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최귀선,이선희,조우현,강혜영,채유미 한국의료QA학회 2001 한국의료질향상학회지 Vol.8 No.2
Background : To propose effective strategies for successful implementation of QI in health care institutions, by identifying facilitating factors and barriers to conducting QI programs. Methods : In order to examine empirical evidence on the success factors or barriers to QI implementation in hospitals, a literature study was performed on the basis of MEDLINE search. Among the identified literature. 13 provided reliable findings and basis comprehensive discussion on this issue and thus were selected for in-depth analysis. A mailed questionnaire survey was conducted for hospital CEOs and QI directors of hospitals with 400 beds or greater to investigate what attributes of their organizations they perceived as success factors or obstacles to QI implementation. Result : The analysis of selected literature and survey results presented that the primary factors considered to be most important as successful implementation of QI were: strong support from hospital CEOs, setting higher priority for QI activities, continuous and persistent efforts in QI activities, and active participation of clinical staffs. The barriers identified in this study were : the lack of orientation and understanding of QI concepts, low level of interest and participation of physician in QI programs, the lack of evaluation and rewarding system for QI activities. Conclusion : By identifying factors that affect facilitation of QI, the study results will be of great use for either institutions being in the early stage of evolving QI or those looking for better strategies to achieve more active and persistent QI implementation in their institutions.
이선희,채유미,지영건,최귀선 한국의료QA학회 2001 한국의료질향상학회지 Vol.8 No.2
Background : This study was carried out to assess the quality improvement(QI)activities in Korean hospitals. Methods : A mailed questionnaire survey was conducted between September 15 and October 30, 2000. The staffs being charge of QI each of the hospitals with 400 beds or more responded to the questionnaire. Of the 108 hospitals eligible for inclusion in our study, 69 participated, yielding a response rate of 63.9%. Results : Based on these survey, 87.3 percent of the responding hospitals were performing QI projects and 54 percent of the hospitals had a separate department for QI activity. About 62 percent of hospitals performing QI activity(QI hospitals)had a QI manager and 58 percent had a separate budget for QI activities. Among the QI hospitals, 85 percent had cross-functional or cross-departmental teams as the major mechanisms for doing QI projects, 94 percent had one or more educational programs on QI. The level of physician’s participation level for QI projects was lower than other staff(CEO, nurses and other administrators). Conclusion : The majority of the hospitals have undertaken activities in QI. For the successful implemented QI, the involvement of and education for employees(including physicians and other health professionals)are needed as well as management strategy and leadership. Understanding of other hospitals experience would be helpful for health care managers to plan and initiate QI activities.
채유미,이선희,최귀선 한국의료QA학회 2001 한국의료질향상학회지 Vol.8 No.2
Background : the hospitals in Korea are in a situation of a severe competition than the past. This situation was resulted from the increase in the number of hospitals and also from the government policy controlling the medical insurance fee. Moreover, consumer’s desire for the high quality medical service g\has been significantly increased. Many programs to improve the quality of medical services are being performed in hospitals since the middle of 1990’s. Studies up to now reported that more than 10 programs are being performed per hospital in Korea. So far studies have been performed to measure only the number of such programs in a hospital. The purposes of this study are to examine a specific area involved in the programs designed to improve the medical service quality and to suggest a future direction of the such programs. In addition, we hope that the results from this study could assist the programs for the medical service quality. Methods : A mailed questionnaire survey of the QI staffs at hospitals with 400 beds or more was conducted between September 15 and October 30, 2000. Of the 108 hospitals eligible for inclusion in our study, 69 participated, yielding a response rate of 63.9%. Excluding 7 hospital which are not responsed about activities of hospital then 62 hospitals were used for the analysis. Result : The total number of programs was 1,081 from the 62 hospitals participated in the survey. The highest number(24.8 programs) was found in the hospital having more than 800 beds and performing the programs more than 5 years. The 1,081 programs were consisted of 445 from the medical examination area, 343 from the medical examination support area, and 296 from the management area. Conclusion : This study showed the present situation of hospitals in Korea regarding to the quality improvement programs. The results from this study suggest that the pattern of the program for the medical service improvement is being changed to service process and result-centered programs from the structural area.
Kui Sun Choi,Dong-Sik Kim,Sung Won Jung,Young-Dong Yu,Sung Ock Suh 한국간담췌외과학회 2014 한국간담췌외과학회지 Vol.18 No.4
Backgrounds/Aims: The prognosis of hepatic resection for hepatocellular carcinoma (HCC) in patients with cirrhosis is worse than in those without cirrhosis. In Korea, the hepatitis B virus prevalence rate is higher than in other countries. Therefore, we investigated patients’ clinicopathologic and metabolic factors that affect the postoperative outcomes of hepatic resection for HCC in our hospital in Korea. Methods: From August 2000 to December 2012, 171 HCC patients underwent hepatic resections at our institution. Two operative mortality cases and two short-term follow up cases were excluded. Data was collected from a retrospective chart review. There were 133 males (79.6%) and 34 females (20.3%), with a mean age of 58.2±10.2 years (range, 22-81 years), and the relationship between clinicopathologic and metabolic factors and the prognosis of patients with HCC undergoing hepatic resection were evaluated by univariate and multivariate analysis. Results: Hypertension, major surgery, perioperative transfusion, resection with radiofrequency ablation (RFA) or cryoablation, and resection margin were risk factors for overall survival, and hypertension, albumin, resection with RFA or cryoablation, perioperative transfusion, and tumor size were risk factors for disease-free survival. Conclusions: We found that hypertension, perioperative transfusion, and resection with RFA or cryoablation were risk factors for both disease-free and overall survival after hepatic resection in HCC patients. Further study is required to clarify the influence of metabolic and other clinicopathologic factors on the prognosis of HCC.
Choi, Sun Young,Lee, Yong Hee,Kim, Hyuk,Koh, Hyun-Ju,Park, Sun-Young,Park, Won-Seok,Bae, Il-Hong,Park, Kui Young,Kim, Beom Joon Informa Healthcare 2014 Journal of cosmetic and laser therapy Vol.16 No.1
<P><I>Background:</I> Within the last few years, hyaluronic acid (HA) fillers and radiofrequency (RF) devices have shown significant promise for skin rejuvenation. But the effects of HA only lasted for a relatively short duration. Therefore, we tried a new combination therapy of intradermal RF and HA filler. <I>Objective:</I> To evaluate the clinical efficacy of combination therapy of intradermal RF and HA filler for nasolabial fold (NLF) wrinkle reduction. <I>Materials and methods:</I> Ten Korean female volunteers with mild to severe NLFs were enrolled. In the control group, five subjects were treated with HA filler alone. In the experimental group, the other five subjects were treated with intradermal RF prior to HA filler. Efficacy was evaluated based on the change on the Wrinkle Severity Rating Scale (WSRS) and the Global Aesthetic Improvement Scale (GAIS) from baseline. <I>Results:</I> At 12 and 24 weeks after treatment, the experimental group showed significantly greater improvement in mean WSRS score compared to the control group. And two (40%) of the five patients in the experimental group achieved ‘very much improved’ and two (40%) showed ‘much improved’ at 12 weeks after treatment. <I>Conclusions:</I> Intradermal RF treatment prior to HA filler injection may provide synergistic and long-lasting effects for the reduction of NLF wrinkles.</P>
( Kui Young Park ),( Woo Sun Jang ),( In Pyeong Son ),( Sun Young Choi ),( Moo Yeol Lee ),( Beom Joon Kim ),( Myeung Nam Kim ),( Byung In Ro ) 대한피부과학회 2013 Annals of Dermatology Vol.25 No.1
Background: Alopecia areata (AA) is believed to be an organ-specific autoimmune disease in which a mononuclear cell infiltrate develops in and around anagen hair follicles. There is no definitive therapy for AA. Objective: We sought to determine whether the combination therapy of cyclosporine and psoralen plus ultraviolet A (PUVA) could be an effective treatment for severe AA. Methods: A total of 41 patients with severe AA were treated with oral cyclosporine and topical PUVA. Cyclosporine was given at an initial daily dose of 200 mg for adult and 100 mg for children for periods of up to 16 weeks. Eight-methoxypsoralen (Methoxsalen) was applied topically 20 minutes prior to ultraviolet A (UVA) exposure, and the patients were irradiated with UVA twice a week for 16 weeks. Results: Of the total 41 patients, 2 (7.3%) patients were lost to follow-up, and 1 (2.4%) patient discontinued the treatment due to abdominal discomfort. Six (14.6%) patients were treated for less than 12 weeks. Of remaining 32 patients, 3 (9.4%) showed excellent response, 3 (9.4%) showed good response, 12 (37.5%) showed fair response, and 14 (43.7%) showed poor response. Conclusion: Although limited by its uncontrolled character, this study shows that the combination therapy with cyclosporine and PUVA may be an additional choice for severe and recalcitrant AA. (Ann Dermatol 25(1) 12∼16, 2013)