Go to the main menu
Skip to content
Go to bottom
REFERENCE LINKING PLATFORM OF KOREA S&T JOURNALS
> Journal Vol & Issue
Quality Improvement in Health Care
Journal Basic Information
Journal DOI :
The Korean Society of Quality Assurance in Health Care
Editor in Chief :
Volume & Issues
Volume 18, Issue 1 - Dec 2012
Selecting the target year
Korean Healthcare Accreditation Perspectives
Yum, Ho Kee ; Hwang, In Sun ;
Quality Improvement in Health Care, volume 18, issue 1, 2012, Pages 1~14
Two years have passed since hospital accreditation was introduced in Korea by the Korean Institute of Healthcare Accreditation (KOIHA), which takes, as its mission, continuously improving healthcare quality and patient safety for the public. KOIHA also has a plan to impose on outcomes in management of patient care. With a view to enhance the practice of accreditation in terms of quality as well as quantity, and to help improve healthcare quality and patient safety in Korea, this paper reviews some issues on healthcare policies which are expected to be adopted in 2013 by the forthcoming government. A few suggestions are added.
How single amount of the intake food is for patients with gastrectomy?
Yang, Ae Ri ; Kim, Lee Young ; Cho, Choon Ja ; Seok, Mi Hee ; Kim, Yeong Soon ; Park, Jeong Yun ;
Quality Improvement in Health Care, volume 18, issue 1, 2012, Pages 15~26
Background : Many gastrectomy patients have experienced poor intake and it was cause of the decreasing nutritional status. The purpose of this study was to identify the amount of the intake food and the influencing factors among gastrectomy patients. Methods : A cross-sectional study was conducted with 163 patients who underwent gastrectomy. Data were collected through self-report questionnaires and chart review about demographic, clinical, nutritional status and dietary information and were analyzed with the SPSS 20.0 WIN program. Result : Among 163 patients, the group with over 3/4 intake food was 115(70.5%). The group with 1/2 intatke was 30(18.4%) and the group with the lowest intake of 1/4 was 18(11.1%). There were significant differences in single amount of intake food by patient's subjective feeling(P<.001). Single amount of intake food among three groups were no significant difference in type of gastrectomy, hospital length, body mass index and albumin level. Conclusion : The findings of the study showed that single amount of the intake food was correlated with subjective feeling of patients. Therefore, subjective feelings should be considered important factors in developing diet program for patients with gastrectomy.
Measuring Effects of Quality Improvement through the Development of Critical Pathway for Gamma Knife Radiosurgery
Kim, Moo Seong ; Ha, So Young ; Bae, Yoon Hyuk ; Jung, Yong Tae ; Kim, Sung Tae ; Lee, Won Hee ; Go, Yeon Joo ;
Quality Improvement in Health Care, volume 18, issue 1, 2012, Pages 27~36
Objectives : A protocol called "critical pathway" was developed to standardize the management of hospital patients the day after they underwent gamma knife radiosurgery. The quality of improvement in patient outcomes was evaluated. Methods : Critical pathway was developed, according to the regulations of the I hospital, by analyzing the medical records of 22 inpatients who underwent gamma knife surgery within the period from January to April 2011 on the day of the surgery. The study included a group of 22 patients admitted to the hospital the day after they underwent gamma knife radiosurgery, between July and September 2011. The control group included 22 patients who had surgery employing the same method within the period from May to June 2011. To measure the effects on quality improvement, the average length of stay, the execution rate of the hospital discharge notice system, daily hospital revenue, and the satisfaction of the patients and the medical team were assessed. The patient questionnaire employed a four-point Likert scale while the medical-staff questionnaire employed a five-point Likert scale. Result : The average length of stay was significantly shorter in the study group compared to the control group (2.3 days vs. 3.8 days, P<0.05). The execution rate of the hospital discharge notice system was higher in the study group (100% vs. 72%) than in the control group. Daily hospital revenues were higher by 264,178 Korean won in the study group when compared to the control group. The study group showed greater satisfaction of patients compared to the control group based on a four-point Likert scale (P<0.05). The study group showed greater satisfaction in medical team compared to the control group based on a five-point Likert scale (P<0.05). Conclusion : The development and implementation of a critical pathway protocol for hospital admission the day after gamma knife radiosurgery is an effective care process that improves the clinical quality.
Development of a Flexible Critical Pathway with Electronic Medical Record for Gastrectomy Patients in a University Hospital
Bae, Myung Sun ; Song, Jung Hup ;
Quality Improvement in Health Care, volume 18, issue 1, 2012, Pages 37~55
Objectives : This study was conducted to evaluate the effect of fixed critical pathway with emr (electronic medical record) on the length of hospital stay, the cost and quality of care provided to gastrectomy patients in a university hospital and to develop flexible critical pathway with emr which can be used excluded or drop-out patients. Methods : Thirty-eight patients with gastrectomy were included as case group and Thirty-four patients included as control group. The comparison between control and case with using fixed critical pathway were done. To develop and to evaluate usefulness of flexible critical pathway with flexible data base, simulation was done for flexible critical pathway with drop-out patients. Result : The major results of this study were as follows: There were no significant differences in patient clinical conditions and no sign of deterioration of quality from critical pathway. The length of hospital stay was 11 days in control group, 8 days in path group(P<0.01). The total costs during the hospital stay were reduced in path group. However the cost per day was significantly increased from reduction of hospital stay(554,352 won in control, 645,669 won in path group). One hundred percentage of drop out patients(60) in the simulation of flexible critical pathway was successful. Conclusion : Computerized critical pathway reduced the length of hospital stay, total hospital costs and resource utilization without harming quality of patient care. The flexible critical pathway program can be used as one of the powerful management tools for reducing the practice variations and increasing the efficiency of care process and decreasing the workload of doctors and nurses in Korean hospital settings.
A survey on Healthcare workers' perception of Patient Safety culture and medical error reporting
Yu, Jung Eun ;
Quality Improvement in Health Care, volume 18, issue 1, 2012, Pages 57~70
Background : The purpose of this study was to understand healthcare workers' perception of patient safety culture and medical error reporting to provide basic resources for the settlement of patient safety culture in medical institutions in Korea. Methods : For this purpose, convenience sampling by self-selection was applied to healthcare workers at a university hospital in Gyeonggi-do and a total of 482 people responded. The survey used the translated version of AHRQ in Korean and distributed through the Intranet system of the hospital. Result : The ratio of positive response was low overall. Among the responses, the response for 'Nonpunitive Response to Error' was the lowest at 17.7%, followed by the responses for 'Staffing' at 21.3%, 'Handoffs & Transitions' at 32.9%, and 'Communication Openness' at 44.3%. In result of surveying whether the responders have reported patient safety incidents during the past 12 months, 68.3% responded 'not once.' Conclusion : The perception of healthcare workers' patient safety culture and medical error reporting, when compared to AHRQ, was lower overall. It is important for healthcare workers to pay greater attention to patient safety to create a safe hospital culture where they do not punish or criticize related individuals or departments.
The prophylactic uses of antibiotics for the prevention of surgical site infection and the effects: The 3-year experience in a tertiary hospital
Yang, Jiyeon ; Kim, Moon-Sook ; Kim, Yu-Jeong ; Lee, Eun-Bong ;
Quality Improvement in Health Care, volume 18, issue 1, 2012, Pages 71~78
Background : The objective of this study was to examine the effect of management system for the appropriate prophylactic use of antibiotics in surgical patients at a tertiary hospital from 2007 to 2010. Methods : We collected clinical data of three different surgical procedures(colectomy, heart surgery, hysterectomy) for three months of 2007 and 2010, respectively. The number of total cases was 245(137, 54, 54) in 2007, 240(133, 42, 65) in 2010. We measured the rate of use of inappropriate prophylactic antibiotics, administration within 1 hour prior to the incision and the antibiotics prescription days after surgery. To evaluate the effectiveness of the management system, the results of the two groups(Group1=2007, Group2=2010) were compared by t-test, chi-square test or Fisher's exact test. Result : The rate of Aminoglycoside uses decreased drastically from 11.4% to 0.8%(P<.001). The selection of 3rd/4th Cephalosporin dropped from 11.8% to 5.8%(P=.020). The combination of antibiotics decreased from 27.8% to 11.7%(P<.001). The antibiotic prescription rate on discharge declined from 11.8% to 2.5%(P<.001) and the number of antibiotics prescription days after surgery was shortened from 4.2 days to 2.3 days(P<.001). No significant difference in the rate of administration within 1 hour between two groups was found. Through 3-year management, 5 out of 6 measures were significantly improved(except the administration within 1 hour). The rate of surgical site infection decreased from 2.4% to 1.3%(P=.504). Conclusion : The findings demonstrate that the management system for the prophylactic use of antibiotics in surgical patients was effective in decreasing the rate of surgical site infection during 3 years.
Root Cause Analysis: A Medication Error
Song, Myeng Hee ; Chun, Ja Hae ; Koh, Hong ; Kim, Ki Jun ;
Quality Improvement in Health Care, volume 18, issue 1, 2012, Pages 79~87