Purpose: The purpose of this paper is to analyze the demand and supply of advanced practice nurses and suggest alternative benefit strategies in the Korean national health insurance. Methods: A revised demand & supply model was used to estimate the excess supply of APNs, and policy making process and key actors in the Korean health insurance were considered to develop a political approach to the APN issue. Results: The social demand for APNs is currently estimated to be less than 50% of its supply and the APN education program fell into difficulties in recruits. No reimbursement mechanism for APN's services in the national health insurance has given no economic incentive to hospital managers who have monopsony power in nursing labor market, which has caused the demand shortage of APNs in hospital industry. Payment for APN's services recognized as one of the most significant strategies to booster the social demand for APN's services should be carefully designed and implemented in the national health insurance. In line with this, key actors in health insurance policy decision-making include government, national assembly, labor unions, NGOs, civic groups, medical associations, and academia. Conclusion: The basic researches for APN's activities and cost-effectiveness analysis in clinical settings are required to support the strategies aforementioned. Constructing a policy network among key actors is able to make the payment strategy feasible, which will increase the socal demand for APNs.
The aim of this study was to identify the effect of organization culture perceived by nurses on the customer orientation. The participants in this were 442 nurses and data were collected from October 1 to 15, 2014. Data was analyzed using SPSS 21.0 programs. The nursing organizational culture positively correlated with nurses' customer orientation. The amount of customer orientation had interrelation with relationship orientated culture, rank orientated and task orientated culture, in charge nurse, and non-shift work as a working type in nursing organizational culture were significant variables which allowed to expect customer orientation. Therefore, hospital managers should put efforts to develop nursing organizational culture filled with internal members in order to improve nurses' customer orientation.
Cho, Myung Sook;Kwon, In Gak;Kim, Kyung Hee;Kim, Mee Soon;Cho, Yong Ae
Journal of Korean Clinical Nursing Research
/
v.23
no.3
/
pp.281-292
/
2017
Purpose: The purpose of this study was to verify the validity and applicability of the Clinical Ladder System(CLS) Model for nurses and to suggest a model for nurses in general hospitals as well as tertiary hospitals. Methods: After refining questionnaires through focus group participation, a survey was carried out with 50 nurse managers and 500 staff nurses from 6 tertiary hospitals and 4 general hospitals. S-CVI and i-CVI for validity and applicability were calculated. Differences in validity and applicability by the type of hospitals and characteristics of respondents were analyzed using t-test and ANOVA. Results: S-CVI for validity and applicability of the CLS model were over 0.8 in two types of hospitals and the validity and applicability of the CLS model were confirmed. No differences were found in the total score for validity between the 2 types of hospitals, but in applicability, general hospitals had significantly lower applicability than tertiary hospitals. Some items showed difference according to characteristics of the respondents. CLS models were postulated based on the study results. Conclusion: The CLS model refined through this study can be used for nurses. In application, modifications are needed according to the conditions of each hospital.
The purpose of this study was to identify a determent of mastery approach goal and performance approach goal using a basic concept of goal orientations and goal setting theory, and to evaluate a preference of goal achievement index as a balance score card (BSC). The study model proposed had a adoptable level of goodness of fit index(.94) and root mean square residual(.08). The meditating variable, goal contribution, totally mediated the impact of goal commitment, Y-theory human behavior, and self-efficacy but organizational resource contribution for pursuing goal orientation. Moreover, goal contribution significantly determined mastery approach goal(p<.01) and performance approach goal(.05). In standardized effects, the most powerful antecedent of mastery approach goal and performance approach goal were in order of organizational resource contribution(.27/.28), goal contribution(.21/.17), self-efficacy(.07/.06), and Y -theory human behavior and goal commitment(.05/.05), respectively. Moreover, goal contribution had a more powerful impact on mastery approach goal(.21) rather than performance approach goal(.17). In the preference of BSC, all job types preferred learning and growth index in first. In the second preference, medical doctors and pharmacists chose financial results, nurses customer service, and office managers internal processes. Each job type reflected its' own preferred BSC index to that of the other job types. In comparing a preference of four BSC index of each own job type, it was statistically different at p<.001. In conclusion, one who emphasize organizational goal contribution in pursuing goal orientation has a more strong orientation toward mastery approach goal rather than performance approach goal. A hospital should overcome and harmonize the different preferences of four BSC index since the differences might cause organizational conflicts among job types with having each unique professional norm.
This study was attempted to identify the knowledge to breast-feeding and the performance of nursing activities for breast-feeding and to test 'how does the degree of knowledge to breast-feeding influence the nursing activities for breast-feeding?' The subjects were 180 nurses working in delivery rooms, nursery, obstetrics & pediatrics wards or OPD of obstetrics & gynecology of 8 general hospitals in Pusan as of August 3 through 13, 1996. The results are abstracted as follows. 1) Subject nurses' age, 25-29 was 45.6%(the major), education levels graduates from junior college were 95.0%, unmarried status was 62.2%, 76.5% of married nurses had children, 39.7% in-service education for Breast-Feeding, 33.7% did nursing activities for breast-feeding actively, the reason for inadequate activities for breast-feeding was 'too much other tasks.' 2) The degree of knowledge to breast-feeding ; mean score was 13.54, the degree of performance of nursing activities for breast-feeding : 92.38±20.93 points out of possible 145 points (3.19±.74 out of possible 5 points) moaned that it was a low level. 3) The hypothesis 'the nurses who have higher degrees of knowledge to breast-feeding will show higher degrees of performance of nursing activities for breast-feeding than the nurses who have lower degrees of knowledge to breast-feeding' was tested by t-test(t=-.01, P=.9888), but rejected because it turned out statistically not significant at the level of P<.05. Above results suggested the degrees of knowledge to breast-feeding and the degrees of performance of nursing activities for breast-feeding were generally low and the degree of knowledge didn't influence the nursing activities. Researchers believe that the education for breast-feeding by the nurses need to be performed systemically & practically and new method of breast-feeding education program need to include hospital managers as well as nurses related mothers and their family. In audition, researchers propose the introduction of &lactation specialist system&, for the specialist can change the attitude of feeding-mothers positively with their specialty and authority.
Objectives : This study was to analyze the status of patients with infertility in the department of oriental gynecology in an oriental medical hospital and propose infertility treatment in oriental medicine. Methods : This study was presented with 2,153 cases of infertile women who had visited the department of oriental gynecology in one oriental hospital in Seoul from 2002 to 2004. Results : The total number infertile patients has decreased year by year. The age range of patients was getting higher and the age group between 30 and 35 took up about one half of the total patients. The duration of infertility for less than 3 years held about 50-60% of the total patients, and the mean duration of infertility was $39.18{\pm}29.57$ months (2004). The most common occupations of females were professionals or administrative managers. The secondary infertility was increasing and unexplained infertility increased from 38.2% (in 2002) to 54.4% (in 2004). However the duration of treatment was shorter. This shows that the age range of the patients having oriental-medicine treatment is gradually getting higher and the number of the patients having oriental-medicine treatment and compliance is decreasing. Conclusions : More studies about objectification of oriental medicine need to precede any other studies. Then, it is thought to be necessary to rebuild cooperative relationships between oriental & western medicine through systematic research and political supports and to establish firm foundations of oriental medicine.
The main objective of this study is to evaluate role-related job stressors of physical therapists and to examine the relationship between job stress and organizational effectiveness. A survey was conducted through structured questionnaire for the physical therapists working in Busan area, and data from 175 therapists were utilized in the final analysis. Survey items included general characteristics of the therapists(sex, age, education, marital status, religion, income, etc.), various kinds of job stressors(role conflict, role overload, role ambiguity, physical burden), and organizational effectiveness measured in terms of job satisfaction, organizational commitment and organizational citizenship behavior. Major results are as follows: 1) The level of physical therapists' job stress was found to be in average range, recording 2.65 on 4-point scale. 2) It appeared that main job stressors of physical therapists were role ambiguity and role overload, and this was more apparent in the case of younger, relatively less-educated, unmarried, and lower-grade employees. 3) On the other hand, in the case of relatively more-educated and higher-paid employees, role conflict was comparatively more important job stressor. 4) Regression analysis suggested that, as Job stress increased, job satisfaction and organizational commitment decreased; however, no significant relationship was found between job stress and organizational citizenship behavior. 5) These results imply that, in order to perform effective and efficient personnel administration of physical therapists, adequate job stress management would be very important task for the hospital managers.
In recent, hospital information systems are widely used to electronically record, manage and share the data collected in hospitals. Such systems have contributed greatly to improving the work efficiency in modern hospitals, however, the collected data concerning the patients should be appropriately processed and reused to provide the healthcare service providers with decision supports. Especially, this paper proposes the patient flow monitoring system for the operations management of the outpatient department for patients with chronic diseases, and discusses the related issues. The proposed system visualizes the standard process model extracted from the patient history data and various performance measures, and this enables the managers to evaluate and enhance the operations of the outpatient clinic. In this paper, the patient flow monitoring system is applied to the rheumatology clinic, and the prototype system optimized for I-pad is illustrated.
Both undergraduate and graduate programs in health services management(HSM) are recently established in colleges and universities in Korea, and the programs train their students for diverse sectors within the field of healthcare management, including hospitals, nursing facilities, consulting firms, health industries such as pharmaceutical, insurance companies, etc. This study investigates many of the managerial roles expected to graduates from academic curricula in HSM, and required competencies to be successful in their positions. The information of roles and competencies for HSM graduates were collected, and their importances were evaluated by healthcare management experts through a Delphi method. As the result, 11 items for present roles and 13 items for future roles were derived, and 15 and 16 items were derived for present and future competencies respectively. Utilizing the classification of work roles by Timmreck and that of managerial competencies by Robbins, the importance of roles and competencies of healthcare managers was analyzed and interpreted. The major domains of roles at present turned out to be 'organizer', 'planner', 'problem solver', and 'coordinator' in order according to importance. On the other hand, as graduates develop their careers, the domains of future roles would be changed to 'director' and 'planner'. For competencies, the most important domain at present was 'technical skill', but the future important domain was 'interpersonal and emotional intelligence'. The result of this study can be seen as an initial step toward improving the academic curricula of HSM in college and universities and promoting collaborative efforts between academic programs and on-site practices in healthcare industries.
This study holds various implications and usefulness toward nurses as well as hospitals in that the study empirically found out the relations among hospitals' ethical climates, employee engagement (job engagement and organizational engagement) and intention to quit. The study shows that nurses' awareness of principles of responsibilities and benevolent ethical climates impact on enhancing organizational engagement and lowering intention to quit. Internally, employees are encouraged to make decisions accompanying fairness and responsibility and thus, shared values will be created between hospitals and nurses, while it will contribute to create a good image of the hospital to the public. However, it is also revealed that climates deficient in ethics, such as a climate of selfishness, have strong negative influences on workplace attitude of nurses. Therefore, recognizing importance and effectiveness of ethical climates, hospitals should underscore personal ethics of managers and nurses, and should go further to exert strategic efforts on the organizational level to create ethical hospital climates where nurses can naturally take ethical actions.
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