. The results were as follows; 1. The average score of the nursing organizational characteristics was 3.7. The score of head nurse's leadership was highest and supervisor's was lowest. The average score of the job satisfaction was 3.1 and was similar to the results of other studies. 2. Being regarded to the nursing organizational characteristics and job satisfaction by general demographic variables, The head nurse's leadership, the supervisor's leadership and interaction, and the overall nursing organizational characteristics showed significant differences by year of career, position status, and service-department(p<.1, p<.05). The job satisfaction showed significant difference by position status(p<.01). 3. There were correlations between the nursing organizational characteristics and job satisfaction(r=0.358-0.815). 4. The most important variable in the job satisfaction was 'organizational climate' and it was explained 32.0% out of the total variance of job satisfaction and 'all of nursing organizational characteristic factors' explained 47.5%. According to the results of this study, the suggestions were as follow: 1. To improve nurses' job satisfaction, the strategy for the development of the cooperative nursing organizational climate and for the strengthening of 'the nursing manager's leadership and interaction' in the nursing department are necessary. It should to be considered the differences in the nursing organizational characteristics and job satisfaction by nursing manager and staff nurses. 2. Further study needed to analysis the organizational climate for the management of the nursing organization. Also it is necessary for further investigation regarding to the relationship between the nursing organizational characteristics and job satisfaction of pre and post-organizational change.

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Awareness about Convergent Patient Safety Culture of Health Professional Working in Tertiary Hospital (상급 종합병원 종사자들의 융합형 환자안전 문화 인식)

  • Choi, Seon-Wook;Jeon, Min-Cheol
    • Journal of the Korea Convergence Society
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    • v.9 no.1
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    • pp.103-109
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    • 2018
  • This study was to measure the awareness of the patient safety culture of medical workers in various occupations working in hospitals and tried to be used as useful data. As a result of evaluating department (ward), hospital, immediate supervisor/manager, communication & procedures and frequency of accident reports, the patient safety accidents considered to be the most dangerous, technicians showed high results in the department(ward), nurses showed high results in the immediate supervisor/manager area. Radiological technologists and physical therapists recognized falls and clinical pathologists and nurses recognized before during after the test as the most dangerous patient safety accidents. To raise awareness of patient safety culture, executives and practitioners should create an atmosphere in which practitioners can prioritize patient safety, gain and manage appropriate personnel, manage cooperative systems between workers or departments.