• Quality Improvement in Health Care
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• v.4 no.2
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• pp.230-240
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• 1997

Background : Hypercholesterolemia is a major independent risk factor of coronary heart disease. Practice guidelines for management of hypercholesterolemia had been made in several developed countries. This study was undertaken to assess the effect of practice guideline reminders and flow-sheets to improve the quality of management of hypercholesterolemia. Methods: Practice guideline reminders and flow-sheets based on National Cholesterol Education Program Adult Treatment Panel II guidelines, were placed on the office desks of outpatient department of family medicine at the Asan Medical Center. Before this intervention, we educated the doctors to use these reminders and flow-sheets. The charts of all patients who had cholesterol levels greater than or equal to 240 mg/dl during 4 months before and after introduction of reminders and flow-sheets, were reviewed retrospectively. We compared the performances of physicians about management of hypercholesterolemia between pre-intervention period and post-intervention period. Results: The detection rate of hypercholesterolemia in post-intervention period was increased to 83.2% compared by 71.5% in pre-intervention period. Risk factor analysis for coronary heart disease increased significantly from 16.9% to 68.7%. Adequacy of management was 19.2% in pre-intervention period and 78.0% in post-intervention period. It showed statistically significant improvement in management of hypercholesterolemia. Conclusion : This study suggested that practice guideline reminders and flow-sheets were the effective methods in improving the quality in management of hypercholesterolemia.

• Journal of Chest Surgery
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• v.47 no.5
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• pp.437-443
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• 2014

The JCVSD (Japan Cardiovascular Surgery Database) was organized in 2000 to improve the quality of cardiovascular surgery in Japan. Web-based data harvesting on adult cardiac surgery was started (Japan Adult Cardiovascular Surgery Database, JACVSD) in 2001, and on congenital heart surgery (Japan Congenital Cardiovascular Surgery Database, JCCVSD) in 2008. Both databases grew to become national databases by the end of 2013. This was influenced by the success of the Society for Thoracic Surgeons' National Database, which contains comparable input items. In 2011, the Japanese Board of Cardiovascular Surgery announced that the JACVSD and JCCVSD data are to be used for board certification, which improved the quality of the first paperless and web-based board certification review undertaken in 2013. These changes led to a further step. In 2011, the National Clinical Database (NCD) was organized to investigate the feasibility of clinical databases in other medical fields, especially surgery. In the NCD, the board certification system of the Japan Surgical Society, the basic association of surgery was set as the first level in the hierarchy of specialties, and nine associations and six board certification systems were set at the second level as subspecialties. The NCD grew rapidly, and now covers 95% of total surgical procedures. The participating associations will release or have released risk models, and studies that use 'big data' from these databases have been published. The national databases have contributed to evidence-based medicine, to the accountability of medical professionals, and to quality assessment and quality improvement of surgery in Japan.

• Journal of Korean Academy of Nursing Administration
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• v.18 no.2
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• pp.222-233
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• 2012

Purpose: This study was conducted to develop an evaluation framework for QI activity in medical institutions and to analyze QI activity cases by applying the developed evaluation framework. Method: A four-phase process was employed to develop the evaluation framework, and a descriptive survey was used for the QI case study. Data were collected in April, 2010 by examining 157 QI activity cases presented at conferences and published in Journal of Korean Society of Quality Assurance in Health Care over the past three years. Developed QI activity evaluation instruments were used for data collection. Data were analyzed using the SPSS 18.0 for Windows program. Result: A QI Activity Evaluation Framework was developed. This framework consisted of 45 items. The department with the highest level of QI participation was the nursing department. The most frequent QI activity theme was patient safety. QI activity levels in Korean medical institutions are relatively equalized without significant differences according to institution characteristics. Conclusions: From the quality aspect of QI activity, more systematic and scientific approaches are required to upgrade QI activity. This study could provide methodological guidelines for QI activity and be useful in setting goals and directions for QI activity in medical institutions in Korea.

• Korea Journal of Hospital Management
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• v.16 no.2
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• pp.19-30
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• 2011

This study aims to present ways to enhance the stabilization of electronic medical records, ensure the commitment to filling in information of the medical record and improve the overall quality Electronic Medical Record(EMR) information. For that purpose, the present state of the incomplete record rate and the doctor's satisfaction in Electronic Medical Record(EMR) have been surveyed by comparing and analyzing Paper-based Medical Record(PMR) and Electronic Medical Record(EMR). The survey was conducted on 31 doctors in charge of EMR system and each PMR and EMR inpatients were collected for a period of 5 months and analyzed. The results showed that the doctor's satisfaction level was higher for EMR, and the rate of incomplete record appeared to be lower in EMR in departments of both internal and external medicine. In this context, it can be said that the higher efficiency of EMR helped accomplish the increase in commitment to completing medical record information and improve the quality of the data.

• Clinics in Shoulder and Elbow
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• v.26 no.1
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• pp.55-63
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• 2023

Background: Common questions about shoulder arthroplasty (SA) searched online by patients and the quality of this content are unknown. The purpose of this study is to uncover questions SA patients search online and determine types and quality of webpages encountered. Methods: The "People also ask" section of Google Search was queried to return 900 questions and associated webpages for general, anatomic, and reverse SA. Questions and webpages were categorized using the Rothwell classification of questions and assessed for quality using the Journal of the American Medical Association (JAMA) benchmark criteria. Results: According to Rothwell classification, the composition of questions was fact (54.0%), value (24.7%), and policy (21.3%). The most common webpage categories were medical practice (24.6%), academic (23.2%), and medical information sites (14.4%). Journal articles represented 8.9% of results. The average JAMA score for all webpages was 1.69. Journals had the highest average JAMA score (3.91), while medical practice sites had the lowest (0.89). The most common question was, "How long does it take to recover from shoulder replacement?" Conclusions: The most common questions SA patients ask online involve specific postoperative activities and the timeline of recovery. Most information is from low-quality, non-peer-reviewed websites, highlighting the need for improvement in online resources. By understanding the questions patients are asking online, surgeons can tailor preoperative education to common patient concerns and improve postoperative outcomes. Level of evidence: IV.

• The Korean Journal of Nuclear Medicine Technology
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• v.28 no.1
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• pp.49-56
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• 2024

Purpose: When performing nuclear medicine examinations, body wraps or plastic supports are used to support and immobilize the patient's upper extremities to prevent patient safety accidents. However, the existing plastic supports compromised patient and staff safety, including finger entrapment and falls. Moreover, the body wrap provided by manufacturers compromised image quality such as upper extremities cutoff during whole body bone scan. Therefore, a new design of body wrap was developed to improve the issue, and this study aims to evaluate the usability of this medical body wrap. Materials and Methods: To evaluate the usability of the newly designed medical body wrap, a quality assessment of whole body bone scan images and a user satisfaction survey were conducted. Adult patients (male:female=129:152, age: 60.3±12.4 years, BMI: 24.0±4.2) aged 16 years or older who underwent a whole body bone scan during two periods: June to July 2022 (before improvement, n=139) and June to July 2023 (after improvement, n=142) were randomly selected for image quality evaluation. Five radiotechnologists visually evaluated the posterior view of the whole body bone image, including the left and right elbow (2 points), arm (2 points), whether the hand is extended (2 points), whether the hand is included (2 points), and the number of visible fingers (10 points), with a total of 18 points, which were converted to 100 points and analyzed for difference before and after improvement using an independent sample t-test. The user satisfaction questionnaire was evaluated using a 5-point Likert scale among 16 radiotechnologists from three general hospitals who experienced the new body wrap. Results: The image quality assessment was 82.0±13.8 before the improvement and 89.3±10.1 after the improvement, an average of 7.3 points higher, with a statistically significant difference (t=5.02, p<0.01). The user satisfaction survey showed an overall satisfaction rating of 4.1±0.8 for ease of use, 3.8±0.7 for scan preparation time, 3.9±0.7 for patient safety, 3.8±1.2 for scan accuracy, and 4.2±0.7 for recommendation (87.5% questionnaire response rate). Conclusion: The developed body wrap showed higher image quality and user satisfaction compared to the old method. Considering these results, it is deemed that the new body wrap may be more useful than existing methods.

• Quality Improvement in Health Care
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• v.5 no.2
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• pp.312-323
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• 1998

Background : Evaluation of patient's satisfaction is one of the most important aspects of quality improvement. If the patient highly satisfies with the medical service provided in the hospital, he/she will be likely to visit the same hospital again. Patient's satisfaction of a particular hospital is directly correlated with hospital profits as well as reputation in the community. For this reason, various kinds of survey measuring satisfaction level have been performed and many kind of QI activities for enhancing the profits as well as reputation in the community. For this reason, various kinds of survey measuring satisfaction level have been performed and many kind of QI activities for enhancing the patient's satisfaction. This study is to find the effect of hospital QI activities on the patent's satisfaction level. Methods: After questionnares were developed, survey of measuring satisfaction level was performed in August, 1998. On the basis of survey results, QI activities were carried out to attain the target point of 4.0 and subsequent survey was done in November, 1998. Results: With three main principles of "problem solving approach with kindness". "helping patient to participate in medical procedure with sufficient information", and "putting employees into practice of attitude with human respect", the average level of satisfaction was enhanced from 3.45 to 3.55 level. Also kindness level of employees was increased from 3.71 to 3.82. Level of dissatisfaction about insufficient explanation and unkind attitude was dropped from 69% to 48% and from 82% to 46% respectively. Conclusion: With the result of this study overall satisfaction level was enhanced. In order to keep these advantages a operation of Quality Improvement Task Force Team in each subject will be required.

• Quality Improvement in Health Care
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• v.12 no.2
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• pp.17-25
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• 2006

• Quality Improvement in Health Care
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• v.15 no.1
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• pp.55-65
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• 2009

• Quality Improvement in Health Care
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• v.15 no.2
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• pp.31-39
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• 2009