• 한국병원경영학회지
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• 제7권2호
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• pp.99-123
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• 2002

This study was conducted to determine whether follow-up management is carried out continuously following CQI activity and to analyze the factors behind the success and failure of follow-up management. Past presentations from 1994-1999 of CQI coordinators and lecturers from various institutions who presented at The Korean Society of Quality Assurance in Health Care(KoSQA) on the conditions of follow-up management in each institution were analyzed. The results of this study were as follows; Since the number of subjects on CQI increased each year at symposiums, this has expanded to all medical institutions. Although medical institutions usually conduct 11-20 subjects on CQI per year, there were many such occasions where more than 31 subjects were conducted. Moreover, institutions with less than 800 beds have come up with more projects than those with more than 800 beds, thus 23.3% of these institutions had at least 1 person involved in 4 projects. This had created an overload of responsibilities for specific persons' involvement, prompting them to incline toward formalities in their work rather than substantial activities. Among the projects presented at the symposiums, 51.7% demonstrated that follow-up management could be carried out. In particular, 55.3% of the projects from provincial regions could carry out follow-up management compared to 48.8% in Seoul. Moreover, it was demonstrated that 80% of the projects from institutions with 600-799 beds carried out follow-up management most effectively. With regards to previous presentations, the older they were, it was found that follow-up management could not be effectively carried out. Some institutions that responded that follow-up management was carried out effectively in their institutions were found to have conducted follow-up management without any inspection strategies or the appropriate tools. CQI activities were executed and terminated with no consistency and team members had no real concern for it. The most important factors that contribute to an effective follow-up management are the need for concern and interest from the directors of the hospitals, from the relevant departments and team members in addition to the role of the supervising department, follow-up management through management of target goals, consistency in tasks along with communication between all team members. The biggest problems were perceived to be overload of work due to accumulation of proposed projects in addition to lack of awareness pertaining to follow-up management. CQI is beneficial for all staff for the improvement of the mind and business administration and thus it is believed to be desirable. To carry out follow-up management effectively, leadership, analysis and application of information, follow-up management and planning, as well as quality management are perceived to be essential, on the other hand, the results showed a significant difference. To prevent CQI activities from becoming just an activity, the basic system should be reconstructed and augmented based on the problems derived from the results of this study. Moreover, we hope this study will be used as reference material that would encourage the administration of follow-up management after CQI activities in most hospitals. Furthermore, various studies on follow-up management should be conducted for CQI activities in the future.

• 의학교육논단
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• 제22권3호
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• pp.189-197
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• 2020

The goal of this study is to present efficient measures to improve the quality of medical education through using a developed and applied continuous quality improvement (CQI) model suitable for medical education. To achieve this purpose, we developed a theoretical CQI model through a review of the literature according to the design-based research method. Through repetitive productive cyclical processes and professional reviews, we finally deduced an appropriate CQI model for medical education. The most important results of this study are as follows: First, the CQI model for medical education is defined as a quality management system with a cyclical course of planning, implementation, evaluation, and improvement of medical education. Second, the CQI model for medical education is composed of quality management activities of educational design, work, and evaluation. In addition, each activity has the implementation strategies of planning, doing, checking, and improving based on the PDCA model (Plan-Do-Check-Act model). Third, the CQI model for medical school education is composed of committees related to medical education doing improvement activities, as well as planning, implementing and evaluating it with CQI. As a result, we can improve teaching by using the CQI model for medical education. It is more meaningful because this gives us organized and practical measures of quality management and improvement in medical education as well as in the educational process.

• 한국의료질향상학회지
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• 제29권2호
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• pp.85-93
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• 2023

Purpose: The predominant approach for mitigating inadequate sampling rates has primarily involved bolstering the volume of education. This study aimed to curtail inadequate sampling rates through the implementation of continuous quality improvement (CQI) activities, tailoring effective methods to the unique needs of each institution. Methods: We developed a sample handling guidebook and implemented QI activities to address this issue. Results: These measures resulted in a 4.7% decrease in inadequate sampling rates, concurrently improving knowledge of sample handling and overall nurse satisfaction. We addressed the root causes of inadequate sampling before laboratory pre-processing by: 1) focusing on systematic rather than erratic errors through CQI activities, 2) revising the sample handling guide, and 3) delivering face-to-face education based on the specific needs of the nursing department. These changes resulted in an additional 0.6% decrease in the inadequate sampling rate. Conclusion: This study demonstrates that the implementation of CQI activities based on evidence derived from a multifaceted causal analysis significantly reduced the inadequate sampling rate compared to previous studies.

• 한국의료질향상학회지
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• 제8권1호
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• pp.10-21
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• 2001

Background : The Clostridium difficile is the most important identifiable cause of nosocomial infectious diarrhea and colitis, which lengthens hospital stay. Recently incidence of C. difficile has been increasing in an university hospital, and an intervention for prevention and control of C. difficile associated diarrhea (CDAD) was in prompt need. Methods : Subjects were the patients in the neurosurgical intensive care unit(NCU) where C. difficile was most frequently isolated. To increase participation of various departments, we used the CQI method, because management of CDAD requires a wholistic approach including control of antibiotics, barrier precaution and environmental cleaning and disinfection. Duration of the CQI activities was 9 months from April to December 1999. Results : The identified problems were misuse and overuse of antibiotics, lack of consciousness of medical personnels and the possibility of transmission from the contaminated environment and tube feeding. Education for proper use of antibiotics and management of C. difficile infection, use of precaution stickers, supplement of handwashing equipments, emphasis on environmental disinfection, and the change of the process of tube feeding were done. The CDAD rate in NCU was significantly decreased after the CQI program (8.6 case per 1,000 patient days from January to April 1999 vs 4.8 from May to December 1999). The distribution of neurosurgical wards including NCU among the total number of isolated C. difficile from the clinical specimens dropped from 49.4% in January to April to 33,7% in May to December. The average hospital stay of the neurosurgical department changed from 19.6 days to 15.2 days. Also, the effect of the CQI activities for C. difficile may have affected the incidence of vancomycin resistant enterococci (VRE). Duration and dosage of certain antibiotics used in the NS department were decreased. The distribution of neurosurgical department in the number of VRE isolated patients declined from 18.4% to 11.1%. Conclusion : Infection control of resistant organisms such as C. difficile is likely to be successful when management of environmental contamination an collaborative efforts of decreasing the patients' risk factors such as antibiotics management and decreasing the length of hospital stay come simultaneously. For this work, related departments need to actively participate in the entire process under a common target through discussions for identifying problems and bringing up solutions. In this respect, making use of a CQI team is an efficient method of infection control for gathering participation and cooperation of related departments.

• 한국의료질향상학회지
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• 제4권1호
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• pp.50-63
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• 1997

Background : A pressure sore was defined as any skin lesion caused by unrelieved pressure and resulting in damage to underlying tissue. The health care institutions in the United States were reported the incident rate of pressure sores ranging from 6 to 14 %. Intensive Care Unit needed highest quality of care has been found over 40% incidence rate of pressure sore. Also, Annual expenditures for the care of pressure sores in patients in the United States have been estimated to be $7.5 billion; furthermore, 50 percent more nursing time is required to care for patients with pressure sore in comparison to the time needed to implement preventive measures against pressure sore formation. However, In Korea, there were little reliable reports, or researches, about incidence rates of pressure sore in health care institution including intensive care unit and about the integrated approach like CQI action team for risk assessment, prevention and treatment of pressure ulcers. Therefore, this study was to develop pressure sore risk assessment tool and the protocol for prevention of pressure sore formation through CQI action team activities, to monitor incident rate of pressure sore and the length of sore formation for patients at high risk, and to approximately estimate nursing time for sore dressing during research period as the effect of CQI action team. Method : CQI action team in intensive care unit, launched since early 1996, reviewed the literature for the standardized risk assessment tool, developed the pressure sore assessment tool based on the Braden Scale, tested its validity, compared on statistics including incidence rate of pressure sore for patients at high risk. Throughout these activities, CQI action team was developed the protocol, called as St. Marys hospital Intensive Care Unit Pressure Sore Protocol, shifted the emphasis from wound treatment to wound prevention. After applied the protocol to patients at high risk, the incident rate and the period of prevention against pressure development were tested with those for patients who received care before implementation of protocol by Chi-square and Kaplan-Meier Method of Survival Analysis. Result : The CQI action team found that these was significant difference of in incidence rate of pressure sores between patients at high risk (control group) who received care before implementation of protocol and those (experimental group) who received it after implementation of protocol (p<.05). 25% possibility of pressure sore formation was shown for the patients with 6th hospital day in ICU in control group. In experimental group, the patients with 10th hospital day had 10% possibility of pressure sore. Therefore, there was significant difference(p<.05) in survival rate between two groups. Also, nursing time for dressing on pressure sore in experimental group was decreased as much as 50% of it in control group. Conclusion : The collaborative team effort led to reduced incidence, increased the length of prevention against pressure sore, and declined nursing care times for sore dressing. However, there have had several suggestions for future study. The preventive care system for pressure sore should be applied to patients at moderate, or low risk throughout continuous CQI team activities based on Bed Sore Indicator Fact Sheet. Hospital-wide supports, such as incentives, would be offered to participants for keeping strong commitment to CQI team. Also, Quality Information System monitoring incidents and estimating cost of poor quality, like workload (full time equivalence) or financial loss, regularly in a hospital has to be developed first for supporting CQI team activities as well as empowering hospital-wide QI implementation. Being several limitations, this study would be one of the report cards for the CQI team activities in intensive care unit of an acute hospital and a trial of quality improvement of health care in Korea.

• 공학교육연구
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• 제12권1호
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• pp.64-72
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• 2009

본 연구는 공학교육인증제 운영과정에서 강조되고 있는 학습성과 중 리더십 교육과 관련한 CQI 방안을 탐구하는 데 목적이 있다. 이를 위해 본 논문에서는 리더십 교육과 관련된 영남대학교의 사례를 연구하였다. 본 연구를 위해 리더십 교육과 관련된 영남대학교의 교과 및 교과 외 교육과정 분석, 리더십 교육 CQI 방안 마련을 위한 전문가 및 유관 기관 실무자 포커스그룹 면담이 실시되었다. 또한 리더십 캠프 참가자를 대상으로 리더십 역량진단, 리더십 교육 수요 조사, 캠프 만족도 조사를 실시하였다. 리더십 캠프진행을 주관한 데일 카네기 연구소 대구지부의 전문 강사들과 포커스그룹 면담을 실시하고 캠프 기간 동안 비참여관찰법을 통한 내용분석과 질적 면접이 병행되었다. 본 연구 결과를 정리하면 다음과 같다. 첫째, 대학수준의 수학능력 향상방안과 심리적 차원의 역량강화 방안이 동시에 고려되어야 한다. 특히 지방대학이라는 특성을 고려할 때 외국어 능력 향상과 자신감 및 비전 수립을 위한 교육에 역점을 둘 필요가 있다. 둘째, 일회성의 단기 리더십 세미나 및 팀 티칭 형태의 교육을 보완하기 위해서 설계교과목 이수체계도를 활용한 중장기 교육계획 수립 및 리더십 캠프 참가 경험이 있는 학생과 차기 캠프 참가자들간의 멘토-멘티제 운영이 고려될 수 있다. 셋째, 리더십 교육에 역점을 두는 전공, 학과 및 교내외 유관기관 관계자들로 구성된 리더십 교육 자문위원회를 구성함으로써 체계적이고 효과적인 리더십 교육을 실현할 수 있을 것이다.

• 간호행정학회지
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• 제16권2호
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• pp.162-171
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• 2010

Purpose: Nursing home quality indicators have been focused widely on result outcomes, not for the environment in that quality of service are delivered, This study aimed to examine structural factors influencing quality management activities in nursing homes. Method: Sample was 170 nursing homes responded to the survey questionnaire which was distributed to the 543 nursing homes nation-wide, Data were collected on structural characteristics, types of services, and quality management activities, Data were analyzed with the descriptive statistics, Pearson correlations, and multiple regression. Result: Most of the nursing homes were operated as free of charge by the social welfare ownership. Average number of residents was 52.1 with severe and mild dementia and bedridden status, In terms of quality management activities, 34% of the sample had CQI committee that focused their activities on services delivery process, performance appraisal, record keeping regularly. 30.6% of quality management activities were accounted for by the number of residents with dementia, the ratio of RN to residents, rehabilitation services, and social wefare services in nursing homes. Conclusion: We recommend that more comprehensive quality management activities should be developed as process quality indicators in conjunction with the outcome indicators.

• 한국의료질향상학회지
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• 제6권1_2호
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• pp.120-134
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• 1999

Background : This study was conducted to reduce the neonatal infection rate in nursery. Methods : 50 items, structural problems in NICU were selected by open questionnaire and categorized into 11 similar items. 38 items were picked out among them and then categorized into 6 similar items. We carried out quality improvement focusing around 6 items. Results : The high achievement of goal in CQI Activities was shown in hand washing for reducing infection of NICU after July. The local infection in IV site was not found and hand washing and gowning of protectors were achieved by 100%. Conclusion : Neonatal infection rate was reduced through the quality improvement activities, but structural problem of Hospital still remained.

• 한국지능정보시스템학회:학술대회논문집
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• 한국지능정보시스템학회 2001년도 The Pacific Aisan Confrence On Intelligent Systems 2001
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• pp.352-357
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• 2001

This study presents an analysis of healthcare quality indicators using data mining for developing quality improvement strategies. Specifically, important factors influencing the inpatient mortality were identified using a decision tree method for data mining based on 8,405 patients who were discharged from the study hospital during the period of December 1, 2000 and January 31, 2001. Important factors for the inpatient mortality were length of stay, disease classes, discharge departments, and age groups. The optimum range of target group in inpatient healthcare quality indicators were identified from the gains chart. In addition, a decision support system was developed to analyze and monitor trends of quality indicators using Visual Basic 6.0. Guidelines and tutorial for quality improvement activities were also included in the system. In the future, other quality indicators should be analyze to effectively support a hospital-wide continuous quality improvement (CQI) activity and the decision support system should be well integrated with the hospital OCS (Order Communication System) to support concurrent review.

• 한국의료질향상학회지
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• 제7권1호
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• pp.118-131
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• 2000

Background : A continuous healthcare quality improvement is needed to provide high quality healthcare service as well as to maintain trust in terms of satisfying the needs of the patients. Recently it also became an essential issue. in hospital management, recognized for it's competitive potentiality among healthcare organization groups. This study was conducted to analyze patient complaints and issues received by the Quality Improvement Department. Its purpose is to improve healthcare qualities within the hospital, as well as establish policies and appropriate strategies in hospital management. Method : From July 1st to September 30th of the year 1999, we analyzed all complaints and issues made by various patients and their families, which were received through 24 hour phone consultation, numerous suggestion boxes, letters and E-mails, The issues were classified into 16 different categories based on a Patient Satisfaction Assessment Tool. All data were segregated according to the departmental frequencies and their contents. To come up with for environmental and patient satisfaction improvement, all complaints or issues were communicated with hospital administrators, medical and nursing staff and employees. Comprehensive customer satisfaction activities including improving phone etiquette were discussed in Customer Satisfaction Team, CQI Team and each Department. All opportunities for improvement were implemented. Feedback actions were discussed. Results : A total of 317 cases were collected. Issues regarding parking and other accommodation facilities were most common complaints that were 14.5% of total. Issues regarding admission rooms (10.7%), admission procedures (10.7%), waiting room environment (8.8%), nurses and nurse assistants (7.6%), physicians (6.6%) and others (23%) followed. Thirteen of 45 departments received more than 8 complaints. The Nursing Department had the most complaint, receiving 9.8% of total complaints. Complaints regarding the Nursing Department were predominantly related to the environment of patient rooms. The Department of Psychiatry for phone etiquette (4.7%), Department of Otolaryngology for the nursing staff's attitude and phone etiquette (4.4%), and the Admission Department followed. As a part of efforts to improve patient satisfaction, a new parking structure was built and reallocation of the parking space was done. Renovation of other accommodation facilities were carried out by hospital administration, Monthly phone call and answering attitude survey was done by QI Department. Based on this survey we made a phone etiquette manual and distributed throughout the hospital. Compare to the last year, Patient Satisfaction Index measured by Korea Productivity Center using National Customer Satisfaction Index was improved 7 points. According to our organization's own study, we confirmed the phone etiquette was improved 11% than last year. Conclusions : Issues related to parking and other accommodation facilities ranked first followed by complaints made regarding the patient care area, the admission and cashier process, and nurses' and doctors' attitude. The Nursing and Psychiatry Departments need improvement regarding phone etiquette. Results were shared and played a vital role in policymaking and strategic planning of the hospital. It is imperative that we keep our database updated by listening to and solving the needs of each patient. The CQI activities can be achieved only by full commitment of the hospital top management supported by related personal.