Medical school accreditation is a relatively new phenomenon in Korea. The development of an accreditation body and standards for a two-tiered "Must" and "Should" system in 1997 eventually led to the implementation of a third "Excellence" level of attainment. These standards were conceived out of a desire to be able to first recognize and promote outstanding performance of medical schools, second to provide role models in medical education, and furthermore to preview the third level as potential components of the pre-existing second level for the next accreditation cycle. It is a quality-assurance mechanism that, while not required for accreditation itself, pushes medical schools to go beyond the traditional requirements of mere pass-or-fail accreditation adequacy, and encourages schools to deliver an unprecedented level of medical education. The Association for Medical Education in Europe developed its own third-tier system of evaluation under the ASPIRE project, with many similar goals. Due to its advanced nature and global scope, the Korean accreditation body has decided to implement the ASPIRE system in Korea as well.
Background: It is important that proper protocols are in place for trauma patients who require massive transfusion upon arrival at the emergency department. This study is a preliminary analysis of massive transfusion cases at the emergency department of our institution aimed to review the characteristics and situations in which massive transfusion occurs in an effort to better manage trauma patients receiving massive transfusion in the emergency department. Methods: This study was conducted at the Department of Emergency Medicine in the Korea University Guro Hospital. We retrospectively reviewed the medical charts of trauma-related patients who required massive blood transfusions between January 2013 and December 2015. The inclusion criteria were as follows: patients who were over the age of 18 years and received more than 4 packed RBC (pRBC) units per hour, or 10 or more pRBC units during a period of 24-hours. Results: A total of 669 patients were included in the study. There were significant differences of initial systolic blood pressure (P<0.0001), diastolic blood pressure (P<0.0001), and Injury Severity Score (P<0.0001) between those who survived and those who expired. Conclusion: Proper initial resuscitation is essential for the improvement of outcome in trauma patients that require a massive transfusion. The findings from this study may serve as preliminary data in developing proper transfusion protocols for massive transfusion among trauma patients. (Korean J Blood Transfus 2016;27:130-136)
Background: South Korea has one of the highest rates of suicide in the world, which poses an immense socioeconomic burden on the healthcare system. Objectives: We hypothesized that the implementation of a Crisis Intervention Team would lead to an improvement in completion rates of suicide prevention counseling programs. Methods: This is a retrospective before-and-after analysis, and was carried out in the emergency department in the city of Ansan, South Korea. The Crisis Intervention Team, funded by the Ministry of Health and Welfare, counsels suicide attempt patients with the ultimate goal of assuring proper administration of mental healthcare from community suicide support programs. Data on suicide attempt patients were collected using medical records. The primary outcome was defined as completion of the 8-week follow-up period for suicide attempt patients with the community suicide support programs. Results: A total of 246 patients from the pre-intervention period and 296 patients from the post-intervention period were included in the study. The completion rates of the 8-week follow-up period increased significantly after the intervention. During the pre-intervention period, 9 patients (3.7%) who were referred to the community suicide support program completed the 8 weeks of follow-up, whereas in the post-intervention period, 56 patients (18.9%) followed up for 8 weeks or more (p < 0.0001). The secondary outcome, overall linkage rates to community suicide support program, did not change significantly, with a minor increase from 46 (18.7%) to 63 (21.3%) (p = 0.45). Conclusion: The implementation of an in-hospital Crisis Intervention Team dedicated to active and assertive counseling that begins in the emergency department was correlated with significantly increased completion rates of the 8-week follow-up counseling program.
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