• 보건행정학회지
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• 제12권4호
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• pp.34-55
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• 2002

In this study, the impact of organizational culture on the quality of social work services in hospitals were empirically analysed. A mailed questionnaire survey was conducted between February 19 and April 10, 2001. A sample of total 70 hospitals, including general hospitals with one social worker at least and single-department hospital with two social workers or more, were identified nationwide through the registry of Korean Association of Medical Social Workers and Korean Association of Hospitals. According to coping strategy and reacting pattern with the environmental changes, four types of organizational culture in each hospital, classified as group culture, developmental culture, hierarchial culture, and rational culture, were adopted for the independent variables. Three dimensional aspects of quality of social work service - structure, process, and outcome were selected as dependent variables in this study. Also the quality of social work service was distributed into provider-perceiving quality and consumer-perceiving quality The major findings were as following in summary; First, most social workers reported that the characteristic of culture in their hospitals are group culture the first, hierarchial culture the second, developmental culture the third, and rational culture finally in order of comparing the level of quality perceived between social worker's recognition. Second, service provider and consumer, The provider-perceiving quality showed less score than that of consumer, especially the lowest was the score of quality of outcome perceived by provider. Third, according to the types of organizational culture, there were significantly different levels of quality in total social work services, structure dimension and process dimension. The quality of outcome dimension did not show significant differences among the type of organizational culture. Finally, the most influential variables to the quality of social work service ice proved departmental form of social work unit, leader of social work unit, and developmental culture of hospital To assure quality services, accordingly, social work unit in hospital is required to be organized as a single unit, that means to be an independent department of which qualified social worker is supposed to control the unit. It is strongly recommended to develop leadership for the leaders of social work unit.

• Journal of Preventive Medicine and Public Health
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• 제43권3호
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• pp.245-256
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• 2010

Objectives: This study aims to compare quality indicators for the hemodialysis services between patients with health insurance and those with medical aid. Methods: This study used data from sampled hospitals that provided a hemodialysis service. A total of 2287 patients were selected, and the information for hemodialysis service has been granted from medical record reviews. A multi-level regression analysis was used to examine the differences in process and outcome indicators for hemodialysis between patients with health insurance and those with medical aid. Process indicators were defined as: frequency of hemodialysis, hemodialysis time, erythropoietin (EPO) use, measurement of hemodialysis dose at least once a month, measurement of phosphate at least once every three months, and measurement of albumin at least once every three months. Outcome indicators were defined as: hemodialysis adequacy, anemia management, blood pressure management, and calcium, phosphate and nutrition management. The total scores for outcome indicators ranged from 0 (worst) to 4 (best). Results: There was a significant difference in the measurement of hemodialysis dose at least once a month between patients with health insurance and those with medical aid (OR 0.66, 95% CI = 0.43 - 0.99). However, frequency of hemodialysis, hemodialysis time, EPO use, measurement of phosphate at least once every three months, measurement of albumin at least once every three months, hemodialysis adequacy management, Hb${\geq}$11 g/dL, blood pressure within the range of 100-140 /60-90 mmHg, calcium x phosphate${\leq}$55 $g^2/dL^2$ and albumin${\geq}$4 g/dL were not significantly different between the groups. Conclusions: There were no significant differences in outcome indicators for hemodialysis between the groups. Further studies are warranted into the mechanism that results in no differences in the outcome indicators for hemodialysis.

• 가정간호학회지
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• 제4권
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• pp.41-52
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• 1997

The purpose of this study is to identify the domestic research results related to the outcomes of home care services for 1981-1996. 12 studies were analized by the characteristics of the subjects, home care services provided, and outcome variables and tools during the period of Apirl-June, 1997. The results were as follows: the subjects of 8 studies conducted before 1993 were discharged patients comparing to early discharged patients of 2 studies conducted after 1994. The main home care service delivered to the clients and their families were education before 1993. The outcome variables were used the level of sat. isfaction of home care services, quality of care, cost-effectveness, health status, quality of life, and self -care ability. A variable, health status, were mainly measured by the global outcome measures such as quality of life, health hehelief, health perception, activity of daily living, health management pattern but also foused outcome measures that could be specified by the medical diagnoses.

• 의학교육논단
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• 제25권3호
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• pp.273-284
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• 2023

According to the World Health Organization, for medical schools to fulfill their obligation of social accountability, it is necessary for medical education, research, and service areas to ref lect the healthcare system's relevance, quality, cost-effectiveness, and equity. This study utilized Boelen and Heck's (1995) social accountability grid model to analyze the degree to which the Accreditation Standards of Korean Institute of Medical Education and Evaluation 2019 (ASK2019) standards apply the World Federation for Medical Education's (WFME) standards. The social accountability characteristics of the former were compared to those of the WFME, the Liaison Committee on Medical Education, and the Australian Medical Council. Experts with experience and certification in medical education and evaluation classified the ASK2019 standards according to the grid model, evaluated social accountability perspectives, and categorized them according to the process, content, and outcome. Of the 92 standards, 61 (66.30%) were selected as social accountability standards; these encompassed all areas. There was a particular focus on outcome-related areas, such as "mission and outcomes," "student assessment," "educational evaluation," and "continuous improvement." Education and quality were the most common (33, 54.11%), followed by 18 standards related to education and relevance. However, the standards on cost effectiveness and equity corresponding to education, research, and service were significantly insufficient. As a result of classification using a logic model, many criteria were incorporated into the process, producing results similar to those of international accreditation institutions. Therefore, to fulfill medical schools' social accountability, it is necessary to develop cost effectiveness and equity standards with reference to grid models and expand them beyond education to include research and service areas. Developing content and outcome standards is also required.

• International Journal of Quality Innovation
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• 제10권2호
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• pp.109-126
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• 2009

The purpose of this study was to examine overall customer satisfaction associated with medical service quality in Taiwan by integrated Kano's model and customer satisfaction index model. Another purpose was to confirmed nonlinear and asymmetric relationship of Customer Satisfaction and Quality Performance by the research outcome. By analyzing 1,100 patients or their family members, this study used the structural equation model (SEM) with AMOS software for data analysis. The results show that must-be attributes, one-dimensional attributes and attractive attributes had a direct effect on overall customer satisfaction, Surprisingly, overall customer satisfaction had positively influenced customer loyalty customer satisfaction had negatively influenced customer complaints. The study also found that customer complaints have direct effect on customer loyalty. Importantly, the study found out the must-be attributes, the attractive attributes and one-dimensional attributes increased, the level of overall customer satisfaction also increased. The customer satisfaction positively influences customer loyalty in medical service quality in Taiwan. The findings might reveal new insights for researchers dealing with quality of medical service and for hospital managers who devote resources exclusively to achieving highest possible levels of patient satisfaction.

• 벤처창업연구
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• 제7권3호
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• pp.89-97
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• 2012

최근 중국 경제성장과 더불어 소득수준과 생활수준이 향상됨에 따라 소비자들의 건강, 고도의 의료서비스와 휴양시설 개발 및 이용에 대한 관심이 점점 증대되고 있다. 따라서 중국 병원 산업에서 경쟁력을 향상시키기 위해서 서비스품질의 가치를 다시 인식하는 것을 필요하다. 본 연구는 중국병원의 서비스 품질 구성요인에 대한 분석하고 각 구성요인은 서비스가치, 고객만족 및 재이용의도간의 인과관계를 확인하고자 한다. 이러한 연구목적을 달성하기위해 본 연구에서는 문헌적인 고찰과 실증적인 분석을 병행 실시하였다. 본 연구의 결과는 중국 병원산업에서 서비스품질의 구성요인을 "상호작용품질", "결과품질", "물리적 환경품질"의 세 차원으로 구분하여 각 차원은 고객만족에 대한 직접적이고 유의적인 영향을 미치는 것으로 나타났다. 그리고 서비스가치는 고객만족 및 재이용의도에 직접적이고 유의적인 영향을 미치는 것으로 나타났고, 고객만족은 서비스품질과 재이용의도간의 관계에서, 서비스가치와 재이용의도간의 관계에서 중요한 매개역할을 하고 있음을 실증적으로 보여주고 있다.

• 보건교육건강증진학회지
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• 제22권1호
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• pp.147-160
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• 2005

The purpose of this study is to identify the nature of the patient service quality of health center, and based on that, to examine the relationship of health center visitor's perceived quality and overall satisfaction. Data were collected on the basis of 'the 3rd Regional Health Care Planning' operated by Rural Health Care Service Technology Aid Task-force Team(RHCSTAT), Ministry of Health and Welfare. Basically, the Manual of 3rd Regional Health Care Planning is composed of structure, process, and outcome measurement indicators. Of these indicators, 21 patient satisfaction questions as outcome indicators are used in this study. The samples are 3,530 patients who visited 80 health centers all of the nation. First, the reliability and validity of patient service quality items was evaluated. Second, the descriptive statistics of health service quality are calculated. Third, through the T-test and ANOVA, the differences of patient satisfaction by responder's general characteristics are compared. In final, to explore the relationship of service quality and overall satisfaction, multiple regression analysis was used. This study shows firstly, the dimension of patient service quality was categorized into 3 dimensions, that is, facilities and environment, staff kindness, and access convenience. Secondly, the reliability and validity of patient service quality items was satisfied. Thirdly, the mean score of staff kindness factors are high in contrast to the facilities and environment. And in regard to the overall satisfaction, the mean score is more higher in Daegu region, County type health center, male group, and upper 65 age group than comparison groups. Lastly, as a result of multiple regression analysis, the effect of patient's perceived service quality, especially, appropriateness of billing time(Beta=0.190) and of reservation time(Beta=0.132) are statistically significant(P<0.01). In conclusion, to satisfy the health need of community people and improve the service quality of the health center, the efforts for the access convenience might be needed. Additionally, the enlargement on health center space and supply of new medical equipment is urgent for the patient satisfaction.

• 한국의료질향상학회지
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• 제5권2호
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• pp.324-334
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• 1998

Background : Strategic planning is an organizationwide or systemwide, ongoing look into the future usually of 2~3 years, based on objective analysis of the current environment and trends, but it can incorporate both short-term and long-term goals. The strategic planning process includes external analysis, internal analysis, issue analysis, development of mission, vision and values, and lastly development of organizational goals and objectives. As a part of the strategic quality planning process, certain service lines, important organizationwide functions, or key processes supporting these functions can be prioritized to expedite and roll out certain strategic goals. This is called strategic quality initiatives. Methods : We organized a quality improvement team, a subgroup of 21st century vision planning corps of our medical center, and pursued QI activities for improvement of healthcare environment, particularly in the admission setting. We developed a strategic quality initiative based on the results of patient satisfaction surveys, and carried out functions of self-directed work team. Results : The strategic goal was to be the benchmark for peer group hospitals in Korea for providing cost-effective best-practice. The QI team included 3 medical doctors, 1 nurse, 1 social worker, and 1 QI consultant as well as many operational members to support services and quality initiatives met every Tuesday for 18 weeks. Outcome objectives were to improve patient satisfaction score. The issues included in the objectives were comfort, temperature, noise, cleanliness of the admission wards, quality and education of patient meals, matters regarding the admission process, and an appurtenant facility such as restaurant or convenience store. Every issue was discussed and recommendations, conclusions and opportunities were implemented. Conclusions : By developing a strategic quality initiative as a part of the strategic quality planning process, and pursuing a self-directed work team, certain sen/ice lines, important organizationwide functions, or key processes supporting these functions can be improved effectively within a short period. Strategic quality initiatives serve to support, or roll out, certain strategic goals that are relevant to performance improvement and development of specific measurable outcome objectives, and associated performance measure for each initiative. Each strategic quality initiative should include a statement of intent outcome objectives, and performance measures. We will come back with follow up of the strategic quality initiative, for improvement of healthcare environment, and results of patient satisfaction re-survey.

• 의학교육논단
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• 제10권2호
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• pp.25-44
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• 2008

Objectives: Through using of the strong research method like a Randomized Controlled Trial: RCT, we have to heighten quality of Medical Education study. I'd like to introduce "CONSORT", which stands for Consolidated Standards of Reporting Trials. Contents: Preventive Service Task Force(200l) in USA proposed Levels of evidence for enlarging evidence-based Practice: EBP. And the CONSORT was introduced, which encompasses various initiatives developed by the CONSORT Group to alleviate the problems arising from inadequate reporting of randomized controlled trials (RCTs). the CONSORT has 13 guides like these: 1. How participants were allocated to interventions 2. Scientific background and explanation of rationale 3. Eligibility criteria for participants. The settings and locations where the data were collected. 4. Precise details of the interventions intended for each group and how and when they were actually administered 5. Specific objectives and hypotheses 6. Clearly defined primary and secondary outcome measures, When applicable. any methods to enhance the quality of measurements (e.g., multiple observations, training of assessors) 7. How sample size was determined. When applicable, explanation of any interim analyses and stopping rules 8. Method used to generate the random allocation sequence, Details of any restriction [of randomization] 9. Method used to implement the random allocation sequence 10. Who generated the allocation sequence, who enrolled participants. and who assigned participants to their groups 11. Whether or not participants, those administering the interventions, and those assessing the outcomes were blinded to group assignment. If done, how the success of blinding was evaluated 12. Statistical methods used to compare groups for primary outcome(s), Methods for additional analyses, such as subgroup analyses and adjusted analyses 13. Flow of participants through each stage (a diagram is strongly recommended) Specifically, for each group report the numbers of participants randomly assigned. receiving intended treatment, completing the study protocol. and analyzed for the primary outcome. Results and Conclusion: Randomized Controlled Trial: RCT guided of CONSORT will contribute to do stronger evidence-based medical studies.

• 컴퓨터교육학회논문지
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• 제16권2호
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• pp.79-90
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• 2013

의료조직 내에서의 커뮤니케이션 오류와 지연은 의료고객의 서비스 질 하락과 의료분쟁 등 심각한 문제를 야기 시키고 있다. 따라서, 최근 협업적 의료 커뮤니케이션 체계의 중요성이 크게 부각되고 있다. 의사, 환자/보호자, 간호사, 실험실들 간의 커뮤니케이션이 원활하게 이뤄질 때 고효율 저비용 서비스는 물론 궁극적으로 병원의 경영성과에도 도움이 된다. 이러한 동기에서 중소 및 대형병원에서 이 시스템 도입이 급증하는 추세이다. 본 논문에서는 유무선 기반의 협업적 의료커뮤니케이션(Clinical Collaborative Communication)시스템의 구현방법과 모델링을 통한 구현 연구 및 시스템 평가를 위해 S병원을 대상으로 계량적 평가를 수행하였다.