The Ho Chi Minh Center for hematology and blood transfusion has been completing the quality management network on the blood bank to assure that the blood products meet the requirement of the ISO9002 including quality management of blood donors (standard making, training on the blood collection; clinical tests and quality management in the preservation, storage, transport, distribution of blood and its components.
Blood transfusion ; Total Quality Management

BACKGROUND: Proficiency testing is part of a total quality management program that provides objective evidence of clinical laboratory testing competence for customers, accrediting bodies, and regulatory agencies. Performing alternative assessment procedures for clinical tests, without proficiency testing, is recommended by Clinical and Laboratory Standards Institute (CLSI) guideline. In our study, an alternative assessment procedure was performed for blood bank tests that do not have an external proficiency program. METHODS: The laboratory for development and an evaluation center, supervised the program. Proficiency testing by seven institutions was performed 3 times at 6 month intervals by evaluating isoagglutinin and anti-D titers, and Weak D, Rh C and E typing, using ID-Internal Quality Control (Bio-Rad Laboratories) kits. RESULTS: Isoagglutinin and anti-D titer results were within one fold dilution range for all seven participating institutions, and Weak D, Rh C and E typing results all demonstrated identical antigenic reference patterns. CONCLUSION: An alternative assessment procedure was successfully performed without a proficiency testing program. Commercially manufactured reference materials could be an alternative method to support commutable, external, proficiency testing program.
Blood Banks ; Isoantibodies ; Mental Competency ; Quality Control ; Total Quality Management

Cell Line ; Humans ; Quality Control ; Research ; standards ; Total Quality Management

The Continuing Professional Development (CPD) program of Korean medical doctors had problems that did not resolve for many years. The primary concern of this study is to examine the problems of the CPD program of Korean medical doctors and to suggest practical guidelines to resolve such barriers. The findings show that the major barrier for improving CPD program is the lack of total quality management. Such lack came from insufficient manpower to plan, execute, and evaluate the CPD programs. The insufficient financial support aggravated the situation. In order to enhance the CPD program, various problems in planning, executing, evaluation stage must be dealt. Specific plans and resolutions in each stage have been suggested.
Financial Support ; Porphyrins ; Program Development ; Total Quality Management

The strategies and methods of the total quality management (TQM) need to applied in quality management of radiation therapy. We should improve the level of quality control and quality assurance in radiation therapy. By establishing quality control system in radiation therapy, standardization of radiation therapy workflow, strengthening quality control of devices and physical technique and paying attention to safety protection and staff training.
Quality Assurance, Health Care ; organization & administration ; Quality Control ; Radiotherapy ; Total Quality Management

PURPOSE: We created an 'AAPM TG18 Evaluation Tool' and we determined its usefulness for the quality control of a diagnostic monitor. MATERIALS AND METHODS: We created an evaluation tool (the AAPM TG18) for conducting quality control of a diagnostic monitor, and we evaluated the measurement items of the AAPM TG18 evaluation tool. The measurement items were geometric distortion, fixed quantity assessment and visual assessment of the veiling glare, and we carried out adjustment for the luminance meter 0% calibration, which was used to revise the diagnostic monitor DICOM LUT. RESULTS: With the AAPM TG18 Evaluation Tool, we measured the 2-dimensional length when evaluating the quantitative geometric distortions in the TG18-QC test pattern, and we measured the veiling-glare ring response function, which provided information regarding the spatial extent of the luminance spread, and this measurement of the can be performed using the TG18-GV pattern. Additionally, the AAPM TG18 Evaluation Tool can be used for sensor calibration to standardize the basic rate of 0% luminance when performing periodic calibration. CONCLUSION: The evaluation tool is a very useful for easily evaluating many of the examination items of the AAPM TG18 for performing quality control of a diagnostic monitor.
Calibration ; Computer Terminals ; Glare ; Organothiophosphorus Compounds ; Quality Control ; Radiology Information Systems ; Total Quality Management

The purpose of this study was to measure patients satisfaction and expectation with hospital foodservices, and thereby identify areas for improvement and provide basic data for the introduction of total quality management with hospital foodservices. This survey was carried out on 383 hospitalized patients of 7 hospitals in Deagu, Busan, Changwon with 350 beds to determine the quality satisfaction with foodservices. The subjects were 50.5% male and 49.5% female. 62.6% of the subjects were over 40 age, 31.4% were only educated to middle school or below, 28.3% were hospitalized for 7 - 14 days. The mean score for taste of diet was 2.79, temperature 3.23, appearances 2.96. Most subjects agreed with following foodservice characteristics that meals of movement (4.03 ), dress of employees (3.84 ), kindness of employees and meals arrived exactly the same time every day (3.47 )and cleanliness of foods (3.34 )and dishes (3.33 ). The unsatisfied quality attributies were information provide (2.82 ), variety of the meals (2.91 ), mixing of meals (2.95 ), the opportunity to meet with a dietitian (2.97 )and prompt dealings with meal complaints (3.01 ). Most subjects expectation that the decrease the multiple of menus, increase provide of fruits in hospital meals and selective menus in hospital foodservices operations. In conclusion, it would seem to be desirable that hospital foodservices departments introduce selective menus, quality assurance, and increase the meal rounding of dietitians in the patient foodservice.
Busan ; Daegu ; Diet ; Female ; Food Quality ; Fruit ; Gyeongsangnam-do ; Humans ; Male ; Meals ; Nutritionists ; Total Quality Management

ISO9000 quality management system (ISO9000QMS) emphasize on the customer-oriented, managers' leadership and all staff's joining, adopt the process method and system management, spread the taking facts as a basis to make decision and improve consistently, and establish win-win relation with the suppliers. So, the digital hospital can adopt the ISO9000QMS. In order to establish the ISO9000QMS, the digital hospital should: (1) Design integrally, including analyzing the operation procedure, clarifying the job duties, setting up the spreading team and setting the quality policy and objectives: (2) Learning the ISO9000 quality standards; (3) Drawing up the documents, including the quality manual, program files and operation guiding files; (4) Training according the documents; (5) Executing the quality standard, including the service quality auditing, quality record auditing and quality system auditing; (6) Improving continually. With the establishment of ISO900QMS, the digital hospital can appraise more accurately, analyze quality matters statistically and avoid the interference of artificial factors.
Hospital Administration/legislation & jurisprudence ; Hospital Administration/*standards ; Hospitals, Public/legislation & jurisprudence ; Hospitals, Public/*standards ; Management Audit/*standards ; Quality Assurance, Health Care/*organization & administration ; Quality Control ; Total Quality Management/methods ; Total Quality Management/*standards

PURPOSE: Prompt reperfusion therapy by means of primary percutaneous coronary intervention is an effective method for treating patients with ST-segment elevation myocardial infarction (STEMI). According to the ACC/AHA guidelines for these patients, the interval between arrival at the hospital and intracoronary balloon inflation (door-to-balloon time) should be 90 minutes or less. The aim of this study was to evaluate the effect of establishing an ECG transmission system and communication procedure in the emergency department (ED) to minimize door-to-balloon time for STEMI patients. METHODS: We established both the out-of hospital and in-hospital aspects of the ECG transmission system. Before patient arrival at our ED, we would attempt to receive initial ECGs from the referring hospitals via fax. In ideal cases, ECG findings were immediately reported to interventional cardiologists by the referring primary ED physician. Door-to-balloon time segments were analyzed in a retrospective manner. We compared the effectiveness in minimizing reperfusion time between the use of inter-hospital 12-lead ECG transmission before patient arrival, and direct communication between emergency physicians and attending interventional cardiologists. RESULTS: Of the total 142 STEMI patients who received percutaneous coronary intervention (PCI) during the study period, 112 (78.9%) received PCI within 90 min. The mean door-to-balloon time of the 27 patients admitted with a pre-arrival 12-lead ECG transmission was significantly less than the others. CONCLUSION: Establishing both out-of hospital and in hospital strategies to reduce door-to-balloon time in patients with STEMI, by using pre-arrival ECG transmission and direct communication between emergency physicians and interventional cardiologists, is an effective approach to minimize time to reperfusion.
Electrocardiography ; Emergencies ; Humans ; Inflation, Economic ; Myocardial Infarction ; Percutaneous Coronary Intervention ; Reperfusion ; Retrospective Studies ; Total Quality Management

PURPOSE: To minimize the process that acute myocardial infarction (AMI) patients have to go through when visiting the emergency room (ER), and thus to provide prompt reperfusion therapy using the six sigma protocol, a business management renovation strategy to standardize the clinical process. METHODS: Analysis was done on data obtained both before and after implementation of the six sigma protocol. Data were collected from ST segment elevation myocardial infarction (STEMI) patients who visited the ER between February 2006 and March 2009 and received reperfusion therapy. For statistical analysis used we used an unpaired t-test. RESULTS: After the six sigma protocol was put into practice, total visiting time was reduced from 124.4+/-76.1 minutes to 91.5+/-50.3 minutes, and the reduction was statistically significant (p<0.0045). Six sigma (6 sigma) means 3.4 PPM, that is, among 1 million cases no more than 3.4 cases should exceed the time limit of 90 minutes from the arrival of the patient to the needle puncture, making the task hard to achieve. sigma score was greatly elevated-from 1.48 sigma to 2.48 sigma and the sigma error rate (the proportion of cases that exceeded 90 min) improved from 62% to 45% . CONCLUSION: In this study we verified that applying the six Sigma protocol significantly reduced the time to reperfusion therapy for AMI patients. The reduction in time was due to changes in software (developed from the existing system) rather than to hardware improvements such as changes in test facilities or manpower amplification. The entire process, from a patient arriving at the ER until the patient received reperfusion therapy was viewed as one systemic flow and applying the six Sigma protocol to such flow was successful as shown by the result of this study. This shows that the six sigma protocol can be applied to a medical system if configured effectively. Further, this method can be useful not only for AMI patients, but also for many other urgent procedures such as acute cerebral infarction patients who require prompt diagnosis and hemolytic therapy, when the definition of the error rate is corrected according to the specific patients groups.
Cerebral Infarction ; Commerce ; Emergencies ; Humans ; Myocardial Infarction ; Needles ; Punctures ; Reperfusion ; Total Quality Management