국내 의료기관의 질 향상 사업의 활성화에 영향을 미치는 요인 - 조직동인적 관점에서

Factors Associated with the Degree of Quality Improvement Implementation

Objectives : To assess the degree of quality improvement (QI) implementation and to identify its associated factors. Methods : A mailed questionnaire survey of the QI staffs at hospitals with 400 beds or more was conducted between September 15 and October 30, 2000. 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 in our analysis. The degree of QI implementation was measured using the Malcolm Baldrige National Quality Award Criteria (MBNQAC). Factors evaluated for association with the degree of QI implementation were cultural, technical, strategic, and structural factors of the hospitals. Results : The average 01 implementation score across the 7 dimensions of MBNQAC was 3.34 on a 5-point scale, with the highest score for the area of customer satisfaction (3.88) followed by information and analysis (3.59) and quality management (3.35). The results of regression analysis showed that hospitals with a ofter information system (p<0.05) and using scientific and systematic problem solving approach (p<0.01) tended to perform a higher degree of QI implementation. While statistically insignificant, positive associations were observed for the factors of group or developmental culture, the degree of employee empowerment, and the use of prospective strategy. Conclusions : It appears that the most important factors contributing to active implementation of QI in Korean hospitals were the use of scientific skills in decision making, and having a quality information system to produce precise and valid information.