Ambulatory Care ; COVID-19 ; Health Facility Planning ; Hospital Bed Capacity ; Hospitals, Rehabilitation ; Humans ; Infection Control ; Rehabilitation ; Remote Consultation ; SARS-CoV-2 ; Singapore ; Telerehabilitation ; Triage

Decentralization to local governments and amending of Health center Law are to promote the efforts of health planning at the level of local agencies. In the health facility planning, it is important to take into account that what to be built, where to be located, how far should be service area and so forth, because health facilities are immovable, and require capital as well as personnel and consumable supplies. The aim of our study, answering to the question of 'where to be located?`, is to determine the best location of urban health sub-center. At the local level, planning is the matter of finding the best location of specific facility, in relation to population needs. We confine the accessibility, which is basic to location planning, to geographic one. Location-Allocation Model is used to solve the problem where the location is to maximize geographic accessibility. To minimize the weighted travel distance, objective function, Rk= aijwidij is used. Distances are measured indirectly by map measure-meter with l:25,000 Suwon map, and each potential sites, 10 administrative Dongs in Kwonson Gu, Suwon, are weighted by each number of households, total population, maternal age group, child age group, old age group, Relief for the livelihood, and population/primary health clinics. we find that Kuwoon-Dong, Seodun-Dong, Seryu3-Dong, according the descending orders, are best sites which can minimize the weighted distance, and conclude that it is reasonable to determine the location of urban health sub-center among those sites.
Child ; Equipment and Supplies ; Family Characteristics ; Gyeonggi-do ; Health Facilities ; Health Facility Planning ; Health Planning ; Humans ; Jurisprudence ; Maternal Age ; Politics ; Urban Health*

The IS(Information System) strategic planning must be based on objectives and strategic planning of the organization. The IS strategic planning for a hospital is not different from other organizations. Perhaps it can be more important than other types of organizations. Hospitals possess unique characteristics which hinder implementation of the IS. Therefore when the objectives and the focus of IS are clear, the resources can be allocated effectively and integrated IS can be applied. This study will suggest general objectives and strategic planning of the hospital. Thereby we will propose the strategic planning and development planning model of IS for hospitals. Suppose that the objectives of a hospital are the quality service and effective costs reduction. To achieve these objectives we will propose the strategies such as procurement of qualified physician and personnel, maximization of productivity, maintenance of good services and comfortable environments, and redesign of business process. Thus strategic planning of IS for hospital organizations is established as the follows: 1. The objectives of the IS for a hospital are to monitor the outcome of medical services and hospital performance, and to deliver the doctor's order in order to provide the quality services to patients. Therefore the IS design strategy for the hospital should be planned to achieve these objectives. To establish these goals all hospital data should be computerized and the IS should be able to monitor the performance of the hospital. Direct dat input environment is essential for the system. 2. The direction of master plan of the IS for a hospital is the integrated system. The methods of approach for the integrated system is selected to cover the all primary data from medical services rather than functional units. 3. The objectives of development of medical service information system, first phase of master plan, include : on-line input and delivery system of all doctor's orders, inquiry about all test in any time at any places in the hospital, automated scheduling of nursing work at nurse station, hospital billing, and ancillary services. 4. In order to achieve the goal, CSFs(critical success factors) to be resolved are : doctors must enter their own orders, the employee consents to replace the manual paper work with IS, the system is maintained with rapid response even though peak time, many functions must be constructed in the short period. 5. Therefore development strategic planning of IS is suggested to maximize user's convenience, specially, for doctors, to apply several data servers with independent functions, and to introduce client-server system, and to use the commercial DBMS.
Commerce ; Efficiency ; Hospital Information Systems* ; Humans ; Information Systems ; Nursing ; Nursing Stations ; Social Change* ; Social Planning

While armed assailant attacks are rare in the hospital setting, they pose a potential risk to healthcare staff, patients, visitors and the infrastructure. Singapore hospitals have well-developed disaster plans to respond to a mass casualty incident occurring outside the hospital. However, lack of an armed assailant incident response plan can significantly reduce the hospital's ability to appropriately respond to such an incident. The authors describe various strategies that can be adopted in the development of an armed assailant incident response plan. Regular staff training will increase staff resilience and capability to respond to a potential threat in the future. The aim of this article is to highlight the need for the emergency preparedness units of all hospitals to work together with various stakeholders to develop an armed assailant incident response plan. This will be of great benefit for keeping healthcare facilities safe, both for staff as well as for the community.
Delivery of Health Care ; Disaster Planning ; Emergency Service, Hospital ; Hospitals ; Humans ; Singapore

We report two cases of toxic methemoglobinemia caused by an inert ingredient in pesticide product after intentional ingestion of pesticide. First, 51-year-old male visited to the emergency department (ED) after the ingestion of pesticide in a suicide attempt. Initial methemoglobin (MetHb) level was 25.6%. We did not know the cause of methemoglobinemia at that time. Second, 56-year-old female visited to the ED after the ingestion of the same pesticide in a suicide attempt. MetHb level after 30 minutes was 16.1%. The patients were treated with methylene blue. We contacted to the Korean Rural Development Administration and estimated that magnesium nitrate was more likely to cause methemoglobinemia. This report highlights the importance of considering the possibility of methemoglobinemia caused by inert ingredient in pesticide and early antidotal therapy.
Eating* ; Emergency Service, Hospital ; Female ; Humans ; Magnesium ; Male ; Methemoglobin ; Methemoglobinemia* ; Methylene Blue ; Middle Aged ; Pesticides ; Social Planning ; Suicide

PURPOSE: Effective triage at the emergency department entrance is the key to dealing with mass casualty incidents. However, in Korea, triage has been accomplished at the disaster scene or at the hospital in only a few cases. Thus, we report on the planning and preparation for triage at Asan Medical Center (AMC) for mass casualty incidents. METHODS: We review the AMC disaster plan and the triage systems used in previous disasters. Also, we review triage principles appearing in the literature. We describe basic hospital triage principles, which include the treatment site, the triage site, the triage officer, triage categories, and triage tags. RESULTS: 1) For external disaster, the emergency department is reassigned to four treatment sites before patients arrive. At the triage site, an emergency medicine specialist classifies patients into six groups according to treatment priority and resources. After classification, a triage tag is attached to each patient, and patients are moved to the previously designated treatment site. 2) For internal disaster, the head nurse (or senior nurse) classifies patients into three groups: urgent, minor, and delayed. The minor group is sent to the casualty collection point while the urgent and delayed groups are moved to the triage site. CONCLUSION: Hospitals should prepare a disaster plan. In particular, preplanning for triage is essential to cope with internal and external disasters. In addition, emergency medicine specialists should play a key role in disaster planning and are essential for successful implementation of the disaster plan.
Chungcheongnam-do ; Classification ; Disaster Planning ; Disasters ; Emergency Medicine ; Emergency Service, Hospital ; Humans ; Korea ; Mass Casualty Incidents* ; Nursing, Supervisory ; Specialization ; Triage*

We report two cases of toxic methemoglobinemia caused by an inert ingredient in pesticide product after intentional ingestion of pesticide. First, 51-year-old male visited to the emergency department (ED) after the ingestion of pesticide in a suicide attempt. Initial methemoglobin (MetHb) level was 25.6%. We did not know the cause of methemoglobinemia at that time. Second, 56-year-old female visited to the ED after the ingestion of the same pesticide in a suicide attempt. MetHb level after 30 minutes was 16.1%. The patients were treated with methylene blue. We contacted to the Korean Rural Development Administration and estimated that magnesium nitrate was more likely to cause methemoglobinemia. This report highlights the importance of considering the possibility of methemoglobinemia caused by inert ingredient in pesticide and early antidotal therapy.
Eating ; Emergency Service, Hospital ; Female ; Humans ; Magnesium ; Male ; Methemoglobin ; Methemoglobinemia ; Methylene Blue ; Middle Aged ; Pesticides ; Social Planning ; Suicide

PURPOSE: The purpose of this study is to systematically review and analyze disasters involving South Korean hospitals from 1990 and to introduce a newly developed implement to manage patients' evacuation. MATERIALS AND METHODS: We searched for studies reporting disaster preparedness and hospital injuries in South Korean hospitals from 1990 to 2008, by using the Korean Studies Information Service System (KISS, copyright Korean Studies Information Co, Ltd, Seoul, Korea) and, simultaneously, hospital injuries which were reported and regarded as a disaster. Then, each study and injury were analyzed. RESULTS: Five studies (3 on prevention and structure, 1 on implement of new device, and 1 on basic supplement to current methods) and 8 injuries were found within this period. During the evacuations, the mean gait speed of walking patients was 0.82 m/s and the mean time of evacuation of individual patients was 38.39 seconds. Regarding structure evaluation, almost all hospitals had no balconies in patient rooms; hospital elevators were placed peripherally and were insufficient in number. As a new device, Savingsun (evacuation elevator) was introduced and had some merits as a fast and easy tool, regardless of patient status or the height of hospital. CONCLUSION: In South Korea, preparation for hospital disasters was noted to be insufficient but has involved various departments such as architectural, clinical, and building operations. In addition, Savignsun has been shown to effectively evacuate and save patients in a hospital disaster.
Disaster Planning/*methods ; *Disasters ; Emergency Service, Hospital ; Equipment Design ; Hospital Administration ; *Hospitals ; Humans ; Japan ; Patient Transfer ; Republic of Korea ; Transportation of Patients ; United States

PURPOSE: This study is to enable emergency centers to adequately cope with a vast number of demonstration-related injured patients by using an interventional study. With this analysis, emergency centers can hopefully prepare with adequate manpower, equipment and resources. METHODS: We reviewed the medical records of 117 patients with injuries related assembly and demonstration who visited the Emergency Medical Center of St. Mary's Hospital from Aug 13, 1999, to Jan 31, 2004 (pre-intervention state). These patients were analyzed according to sex, age, the severity of injury, the presence of a laceration, the injury mechanism, the final diagnosis, and the areas of the injury. Using these data, we established a disaster plan, then, we applied that plan to 59 patients who visited the Emergency Medical Center during Feb 2004 (post-interventional preliminary study). RESULTS: The common areas of the injury were the face (35.1%), the head (33.1%), and the extremities (25.4%) during the pre-intervention state. The number of patients with lacerations was 61 (52.1%). According to this, we established our own external hospital disaster plan. During the preliminary post-interventional study, the plan reduced the length of hospital stay, the delayed time to radiology, and the not-sutured rate (p<0.05). CONCLUSION: When patients injured during violent demonstrations are expected, local emergency care hospitals need to prepare manpower, resources, and supplies for facial and head lacerations and apply their disaster plan.
Diagnosis ; Disaster Planning* ; Disasters* ; Emergencies* ; Emergency Medical Services ; Emergency Service, Hospital* ; Equipment and Supplies ; Extremities ; Head ; Humans ; Lacerations ; Length of Stay ; Medical Records

Due to heightened concerns regarding possible bioterrorist attacks, the Korea Center for Disease Control and Prevention introduced syndromic surveillance systems, which have been run by emergency departments in hospitals throughout Korea since 2002. These systems are designed to identify illness clusters before diagnoses are confirmed and reported to public health agencies, to mobilize a rapid response, and thereby to reduce morbidity and mortality. The Korea Center for Disease Control and Prevention performed drop-in syndromic surveillance successfully during the World Cup Football Games in 2002, the Universiad games in 2004, and the Asian Pacific Economic Cooperation meeting in 2005. In addition, sustainable syndromic surveillance system involving the collaborative efforts of 125 sentinel hospitals has been in operation nationwide since 2002. Because active data collection can bias decisions a physician makes, there is a need to generate an automatic and passive data collection system. Therefore, the Korea Center for Disease Control and Prevention plans to establish computerized automatic data collection systems in the near future. These systems will be used not only for the early detection of bioterrorism but also for more effective public health responses to disease.
*Bioterrorism ; Disaster Planning/organization & administration ; Disease Notification/*methods ; Disease Outbreaks/prevention & control ; Emergency Service, Hospital/*organization & administration ; Humans ; Korea ; Public Health Informatics/*organization & administration ; *Sentinel Surveillance ; Syndrome