• Quality Improvement in Health Care
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• v.28 no.2
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• pp.50-60
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• 2022

Purpose: To examine the degree of recognition regarding the concept of patient safety, as perceived by the patient, using a focus group discussion. Methods: A focus group discussion was conducted with a patient group comprising seven patients. Results: When the participants heard the term "patient safety" they seemed to understand it to be related to the hospital environment or satisfaction with the overall hospitalization experience. The participants emphasized communication between the medical staff and the patients in relation to the explanation of treatments, as well as the provision of information regarding prevention, experience, and the treatment of incidents with patient safety. They agreed on the need for indicators reported by patients. However, they emphasized that additional items and a questionnaire method that considers the patients' point of view are needed. Conclusion: It is necessary to establish and implement various strategies that can raise the awareness of patient safety using patient safety indicators and increase participation in patient safety activities.

• Korea Journal of Hospital Management
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• v.25 no.3
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• pp.78-86
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• 2020

Purposes: This study purposed to identify factors influencing the composite quality score from the quality assessment program for long-term care hospitals Methodology: The study variables was obtained from HIRA(Health Insurance Review and Assessment Service): the composite quality scores and hospital variables such as number of doctors, nurses, beds, medical technicians, medical equipments, administrative region, ownerships from 3rd (2010) to 7th (2018) quality assessment program. National Statistical Portal(www.kosis.go.kr) provided the number of senior citizens aged over 65 in city·county·district area. SAS 9.4 was used for the data processing and used to analyze the data. Findings: The results showed that composite quality score increased past 9 years. Hospital variables such as number of doctor, nurse, medical technicians, bed and public hospitals had significant positive relationship with the composite quality score. Administrative region(district) showed higher scores compare to that of city. Compare to the score of quality assessment year(2010), as the assessment year move to 2012, 2013, 2015, 2018, results showed higher significant positive coefficients. Practical Implication: Continuously improve the performance of long-term care hospitals, current quality assessment program are needed to update their system such as adopting indicators measuring the service process, or compensating the cost for quality assessment program. It will enable to provide more reasonable and accurate performance assessment scores.

• Quality Improvement in Health Care
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• v.24 no.2
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• pp.41-61
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• 2018

Purpose: Falls are one of the most frequent health events in medical institutions, however, they can be predicted and prevented. The Quality Improvement Nurse Society clinical practice guideline Steering Committee developed the Clinical Practice Guideline for the assessment and prevention of falls in adult people. The purpose of this study was to assess the risk factors for falls in adults aged 19 years and older, to present an evidence for preventing falls, formulate a recommendations, and indicators for applying the recommendations. Methods: This clinical practice guideline was developed using a 23-step adaptation method according to the Handbook for clinical practice guideline developer (version 1.0) by National Evidence-based Healthcare Collaborating Agency. Evidence levels and recommendation ratings were established in accordance to SIGN 2011 (The Scottish Intercollegiate Guidelines Network). Results: The final 15 recommendations from four domains were derived from experts' advice; 1) assessment of risk factor for falls in adult 2) preventing falls and reducing the risks of falls or falls-related injury 3) management and reassessment after a person falls 4) leadership and culture. Conclusion: This clinical practice guideline can be used as a basis for evaluation and prevention of fall risk factors for adults, to formulate recommendations for fall risk assessment and fall prevention, and to present monitoring indicators for applying the recommendations.

• Journal of Korean Academy of Nursing Administration
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• v.2 no.2
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• pp.59-71
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• 1996

Today, quality management is appearing as a critical issue in the field of health care service, partly because of increasing cost of health care. And qualified health care is also accepted as the right of clients, and the responsibility of health professions. So nursing profession can survive and develop only through the quality management of nursing practice like other health professions. Recently, Consumers of nursing service require the effectiveness and the efficiency of nursing practice. Effectiveness and efficiency of nursing practice can be accomplished by outcome evaluation. The focus of outcome evaluation in nurisng practice is on the change which occures in patient's health status with nurisng intervention. Evaluation of outcome is difficult because of some related problems which should be solved, or managed. These problems could be classified as problems of measurement, and attribution. To solve the problems and to evaluate the outcome in nursing practice more accurately, following tasks were suggested. 1) Outcome indicators, and outcome measurement tools should be developed. For these purpose, outcome variables that nursing interventions can contribute primarily should be found out. Also, outcome variables which are driven from nursing theories should be developed. 2) Outcome researches which can explain the effect of nursing care to patient outcomes should be performed. The outcome researches are the methods which can increase the power of nursing profession. 3) Models which can be used for the systematic and scientific quality management in nursing practice should be developed. The models should include outcome variables, and be able to explain the relationship between structure, process, and outcome aspects of quality management. 4) The method which can make patients participate in the evaluation process of quality of nursing practice should be devised. Because outcome evaluation is client-focused evaluation, the perspectives of patients should be emphasized, and reflected in the process of evaluation.

• Journal of Korean Public Health Nursing
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• v.16 no.1
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• pp.201-212
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• 2002

This study was designed to identify the risk factors of unplanned readmission in a university hospital. The six-month discharge information from January to June, 2000 in a tertiary university hospital was used as a source of data through the medical record and hospital information system. To increase the effect of comparison. the data were collected by sampling 192 couples (384 patients) of unplanned readmission group through the matching by its disease groups, sex, and age. The accuracy of prediction for unplanned readmission was analyzed by constructing the predicted model of unplanned readmission through the logistic regression. The study results are as follows. The conditional logistic regression analysis was performed with nine variables at the significance level 0.05 through univariate analysis including residence, days after discharge, initial admission route, previous admission, transfer to special care unite, hospital stay days, medical care expenses, special cares, and laboratory and imaging services. As a result, the closer the patients live in Seoul and Gyeong-in area (Odds ratio=2.529, p=0.003), the shorter the days after discharge was (Odds ratio=0.600, p=0.000), and the more frequent admission rate was (Odds ratio=2.317, p=0.004), the more unplanned readmission was resulted. Also, the accuracy of prediction for data classification of this regression model showed $70.3\%$(032+83/306).

• 한국노년학
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• v.32 no.2
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• pp.467-485
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• 2012

National Health Insurance Corporation initiated Home and Community Long-term care Agency Quality Assessment(HCLA-QA) program in 2010. This study aims to explore long-term care agencies' perceptions and attitudes toward HCLA-QA program, focused on the home-visit care agencies. Total 473 agencies completed the questionnaires(response rate 13.6%), using the e-mail and fax survey methods with high-capacity web-fax server of NHIC. On the results of this study, we found the agencies' different perceptions and attitudes on HCLA-QA program according to their quality ratings as QA results. Compared to the agencies with low quality ratings, the agencies with high quality ratings tend to have more time for preparation, better understandings about HCLA-QA program, more positive perceptions that quality indicators generally are valid, and more affirmative attitudes that the notifications of QA results are helpful for agencies. Our findings can be very useful for establishing strategies for improving the HCLA-QA program. The policy makers, the insurer, and the agencies need to consider the opinions of the agencies with high quality ratings as well as the ones with low quality ratings.

• Journal of Korean Academy of Dental Administration
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• v.9 no.1
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• pp.38-43
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• 2021

Based on data from the Korean Academy for Dental Administration, which has been conducting the Dental Quality Improvement (QI) Contest since 2010, we aimed to provide basic data for the development of dental quality improvement indicators by analyzing the trends of dental quality improvement activities. A total of 54 articles in the dental QI contest from 2015 to 2021 were used to search for frequently used words and to classify the quality of dental care. The criteria for the quality dimension of dental care were first classified into structure, process, and outcome, and secondary classification was performed into patient safety, timeliness, patient-centeredness, equity, efficiency, effectiveness, and accessibility. The frequently used key terms were satisfaction (five times), efficiency (four times), system (three times), and implant (three times). The activities for process evaluation were high at 62.26%, structural evaluation activities at 35.85%, and outcome evaluation activities at 1.89%. According to the components of dental care quality improvement, the activity performed under efficiency was the highest (33.96%), followed by patient-centeredness (18.87%), effectiveness (16.98%), patient safety (15.09%), accessibility (5.66%), timeliness (1.89%), and the equity (1.89%). QI activities in dental hospitals were mainly activities on improvement in structure and process, as well as activities on efficiency, patient-centeredness, effectiveness, and patient safety.

• Health Policy and Management
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• v.22 no.1
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• pp.65-84
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• 2012

Because of the rising healthcare costs, there is a growing need for developing efficiency indicators for medical resources use and measuring efficiency of healthcare providers and healthcare systems using them. In this study, we aimed to develop efficiency indicators for medical resources use by means of Delphi technique. We systematically reviewed the existing measures of medical resource use. Thirty nine indicators were selected as a candidates across the six domains: medical personnel, medical equipment, medical facilities, ethical management, resource efficiency, and drug use. To develop efficiency indicators with professional consensus, a 2-round Delphi survey was conducted among 29 professional experts. The following indicators were selected based on the Delphi survey results: adjusted number of the patient per day and level of the nurse number medical personnel in medical personnel domain; the number of the scan a professional physician and the quality of the scan in medical equipment domain; bed utilization rate in medical facility domain; drug price reported pharmaceutical price by medical institutions, medical fee billing transparency, and medical care appropriateness in ethical management domain; costliness index in resource efficiency domain; and utilization of high cost drug and items per prescription in drug use domain. The efficiency indicators could provide valid information about efficiency of healthcare providers and healthcare systems with respect to their resources use and facilitate policies to improve their efficiency.

• The Journal of Korean Academic Society of Nursing Education
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• v.5 no.1
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• pp.133-141
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• 1999

Recently there are increasing concerns on quality improvement activities related to difficult economic situations, more competitive environment, health professional's emphasis on quality, and customer's needs in health care. The purpose of this study was to identify educational needs in the quality improvement for staff nurses. Study setting was an acute care hospital having more than 1000 bed in Seoul, Korea. The subjects were 40 staff nurses who participated in the first Quality Assurance(QA) inservice education. Data were collected by self-administered questionnaire which consisted of four parts : QA knowledge and attitude(ten items, by five Likert scale), contents of QA education(ten items, by setting the priority), evaluation of the program(structure, time allocation, place, educational method), and general characteristics of respondents (age, duration to work for hospitals etc.) The response rate was 85%(34/40), Most had positive perspective and attitude about QI/QA activities, but 9% had negative impression and knowledge about this activities. Also they'd like to know the plan of hospital-level QI/QA activities, QI/QA current practice, general hospital system, the role of QA specialist and so on. Consequently, for building the quality improvement activities that is customer-focused, coordinated, outcome-oriented, resource-efficient, collaborative in Korea, at first the education about philosophy, theory, and implementation process of QI/QA should be conducted, and then that on QI/QA terminology, quality indicators development, the analysis and presentation of quality-related data and so forth be followed.

• Journal of Korean society of Dental Hygiene
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• v.21 no.5
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• pp.621-628
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• 2021

Objectives: The purpose of this study was to determine the differences in quality of life between groups that promote oral health and those that treat oral diseases using data from the National Health and Nutrition Examination Survey. Methods: Data analysis was performed using IBM SPSS ver. 21.0 (IBM Co., Armonk, NY, USA). A total of 3,338 subjects were selected as subjects for the study before applying oral health promotion (OHP; 1,132 persons) and oral disease treatment (ODT; 2,206 persons). Complex sample logistic regression analysis was performed to determine the effects of OHP and ODT on health-related quality of life. Results: As a result of confirming the effect of OHP and ODT on the quality of life, which are indicators of the quality of life, HINT-8 had a significant effect even in Model 2, adjusted for demographic characteristics, with a significant difference (p<0.01). Conclusions: The above results confirmed that persons who promote oral health have a significant effect on HINT-8, a quality of life scale developed for Koreans. Therefore, continuous oral care is required to improve quality of life.