Japanese National University Research Articles

Overview of the Japanese National University Council for Clinical Quality Management

Overview of the Japanese National University Council for Clinical Quality Management

A Simulation Model of Hospital Management Based on Cost Accounting Analysis According to Disease

Since a little before 2000, hospital cost accounting has been increasingly performed at Japanese national university hospitals. At Kumamoto University Hospital, for instance, departmental costs have been analyzed since 2000. And, since 2003, the cost balance has been obtained according to certain diseases for the preparation of Diagnosis-Related Groups and Prospective Payment System. On the basis of these experiences, we have constructed a simulation model of hospital management. This program has worked correctly at repeated trials and with satisfactory speed. Although there has been room for improvement of detailed accounts and cost accounting engine, the basic model has proved satisfactory. We have constructed a hospital management model based on the financial data of an existing hospital. We will later improve this program from the viewpoint of construction and using more various data of hospital management. A prospective outlook may be obtained for the practical application of this hospital management model.

Challenges Facing Japanese National University Libraries and Potential Solutions

Challenges Facing Japanese National University Libraries and Potential Solutions

Voluntary medication error reporting program in a Japanese national university hospital.

In Japan, as in other countries, medical accidents arising from human error can seriously damage public confidence in medical services, as well as being intrinsically undesirable. Errors voluntarily reported by the healthcare practitioners in our institution (Kanazawa University Hospital) were considered to assess the contributory factors by using the accumulated error database in the hospital information system. Medical errors in our institution during the period from July 1, 2000, to June 30, 2002, were counted using the error reporting system database and were classified. The number of errors reported during the investigation period was 1378, of which 78% were reported by nursing staff. Medication errors involving administration of injectable or oral drugs to inpatients, dispensing, and prescription accounted for about 50% of that number. Among dispensing errors, 53% were detected by patients or their families and 36% by nurses. The best method of error prevention is to learn from previous errors. For this purpose, the error reporting program is effective. In patient safety management, it is important to take into account the potential risks of future errors, as well as to capture information about errors that have already happened. For safety management, adoption of appropriate information technology (e.g., implementation of a prescription order entry system) is effective in reducing medication errors. However, it is important to note that serious errors can also arise in computer-based systems.

Online exclusive: family satisfaction with perception of and barriers to terminal care in Japan.

To examine how families of patients with cancer perceive and are satisfied with terminal care given in a university hospital and to identify barriers to the best care for patients and proper support for their families. Quantitative, descriptive. A Japanese national university hospital. Convenience sample of 73 family members of deceased patients with cancer (response rate was 55%). Completion of a questionnaire comprised of 23 items, including multiple-choice and open-ended questions. Satisfaction with terminal care, misunderstanding of narcotics use, recognition of disease signs and symptoms, and expectations for terminal care. Ninety percent of respondents were satisfied with nursing care. Eighty percent were satisfied with the information they received at admission, 70% were satisfied at the critical phase, and 63% were satisfied at the end of life. The main expected types of desirable terminal care were pain management and spiritual care. The bereaved had difficulty dealing with patients' pain, dyspnea, and appetite loss. Forty-four patients were treated with narcotics. Fifty-seven percent of the family members of these patients found pain to be the most difficult symptom to deal with. Fifty-eight percent of the respondents believed that if narcotics were used, patients would soon die. Terminal cancer care given in Japanese university hospitals does not appear to be adequate in terms of patients' and families' quality of life. The findings indicate that insufficient current information is given throughout the terminal stage of cancer and patients and their families misunderstand the use of narcotics. Oncology nurses need to consider different cultural backgrounds when offering specific care to patients with terminal cancer. Patients and their families must be educated about the efficacy of narcotics in the care of terminally ill patients with cancer.

Development and trial operation of a World Wide Web-based data entry system for the collection of statistical data on the management of the national university hospitals in Japan.

A WWW-based, on-line, data-entry system for the collection of statistical data on the management of Japanese national university hospitals has been developed. Trial operation of the system showed that it can reduce the labour and budgetary costs of data collection and also demonstrated that an on-line, data-entry system is feasible in Japan. In April 1997, we began production use of the system, and we are to develop another WWW-based data-entry system that can deal with all other statistics on hospital management.

An Effective Technique for Reading Research Articles - The Japanese KENSHU Method

In this paper, we outline a method that teaches students how to study research literature. The method aids in developing a student's confidence by posing a simple set of steps with questions. The method has been used successfully for developing literature skills with high-school, undergraduate and graduate students in U.S. engineering curriculum. The method, which has the Japanese name, KENSHU, was developed by modifying a system used at a top Japanese national university. KENSHU is Japanese for research understanding. The basic steps of KENSHU are: (i) take a recent foreign (English) scientific article and divide it into sections, (ii) read and discuss a single section with a more experienced classmate, (iii) translate the section, (iv) continue step iii until all sections are finished, (iv) prepare a one page summary of the article with key graphs and tables, and (v) present the findings of the article at a miniconference. In this work, we have put into words, the aspects of reading a scientific article that incorporates the KENSHU framework. We applied the method to U.S. university juniors and seniors, graduate students as well as junior and senior high-school students. We conclude that the method is effective for not only learning how to read scientific articles, but also for learning how to write scientific articles.

国立大学図書館における自己点検・評価について : よりよき実施に向けての提言 平成5年3月

国立大学図書館における自己点検・評価について : よりよき実施に向けての提言 平成5年3月

Relationship between coagulase toxin-type and drug susceptibility in Staphylococcus aureus strains isolated in all the Japanese National University Hospitals

Drug susceptibility of 430 Staphylococcus aureus strains isolated in 1991 from clinical specimens at all of the Japanese national university hospitals was evaluated in relationship with the epidemiological markers, namely, coagulase typing, and staphylococcal enterotoxins (SE) and toxic shock syndrome toxin 1 (TSST-1) production. There were five major methicillin-resistant Staphylococcus aureus (MRSA) groups in all the 252 MRSA strains: coagulase-type II-SEC + TSST-1- producing strains (II-SEC + TSST-1): 34.5%; coagulase-type II-no toxin-producing strains (II-): 15.4%; coagulase-type IV-SEA-producing strains (IV-SEA): 10.3%; coagulase-type II-SEA + SEC + TSST-1- producing strains (II-SEA + SEC + TSST-1): 8.7%; and coagulase-type III-no toxin-producing strains (III-): 7.1%. II-SEA + SEC + TSST-1 group was highly resistant to OFLX, whereas half of the other strain groups were sensitive to OFLX. Seventy-eight percent of the IV-SEA group was sensitive to FMOX, but there was no sensitive strain to FMOX in the II-SEA + SEC + TSST-1 group. More than 50% of the IV-SEA, III- and II-groups were sensitive to IPM, while the II-SEC + TSST-1 and II-SEA + SEC + TSST-1 groups were highly resistant to IPM. The III- and II-groups showed very good sensitivity to MINO, but the sensitivity to it of the II-SEA + SEC + TSST-1 group was very low. All of the strain groups were sensitive to ST except for the IV-SEA group. These results may provide useful information in the choice of antibacterial agents for MRSA infection.

Epidemiological study of Staphylococcus aureus isolated from the Japanese National University and Medical College Hospitals with coagulase typing, and production of enterotoxins and toxic shock syndrome toxin-1

Coagulase typing, staphylococcus enterotoxins (SE) A to E or toxic shock syndrome toxin-1 (TSST = 1) production, and susceptibility to Oxacillin (MPIPC) were examined in 430 strains of S. aureus, which were isolated from clinical specimen of 43 Japanese National University or Medical College Hospitals during the one month period of August in 1990. Methicillin-resistant Staphylococcus aureus (MRSA): more than 4 mmg/ml of minimum inhibitory concentration for MPIPC in Mueller-Hinton broth containing 2% NaCl, occupied 58.6% of all the S. aureus, and more than 60% of the strains from admitted patients in all the areas of Japan except Hokkaidoh. Coagulase type II, SEC and TSST-1 producing strains were most frequently detected, 34.5% of all the MRSA. This kind of strain was distributed mainly in the eastern part of the Honshyu island, and showed high percentage especially in the Tohhoku and the Chyubu area. The second most frequent kind of MRSA was coagulase type II, no SE nor TSST-1 producing one, 15.4%, which was distributed mainly in the western part of Japan. Coagulase type IV, SEA producing MRSA strains and Coagulase type II, SEA, SEC and TSST-1 producing strains were detected in relatively high incidence, 10.3% and 8.7% respectively. Coagulase type III, no SE nor TSST-1 producing MRSAs demonstrated characteristic distribution, and were detected only in the western part of Japan, presenting the highest incidence in the Shikoku Island.

INDIVIDUAL DECISION MAKING BEHAVIOR AND PERSONALITY

Decision making is a basic cognitive function which is found across cultures. In the present preliminary study, the decision making behavior and personality characteristics of a sample of 156 undergraduate students from a Japanese national university were examined by using measures based on the conflict theory of decision making proposed by Janis and Mann (1977). Results supported prediction based on the conflict theory that high selfesteem as a decision maker is positively correlated with a vigilances style of decision making, and negatively correlated with the maladaptive style of‘complacency’, ‘defensive avoidance’and‘hypervigilance’. Comparisons made with a similar sample of Australian students revealed differences in decision making behavior. These results are discussed in term of their consequences for the crosscultural application of the conflict theory of decision making.