• 보건행정학회지
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• 제16권1호
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• pp.117-139
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• 2006

The role of medical service quality to provide patients enhances influence on the hospital performance under being severe competition among the large size hospitals and increasing the right of patients. When a large hospital perceived factors of quality that a customer expects and feels value of care and it invests its resources to improve the factors of quality, it can get successful performances. Therefore, the purpose of the study explores the factors of quality affecting the trust of care and the patient satisfaction, and tests relationship among the trust of care, patient satisfaction and revisit intention. When considering the factors, a large size hospital can increase the trust of care and the patient satisfaction, through this process the hospital can assure patients' revisit and increase its revenue. This study uses interview data on outpatients visiting clinics in about 1000 beds sized training hospital located in Seoul. This study uses casual relationship model for the analysis. This study finds that 1) the trust of care and the procedure of care significantly influence the value of care felt by patients, 2) the trust of care, quality of doctors' care, procedure of care significantly influence the patient satisfaction, 3) the trust of care increases the patient satisfaction, and 4) the value of care and the patient satisfaction increase revisit intention.

• Journal of the Korean Association of Oral and Maxillofacial Surgeons
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• 제35권3호
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• pp.158-163
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• 2009

Objective : Recently, we are interested in bisphosphonate related osteonecrosis of the jaw (BRONJ). Most of patients with osteonecrosis have taken medicine bisphosphonate for a long time. But the mechanism of osteonecrosis in BRONJ was not clarified yet. The aim of this study is to evaluate the difference of bone healing effect after bone graft from ilium to maxillary sinus in rabbits between zoledronate-treated and zoledronate-not treated groups. Method : The subjects was divided into two groups. The experimental group was 9 rabbits, treated with intraperitoneal administration of zoledronate(0.06mg/kg) once per week for 3 weeks. In control group, same procedure was applied but administerd saline instead of zoledronate. After 4 weeks, surgical operation under local anesthesia (ketamine 3.0cc, xylazine 1.0cc) was done. At postoperative 1, 2, 4, 8 weeks later, each rabbits were sacrificed and removed the bone grafted area. Gross, radiologic and histopathologic exminations of bone grafted area were performed. Result : There were no conspicuous differences of radiological findings between experimental and control groups in any experimental weeks. In experimental group, new bone formation appeared earlier than control group at 1 week after operation, and maturation of bony tissue were more conspicuous at 2 and 4 weeks after operation, compared with control group. In 8 weeks after operation, similar microscopic findings were noted in both groups. Conclusion : In the bisphosphonate-treated rabbits, new bone formation in the bone grafted area appeared earlier and bony maturation was more concpicuous, even though there were no significant differences of gross and radiological findings. These findings suggest that bisphosphonate might be promotive effect in the healing process in early stage after administration.

• 대한치과의료관리학회지
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• 제9권1호
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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.

• 간호행정학회지
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• 제9권3호
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• pp.415-427
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• 2003

Purpose: The purpose of this study was to investigate the degree and pattern of knowledge management process, and to identify the relationship between knowledge management process and organizational effectiveness in clinical nurses. Method: Participants were 665 regular clinical nurses who had worked for over 1 year in general units of 9 tertiary medical hospitals including 2 national university hospitals, 5 university hospitals, and 2 hospitals founded by business enterprises. Data were collected from March to May 2003 through questionnaires. Four structured instruments were used to collect the data: Knowledge Management Process Scale(Jeong, Lee, Lee, & Kim, 2003), cCommitment Questionnaire(Mowday, Steers, & Porter, 1979), General Satisfaction Scale(CooK, Hepworth, Wall, & Warr, 1981), and one for general characteristics. The data were analyzed using factor analysis, reliability analysis, descriptive analysis, cluster analysis, one-way ANOVA, Scheffe test, correlation analysis with the SPSS for Windows 10.0 program. Result: 1) The average score for knowledge management process in nurses was $3.08{\pm}.54$ on a 5-point Likert scale. In order from highest mean score, the elements of knowledge management process, were Knowledge $Utilization(3.35{\pm}.57)$, Knowledge $Sharing(3.07{\pm}.58)$, Knowledge $Creation(2.99{\pm}.63)$, and Knowledge $Storage(2.91{\pm}.82)$. 2) Four knowledge management patterns for nurses, which were derived from cluster analysis, were inactivate pattern, delayed pattern, activate pattern, and high-activate pattern of knowledge management. 3) The degree of knowledge management process activation and 4 elements of knowledge management process, Knowledge Creation, Knowledge Storage, Knowledge Sharing, and Knowledge Utilization, were significantly correlated with nurses' organizational commitment and job satisfaction(p=.000). 4) The nurses' organizational commitment and job satisfaction showed significant differences according to the knowledge management patterns derived from cluster analysis of high-activate pattern, activate pattern, delayed pattern, inactivate pattern(p=.000). Conclusion: These results suggest that there are four knowledge management patterns for nurses, and knowledge management process positively affects the nurses' organizational commitment and job satisfaction. From the above findings, knowledge management process is empirically verified as a useful and effective method to increase organizational effectiveness, and develop the organization.

• 간호행정학회지
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• 제10권1호
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• pp.37-48
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• 2004

Purpose: This study was investigated to identify the relationship among hospital nursing organizational structure(decentralization, communication, bed/nurse ratio), process(nurses' job satisfaction, nurses' clinical experiences, nurses' unit experiences), and nursing outcome(patient satisfaction, physiologic adaptation, length of stay, number of complication). Method: The subjects consisted of 86 hysterectomy patients and 23 nurses in gynecology unit. Data were collected from May 16, 2002 to August 15. 2003 by the structured questionnaires and chart review. Data analysis was done with ANOVA, Pearson's correlation coefficient, path analysis. Result: Relationship between organizational structure and process ; Bed/nurse ratio was negatively related to nurses' job satisfaction(r=- .37, p<.05), and nurses' clinical experience(r=- .69, p<.00). Decentralization(r=.42, p<.05) and comunication(r=.61, p<.00) were positively related to nurses' clinical experiences. Relationship between process and nursing outcome ; There was a significant relationship between nurses' unit experiences and patient satisfaction(r=.63, p<.00), nurses' job satisfaction and physiologic adaptation(r= .44, p<.05), nurses' unit experiences and physiologic adaptation(r=.64, p<.00), Relationship between organizational structure and nursing outcome ; Decentralization and communication were positively related to patient satisfaction(r=.86, p<.00 ; r=.88, p<.00) and physiologic adaptation(r=,51, p<.01, r=.64, p<.00). Conclusion: Nurses' unit experience, communication, decentralization were significant variables for patient satisfaction. Nurses' unit experience, nurses' job satisfaction, communication were significant variables for patient physiologic adaptation.

• 간호행정학회지
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• 제9권1호
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• pp.19-30
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• 2003

Purpose : The concept of organizational socialization has been regarded as an abstract concept of organizational learning process and it has been used as strategy for the organizational goal attainment. New graduated nurses' organizational socialization has been a very important process for learning knowledge, skills and behaviors in hospital setting. This study was to analyze and clarify the meaning of the concept of Organizational Socialization. Method : This study use the process of Walker & Avant's concept analysis. Results : The critical attributes of organizational socialization were identified as : 1) Internalization of Value and belief of organization; 2) Learning of organizational rules and modes of living; 3) Improvement of job performance; 4) Maintenance of supportive relationship; 5) Formation of occupational identity. The antecedents of organizational socialization consist of those facts that 1) negative feeling of role; 2) difficulties of interpersonal relationship; 3) unskilled work performance. And the consequences of organizational socialization consist of those facts that 1) organizational commitment; 2) job satisfaction; 3) intention of leave work setting; 4) improvement of job performance; 5) improvement of decision making; 6) maintenance of supportive relationship. Conclusion : Through this concept analysis, the concept of organizational socialization is defined as internalization of value and belief of organization, learning of organizational rules and modes of living, improvement of job performance, maintenance of supportive relationship and formation of occupational identity.

• 간호행정학회지
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• 제5권2호
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• pp.237-251
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• 1999

The purpose of this study is to suggest successful strategies through which the effect of the information system of a hospital can be forecasted at the nursing department. In order to set up successful strategies, in the first place, both the methods of CSF(Critical Success Factor: Rockart, 1979) and ULD(User-Led Development) method and the method suggested by the Korea Productivity Center were applied. In order to measure the improvement of nursing productivity, the Dissonance theory was used. The data were collected from 100 employees serving at the clinic department of Kwangju Patriots' and Veterans' Hospital from July 4 to July 25, 1998 with reference to all 222 cases, for sampling work; then the part of the efficiency of the treatment or management of hospital business - simplification of the process of the treatment of hospital business and reduction of the time of the treatment of hospital business were measured; and in order to forecast organizational behavior, 100 cases of organization behavior were analysed, based on the well structured, questionnaires. In order to forecast the user's organizational behavior, a tool(Ronald. 1988; Stephen, 1982: Senn, 1992: Olsen, 1980: Anderson, 1988: Kim. 1992: Cho. 1994) to measure the extent or degree of the user's recognition or understanding whose reliability coefficient is 0.63 was used: and regarding the items expected by the users concerning the convenience of the system, a tool created by Bernadett, Szajna and Richard W. Scamell(1993) whose reliability coefficient is 0.88 was used. And finally, those data were analysed, utilizing the statistical package of SPSS/PC 6.0. successful strategies are suggested as follows: 1. In order that the Kwangju Patriots' and Veterans' Hospital's purpose can be successful through its strategic, information system, the quality of its services should be elevated. and for elevating the quality of medical services, elevation of the quality of medical expertism or specialty is an important factor in determining such quality. 2. In order to make the hospital information system to be successful, the hospital's top manager should participate in the effort making it successful with helping hands of the members or personnel of the hospital. 3. In order to make users participate in the hospital information system, it is prerequisite that all nurses in a hospital should voluntarily participate in the system 4. In order to reduce the expense, the time in coping with business per duty should be reduced by 10${\sim}$33.23%. The time of the direct nursing care which added value is relatively high should be elongated in order to elevate the quality of hospital services. 5. Since the introduction and spread of the hospital information system are influenced by the duration in the experience of computer use, the user of the hospital information system should have a plan to receive well-planned computer education. Finally it is suggested that the forecast of long-term productivity through a review of the user's expectation of the system should be inspected and tested through continuous studies of its effectiveness.

• 품질경영학회지
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• 제41권4호
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• pp.555-566
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• 2013

Purpose: The purpose of this study is to develop innovation index of hospital service integrating 6 sigma and SERVQUAL. Methods: This study used DMA(Define, Measure and Analysis) from 6 sigma and 5 Factors from SEVQUAL. To test data, chi-squire text, association analysis and behavior analysis was conducted. Results: This study indicated the management index through CTQ (Critical to Quality) and Chosen few X using 6 sigma process. Finally, And this study developed 5 Factors; Equipment Utilization in Tangibility, Ratio of Patients/Disease/Behavior/Treatment in Reliability, Survival RAte, Canselation Rate of Reservation, Churn Rate, Interval of Treatment and Confidence in Responsiveness, Frequency of Patients/Disease/Behavior/Treatment in Assurance and Contrast to Best Department/Best Doctor/Best Doctor in Faculty/Average of Mine in Empathy. Conclusion: This study developed innovation index of hospital service. Managing this index, hospital is able to achieve the decline of total treatment cycle, adjustment of patients behavior and increase of equipment utilization. Ultimately, hospital is able to accomplish innovation of healthcare service.

• 간호행정학회지
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• 제16권4호
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• pp.399-408
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• 2010

Purpose: The purpose of this study was to compare the cost using different methods of costing nursing activities for patients with chronic otitis media having surgery. Method: Data were collected from 30 patients who had mastoidectomy and tympanoplasty. To compare the cost, the researchers used three different costing methods; consumed time, resource based relative value scale (RBRVS), and critical pathway (CP). Results: Twenty-six nursing activities for surgical patients with chronic otitis media were found. Total cost was 83,843.7 won using RBRVS. The costliest activity was recording at 9,734.4 won, followed by confirmation of doctors' orders at 9,302.4 won, and injection with infusion pump at 9,072.0 won. There was a difference in nursing activities performed according to the length of hospital stay, and the cost was highest on the surgery day at 13,417.8 won. Comparatively, the total cost was 72,014.4 won using CP. Conclusions: Nursing activities are performed in various forms according to the disease and patient's condition, and different nursing activities are executed according to the length of hospital stay. In order to measure the load of nursing activities and distribute it appropriately, it is necessary to analyze the cost of nursing activities by the process of nursing services performed.

• 간호행정학회지
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• 제17권3호
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• pp.315-326
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• 2011

Purpose: Purposes of this study were to identify non-value-added nursing activities (NVANAs) and to estimate the amount of time spent on NVANAs among total nursing activities. Methods: Non-value-added nursing activities were identified though the use of a focus group. The nurses in the focus group were nurses working in a tertiary hospital. They discussed possible activities that could be NVANAs. Based on the focus group discussion, a pilot study was done to examine the actual occurrence of NVANAs in clinical settings. Results: The focus group discussion showed that NVANAs occurred in ten categories of nursing performances including communication with physicians, communication with other departments, medications, equipment/supplies, nursing records, tests, admission, discharge, and transfer. Direct nursing activities accounted for 35.5% of total nursing activities while indirect nursing activities accounted for 64.5%. Of indirect nursing activities, 16% were NVANAs. Most NVANAs were related to communication and equipment/supplies. Conclusions: To improve the quality and efficiency of nursing activities, it is necessary to identify NVANAs and their causes. Results of this study suggest that improvement in the work process and nursing unit structure, support for equipment/supplies, and effective communication are needed to reduce NVANAs in tertiary hospitals in Korea.