• 한국의료질향상학회지
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• 제6권1_2호
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• pp.136-149
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• 1999

Background : Although a number of studies are related to QA improvement, there are few studies applied various method of QA tools. This study reviewed the availability of general quality assurance(QA) tools according to ten steps in performing quality improvement activities at emergency room of a tertiary teaching hospital which has more than 1,000 beds. Methods : All patients in emergency room from 15th Oct. 1997 to 5th Sep. 1998 were surveyed. The survey data based on the patient's records of emergency room were evaluated according to length of stay, and we tried to identify problems with management of emergency room. To solve the problems, our team applied general QA tools(brainstorming, flow chart, nominal group technique, benchmarking, cause-and-effect diagram, run chart, control chart) to quality improvement activities and discussed the availability of the tools. Results : After the activities such as changes of staffing, the establishment of local area network and chest pain clinic, application of triage and so on, the percentage of patient who had stayed more than six hours was reduced from 56.0% to 46.8%. The mean number of patients per day in emergency room was increased from 49 to 62. But the reporting time for laboratory test was not changed after these activities. Conclusion : Each QA tool has unique benefit and limitation, but we can implement and evaluate the quality improvement activities more scientifically and systematically by applying these tools to practice according to QA ten steps.

• 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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• 제11권1호
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• pp.33-41
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• 2005

The construction can proceed in different ways according to the acquired profitability of the hospital during the construction and to the features of departments or areas. This study is an analysis of remodeling construction processes to resolve major tasks of remodeling. The remodeling strategies gained from this study can be summed up as follows: 1) Remodeling work in hospitals involves the acquire relocation of space through extensive area renovations and then moving back to the space, and lastly working on the empty space. Thus, it is more advantageous in terms of construction work to demolish the existing buildings than to acquire the relocation space through extensions or renovations. That is, demolition after the maximum utilization of the existing buildings is the most desirable in terms of space availability. 2) The construction methods for remodeling are two: a method of carrying out construction by dividing the plane areas into several individual ones and of working on it floor by floor. In case of ward areas, and the outpatient area, the construction proceeds after securing the relocation space and partially setting construction areas in order to minimize the decrease in profitability due to the smaller number of beds and treatment rooms during construction. If the outpatient diagnosis/ treatment area and the supply area relocate together with the ward areas, there may be extra expenses. Thus, doing construction by area, while partially operating those areas or after relocating the whole areas.

• 한국간호교육학회지
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• 제20권4호
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• pp.628-638
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• 2014

Purpose: This study identifies the relation among the essentials of fundamental nursing skills performance (EFNSP), work capability and stress from work experienced by new clinical nurses. Method: This is a cross-sectional descriptive study with a self-reported questionnaire. The subjects were 224 new clinical nurses employed by general hospitals having more than 400 beds. The data, collected from February 10 to March 7, 2014, were analyzed using descriptive statistics, t-tests, ANCOVA, Pearson's correlation analysis and hierarchical linear regression. Results: The highest frequency of EFNSP of new clinical nurses was vital sign measurement (4.74, ${\pm}.89$) and the lowest frequency of performance was Basic CPR & defibrillator application (1.81, ${\pm}.94$). There were significant positive correlations between frequency and confidence of EFNSP (r=.64, p<.001), frequency and work capability (r=.34, p<.001), and confidence of EFNSP and work capability (r=.48, p<.001), but negative correlation stress from work and work capability (r=-.17, p=.009). General characteristics, stress from work, frequency and confidence in EFNSP and stress from work explain 25.1% of work capability. Conclusion: This result suggests the importance of EFNSP education in nursing schools and availability of opportunities to practice EFNSP during the post-graduation waiting period until assignment to a hospital.

• 한국병원경영학회지
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• 제23권1호
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• pp.41-50
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• 2018

The purpose of this research is to evaluate Brand Value by using the K-BPI(Korea Brand Power Index) of Korea Management Association which is based on consumer awareness, as well as to identify how Brand Value which is composed of top of awareness, unaided awareness, aided awareness, image, possibility of purchasing, preference, affects on the Market Share perceived by consumers. This research subjects were 10 hospitals with more than 1,000 beds in Seoul and Gyeonggi-do, and survey subjects were 20 or older adults living in the metropolitan area of Korea. Using K-BPI for measuring Brand Value and used calculation of Market Share according to consumer preference model for measuring Market Share. The major results of this research are as follows: First, this research identified that the top 5 hospitals of largest hospitals in metropolitan area measured by using K-BPI and Market Share were same hospitals as Big 4 hospitals of previous research evaluating the comprehensive competitiveness of hospitals and also same as hospitals that appeared recently. Second, Big 5 hospitals ranked first to fifth in both Brand Value and Market Share. To identify the relationship between K-BPI items(top of awareness, unaided awareness, aided awareness, image, availability, preference) and Market Share, multiple linear regression was used by dividing 5 upper and 5 lower group of hospitals per each. The group of 5 upper hospitals had a significant effect on Market Share, with 'top of awareness', 'unaided awareness', 'aided awareness'. The group of 5 lower hospitals had a significant effect on Market Share with 'unaided awareness', 'aided awareness'. The results of this study and hospitals of the first to third hospitals published in the K-BPI press release reported by KMAC in 2017, and the previous studies evaluating the comprehensive competitiveness hospitals, all had one thing in common that Big 4 hospitals ranked high position. This suggests that evaluation of Brand Value also can be a evaluation measure of hospital. A new competitiveness of hospital is expected by managing brand awareness to have a brand competitiveness and by securing intrinsic Market Share of consumer to reach hospital use ultimately.

• Journal of Preventive Medicine and Public Health
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• 제27권3호
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• pp.609-626
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• 1994

This study was conducted to investigate whether variations in hospital services utilization across small geographic areas in Korea existed, and if so, what factors are responsible for the variation. The claims data of the fiscal year 1992 obtained from the regional health insurance societies were used for the study. Main findings of the research can be summarized as follows: 1 Extremal Quotients (EQ) of hospital expenditure per capita and hospital days per capita were 2.69 and 2.73, and Coefficient of Variation (CV) were 0.14, both, respectively. The EQ and the CV of admission rate were also 2.71, 0.15. The EQ and the CV of expenditure per admission were 1.73, 0.10 and those of hospital days per admission were 1.29, 0.06. All these statistics were statistically significant and this result provides strong evidence for the existence of small area variations. 2. Comparing patterns of variation among areas, the area which showed higher utilization amounts is Chansungp'o. Koje area, whereas the areas which showed lower utilization amounts are Yongju, Changhung, Miryang, Mokp'o, Koch'ang area. 3. Multivariate analytic methods were used to examine factors related to the variation across areas. In terms of the health resource availability variables, beds per capita or physicians per capita were positively associated with all utilization indices. As for the health service market structure variables, the proportion of health care institutions operating for less than f years was positively related to the expenditure per capita, hospital days per capita and expenditure per admission. In addition the proportion of the private health care institutions also had a negative relationship with total utilization amount and admission rate and the proportion of physicians under age 40 was negatively associated with expenditure per capita and expenditure per admission. With regard to the socio-demographic characteristics, proportion of medicaid population was positively related to hospital days per capita, and percentage of paved road was positively related to hospital days per admission. As a conclusion, wide variations existed across small areas in Korea and supply factors were found to be important in explaining the variation.

• Journal of Preventive Medicine and Public Health
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• 제23권3호
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• pp.285-295
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• 1990

The utilization of medical care services has been partly regionalized with the implementation of referral requirement by the government since July 1, 1989 when the health insurance coverage was extended to all the people. For the purpose of regionalization, the whole country has been primarily divided into tertiary care regions, and each of them again into secondary care regions. This study investigates the self-sufficiency for in-patient care services of secondary care regions focusing on why it varies among the regions. In doing so, analysis is performed to examine a model which embodies three sets of hypotheses as follows : 1) The regional self-sufficiency for medical care services would be subject to direct influences of regional characteristics, amount of available services and structural properties of regional medical care system ; 2) The regional characteristics would have indirect effects on the self-sufficiency which are mediated by medical care services ; and 3) The amount of available services would indirectly affect the self-sufficiency by influencing the structure of regional medical care system. The results of analysis were generally consistent with the model. The findings have some practical implications. The regional self-sufficiency for medical care services partly depends upon basic properties of each region which cannot be changed in a short period of time. Thus the self-sufficiency for medical care services can be improved mainly by health policy measures. In some of the regions the self-sufficiency for in-patient care services was much higher or lower than can be predicted from the bed-population ratio. Indication is that the allocation of health resources should be made considering a variety of factors bearing upon the supply of and demand for health care ; not on the basis of just a single criterion like the availability. The self-sufficiency of a certain region is related to not only its own characterstics but also the characteristics of neighboring regions. Therefore, attention should be also directed to the inter-regional relationships in health care when the needs for investment of health resources in a region are assessed. However, it should be noted that this study used the data collected before the referral requirement was imposed. A replication of this analysis using recent data would provide an evaluation of the impact on the self-sufficiency of the referral requirement as well as a confirmation of the findings of this study.