수련병원의 평균재원일수에 영향을 주는 요인에 관한 연구

서순원,박일환 한국의료QA학회 1994 한국의료질향상학회지 Vol.1 No.2

Background: The average hospital stay in most Korean teaching hospitals is longer than that of hospitals in developed countries. The investigation of average hospital stay of teaching hospitals is considered as an important measure to evaluate the effectiveness of hospital management. In this article authors analyzed the relationship of several variables (hospital ownership, number of beds, location of hospitals, number of physician) to length of hospital stay in each clinical department Methods: The average hospital stay of each clinical department of 184 teaching hospitals was investigated. Authors reviewed the papers of teaching hospitals, that was reported to the Korean Association of Hospitals. Results: The means of hospital stay day of hospitals were not significantly different according to the number of hospital beds and location of hospitals. Only the difference of hospital stay according to ownerships was significant. The length of stay was the highest in public hospitals and the lowest in juridical hospitals. Conclusions: The number of beds and location of hospitals were not associated with the average hospital stay. But ownerships affected the average hospital stay. The national or public hospitals had the longest length of hospital stay. Number of specialists and number of all physicians were closely related to the average hospital stay.

의료기관 종별 의무기록 중요서식 항목별 작성 실태 및 의무기록 완결점검표 분석

서순원,김광환,황용화,강선희,강진경,조우현,홍준현,부유경,이현실 한국의료QA학회 2002 한국의료질향상학회지 Vol.9 No.2

Background : This study is to suggest the standardized format of the clinical sheets and the standardized items of every clinical sheet. The standardization of the medical records will increase the faithfulness of the contents in them and it will contribute to construct the good health information system. Method : From Jan. 1st. 2001 to March 31st 2001, we gathered as many paper clinical sheets as possible by every class of institutions to review the faithfulness of the clinical contents in them. Clinical sheets of 9 tertiary care hospitals, 6 general hospitals and 56 clinics were gathered. Two experienced medical record administrators reviewed them. The review focus was to check whether the items recommend by the hospital standardization review criteria and hospital service evaluation organization were appeared in the clinical sheets and whether the contents of every item were written. Results : Tertiary care hospitals ; In case of administrative data, the contents were filled well if the items were fixed. The clinical data like C.C, history, physical examiniation were filled well, but if the items were not fixed, some items were omitted. The result is that more items are to be filled if they are fixed. General hospitals Administrative data were filled more than 50%. Final diagnosis was filled about 66.7%. But other clinical data were not filled well and not many clinical related items were appeared in the sheets. In the legal point of view, the reason for visiting hosptals or the right diagnosis, patient condition at discharge could not be confirmed well. In surgery cases, surgical procedures could not be confirmed well as many surgical related information(surgery time, fluids and blood, number of sponges, biopsy, etc) were omitted. Clinics : More than 70% administrative data were filled and fixed as items. Among the clinical related data, laboratory result was the most credible data. But without the right diagnosis, drug orders were given and doctors’ written signatures were not appeared over 96.4%. So the clinical sheets cannot be used as a legal document. Conclusion : There was a tendency that the contents were filled well if the items were fixed in the documents, We also suggest a clinical check list to review the completeness and faithfulness of the clinical sheets. If many hospitals use the suggested clinical check list and in they make the necessary items fixed in the clinical sheets, the quality of the medical record will increase dramatically.

Analysis of Information Security Management Systems at 5 Domestic Hospitals with More than 500 Beds

서순원,박우성,손승식,이미정,김신효,최은미,방지언,김예은,김옥남 대한의료정보학회 2010 Healthcare Informatics Research Vol.16 No.2

Objectives: The information security management systems (ISMS) of 5 hospitals with more than 500 beds were evaluated with regards to the level of information security, management, and physical and technical aspects so that we might make recommendations on information security and security countermeasures which meet both international standards and the needs of individual hospitals. Methods: The ISMS check-list derived from international/domestic standards was distributed to each hospital to complete and the staff of each hospital was interviewed. Information Security Indicator and Information Security Values were used to estimate the present security levels and evaluate the application of each hospital’s current system. Results: With regard to the moderate clause of the ISMS, the hospitals were determined to be in compliance. The most vulnerable clause was asset management, in particular, information asset classification guidelines. The clauses of information security incident management and business continuity management were deemed necessary for the establishment of successful ISMS. Conclusions: The level of current ISMS in the hospitals evaluated was determined to be insufficient. Establishment of adequate ISMS is necessary to ensure patient privacy and the safe use of medical records for various purposes. Implementation of ISMS which meet international standards with a long-term and comprehensive perspective is of prime importance. To reflect the requirements of the varied interests of medical staff, consumers, and institutions, the establishment of political support is essential to create suitable hospital ISMS.

‘생각맞이 수업’을 통한 교실 속 인성교육의 실천

서순원 한국인성감성교육학회 2017 한국인성감성교육학회 학술대회자료집 Vol.2017 No.2

3개 대학병원의 주 진단 코딩사례 평가

서순원,김광환,부유경,서진숙,서정돈,윤석준,이영성,이무식,정희웅 한국의료QA학회 2002 한국의료질향상학회지 Vol.9 No.1

Background : Coding of principal diagnosis is essential component for producing reliable health statistics. We performed this study to evaluate the current practice of principal diagnoses determination and coding, and to give some basic data to improve coding of principal diagnosis. Method : Nineteen medical record administrators(MRAs) of 3 university hospitals participated in coding principal Dx. From August 1, 2001 to August 31, 2001. From each hospital, 10 medical records of patients with high frequency disease were selected randomly. Each 10 medical records were grouped into three(A,B,C). Then, these 30 medical records were given to each MRAs for coding. At the same time questionnaire was given to each of them. Questions were to prove how they decide and code the principal diagnosis among many current diagnoses ; how they decide and code the principal diagnosis when day see irrelevant diagnosis recorded as the principal diagnosis in medical record, when only tentative diagnoses were recorded without final diagnosis, and when different diagnoses were recorded in different sheets of same record. Agreement of coding among 3 hospitals were compared and survey results were analysed with SAS 6.12. Results : Agreement of coding was found in medical records 5-6 of each 10 medical records. Causes of disagreement were as follows. Difference of clinician’s opinion from each hospital; mixed use of guideline from KCD-3 and guideline from DRG; difference in 4th digit classification according to the absence of pathology report in the medical record; difference of abbreviations among hospitals. 57.9% of decided principal diagnosis after consulting to KCD-3 guideline. When there were difficulties in determining the principal diagnosis, 42.1% of MRAs decided principal diagnosis after discussion with the physician, 26.3% after discussion with fellow MRAs. Conclusion : There were differences in coding among hospitals. To minimize the difference, we suggest the development of disease-specific guidelines for coding in addition to the current general guideline such as KCD-3. To do this, Coding Clinic which can produce guidelines is needed.

선생님, 우리 선생님 - 달맞이꽃 향기로 아침을 열며

서순원 샘터사 2002 월간 샘터 Vol.33 No.11

미 완결 의무기록의 개선방향을 위한 미비점검 방법 모델 개발에 관한 연구

서순원,김광환,원시연,장혜숙,김기현,김해현,이명익,박우성,윤석준 한국의료QA학회 1999 가을학술대회 Vol.1998 No.-

미 완결 의무기록 검토를 위한 접근법은 최근까지 두 가지 방법이 주로 사용되었다. 첫째, 퇴원 후에 의무기록과에서 양적 분석을 통하여 필수기록들과 담당의사의 서명이 되어 있는지, 모든 기록에 환자의 인적사항이 정확히 기재 유무상태와 미비항목이 표시된 미비기록 검토기록지를 의무기록지에 끼워 보관해 온 방법이다. 둘째, 미비체크된 항목을 미비관리 프로그램에 입력한 후 검토, 분석하는 내용이나 방법은 이미 정형화된 통계형식의 있는 미비된 항목을 분석해 내는 비교적 단순한 검토 방법으로, 내용적인 분석이라기 보다는 기록중 소홀하였거나 업무 수행상 발생되는 문제들을 검토하는 수준이다. 이와 같은 방법은 의무기록 표준에 부합하는 자료의 보완에는 도움이 되었지만 의무기록관리규정에서 정한 기간 내에 완성되지 않은 미완결기록이 많을 경우에는 퇴원후 소급하여 기록을 완성하게 되므로 양질의 의무기록에 도움이 되지 않으며 효율적인 병원 행정 측면에서는 소비적인 업무가 될 수도 있다. 이와 같은 배경하에 위 두 방법을 사용한 미 완결 의무기록 검토는 각각의 방법마다 장단점이 있으나 실제 병원에서 의무기록충실도를 높이기 위해서는 보다 새로운 모형을 개발할 필요가 제기 되고 있다.

SmartTV 기반의 콘텐츠 공유에 관한 서비스 연구

서순원(Seo Soon Won),강형구(Kang Hyung Ku),윤희용(Youn Hee Yong) 한국통신학회 2012 한국통신학회 학술대회논문집 Vol.2012 No.11

외래환자의 고객충성도 예측요인

이은휘;반영란;서종희;김미경;서순원;이은경 중앙대학교 의과대학 간호학과 간호과학연구소 2009 중앙간호논문집 Vol.13 No.-

Purpose: This study is to identify predictors of customer loyalty on outpatients. The sarnple consisted 200 outpatients who visit the C university hospital in Seoul. Data were collected from September 14. 2009 to October 9. 2009 through self report questionnaire. Methods: The data were analyzed using factor analysis, partial correlation analysis, one-way ANOVA, and multiple regression analysis with the SPSS for Windows 12.0 program. Three structured instruments were used to collect the data : Medical service quality measurement. Customer loyalty questionnaire. switching barrier questionnaire which were developed by the researcher. Results: The result of this study are as follows 1) The most important predictor was the medical service quality. The explartation showed 67.0% for medicall service quality, 63% for switching barrier barrier 4 % and for type of the residency 1% 2) The most irnportant predictor of the Custorner loyalty was the medical service quality. The switching barrier effected it secondly. The general characteristics was affected by the type of the residency. The mean scores of medical service quality(5.23±1.04), switching barrier(5.18±1.04) and customer loyalty(5.l8±1.04) were respectively. Conclusion: This study has drawn the loyalty in the medical service of outpatients. Further more. This result can be used in the marketing prograrn for getting predominant lasting competition among the hospital.

응급실 주진단명과 퇴원시 주진단명의 불일치도 조사

김광환,서순원,원시연,박석건,김승렬,송화식,김갑득,조혜경,부유경,이현경 한국의료QA학회 1998 한국의료질향상학회지 Vol.5 No.2

We surveyed the discordance rate of principal diagnosis made at emergency room(ER) & made at ward on discharge of the patients. Subjects were four hundred eighty cases who came to the ER of one third-line hospital from January 1. 1998 to January 31, 1998. The discordance rate was higher in patients admitted to medical department's.2%) than surgical department(1.5%). If the patients were transferred to other department during hospital stay, discordance rate increased from 3.3% to 6.3%. In conclusion, discordance rate of principal diagnosis made at ER and made at ward was higher in patients with complicated problems. Medical record department should keep these findings in mind if it has a plan to support the management of ER record.