1.Development of the Korean Quality Improvement Platform in Surgery (K-QIPS) program: a nationwide project to improve surgical quality and patient safety
Jeong-Moo LEE ; In Woong HAN ; Oh Chul KWON ; Hye Rim SEO ; Jipmin JUNG ; So Jeong YOON ; Ahram HAN ; Juhan LEE ; Soo Young LEE ; Hoseok SEO ; Wooil KWON ; Bang Wool EOM ; In-Seob LEE ; Ji Won PARK ; Hae Won LEE ; Ho Kyoung HWANG ; Suk-Hwan LEE ; Eung Jin SHIN ; Woo Yong LEE
Annals of Surgical Treatment and Research 2024;107(6):305-314
Purpose:
Improvements in surgical quality and patient safety are critical components of the healthcare system. Despite excellent cancer survival rates in Korea, there is a lack of standardized postoperative complication management systems.To address this gap, the Korean Surgical Society initiated the development of the Korean Quality Improvement Platform in Surgery (K-QIPS) program.
Methods:
K-QIPS was successfully launched in 87 general hospitals. This nationwide surgical quality improvement program covers 5 major surgical fields: gastric surgery, colorectal surgery, hepatectomy and liver transplantation, pancreatectomy, and kidney transplantation.
Results:
Common and surgery-specific complication platforms will be developed, and the program will work toward the implementation of an artificial intelligence-based complication prediction system and the provision of evidence-based feedback to participating institutions. K-QIPS represents a significant step toward improving surgical quality and patient safety in Korea.
Conclusion
This program aims to reduce postoperative complications, mortality, and medical costs by providing a standardized platform for complication management and prediction. The successful implementation of this nationwide project may provide a good model for other countries that are required to improve surgical outcomes and patient care.
2.Development of the Korean Quality Improvement Platform in Surgery (K-QIPS) program: a nationwide project to improve surgical quality and patient safety
Jeong-Moo LEE ; In Woong HAN ; Oh Chul KWON ; Hye Rim SEO ; Jipmin JUNG ; So Jeong YOON ; Ahram HAN ; Juhan LEE ; Soo Young LEE ; Hoseok SEO ; Wooil KWON ; Bang Wool EOM ; In-Seob LEE ; Ji Won PARK ; Hae Won LEE ; Ho Kyoung HWANG ; Suk-Hwan LEE ; Eung Jin SHIN ; Woo Yong LEE
Annals of Surgical Treatment and Research 2024;107(6):305-314
Purpose:
Improvements in surgical quality and patient safety are critical components of the healthcare system. Despite excellent cancer survival rates in Korea, there is a lack of standardized postoperative complication management systems.To address this gap, the Korean Surgical Society initiated the development of the Korean Quality Improvement Platform in Surgery (K-QIPS) program.
Methods:
K-QIPS was successfully launched in 87 general hospitals. This nationwide surgical quality improvement program covers 5 major surgical fields: gastric surgery, colorectal surgery, hepatectomy and liver transplantation, pancreatectomy, and kidney transplantation.
Results:
Common and surgery-specific complication platforms will be developed, and the program will work toward the implementation of an artificial intelligence-based complication prediction system and the provision of evidence-based feedback to participating institutions. K-QIPS represents a significant step toward improving surgical quality and patient safety in Korea.
Conclusion
This program aims to reduce postoperative complications, mortality, and medical costs by providing a standardized platform for complication management and prediction. The successful implementation of this nationwide project may provide a good model for other countries that are required to improve surgical outcomes and patient care.
3.Korean National Healthcare-associated Infections SurveillanceSystem for Hand Hygiene Report: Data Summary from July 2019to December 2022
Sung Ran KIM ; Kyung-Sook CHA ; Oh Mee KWEON ; Mi Na KIM ; Og Son KIM ; Ji-Hee KIM ; Soyeon PARK ; Myoung Jin SHIN ; Eun-Sung YOU ; Sung Eun LEE ; Sun Ju JUNG ; Jongsuk JEOUNG ; In-Soon CHOI ; Jong Rim CHOI ; Ji-Youn CHOI ; Si-Hyeon HAN ; Hae Kyung HONG
Korean Journal of healthcare-associated Infection Control and Prevention 2024;29(1):40-47
Background:
Hand hygiene is considered the simplest and most cost-effective method of infection prevention. Regular observation and feedback on hand hygiene compliance are key strategies for its enhancement. This study evaluated the effectiveness of hand hygiene surveillance, including direct observation and feedback, by comprehensively analyzing the reported hand hygiene compliance within the Korean National Healthcare-Associated Infections Surveillance System from 2019 to 2022.
Methods:
Participating medical institutions included general hospitals and hospitals with infection control departments that consented to participate. Hand hygiene surveillance was conducted using direct observation. Collected data, including healthcare workers, clinical areas, hand hygiene moments, and hand hygiene compliance, were recorded to calculate hand hygiene compliance rates. Additionally, the volume of alcohol-based hand sanitizers used per patient per day was investigated as an indirect indicator of hand hygiene compliance. The study was conducted from July 2019 to December 2022.
Results:
Hand hygiene compliance increased from 87.2% in Q3 2019 to 89.9% in 2022. Nurses and medical technologists showed the highest compliance rates, whereas doctors showed the lowest compliance rates. Intensive care units excelled in compliance, whereas emergency de partments lagged. Compliance was highest after patient contact and lowest when the patient’s surroundings were touched. Larger hospitals consumed more alcohol-based hand sanitizers than smaller hospitals did.
Conclusion
This study confirmed an improvement in hand hygiene compliance through sustained surveillance, indicating its contribution not only to preventing infection transfer within healthcare facilities but also to fostering a culture of hand hygiene in the country.
4.A Case of Skin Burns Occurring during Laparoscopic Surgery
Yujun PARK ; Jeong Soo CHOI ; Hae Rim CHUN ; Jinhun CHUNG
Soonchunhyang Medical Science 2024;30(1):46-48
Skin burn injury from light cables is a rare complication of laparoscopic surgery. We report the case of a 57-year-old female who underwent laparoscopic-assisted right hemicolectomy under general anesthesia. During surgery, the anesthesiologist discovered that the tip of the light cable, with the light source powered on, penetrated the surgical drape and was positioned on the right forearm of the patient, where a bulla measuring 2.0× 2.5 cm in size and a second-degree burn were identified. All medical personnel participating in laparoscopic and arthroscopic procedures should always be aware that the light cable can cause burns to the patient. Additionally, after connecting the light cable to the scope, the light source should be activated. The light cable should not be placed around the patient or on the surgical drape while the light source is active. Immediately after completing the surgery, the power to the light source should be turned off, and the light cable should be placed in a safe place.
5.Development of the Korean Quality Improvement Platform in Surgery (K-QIPS) program: a nationwide project to improve surgical quality and patient safety
Jeong-Moo LEE ; In Woong HAN ; Oh Chul KWON ; Hye Rim SEO ; Jipmin JUNG ; So Jeong YOON ; Ahram HAN ; Juhan LEE ; Soo Young LEE ; Hoseok SEO ; Wooil KWON ; Bang Wool EOM ; In-Seob LEE ; Ji Won PARK ; Hae Won LEE ; Ho Kyoung HWANG ; Suk-Hwan LEE ; Eung Jin SHIN ; Woo Yong LEE
Annals of Surgical Treatment and Research 2024;107(6):305-314
Purpose:
Improvements in surgical quality and patient safety are critical components of the healthcare system. Despite excellent cancer survival rates in Korea, there is a lack of standardized postoperative complication management systems.To address this gap, the Korean Surgical Society initiated the development of the Korean Quality Improvement Platform in Surgery (K-QIPS) program.
Methods:
K-QIPS was successfully launched in 87 general hospitals. This nationwide surgical quality improvement program covers 5 major surgical fields: gastric surgery, colorectal surgery, hepatectomy and liver transplantation, pancreatectomy, and kidney transplantation.
Results:
Common and surgery-specific complication platforms will be developed, and the program will work toward the implementation of an artificial intelligence-based complication prediction system and the provision of evidence-based feedback to participating institutions. K-QIPS represents a significant step toward improving surgical quality and patient safety in Korea.
Conclusion
This program aims to reduce postoperative complications, mortality, and medical costs by providing a standardized platform for complication management and prediction. The successful implementation of this nationwide project may provide a good model for other countries that are required to improve surgical outcomes and patient care.
6.Comparative effectiveness of JAK inhibitors and biologic disease-modifying antirheumatic drugs in patients with rheumatoid arthritis
Soo-Kyung CHO ; Hyoungyoung KIM ; Yeo-Jin SONG ; Hye Won KIM ; Eunwoo NAM ; Shin-Seok LEE ; Hye-Soon LEE ; Sung-Hoon PARK ; Yeon-Ah LEE ; Min-Chan PARK ; Sung Hae CHANG ; Hyoun-Ah KIM ; Seung-Ki KWOK ; Hae-Rim KIM ; Hyun-Sook KIM ; Bo Young YOON ; Wan-Sik UHM ; Yong-Gil KIM ; Jae Hoon KIM ; Jisoo LEE ; Jeongim CHOI ; Yoon-Kyoung SUNG
The Korean Journal of Internal Medicine 2023;38(4):546-556
Background/Aims:
We aimed to compare the effectiveness and safety of Janus kinase inhibitors (JAKi) vs. biologic disease- modifying antirheumatic drugs (bDMARD) in Korean patients with rheumatoid arthritis (RA) who had an inadequate response to conventional synthetic DMARDs.
Methods:
A quasi-experimental, multi-center, prospective, non-randomized study was conducted to compare response rates between JAKi and bDMARDs in patients with RA naïve to targeted therapy. An interim analysis was performed to estimate the proportion of patients achieving low disease activity (LDA) based on disease activity score (DAS)–28– erythroid sedimentation rate (ESR) (DAS28-ESR) at 24 weeks after treatment initiation and to evaluate the development of adverse events (AEs).
Results:
Among 506 patients enrolled from 17 institutions between April 2020 and August 2022, 346 (196 JAKi group and 150 bDMARD group) were included in the analysis. After 24 weeks of treatment, 49.0% of JAKi users and 48.7% of bDMARD users achieved LDA (p = 0.954). DAS28-ESR remission rates were also comparable between JAKi and bDMARD users (30.1% and 31.3%, respectively; p = 0.806). The frequency of AEs reported in the JAKi group was numerically higher than that in the bDMARDs group, but the frequencies of serious and severe AEs were comparable between the groups.
Conclusions
Our interim findings reveal JAKi have comparable effectiveness and safety to bDMARDs at 24 weeks after treatment initiation.
7.Effects of Cannabidiol on Adaptive Behavior and Quality of Life in Pediatric Patients With Treatment-Resistant Epilepsy
Se Hee KIM ; Han Som CHOI ; Chung Mo KOO ; Bong-Rim JOO ; Byung-Joo PARK ; Hae Kook LEE ; Joon Soo LEE ; Heung Dong KIM ; Hoon-Chul KANG
Journal of Clinical Neurology 2023;19(2):214-214
8.Risk of cancer, cardiovascular disease, thromboembolism, and mortality in patients with rheumatoid arthritis receiving Janus kinase inhibitors: a real-world retrospective observational study using Korean health insurance data
Hong Ki MIN ; Hyeongsu KIM ; Ho Jin JEONG ; Se Hee KIM ; Hae-Rim KIM ; Sang-Heon LEE ; KunSei LEE ; Soon-Ae SHIN ; Jong Heon PARK
Epidemiology and Health 2023;45(1):e2023045-
OBJECTIVES:
This study investigated whether Janus kinase inhibitors (JAKis) raise the risk of cardiovascular disease (CVD), venous thromboembolism (VTE), and cancer in patients with rheumatoid arthritis (RA).
METHODS:
We conducted a real-world retrospective observational study using data obtained from the Korean National Health Insurance Service database. Two data sets were analyzed: tumor necrosis factor inhibitor (TNFi)/JAKi-naive RA patients (set 1) and all RA patients who used TNFis or JAKis (set 2). The incidence rate ratios (IRRs) and hazard ratios (HRs) for acute myocardial infarction (AMI), stroke, cardiovascular (CV)-related mortality, major adverse cardiovascular events (MACE), VTE, arterial thromboembolism (ATE), cancer, and all-cause mortality were compared between the JAKi and TNFi groups.
RESULTS:
Set 1 included 1,596 RA patients (JAKi group: 645; TNFi group: 951), and set 2 included 11,765 RA patients (JAKi group: 2,498; TNFi group: 9,267). No adverse events (AEs) showed significantly higher IRRs in the JAKi groups than in the TNFi groups of sets 1 and 2. The HRs for MACE in the JAKi groups of sets 1 and 2 were 0.59 (95% confidence [CI], 0.35 to 0.99) and 0.80 (95% CI, 0.67 to 0.97), respectively. The JAKi group of set 2 showed a significantly higher risk of all-cause mortality (HR, 1.71; 95% CI, 1.32 to 2.20), but the other AEs did not demonstrate increased risks in the JAKi groups.
CONCLUSIONS
In this study, JAKis did not increase the risk of AMI, stroke, CV-related mortality, MACE, VTE, ATE, or cancer in Korean RA patients relative to TNFis.
9.Effects of Cannabidiol on Adaptive Behavior and Quality of Life in Pediatric Patients With Treatment-Resistant Epilepsy
Se Hee KIM ; Han Som CHOI ; Chung Mo KOO ; Bong-Rim JOO ; Byung-Joo PARK ; Hae Kook LEE ; Joon Soo LEE ; Heung Dong KIM ; Hoon-Chul KANG
Journal of Clinical Neurology 2022;18(5):547-552
Background:
and Purpose Data regarding the effects of cannabidiol (CBD) on the quality of life (QOL) are currently inadequate. We assessed the QOL of pediatric patients with epilepsy who were treated with CBD.
Methods:
This prospective, open-label study included pediatric and adolescent patients (aged 2–18 years) with Dravet syndrome or Lennox-Gastaut syndrome. Oral CBD was administered at 10 mg/kg/day. The Korean version of the Quality Of Life in Childhood Epilepsy (QOLCE) questionnaire was administered when CBD treatment began and again after 6 months. Adaptive behavior was measured using the Korean versions of the Child Behavior Checklist (K-CBCL) and the second edition of the Vineland Adaptive Behavior Scales (Vineland-II).
Results:
This study included 41 patients (11 with Dravet syndrome and 30 with LennoxGastaut syndrome), of which 25 were male. The median age was 4.1 years. After 6 months, 26.8% (11/41) of patients experienced a ≥50% reduction in the number of seizures. The total score for the QOLCE questionnaire did not change from baseline to after 6 months of CBD treatment (85.71±39.65 vs. 83.12±48.01, respectively; p=0.630). The score in the motor skills domain of Vineland-II reduced from 48.67±13.43 at baseline to 45.18±14.08 after 6 months of treatment (p=0.005). No other Vineland-II scores and no K-CBCL scores had changed after 6 months of CBD treatment.
Conclusions
CBD is an efficacious antiseizure drug used to treat Dravet syndrome and Lennox-Gastaut syndrome. However, it did not improve the patient QOL in our study, possibly because all of our patients had profound intellectual disabilities.
10.Understanding Physicians’ and Nurses’ Adaption of National-Leading Patient Safety Culture Policy: A Qualitative Study in Tertiary and General Hospitals in Korea
Won LEE ; MoonHee CHOI ; Eunjung PARK ; Eunji PARK ; Shinhee KANG ; Jessie LEE ; Seung Gyeong JANG ; Hae-Rim HAN ; Sang-il LEE ; Ji Eun CHOI
Journal of Korean Medical Science 2022;37(14):e114-
Background:
In Korea, the safety culture is led by national policy. How the policy ensures a patient safety culture needs to be investigated. This study aimed to examine the way in which physicians and nurses regard, understand, or interpret the patient safety-related policy in the hospital setting.
Methods:
In this qualitative study, we conducted four focus group interviews (FGIs) with 25 physicians and nurses from tertiary and general hospitals in South Korea. FGIs data were analyzed using thematic analysis, which was conducted in an inductive and interpretative way.
Results:
Three themes were identified. The healthcare providers recognized its benefits in the forms of knowledge, information and training at least although the policy implemented by the law forcibly and temporarily. The second theme was about the interaction of the policy and the Korean context of healthcare, which makes a “turning point” in the safety culture.The final theme was about some strains and conflicts resulting from patient safety policy.
Conclusion
To provide a patient safety culture, it is necessary to develop a plan to improve the voluntary participation of healthcare professionals and their commitment to safety.Hospitals should provide more resources and support for healthcare professionals.

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