치과의료 질 향상활동 현황과 개선활동 만족도

Conditions and Performance of Quality Improvement Activity in Korean Dental Hospitals

  • 김한나 (부산대학교 치의학전문대학원 예방치과학교실) ;
  • 김호 (서울대학교 보건대학원 보건통계학교실) ;
  • 김혜영 (고려대학교 보건과학대학 치기공학과, 고려대학교 대학원 보건과학과 및 BK21+ 보건과학사업단)
  • Kim, Han-Na (Department of Preventive and Community Dentistry, Pusan National University School of Dentistry) ;
  • Kim, Ho (Department of Epidemiology and Biostatistics, Graduate School of Public Health, Seoul National University) ;
  • Kim, Hae-Young (Department of Dental Laboratory Science and Engineering, College of Health Science & Department of Public Health Sciences, Graduate School & BK21+ Program in Public Health Sciences, Korea University)
  • 투고 : 2013.08.28
  • 심사 : 2013.10.10
  • 발행 : 2013.12.31

초록

본 연구에서는 치과의료 QI 활동이 활발할 가능성이 있는 21개 대표적인 의료기관을 선정하여 QI 활동의 개괄적인 현황을 조사하고, 동시에 그 기관에 근무하는 치과위생사 전체를 대상으로 치과의료 QI 활동의 시행 실태 및 QI 활동시행 후 개선효과에 대한 만족도를 조사하고 QI 활동의 활성화 요인과 저해요인 등을 알아봄으로써 치과의료 QI 활동의 현황을 파악하고 이에 따른 발전 방안을 제시하고자 하였다. 주요 결과는 다음과 같다. 1. QI 활동 주제별 시행률은 외부고객만족 주제가 59.9%로 가장 높았고 비용절감 59.4%, 의료의 질 향상 58.8%, 위험관리 52.8%, 업무효율성 향상 46.5%의 순으로 나타났다. 2. QI 활동 시행 후 개선 효과에 대한 만족도 점수는 비용절감 3.68점, 의료 질 향상 3.66점, 위험관리 3.65점, 외부고객만족 3.61점, 업무 효율성 향상 3.45점 등의 순으로 나타났다. 3. 의료기관 종류별 비교에서는 일반(종합)병원의 QI 활동 시행률이 유의하게 높았고 만족도 점수에서는 치과대학병원이 여러 항목에서 낮은 만족도 점수를 보였다. 4. 가장 많은 응답자가 지적한 QI 활동을 활성화 하는 요인은 병원종사자들의 적극적인 참여도, 저해하는 요인으로는 QI 활동의 인력과 예산 부족이 있다. 결론적으로 치과의료 QI 활동은 외부고객만족도 등 가시적인 효과가 용이하게 나타나는 주제에 집중되는 반면 복잡하고 가시적인 효과가 빠른 시간 내에 나타나기 어려운 주제에 대한 QI 활동은 소홀한 경향이 있으므로 균형 있는 사업 시행을 도모하고 QI 활동을 활성화하기 위해서 노력하여야 할 것으로 생각된다.

This study aimed to evaluate conditions and performance of quality improvement (QI) activity in Korean dental hospitals. Twenty one representative dental hospitals in Korea were selected by the selection criteria. A questionnaire was implemented to measure awareness, perceived needs, educations, conferences, works, activating/obstructive factors and satisfaction related to QI activities. Satisfaction score range from 0 (lowest) to 5 (highest) among 329 dental hygienists who worked in the selected 21 dental hospitals. Implementation rate of programs on external customer satisfaction was the highest 59.9% in QI activities, and reduction of expenses (59.4%), Improvement in health care quality (58.7), risk management (52.8) were followed, while improvement in work efficiency (46.5) showed the lowest implementation rate. The most influencing factor accelerating QI activities was 'active participation of hospital workers' (54.7%), and 'effort to improve customer satisfaction' (44.7%) followed. The most influencing QI related obstructive factor was 'lack of QI-related manpower and support' (47.1%). A balanced development including QI programs with lower implementation rates is necessary. Encouraging participation of workers may be the most important in developing dental QI activities further.

키워드

참고문헌

  1. Song IJ: Present situations and the reality of quality assurance: Department of Nursing, Yonsei Medical Center. J Nurs Query 5: 48-59, 1996.
  2. Ministry of Health and Welfare: 2004 Hospital Evaluation Programme: survey report. Korea Health Industry Development Institute, Seoul, pp.2-8, 2005.
  3. Kim JI, Oh HW: Factors for medical service quality improvement in hospital. Health & Welfare 12: 37-49, 2010.
  4. Choi JH: The performance of QI programs in general hospitals. Unpublished master's thesis, Yonsei Univesity, Seoul, 2002.
  5. Shin HS, Jeong MK: Evaluation of 2007 dental hospital accreditation demonstration project. J Korean Acad Oral Health 32: 350-362, 2008.
  6. Gunchi News: Competition of quality improvement activities has been keen in dental hospitals. Retrieved December 11, 2012, from: http://www.gunchinews.com/news/articleView.html?idxno=25258(2013, January 25).
  7. Kwon YD, Kim MK, Shin YS: A study on attitude of members quality assurance committee in hospitals affiliated with university on quality assurance. Korean Public Health Res 17: 90-100, 1991.
  8. Oh HY: A study on the perception about quality improvement activities in hospital management. Unpublished master's thesis, Wonkwang University, Iksan, 2010.
  9. Hong AR: A study on the effect of quality improvement activities in health care organizations. Unpublished master's thesis, Konyang University, Daejeon, 2005.
  10. Hwang JI: The current state of and barriers to quality measurement, and quality managers' reported evaluation on quality indicators in Korea. Health Policy Manag 15: 26-45, 2005. https://doi.org/10.4332/KJHPA.2005.15.4.026
  11. Choi KS, Lee SH, Cho WH, Kang HY, Chae YM: Succeeding factors and barriers to implementing quality improvement program. Quality Improv Health Care 8: 146-159, 2001.
  12. Park MH, Cho WH, Seo YJ, Lee SH: Job satisfaction and organizational commitment of quality improvement coordinators in general hospitals. Quality Improv Health Care 5: 278-294, 1998.
  13. Lee SI: Quality of care and clinical risk management. Quality Improv Health Care 8: 96-106, 2001.
  14. Park CS, Kim J: Dental consumers lifestyle of dental hospital satisfaction. J Dent Hyg Sci 9: 61-67, 2009.
  15. Yoon YS, Jung YH: A study of job satisfaction and job performance according to the leadership styles of dental hospital managers. J Dent Hyg Sci 3: 51-57, 2003.
  16. Choi JS, Lee SB: A study on the patient's expectation toward quality care of dental services. J Dent Hyg Sci 2: 1-9, 2002.
  17. Choi NR: An effect of QI education of dental hospital on Its sustained quality improvement activity. Unpublished master's thesis, Yonsei University, Seoul, 2012.
  18. Song YC: A study on dental hospital staff's acceptance toward the dental institutions accreditation system; centered on infection management part. Unpublished master's thesis, Kyung Hee University, Seoul, 2010.
  19. Bae SS: Development of evaluation index for infection control and prevention at dental hospital. Unpublished doctoral dissertation, Ewha Womans University, Seoul, 2011.
  20. Bae SS: Development of role model for dental hygienist in the changed environment medical service. Unpublished master's thesis, Yonsei University, Seoul, 2006.
  21. Choi KS, Kang HY, Cho WH, Chae YM, Lee SH: Factors associated with degree of quality improvement implementation. Korean J Prev Med 34: 363-371, 2001.
  22. Kim SM: A study on effects of the joint commission international (JCI) review on the awareness and attitude of hospital employees. Unpublished master's thesis, The Catholic University of Korea, Bucheon, 2012.
  23. Shortell SM, Kaluzny AD, Learning DT: Health care management; organization design and behavior. 4th ed. Thomson Learning, Singapore, pp.488-489, 2000.
  24. Han YJ: Awarence and attitude of medical personnel for the activities to improve medical quality in a university hospital. Unpublished master's thesis, Dankook University, Cheonan, 2003.
  25. Jo HJ: Analysis of factors affecting on the satisfaction of patients in university hospitals-focused on patients in university hospitals at Seoul. Unpublished master's thesis, Chung-Ang University, Seoul, 2009.