Health Policy and Management (보건행정학회지)

Korean Academy of Health Policy and Management (한국보건행정학회)
권호 표지

Factors associated with the Degree of Quality Improvement Performance

질 향상 활동성과에 영향을 미치는 요인

  • 이선희 (이화여자대학교 의과대학 예방의학교실) ;
  • 강혜영 (연세대학교 대학원 보건학과) ;
  • 조우현 (연세대학교 의과대학 예방의학교실) ;
  • 채유미 (이화여자대학교 의과대학 예방의학교실) ;
  • 최귀선 (이화여자대학교 의과대학 예방의학교실)
  • Published : 2001.12.01
Download PDF
⟨ Previous Next ⟩

Abstract

This study was conducted to assess factors associated with the degree of performance of qualify improvement(QI) activities. A mailed questionnaire survey was conducted between September 15 and October 30, 2000, with the staffs being charge of QI at each of the hospitals with 400 beds or greater. Of the 108 hospitals eligible for inclusion in our study, 79 participated, yielding a response rate of 73.1%. After excluding 12 hospitals that did not perform any QI activities, 117 responses from 67 hospitals were used for the analysis. Using the Malcolm Baldrige National Quality Award Criteria(MBNQAC), perceived performance of QI was measured in terms of the improvement of the quality of clinical practice, clinical supporting department, administrative procedure of receiving care, customer satisfaction, efficiency and standardization of work process. Factors evaluated for the association were the extent of QI implementation, compliance to 5 QI principles, participation of hospital CEOs, budget allocation, history of QI, and bed size. Path analysis was performed to assess the relationship between QI performance and these factors. Major findings of this study are as follows. Hospitals showing higher degree of QI implementation (path coefficient=0.5967, p<0.001)) and better compliance with the basic principes of QI(0.5736, p<0.05) tended to achieve better performance. Path analysis results showed that interest and participation of hospital CEOs(0.1954, p<0.05) and compliance with the basic principes of QI(0.4028, p<0.0001) indirectly affected the outcomes of QI by influencing the intermediate variable of the level of QI implementation. This study results suggest that having employees have a good orientation of the basic concept and principes of QI through relevant training be the most important requirement to achieve better outcomes from QI activities. In addition, to educate leaders of hospitals the need of active implementation of QI is important to encourage their participation and draw strong support for QI programs.

Keywords

References

  1. 한국의료QA학회 병원질 향상 사업의 성공요인.한국의료QA학회 1998년 가을정기 학술대회 및 연수교육 이선희
  2. 한국의료QA학회 국내 병원들의 질 향상 활동현황 및 성공과 실패요인.한국의료QA학회 2000년 가을정기 학술대회 및 연수교육 이선희
  3. Hosp Health Netw v.5 The quality march: national survey profiles quality improvement activities Barsness ZI;Shortell SM;Gillies RR(et al)
  4. Health Care Manage Rev v.20 no.4 Total quality management:field of dream? Bigelow B;Arndt M
  5. New Engl J Med v.320 Continuous improvement as an ideal in health care Berwick DM
  6. Jossey-Bass Curing health care Berwick DM;Godfrey AB;Rossner J
  7. Health Care Manage REv v.21 no.1 Keys for successful implementation of total quality management in hospitals Carman JM;Shortell SM;Foster RW(et al)
  8. Hosp & Health Serv Adm v.42 no.4 Continuous quality improvement: a survey of American and Canadian healthcare executives Chan YC;DeGroote MG;Ho SJ
  9. Healthcare Financ Manag v.46 no.9 Is there a lind between hospital profit and quality? Cleverley WO;Harvey RK
  10. Hosp Health Serv Adm v.40 no.1 Improving hospital performance: issues in assessing the impact of TQM activities Counte MA;Glndon GL;Oleske DM;Hill JP
  11. Hosp Health Serv Adm v.37 no.4 Total quality management in a health care organization:how are employees affected? Counte MA;Glandon GL;Oleske DM;Hill JP
  12. Center for Advanced Engineering Science Out of the crisis. Cambridge, Massachusetts Institute of Technology Deming WE
  13. Healthcare Executive v.7 no.1 Strategies to improve care and control costs Elliott B
  14. The American Quality Foundation International quality study: health industry report. Cleveland Ernst Y
  15. Qual Manage Health Care v.6 no.3 Do TQM intercentions change management culture? findings and inplications Gerowitz MB
  16. SAS Institute Inc. A step-by-step approach to using the SAS system for factor analysis and structral equation modeling Hatcher L
  17. Striving toward improvement: six hospitals in search of quality Joint Commission on Accreditation of Healthcare Organizations
  18. Jiran on planning for quality New York Press Juran JM
  19. Hosp Health Serc Adm v.36 no.4 A systemic health care quality service program Kalafat J;Siman ML;Walsh L
  20. Qual Manag Health Care v.1 no.4 Total quality management in health care:taking stock Melum MM;Sinioris ME
  21. Qual Manag Health Care v.3 no.4 An intergrative model for organization-wide quality improvement: lessons from the field O'Brien JL;Shortell SM;Hughes EF;Foster RW;Carman JM;Boerstler H;O'Connor EJ
  22. BMJ v.317 no.7150 The NHS's 50 anniversary.Clinical gocernance and the drive for quality improvement in the new NHS in England Scally G;Donaldson LJ
  23. Hosp Health Serv Adm v.40 no.1 Assessing the evidence on CQI: Is the glass half empty or half full Shortell SM;Levin DZ;O'Brien JL;Hughes EFX
  24. Health Serv Res v.30 no.2 Assessing the impact of continuous quality improvement/total quality management: concept versus implementation Shortell SM;O;Brien JL(et al)