PURPOSE: The purpose of the study was to examine mission statements and their elements and to investigate correlations between mission statements and organizational performance. METHODS: The current research was a descriptive study based on the examination of mission statements of 353 hospitals that posted mission statements on their webpage and 92 hospitals that made their income statements public. RESULTS: The most common mission element was 'identification of principal services', which accounted for 92.6%. Mission statements of hospitals included the average of 4.82 mission elements out of 9, and the objective of medical quality improvement was 0.81 among 6 objectives of IOM (Institute of Medicine). Net profit of hospitals with mission statements that have above average number of mission elements were significantly higher (t=2.71, p =.008) than those of other hospitals. Net profit was significantly correlated with mission statements (r=.26, p <.001), and mission elements (r=.29, p <.001). CONCLUSION: The results of the study empirically reveal that mission statements in the hospital affect organizational performance. That is, better organizational performance is shown for hospitals with better, more diversified, and more firmly stated mission statements which include identification of target customers, identification of principal services, contribution to society as a non-profit organization, and concern for employees.
*Hospitals ; Humans ; Organizational Culture ; *Organizational Objectives ; Organizational Policy ; Republic of Korea

BACKGROUND: In Korea, a platelet transfusion dose (TD) of 8 units of platelet concentrates (PC) is usually used. To minimize the shortage of blood products and transfusion-related adverse reactions, the TD has been changed from 8 to 6 units in 2006 in our hospital. Here, we analyzed the dose reduction effect on patients' platelet counts and transfusion frequency. METHODS: We compared the amount of issued PC, platelet counts before and after transfusion, post-transfusion platelet increments, and transfusion frequencies in patients who were transfused with 8 PC in 2006 and 6 PC in 2008. RESULTS: Despite an increase in the number of admitted patients by 20% in 2008 with a disease distribution similar to that in 2006, the number of issued PC in 2008 was decreased by 26.6% compared to that in 2006. In 2008, post-transfusion platelet counts, pre-transfusion platelet counts in patients transfused with 320 mL whole blood-derived PC, and platelet increments in patients transfused with 400 mL whole blood-derived PC were significantly decreased. However, the mean transfusion frequency per one month was not significantly different, 4.3 times in 2006 and 4.7 in 2008. CONCLUSIONS: By implementing a policy of platelet TD restriction, the amount of total issued PC was markedly decreased. Although post-transfusion platelet counts were decreased, the transfusion frequency in a month was not significantly increased. The restriction of platelet TD was helpful for increasing physicians' recognition of blood shortage while achieving similar transfusion effects. We conclude that 6 units of PC would be a better guideline for the platelet TD.
Evaluation Studies as Topic ; Humans ; Organizational Policy ; Platelet Count ; *Platelet Transfusion

OBJECTIVES: This study examined the use of health impact assessment (HIA) as a tool for intersectoral collaboration using the case of an HIA project conducted in Gwang Myeong City, Korea. METHODS: A typical procedure for rapid HIA was used. In the screening step, the Aegi-Neung Waterside Park Plan was chosen as the target of the HIA. In the scoping step, the specific methods and tools to assess potential health impacts were chosen. A participatory workshop was held in the assessment step. Various interest groups, including the Department of Parks and Greenspace, the Department of Culture and Sports, the Department of Environment and Cleansing, civil societies, and residents, discussed previously reviewed literature on the potential health impacts of the Aegi-Neung Waterside Park Plan. RESULTS: Potential health impacts and inequality issues were elicited from the workshop, and measures to maximize positive health impacts and minimize negative health impacts were recommended. The priorities among the recommendations were decided by voting. A report on the HIA was submitted to the Department of Parks and Greenspace for their consideration. CONCLUSIONS: Although this study examined only one case, it shows the potential usefulness of HIA as a tool for enhancing intersectoral collaboration. Some strategies to formally implement HIA are discussed.
*Health Policy ; Humans ; Organizational Case Studies ; Politics ; *Public Health ; Public Policy ; Urban Health

China ; Clinical Trials as Topic ; methods ; Humans ; Organizational Policy ; Publishing ; standards ; Registries

INTRODUCTIONThis paper aimed to ascertain if hospital policy on medical futility helps in conflict resolution, and in ensuring good end-of-life care.

MATERIALS AND METHODSLiterature on the subject published in the last 5 years was identified through Pubmed, and those with empirical data pertaining to the outcomes of interest were examined. A systematic analysis was not possible as papers varied greatly in aims, designs, outcomes and their measures. Instead, the outcomes of representative papers were described and discussed.

RESULTSThere is a widespread use of policies and guidelines based on the concept of medical futility. Conflicts are rare and appear to arise primarily from the manner in which policies are implemented. End-of-life care appears to be improving as evidenced by a significant number of deaths occurring following: (i) discussions involving patient, family, healthcare team members; (ii) cessation of intensive care and (iii) cessation of institution of palliative care. Deaths are increasingly taking place in the presence of family and outside the intensive care wards. Finally, post mortem audit of processes and practices indicate (i) compliance but in a limited manner with policies and recommended guidelines, (ii) family satisfaction and (iii) identify areas where improvement in end-of-life (EOL) care can be effected. Key areas are in improving education of, communication with, and documentation by all stakeholders.

CONCLUSIONHospital policies on medical futility have helped to resolve conflicts and improve end-of-life care. Prospective, multicentre and controlled trials will be useful in determining the value of specific interventions, obtaining generalisable data and facilitating implementation of better end-of-life care models.

Conflict (Psychology) ; Ethics, Medical ; Humans ; Medical Futility ; ethics ; psychology ; Organizational Policy ; Palliative Care ; ethics ; methods ; standards

This study aimed to evaluate the outcomes of the implementation of a smoke-free university policy after two years and to analyze predictors for organizational policy management and smoke-free university. A cross-sectional survey study was designed and undertaken as a baseline in 2014 and as an evaluation in 2016 in a government university within 2 campuses in the Northeast of Thailand. Students and staff/personnel returned questionnaires at a university. There were 891 and 960 people enrolled in to the study in 2014 and 2016, respectively. Outcomes were smoke-free environment, smoking rate, quit rate and variables affecting a smoke-free university. After two years, the smoke-free environment was improved significantly (p<0.001). The smoking rate was not a statistically significant increase, (6.73% in 2014 and 8.42% in 2016, p>0.05). Of this increase, the rate for regular smoking was lower than its expected value by 7.6%. The quit rate significantly increased from 8.33% to 33.96% (p<0.05). Law and organizational support were significant predictors of organizational policy management (adjusted R2 = 19%, p<0.001). Organizational policy management was a significant predictor for being smoke-free university (adjusted R2= 41%, p<0.001). Two years’ experience of implementing a smoke-free university policy showed significant improvements. The organizational policy management directly strengthened these improvements.
smoke-free university ; organizational policy management ; smoking rate ; quit rate ; Thailand

This study was conducted to recognize the role of Korean Council on Medical Education (KCME), which is composed of 12 medical organizations related to medical education, and its importance in Korean medical society. The historical background of the establishment of the KCME is reviewed, along with changes in medical education in Korea starting in the early 1960s. In 1971, the first organization for medical education in Korea, the Association of Korean Medical Colleges, was established by 14 deans of medical colleges. This organization sought to create a good environment for medical education, but because of conflict between deans and medical educators, in 1983 it was divided into two organizations : the Korean Society of Medical Education and the Korean Council of Deans of Medical Colleges. Neither was active until they co-organized a congress about medical education in 1994, and fortunately, they have continued to collaborate since. At that time, the Korean government aggressively tried to authorize 9 new medical colleges, which caused Korean organizations related to medical education to unite against this governmental policy by establishing the KCME. The KCME played an important role in monitoring policy changes and achieved some noteworthy results. However, recent changes, including the fourth industrial revolution and patterns of mutual influence among medical education, research and clinical practice, have spurred the KCME to change and broaden its activities. Therefore, the KCME should take the lead in launching a serious discussion reorganizing Korean medical societies so that academic medicine and practical medicine may flourish.
Capacity Building ; Education, Medical ; Korea ; Organization and Administration ; Organizational Policy ; Societies, Medical

The purpose of this study was to introduce the concept of academic medicine to the medical societies of Korea and to identify any potential obstacles in the establishment of academic medicine in Korea. The core concepts of academic medicine include medical education, research, and patient care. Academic medicine can be practiced in the unique area of healthcare involving medical schools and teaching hospitals by faculty physicians in the academic medicine field. Through academic medicine, the next generation of healthcare professionals is trained, new discoveries can be made, and patients can find new hope for a cure. The flourishing of academic medicine has resulted in substantial advancements in medicine over the past few centuries, but at the turn of the 21st century, there was concern that academic medicine was on the decline. To address this concern, the International Campaign to Revitalize Academic Medicine was established and announced five scenarios to 2025 to debate the future of academic medicine. Although the system resembles that of Western medical societies, Korean medical societies were not familiar with academic medicine, and poor conditions caused by the distorted healthcare system in Korea have actually interfered with the nurturing of academic medicine. One of the main problems may include less interest in medical education and research relative to clinical practice by medical societies and the government. Collaborative efforts from both medical societies and the government are needed to establish academic medicine successfully in Korea for a better future.
Delivery of Health Care ; Education, Medical ; Hope ; Hospitals, Teaching ; Humans ; Korea ; Organizational Policy ; Patient Care ; Schools, Medical ; Societies, Medical

Neonatal thrombocytopenia, defined as platelet counts of less than 150,000/µL, is a frequent hematologic abnormality in neonatal period. Differential diagnosis of neonatal thrombocytopenia may be challenging to pediatric hematologists and neonatologists because neonatal thrombocytopenia is associated with diverse maternal or neonatal clinical conditions. An accurate diagnosis for neonatal thrombocytopenia will lead to appropriate evaluation and management. Platelet transfusion is the primary management of neonatal thrombocytopenia. Most thrombocytopenic newborns received platelet concentrates to prevent major hemorrhage or treat ongoing bleeding according to institutional policy. However, scientific evidences for benefit and consistent guideline for platelet transfusion in neonates are lacking, further investigation to establish the standard recommendation for platelet transfusion is needed. This article reviewed the diagnostic approach and current guideline for platelet transfusion management for neonatal thrombocytopenia.
Blood Platelets ; Diagnosis ; Diagnosis, Differential ; Hemorrhage ; Humans ; Infant ; Infant, Newborn ; Organizational Policy ; Platelet Count ; Platelet Transfusion ; Thrombocytopenia ; Thrombocytopenia, Neonatal Alloimmune

PURPOSE:This research explored the voices of nurses in contemporary times and unraveled nurses' situations for the purpose of generating a substantive theory to guide and refine nursing practice.
METHOD:The  grounded  theory  methodology  of  qualitative  research  was  utilized patterned mainly in the works of Glaser and Strauss. Criterion sampling was used in the selection of 31 participants and the basis for selection was employment in the hospital, academe, and community and being part of different levels of management (nurses from top, middle, first, and staff levels). Theoretical sampling also informed the final list of study informants and was conducted by snowballing that consisted of 10  participants.  The  data  gathering  procedures  included  the  combination  of interviews, observations, and document and literature analysis.
FINDINGS:The study revealed three major themes: (1)nursing as a profession,(2)Nightingale in the 21st century:life of a nurse in today's context,and (3)the challenges and opportunities to quality of nursing care.
CONCLUSION:Nursing   is   dynamic,   complex,   diverse,   expanding   and   highly contextualized. Nursing is a field that grows with time and nurses are adaptive to the widening demands of their profession. The goal of nursing remains a Nightingale's pledge  and  an  endeavor  amidst  nurses'  constant  battle  between  motivations  and challenges.  The  Integrated  Systems  Approach  to  Nursing  Care  model  was developed to be used as a framework for sound decision-making in nursing practice.Nursing,  nightingale  and  beyond  is  a  picture  of  struggles,  success,  and  potential solutions to the predicaments surrounding the nursing profession.
CLINICAL RELEVANCE:The  study  has  potential  to  help  health  managers  and  policy implementers in providing assistance to nurses in enhancing their knowledge and skills, increasing their emotional and psychological resilience and in revitalizing their commitment to the nursing profession.It may also aid in  the  reconsideration  of institutional policies and set-ups toward collaborative and enabling work environment. In addition, it may serve as a guide in creating proactive health governance, in facilitating nurses' work motivation  and  retention  through  the  due  implementation  of nursing law and other statures for the welfare of health workers, in providing additional plantilla position for nurses in the country, and in increasing funding for health programs to create more learning and practice environment for nurses. Lastly, the utilization of the theory  can  be  used  in  developing  a  more  responsive  nursing practice.

Human ; Male ; Female ; Middle Aged ; Adult ; Motivation ; Organizational Policy ; Resilience, Psychological ; Goals ; Nurses ; Workplace ; Qualitative Research ; Models, Nursing ; Decision Making