Thank you Mister Chairman. It’s a great honor for me to discuss some of the quality improvement activities of my institution. After a short introduction to Samsung Medical Center, I’d like to talk about some of the quality improvement programs, such as patient safety round, clinical pathway, and logistics innovation. In my opinion, standardization is the beginning and the goal of quality improvement activities. And finally, recent work at the regional patient safety center, which is a KOIHA-sponsored program, will be briefly touched. In 1994, Samsung Medical Center was established at the South-eastern part of Seoul. Fourteen years later, Samsung Comprehensive Cancer Center opened. Ten years ago, we also established heart, vascular and stroke institution. Proton therapy center, Research Institute for Future Medicine, and Administration center opened more recently. Right side is the main building and left side is the comprehensive cancer center. Outpatient is about 9 thousand 5 hundreds every day. About 2 hundred surgeries are done at 56 operating rooms We have a very good reputations from many organizations and patient groups. This is a recent example. The Newsweek ranked Samsung Medical Center as the top 5 world’s best specialized hospital in 2023. Regarding oncology, our institution ranked as the first in Asia and number 6 in the world. Personally, as a gastric cancer specialist, I am very much proud of this achievement. As you know, patient safety is the top component of the quality of Medicine. Without a perfect safety, other thing such as effectiveness, patient-centeredness, efficiency, timeline, and equitability have no meaning. We should focus on the patient safety. At my institution, we are trying to establish international standard processes through KOIHA accreditation activities. [Click] As I mentioned before, standardization is so important in the safety and quality of medicine. We try to further develop standardized patient care system through a lot of clinical pathways. [Click] Implementation of international patient safety goals and establishment of safety culture is also very important. For example, we try to reduce surgical site infection through the SCIP activities. We also have much interest in the logistics innovation using innovative technologies Culture matters. Every hospital is doing some creative activities to improve safety culture mind among their doctors and nurses. Today I’d like to show you one activity ? the patient safety round. We regularly go to the general wards, laboratories, operation rooms and other locations once or twice a month with president 박승우 of Samsung Medical Center. Patient safety round is a very important chance for mutual communication. Patient safety round is focused on listening from doctors and nursing staffs in each location, so the quality department prepares only very basic information about the patient safety culture and the reported cases. A lot of patient safety related issues are raised during the patient safety round. We try to solve the issues as soon as possible, because quick response is very important to keep the patient safety round staff-friendly and productive. This is an example. In the screening center, patients sometimes go upstairs after endoscopy. If the patient is not fully recovered from the sedation, there is a risk of fall down at the stair. Need for hand-rails was raised during the patient safety round, and [click] quickly fixed. Speed is so important to win the confidence of the house-staffs. Standardization is so important to improve quality and patient safety. I’d like to introduce the clinical pathway activities of my institution. If three surgeons are doing the same procedure with different protocols, it is almost impossible to check whether the procedures are going well exactly as planned. Only the surgeon knows it’s OK or not. If three surgeons make a single standardized uniform protocol, anyone can see and check whether the procedure is going exactly as planned. If there is something wrong, it can be fixed quickly. If your processes are currently not in control and are nowhere near being Best in the Class, don’t expect that you can simultaneously achieve the goals. In practice, it’s easiest to bring the process in control first and then work on improving its capability. So control is the first thing and improvement can follow. CP, clinical pathway, is a strong tool to control the complex procedures. CP is a time task matrix. Doctors and nurses should talk together to make a single standardized uniform protocol. Everything should be the best in the class. We are trying to make a different kinds of CPs for every patient care situations in the hospital. It includes general CP, event CP, in-patient CP and out-patient CPs. We are using 431 in-patient CPs and 58 outpatient CPs. Each year, a lot of new CPs are developed at Samsung Medical Center. The CP application rate is 65% this year. Sixty five means two third. Medical services to two thirds of patients at Samsung Medical Center are provided following a standardized, best in the class, uniform clinical pathways. Ten years ago, it was 16 percent. [Click] How can we make such a dramatic chance in the patient care? There are many steps in the development of clinical pathway. What do you think is the most important step to change your hospital into CP-based institution? I think it is the initiation. [Click] Each clinician or individual department can initiate the CP development procedure. Or the hospital, the CP committee, can make a strong policy to use CP always unless impossible. We think CP as a default procedure. All the procedures should be standardized with only a few exceptions. The exceptions should be very few, very rare. That’s our mindset. Always use CP. Always try to us a standardized protocol, because standardization is the beginning of quality improvement. Communication with doctors and nurses are critical for culture changes. We have done a lot of lectures, discussion sessions, and sometime nice dinners. Analysis and feedback is also very important. This is a recent feedback for the CP application and the drop-out rate for my center, the gastric cancer center. The CP application rate of the gastric cancer team was 93 percent. We are making guidebooks… And leaflets for further development of CPs. From now on, I’d like to show you how I use the CP in my personal practice. I am a gastroenterologist. I focus on the endoscopic diagnosis and treatment of early gastric cancer. As you understand, early detection of gastric cancer is so important for less invasive treatment. At my institution at Samsung Medical Center, gastric ESD is done about 1,000 cases a year. In the recent 5 years, the rate of gastric cancer among ESD cases was 73%. The rate of additional surgery after ESD for gastric cancer was 15%. For the selection of ESD candidate, endoscopic assessment of early gastric cancer is so important. . . . From now on, I’d like to move to the second part of my talk, the logistics innovation. From the beginning of Samsung Medical Center, we have tried to lead the healthcare sector in digital transformation. Intelligent hospital was our motto at that time. Logistic innovation is strongly required. Hospitals need a lot of medical materials, which are mostly carried by people. It is the same 100 years ago and until now. We tried to use robot technology to change this old tradition. In the logistics innovation, we considered three important aspects. Needs for real-time care support, the lack of space and the manpower resource shortage. A total of six robots deliver medical materials from 9 p.m. to 4 a.m. the next day. Robots plan their own schedules and use elevators to move vertically. When robots finished the job, it come back to the charging station. And we need a central control tower to manage many of these robots. We are managing robots by establishing a control center in a?Metaverse?environment. And these robots can be controlled remotely. My final topic is the regional patient safety center. The Korea Institute for Healthcare Accreditation (KOIHA) is running the central patient safety center. Under the central patient safety center, there are five regional centers. Our hospital is one of them. We are working with some of the middle sized local hospitals in areas of quality and patient safety. I have visited some local hospitals and had discussion on patient safety issues. We, the regional center, support patient safety day activities at each hospitals. We share our experience of quality improvement activities such as FMEA with local hospitals. And we regularly have symposium on patient safety. This is the outcome of regional patient safety center at Samsung Medical. I’d like to appreciated the KOIHA, 의료기관평가인증원, for supporting my institution. Ladies and gentlemen, I’d like to conclude my talk by saying that patient safety is the top priority in the hospital patient care. Cultural change, standardization, and use of modern technologies are key components of the quality improvement activities at Samsung Medical Center. Thank you for your attention.