Barcode and radio frequency identification utilization varied across Korean hospitals.

Barcodes and radio frequency identification (RFID) are increasingly used in health care to improve patient safety. However, studies on their utilization in clinical settings are limited. This study aimed to comprehensively examine the utilization status of barcodes and RFID in Korean hospitals, recognize the effects and obstacles associated with utilization, and explore the measures to expand the applications of barcodes and RFID. A self-reported online survey was conducted in tertiary hospitals, general hospitals, hospitals, and nursing hospitals in the Republic of Korea. The survey questionnaire comprised questions on barcodes and RFID utilization status, the effect of barcodes and RFID utilization, measures to expand the utilization of barcodes and RFID, and information on respondents' demographics and hospitals. A representative from each of 23 tertiary hospitals, 101 general hospitals, 232 hospitals, and 214 nursing hospitals completed the survey (total response rate 17%). The data were analysed using the chi-square test or Fisher's exact test to determine the differences in responses based on the type and characteristics of hospitals. The tertiary hospitals had the highest utilizations of both RFID and barcodes (n = 10, 43.5%), whereas the nursing hospitals had the lowest (n = 96, 55.1%). Barcodes and RFID were most commonly used in the visits and security management domains. However, the use of barcodes and RFID in medication dispensing and administration safety was low, despite its value in improving patient safety. The hospitals recognized the positive effect of utilization of barcodes and RFID, reporting the highest frequency for the prevention of patient safety incidents (n = 79, 85.9%). Nevertheless, the cost of barcodes and RFID facility investments (n = 128, 90.3%) appeared to be the greatest obstacle to the introduction of barcodes and RFID. Hence, barcodes and RFID facility investment support (n = 133, 95.5%) were given the highest priority among the measures to expand barcode and RFID utilization in health care. The utilization of barcodes and RFID varied across the type and domain of hospitals in the Republic of Korea. Hospitals recognized the positive effects of barcode and RFID utilization. Nonetheless, all hospitals were concerned about the cost of investment and maintenance of barcode and RFID facilities as the main obstacles to utilization. Therefore, a support plan must be developed for the cost of barcodes and RFID facility investments to expand barcode and RFID utilization in health care.

Variation between hospitals and reviewers in detection of adverse events identified through medical record review in Korea.

OBJECTIVES: This study utilized the method of medical record review to determine characteristics of adverse events that occurred in the inpatient units of hospitals in Korea as well as the variations in adverse events between institutions. DESIGN: A two-stage retrospective medical record review was conducted. The first stage was a nurse review, where two nurses reviewed medical records of discharged patients to determine if screening criteria had been met. In the second stage, two physicians independently reviewed medical records of patients identified in the first stage, to determine whether an adverse event had occurred. SETTING: Inpatient units of six hospitals. PARTICIPANTS: Medical records of 2 596 patients randomly selected were reviewed in the first stage review. INTERVENTION(S): N/A. MAIN OUTCOME MEASURE(S): Adverse events. RESULTS: A total of 277 patients (10.7%) were confirmed to have had one or more adverse event(s), and a total of 336 adverse events were identified. Physician reviewers agreed about whether an adverse event had occurred for 141 patients (5.4%). The incidence rate of adverse events was at least 1.3% and a maximum of 19.4% for each hospital. Most preventability scores were less than four points (non-preventable), and there were large variations between reviewers and institutions. CONCLUSIONS: Given the level of variation in the identified adverse events, further studies that include more medical institutions in their investigations are needed, and a third-party committee should be involved to address the reliability issues regarding the occurrence and characteristics of the adverse events.

Development of the Korean Patient Safety Incidents Code Classification System.

OBJECTIVES: Attempts to understand patient safety using administrative data in Korea have been rare. This study develops a Korean patient safety incident code classification system and identifies its characteristics to boost diagnosis code usage for assessing patient safety. METHODS: Based on existing literature, we selected Korean Standard Classification of Diseases 7 codes for characterizing patient safety incidents using diagnosis codes. We conducted 2 rounds of review to evaluate the codes applicability to different patient safety incidents using the Delphi method. The verified diagnosis codes were then classified by incident type. RESULTS: Of the 54,259 Korean Standard Classification of Diseases 7 codes, 4509 were applicable for Korean patients, which were divided into 2435 code groups and 2074 candidate groups. The codes were classified into 6 categories (diagnosis, medication, patient care, operation or procedure, infection related, and other) and then further classified into 35 subcategories. The major categories of patient safety incidents, in the order of frequency, involved medication, fluid and blood related (1719, 38.1%), operation and procedure related (1339, 29.7%), and patient care related (991, 22.0%). Meanwhile, there were only 2 codes related to diagnosis. CONCLUSIONS: Our study provides a basis for estimating patient safety incidents using diagnosis codes. We suggest that gradually increasing the utilization and accuracy of the patient safety incident codes will help develop effective patient safety indicators in Korea similar to other countries. Moreover, clinicians are also needed to be aware of using the developed code classification system.

Efficient and Stable Fiber Dye-Sensitized Solar Cells Based on Solid-State Li-TFSI Electrolytes with 4-Oxo-TEMPO Derivatives.

Fiber-shaped dye-sensitized solar cells (FDSSCs) with flexibility, weavablity, and wearability have attracted intense scientific interest and development in recent years due to their low cost, simple fabrication, and environmentally friendly operation. Since the Grätzel group used the organic radical 2,2,6,6-tetramethyl-1-piperidinyloxy (TEMPO) as the redox system in dye-sensitized solar cells (DSSCs) in 2008, TEMPO has been utilized as an electrolyte to further improve power conversion efficiency (PCE) of solar cells. Hence, the TEMPO with high catalyst oxidant characteristics was developed as a hybrid solid-state electrolyte having high conductivity and stability structure by being integrated with a lithium bis(trifluoromethanesulfonyl)imide (Li-TFSI) film for FDSSCs. The optimized 4-Oxo TEMPO (OX) based solid-state FDSSC (SS-FDSSC) showed the PCE of up to 6%, which was improved by 34.2% compared to that of the reference device with 4.47%. The OX-enhanced SS-FDSSCs reduced a series resistance (Rs) resulting in effective electron extraction with improved short-circuit current density (JSC), while increasing a shunt resistance (Rsh) to prevent the recombination of photo-excited electrons. The result is an improvement in a fill factor (FF) and consequently a higher value for the PCE.

Tankyrase inhibition preserves osteoarthritic cartilage by coordinating cartilage matrix anabolism via effects on SOX9 PARylation.

Osteoarthritis (OA) is a prevalent degenerative disease, which involves progressive and irreversible destruction of cartilage matrix. Despite efforts to reconstruct cartilage matrix in osteoarthritic joints, it has been a difficult task as adult cartilage exhibits marginal repair capacity. Here we report the identification of tankyrase as a regulator of the cartilage anabolism axis based on systems-level factor analysis of mouse reference populations. Tankyrase inhibition drives the expression of a cartilage-signature matrisome and elicits a transcriptomic pattern that is inversely correlated with OA progression. Furthermore, tankyrase inhibitors ameliorate surgically induced OA in mice, and stem cell transplantation coupled with tankyrase knockdown results in superior regeneration of cartilage lesions. Mechanistically, the pro-regenerative features of tankyrase inhibition are mainly triggered by uncoupling SOX9 from a poly(ADP-ribosyl)ation (PARylation)-dependent protein degradation pathway. Our findings provide insights into the development of future OA therapies aimed at reconstruction of articular cartilage.

Japanese Cancer Association Meeting UICC International session--what is cost-effectiveness in cancer treatment?

The Japan National Committee for the Union for International Cancer Control (UICC) and UICC-Asia Regional Office (ARO) organized an international session as part of the official program of the 72nd Annual Meeting of the Japanese Cancer Association to discuss the topic "What is cost-effectiveness in cancer treatment? " Healthcare economics are an international concern and a key issue for the UICC. The presenters and participants discussed the question of how limited medical resources can be best used to support life, which is a question that applies to both developing and industrialized countries, given that cancer treatment is putting medical systems under increasing strain. The emergence of advanced yet hugely expensive drugs has prompted discussion on methodologies for Health Technology Assessment (HTA) that seek to quantify cost and effect. The session benefited from the participation of various stakeholders, including representatives of industry, government and academia and three speakers from the Republic of Korea, an Asian country where discussion on HTA methodologies is already advanced. In addition, the session was joined by a representative of National Institute for Health and Care Excellence (NICE) of the United Kingdom, which has pioneered the concept of cost-effectiveness in a medical context. The aim of the session was to advance and deepen understanding of the issue of cost-effectiveness as viewed from medical care systems in different regions.