OBJECTIVES: This study aims to discover patients loyal to a hospital and model their medical service usage patterns. Consequently, this study proposes a data mining application in customer relationship management (CRM) for hospital inpatients. METHODS: A recency, frequency, monetary (RFM) model has been applied toward 14,072 patients discharged from a university hospital. Cluster analysis was conducted to segment customers, and it modeled the patterns of the loyal customers' medical services usage via a decision tree. RESULTS: Patients were divided into two groups according to the variables of the RFM model and the group which had significantly high frequency of medical use and expenses was defined as loyal customers, a target market. As a result of the decision tree, the predictable factors of the loyal clients were; length of stay, certainty of selectable treatment, surgery, number of accompanying treatments, kind of patient room, and department from which they were discharged. Particularly, this research showed that when a patient within the internal medicine department who did not have surgery stayed for more than 13.5 days, their probability of being a classified as a loyal customer was 70.0%. CONCLUSIONS: To discover a hospital's loyal patients and model their medical usage patterns, the application of data-mining has been suggested. This paper suggests practical use of combining segmentation, targeting, positioning (STP) strategy and the RFM model with data-mining in CRM.
Data Mining ; Decision Trees ; Hospital-Patient Relations ; Humans ; Inpatients ; Internal Medicine ; Length of Stay ; Patient Satisfaction ; Patient-Centered Care ; Patients' Rooms

PURPOSE: The main purpose of this study was to explore nurse-patient interaction behaviors and patient satisfaction with the interaction in the emergency department. METHOD: This study used video technology to record complete conversations between the nurse and patient, thus obtaining the interactions naturally occurring in a clinical setting. The participants were 28 nurses and 63 patients in the emergency department at one university hospital located in Seoul. The data was collected from November, 2002 to April, 2003. The video recordings were observed for 4 hours for each case and coded using an adapted version of Roter's Interaction Analysis System (RIAS), which yields frequencies of thirty-six types of interaction behaviors. RESULT: The information exchange related to therapeutic items including medications, simple orientation, and situational positive talk were characterized in the nurses' interaction behaviors. Giving information about one's own condition, questions about therapeutic regimen, and showing worry were characterized in patient interaction behaviors. The patients' satisfaction with the interaction was 37.75.9 (range 9-45). CONCLUSION: The emergency nurse-patient interaction behavior was task-related. The results suggest that identification of effective interaction behavior in the Emergency department and an interaction skill training program could increase patient satisfaction.
Patient Satisfaction ; *Nurse-Patient Relations ; Middle Aged ; Male ; Humans ; Female ; *Emergency Service, Hospital ; *Communication ; Aged, 80 and over ; Aged ; Adult

PURPOSE: The purpose of this study was to develop evaluation criteria for conversations about medication and to demonstrate conversational analysis with actual dialogues on medication as examples. METHODS: This study was a secondary analysis of qualitative research using conversational analysis which showed functional phases and patterns of dialogue about medication (greeting, identifying the patient, medicating, finishing). Nurse-patient conversations were videotaped and transcribed and 75 conversations were used for analysis. RESULTS: Not all functional phases were showed in the conversations about medication. Therefore, conversations about medication can be considered as incomplete dialogues. The evaluation-criteria were represented in terms of the structure and content of the dialogues. Structural evaluation-criteria were the same as the functional phases, as functional stage is the standard for evaluation. The criteria of evaluation for content suggested 3 domains, content, expression, and interaction with 20 items scored on a Likert-type scale of 5-points. Finally, analysis of actual conversations about medication according to the evaluative criteria were provided. CONCLUSION: The results provide the basic data to develop educational programs and strategies to improve nurses' competency in conversation about medication.
Clinical Competence ; *Communication ; Humans ; Medication Adherence ; *Nurse-Patient Relations ; Nursing Staff, Hospital/*psychology ; *Pharmaceutical Preparations ; Videotape Recording

PURPOSE: The purpose of the study was to determine the impact of regular nursing rounds on patient satisfaction with nursing care. METHODS: This was a controlled clinical trial in which 100 hospitalized patients in a medical surgical ward were allocated to control and experimental groups through convenience sampling. The experimental group received regular nursing rounds every 1e2 hours. Routine care was performed for the control group. Patient satisfaction with the quality of nursing care was assessed on the second and fifth days of hospitalization in both groups using Patient Satisfaction with Nursing Care Quality Questionnaire. RESULTS: On the second day, patient satisfaction scores of the two groups had no significant difference (p = .499). However, the intervention was associated with statistically significant increased patient satisfaction in the experimental group compared to the control group (p < .001). CONCLUSION: Implementing regular nursing rounds had a positive impact on patient satisfaction. This method may hence improve patient-nurse interactions and promote the quality of nursing care and patient satisfaction.
Adolescent ; Adult ; Aged ; Female ; Humans ; Iran ; Male ; Middle Aged ; Nurse's Practice Patterns/*organization & administration ; *Nurse-Patient Relations ; Nursing Staff, Hospital ; *Patient Satisfaction ; Questionnaires ; Young Adult

PURPOSE: The purpose of this study was to develop an informational leaflet on emergency care and to explore effects of facilitative nurse-patient interaction behavior using an informational leaflet on patient satisfaction with nurse-patient interaction behavior, patient anxiety, and patient satisfaction with use of emergency care. METHODS: This study was a quasi-experimental study that applied a nonequivalent control-group posttest-only design. The participants were 81 patients who visited the emergency department of a hospital in Korea; the experimental group (n=40) received facilitative nurse-patient interaction behavior using an informational leaflet, and the control group (n=41) received care under routine protocols without an information leaflet. The effects of the two groups were analyzed using an independent t-test with SPSS computer program. RESULTS: Patient satisfaction with nurse-patient interaction behavior and use of emergency care in the experimental group were significantly higher than in the control group. Patient anxiety related to using emergency care in the experimental group was significantly lower than the control group. CONCLUSION: Therefore, facilitative nurse-patient interaction behavior using an informational leaflet to the patient may be useful interventions that are easily implemented by nurses in emergency settings.
Anxiety ; Emergencies ; Emergency Medical Services ; Emergency Nursing ; Emergency Service, Hospital ; Humans ; Korea ; Non-Randomized Controlled Trials as Topic ; Nurse-Patient Relations ; Patient Satisfaction

PURPOSE: Current increase and complexity of medical tests and surgical procedures at outpatient department (OPD) require OPD nurses to have customer orientation focusing on various customers' interests and needs. The purpose of this study was to identify the factors associated with customer orientation in nurses working at OPD of hospitals. METHODS: The study used a descriptive correlational design with cross-sectional survey. The study settings were four general hospitals in Seoul and its metropolitan area. Data were collected from 138 OPD nurses from general hospitals. Study variables were personal traits, emotional intelligence, internal marketing, service management and customer orientation. RESULTS: Factors associated with customer orientation were identified as conscientiousness from personal traits (β .37, p < .001), emotional intelligence from individual characteristics (β .21, p = .032), and internal marketing from environmental characteristics (β .21, p = .001). CONCLUSIONS: Hospital administrators should support OPD nurses to cultivate sincere and sociable personal traits and emotional intelligence, and to consider employees as internal customers to improve patient-oriented services and satisfaction.
Adult ; Attitude of Health Personnel ; Cross-Sectional Studies ; *Emotional Intelligence ; Female ; Humans ; Male ; Marketing/*methods ; Middle Aged ; *Nurse-Patient Relations ; Nursing Staff, Hospital/*psychology ; Organizational Culture ; Outpatient Clinics, Hospital/*organization & administration ; Outpatients/*psychology ; *Patient-Centered Care ; Seoul ; Surveys and Questionnaires ; Young Adult

PURPOSE: The purpose of this study was to identify effective nurse interaction patterns with patients in the emergency department. METHODS: For this study, video technology was used to record complete conversations between the nurse and patient. The participants were 28 nurses and 63 patients in the emergency department at one university hospital located in Seoul. The data were collected from November, 2002 to April, 2003. The video recordings were observed for 4 hr for each case and coded using an adapted version of Roter's Interaction Analysis System (RIAS). The data were analyzed using cluster analysis to identify the patterns of nurse-patient interaction. RESULTS: Cluster analysis revealed 4 distinct nurse interaction patterns; 1) "closed" characterized by orientation and negative talk, 2) "positive" characterized by positive affective talk, 3) "informative and directing" characterized by task-focused behavior including data gathering, and giving information about medical condition and treatment, 4) "facilitative" characterized by balance of psychosocial and biomedical topics. Patient satisfaction was highest in the facilitative interaction pattern. CONCLUSION: The patient centered interaction pattern, balancing information exchange and psychosocial exchange are the most effective interactions in the emergency department, suggesting that effective interaction skill is a core clinical nursing intervention in acute care.
Adult ; Aged ; Aged, 80 and over ; Cluster Analysis ; Emergency Service, Hospital/*standards ; Female ; Humans ; Male ; Middle Aged ; *Nurse-Patient Relations ; Nursing Staff, Hospital/*psychology/standards ; *Patient Satisfaction ; Universities ; Videotape Recording

PURPOSE: The purpose of this study was to describe and to analyze real communication about a patient's discomfort between a patient with cancer and a nurse. METHOD: A dialogue analysis method was utilized. Fifteen patients and 4 nurses who participated in this research gave permission to be videotaped. The data was collected from January, 3 to February 28, 2006. RESULTS: The communication process consisted of 4 functional stages: 'introduction stage', 'assessment stage', 'intervention stage' and 'final stage'. After trying to analyze pattern reconstruction in the 'assessment stage' and 'intervention stage', sequential patterns were identified. In the assessment stage, if the nurse lead the communication, the sequential pattern was 'assessment question-answer' and if the patient lead the communication, it was 'complaint-response'. In the intervention stage, the sequential pattern was 'nursing intervention-acceptance'. CONCLUSION: This research suggests conversation patterns between patients with cancer and nurses. Therefore, this study will provide insight for nurses in cancer units by better understanding communication behaviors.
Adult ; Aged ; *Communication ; Female ; Humans ; Inpatients ; Male ; Middle Aged ; Neoplasms/nursing/*psychology ; Nurse's Role/psychology ; Nurse-Patient Relations ; Nursing Methodology Research ; Nursing Staff, Hospital/*psychology ; Tape Recording

PURPOSE: Effective communication is an essential aspect of nursing care. This qualitative study was performed to analyze nurse-patient conversations about medication. METHOD: The nurse-patient dialogue was collected by video tape recording during the nurse's duty time in an internal medicine ward. One hundred seventy-eight episodes were extracted from the conversation. Using conversational analysis, the functional phases and patterns of dialogue sequence pertaining to medication were analyzed. RESULTS: Conversations about medication were very brief dialogues, so 68.8% of the dialogue had a duration of less than 20 seconds. However, it was a systematic and comprehensive dialogue which had structures and sequential dialogue patterns. Four functional phases were explored: greeting, identifying the patient, medicating, finishing. The medicating phase was essential, in which the nurse gave the drug to the patient and provided information initiated by the nurse simultaneously. The patterns of the dialogue sequence represented were the nurse provided information first, and then, patients responded to the nurse as accepting, rejecting, raising an objection, or asking again later. CONCLUSION: As the results of this study show, a nurse's role is important as an educator. For effective conversation about medication, the development of an educational program should be considered, which includes knowledge about medication and communication skills.
*Communication ; Drug Therapy/*psychology ; Humans ; Internal Medicine ; Nurse's Role/*psychology ; *Nurse-Patient Relations ; Nursing Care ; Nursing Education Research ; Nursing Staff, Hospital/*psychology ; Tape Recording

PURPOSE: The purpose of this study was to propose optimal hospitalization fees for nurse staffing levels and to improve the current nursing fee policy. METHODS: A break-even analysis was used to evaluate the impact of a nursing fee policy on hospital's financial performance. Variables considered included the number of beds, bed occupancy rate, annual total patient days, hospitalization fees for nurse staffing levels, the initial annual nurses' salary, and the ratio of overhead costs to nursing labor costs. Data were collected as secondary data from annual reports of the Hospital Nursing Association and national health insurance. RESULTS: The hospitalization fees according to nurse staffing levels in general hospitals are required to sustain or decrease in grades 1, 2, 3, 4, and 7, and increase in grades 5 and 6. It is suggested that the range between grade 2 and 3 be sustained at the current level, the range between grade 4 and 5 be widen or merged into one, and the range between grade 6 and 7 be divided into several grades. CONCLUSION: Readjusting hospitalization fees for nurse staffing level will improve nurse-patient ratio and enhance the quality of nursing care in hospitals. Follow-up studies including tertiary hospitals and small hospitals are recommended.
Bed Occupancy/economics ; Costs and Cost Analysis ; Hospitals, General/*economics ; Humans ; National Health Programs/*economics ; Nurse-Patient Relations ; Nursing Care ; Nursing Staff, Hospital/economics