• Journal of Preventive Medicine and Public Health
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• v.34 no.4
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• pp.363-371
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• 2001

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.

• Health Policy and Management
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• v.11 no.4
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• pp.54-69
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• 2001

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.

• Quality Improvement in Health Care
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• v.19 no.2
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• pp.14-34
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• 2013

Objectives: The purpose of this study is to provide comprehensive information of qualification systems of developed countries needed to establish our national system for QI(Quality improvement) specialists. Methods: All articles related to any applicable domestic or foreign countries' laws, operational status, and detailed programs for professional qualification system of QI were reviewed. Result: In the United States, a non-profit organization, Healthcare Quality Certification Commission (HQCC) has set the policies, procedures and standards in the field of health care quality. And qualification system of CPHQ (certified professional in healthcare quality) has been operated in order to authenticate the qualifications in the field of quality management. IBQH(international Board for quality in healthcare), a qualification system of experts in the United Kingdom, was designed to assist the qualification of professionals to improve the quality of healthcare. In addition, Health Research Center of Feinberg School of Medicine in Northwestern University has been operating Master's and doctoral degree programs in the field of the quality of care and patient safety and IHI (institute for healthcare improvement) open school was operating a professional training course related to the quality of care and patient safety. Conclusion: Quantity and complexity of information of the quality of care and patient safety have been increased. For reform of the health care system, a special training course of the expertise and leadership are needed. So far, there is no national professional certification courses in our nation. Therefore essential job skill should be acquired individually. For systematic and effective quality improvement activities, the educational and certification system with professional development model are needed.

• Quality Improvement in Health Care
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• v.30 no.1
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• pp.88-104
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• 2024

Purpose: This study explored the suitability of interventions for medication interruption and intervention preferences. Methods: Two rounds of Delphi surveys were conducted with 18 expert panels comprising staff (or charge) nurses, nursing managers, and Quality Improvement (QI) team nurses working in a tertiary general hospital. For 47 situations involving the location of interruption, medication step, and source of interruption, the suitability of three interventions (no-interruption zone, medication safety vest, and education) was evaluated using a 5-point scale. Results: A total of 51 interventions for each situation were found appropriate by satisfying the degree of convergence and consensus. Patients or caregivers, peer nurses, doctors, telephones, and call bells were sources of interruption and were identified as appropriate for the application of interventions. 'Responding to requests and inquiries' by patients or caregivers showed high overall suitability. The nurses' preferred color for the intervention design (no-interruption zone, medication safety vest) is blue text on a yellow background. The priority groups for education related to medication interruptions were patients or caregivers, nurses, and non-nursing staff, in that order. Conclusion: Effective implementation of tailored intervention strategies that consider the specific characteristics of medication interruptions is crucial for mitigating interruptions and enhancing patient safety. Comprehensive educational programs aimed at reducing medication interruptions by improving awareness are necessary. Moreover, future research should evaluate these strategies in clinical settings to ensure their effectiveness in enhancing patient safety.