• Journal of the Korean Society of Laryngology, Phoniatrics and Logopedics
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• v.16 no.2
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• pp.146-151
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• 2005

Objectives: Prospective study of quality of life in patients underwent microlaryngeal surgery for dysphonia was performed. Materials and Methods : 51 patients with dysphonia took part in the study, and patients with malignancies or functional voice disorder were excluded. Patients were asked to complete the SF-36 questionnaire before surgery and within 6-12 months after surgery. Preoperative and postoperative SF-36 scores were compared with data on 46 age-matched healthy controls. Results The most of SF-36 subscale scores showed significantly improvement after surgery, except of PF (physical functioning) and MH (mental health). Preoperative scores had significantly poorer than the normal controls on 6 subscales, but there is no statistically significant differences between postoperative scores and normal controls on 5 subscales. Conclusion In the study, patients with organic voice disorder show improvement in quality of life after microlaryngeal surgery.

• International Journal of Quality Innovation
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• v.9 no.3
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• pp.1-14
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• 2008

Patient satisfaction with the Emergency Department(ED) in a hospital is related to the length of stay, and especially to the amount of waiting time for medical treatments. ED overcrowding decreases quality and efficiency, therefore affecting hospitals' profitability. This paper presents a forecasting and simulation model for resource management of the ED at Moses H. Cone Memorial Hospital. A linear regression forecasting model is proposed to predict the number of ED patient arrivals, and then a simulation model is provided to estimate the length of stay of ED patients, system throughput, and the utilization of resources such as triage nurses, patient beds, registered nurses, and medical doctors. The near future load level of each resource is presented using the proposed models.

• Korea Journal of Hospital Management
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• v.22 no.4
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• pp.74-86
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• 2017

Purposes: This study was performed to understand the recognition about accreditation motives, support within the hospital and accreditation survey process for the hospitals that participated in the accreditation program and to find out whether these factors are related to hospital management performances, so that the study can suggest plans for activation and development of the accreditation program. Methodology: This study was performed targeting 98 hospitals answered th the survey among 189 acute care hospitals that acquired accreditation from December 2010 to February 2014. For data analysis, frequency analysis, ${\chi}^2$-test, reliability analysis, ANOVA, Kruskal-Wallis H test and multiple regression analysis with SPSS 21.0 were used. Findings: The hospitals that had staff in charge of patient safety had bigger hospital culture change than those that didn't have(p<.05). In addition, the hospital culture change was bigger as internal motives were bigger, and as CEO's will was bigger(p<.05). Meanwhile, as maintenance rate of internal management after accreditation was higher, and as CEO's will was bigger, process improvement level was higher(p<.05). The quality improvement and patient satisfaction level were higher as CEO's will was bigger, and as suitability of survey process was recognized to be high(p<.05). As a result of analyzing the factors that affect hospital management performances with hospital culture change, process improvement and quality improvement combined, as internal management maintenance rate was higher, as CEO's will was bigger, and as suitability of survey process was higher, performances were higher(p<.05). Practical Implications: Hospitals need to reinforce internal motives to improve internal competences such as the whole system maintenance opportunity and staff training. In addition, the will of hospital director is most important, and if there is hospital director's interest in quality improvement and improvement intention definitely, employees voluntarily participate in and cooperate with the accreditation program, so that prompt medical service provision and high quality of medical services can be guaranteed, leading to hospitals' management performances.

• Quality Improvement in Health Care
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• v.24 no.1
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• pp.30-39
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• 2018

Objectives: In Korea, there are many kinds of evaluations for medical institutions. However, evaluations are increasingly burdensome for medical institutions because evaluation agencies, evaluation timing, and evaluation methods are different. The purpose of this study is to improve the efficiency of evaluation for medical institutions and ultimately to provide quality medical services to patients. Methods: In this study, 2,310 indicators of 19 kinds of evaluation for medical institutions were analyzed. Results: 1,424 indicators were available for on-site surveys and 886 indicators were not available for on-site surveys. There were 4 kinds of evaluation that can be integrated in total, 12 kinds of evaluation that can be integrated partially, and 3 kinds of evaluation that need to maintain the current evaluation system. Conclusion: In order to provide patient-centered quality medical services through reduction of burden due to the evaluation for medical institutions, it is necessary to deeply discuss the efficiency of evaluation integration and result utilization.

• Korean System Dynamics Review
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• v.6 no.2
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• pp.73-93
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• 2005

This paper on an experiment, using System Dynamics, on the affect of increase in number of beds and medical instruments used for the care of premature infants, which constitute the physical requirements in quality of medical services, on changes in the survival rate of premature in ants that leads to demographic changes of Newborn infants. The model has four sectors: take-in capacity, survival rate of premature infants, demographics without newborn infants and demographics with newborn infants. The model simulates the changes in demographics of the newborn infants from 2002 to 2022. The study results show that the survival rate of premature infants can be increased by improving the physical aspects in the quality of medical services. An average of 1,900 premature infants can survive as a result of the physical quality improvements in medical services, adding up to an increase of 37,300 newborn infants by the year 2022.

• Journal of Korean Society for Quality Management
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• v.36 no.2
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• pp.59-66
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• 2008

Dental implant has recently become one of the most viable treatment options for regaining the oral function and dental aesthetics compared with conventional fixed or removable dentures. Dental implants vary in material, dimensions, geometries, surface properties, and interface geometries. It has been reported that there has been a proliferation of manufacturers who produce implants using various materials and surface treatments, and the dentist needs to select from over 2,000 different dental implants and abutments in a specific treatment situation. Unfortunately, however, no metrics have been specifically identified for the purpose of quality assessment and selection of an appropriate dental implant. This study aims to provide practical guidelines for quality assessment of dental implant based on clinical data. Like other medical devices and materials, the superiority related to specific characteristics of the dental implant needs to be verified through extensive clinical studies. The procedures of clinical monitoring for dental implants have been proposed along with a case study to exemplify the usefulness of clinical monitoring for the purpose of continuous quality improvement in medical industry.

• Quality Improvement in Health Care
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• v.14 no.1
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• pp.69-74
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• 2008

문제: 전자의무기록(EMR) 시행 후 의무기록 정리율의 저하와 질적인 측면에서의 충실성과 정확성에 대한 문제점이 제기되었다. 목적: 전자의무기록의 정리율과 충실성 검토를 통하여 문제점을 파악하고 개선점 찾아 의무기록 정리율을 향상시키고 충실성을 높이고자 하였다. 의료기관: 서울시에 소재한 대학병원 의무기록과 질 향상 활동: 전자의무기록의 문제점을 개선하기 위하여 사용자 편의를 위한 EMR 프로그램 수정 및 보완, 진단 수술 관련 작업, 업무개선, 교육, 홍보 등의 활동을 실시하였다. 개선효과: 의무기록 정리율, 전자인증미비, 경과기록 기재일수, 퇴원요약 주진단 적합률, 기록지별 필수항목 기재율, 충실성에서 향상이 이루어졌다.

• Quality Improvement in Health Care
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• v.2 no.2
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• pp.112-129
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• 1996

Background : A small number of high cost patients usually spend a larger proportion of scarce health resources. Aged, long-term care and readmitted patients usually belong to these high cost patient group. Among others, long length of stay and readmission can be reduced by checking its cause, and these are the areas needed most of quality improvement activity. Characteristics of high cost medical users between health insurance program and medical assistance program were reviewed. Methods : The inpatient claims of health insurance and medical assistance program were analyzed. Patients were divided by 6 groups; long-term, mid-term, short-term, readmitted, cancer and aged. We defined high cost patients as those who had spent one and half million won and over per 6 months. Characteristics of high cost patients for each group were reviewed. Results : medical assistance patients used much more resources than the insured members in the average hospital cost per case but less in daily hospital cost. The former had a longer length of stay and had much heavier diseases. Major diseases of both group were cancer, diseases of circulatory system and chronic degenerative diseases. Gallstone and schizophrenia were more in the insured program. However, pulmonary tuberculosis, asthma were more common among the medical assistance patients. Early readmission before 2 weeks were 28-30% of the total readmission. Readmission rate in the malignat neoplasm and renal failure were 80% and more. Q.A program should be installed to prevent unnecessary readmissions. Conclusion : Almost 30% of early readmissions and admissions due to complications and long length of stay should be reviewed carefully to keep cost down and to enhance the quality of hospital care.

• Journal of Korean Society for Quality Management
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• v.41 no.2
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• pp.261-276
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• 2013

Purpose: This study intends to offer strategic implications that can be used in Korean medicine hospitals through analysis of causal relationship among factors focusing on image improvement and trust building. Methods: Differential model was introduced to test causal relationship. Questionnaire was developed, and data was collected and analyzed with Structural Equation Modeling. Results: Medical service has effects on image, trust, and CS. CS has an effect on trustworthiness, and trustworthiness has positive effect on loyalty intention and has negative effect on switching intention. Emotional attachment has moderating functions between trust and loyalty intention and between trust and switching intention. Conclusion: This study offers practical implications to relevant managers, at the same time it has limitations that omits relevant study of inducing factor for emotional attachment.

• Quality Improvement in Health Care
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• v.21 no.1
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• pp.52-61
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• 2015

Objectives: Because recently hospital had to faced with financial hardship, we have to have more effective hospital management. The purpose of this study was to reduce loss costs of the hospital through the systematic management of medical supplies and increase operational efficiency. Methods: The team was composed of outpatient nursing staff, medical record administrator, nurses in medical insurance, medical computer center, dermatologists for this study. We surveyed for 114 people including outpatient nursing staff, nurse aids, medical assistant, physician assistant. Pre-survey period was 2013.03.11 ~ 03.30(2 weeks), and post-survey period was 2013.09.03 ~ 09.17(2 weeks). Result: We improved this way through the computational improvement, conservation campaigns, inventory management, staff training, replaced by low-cost medical supplies. The finding of this study were as follows: Comparing before and after the activity of outpatient nursing staff's degree of knowledge, performance, economic consciousness, the degree of knowledge, performance was increased, but there was no significant change in economic consciousness. Performance of Married person is higher than the unmarried, In addition, the high-position people were more the degree of knowleage, economic consciousness. After activity, correlation of goods and treatment, examinations is increasing, but statistically there was no mean. Conclusion: This study revealed that knowledge in a short period of activity, but also can improve, perform the same change in behavior is not easy. This one shows the intensive training required to sustained and systematic behavioral changes, such as changes in behavior, perform rituals to help the economy. Expensive medical supplies to replace a similar effect as the cost of materials just to have a lot of cost savings. Therefore, more medical supplies change is necessary to develop alternative treatment and cost cutting.