• 한국산학기술학회논문지
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• 제19권9호
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• pp.391-401
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• 2018

이 연구는 요양병원 의료기관인증제 시행 후 요양병원의 환자안전, 의료의 질, 조직문화 및 경영성과에 미친 영향을 파악함에 목적이 있다. 2015년 9월 말까지 요양병원 의료기관인증을 획득한 대구지역의 36개 요양병원 중 10개 기관을 임의로 선정하였으며 2016년 2월 15일부터 2016년 3월 25일까지 요양병원 종사자들에게 설문조사를 하여 253명을 최종분석 대상자로 선정하였다. 설문조사 내용으로는 일반적 특성, 인증이후 환자안전과 의료의 질 향상, 조직문화, 경영성과의 변화가 포함되어 있다. 연구결과 환자안전과 의료의 질 향상의 변화정도에서는 진료지원체계가 3.93점으로 가장 높았으며, 조직문화의 변화정도에서는 인적자원문화가 3.78점으로 가장 높았고, 요양병원의 경영성과 부분에서는 내부프로세스 관점, 학습 및 성장관점이 3.71점으로 가장 높게 나타났다. 병원경영성과에 영향을 미치는 요인을 파악한 결과 직종이 행정직보다 간호직, 직급이 국장보다 사원이거나 과장, 환자안전과 질 향상에서 기본가치체계가 개선되었다고 생각하는 경우, 조직문화에서 인적자원문화, 개방체계문화, 위계서열문화, 생산중심문화가 개선되었다고 생각하는 경우 병원경영성과를 긍정적으로 변화시키는 영향 요인이라 응답하였다. 요양병원 의료기관인증제 시행 후 환자안전과 의료의 질 향상에는 높은 변화를 보여 긍정적 영향을 미쳤으나, 조직문화의 4가지 유형 중 위계서열문화와 생산중심문화는 보통수준의 변화를 보였으며 병원경영성과 중 재무관점은 다른 관점에 비해 상대적으로 낮은 변화를 보였다.

• 한국의료질향상학회지
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• 제28권2호
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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.

• 한국의료질향상학회지
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• 제26권2호
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• pp.104-112
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• 2020

This study was done to investigate the independent organizations established for patient safety, related policies, and the duties of experts in other countries. Australia established an organization called the Commission in 2006, the United Kingdom established the National Patients Safety Agency in 2001, and the United States assigned its work to the Agency for Healthcare Research and Quality in 2005. This was done by law in all three countries. The experts for patient safety were mainly called the "patent safety and quality coordinator", and although there was no qualification system for carrying out patient safety work, all three countries had licenses in the health care field or required more than 4-5 years of practical experience. The main duties were planning on patient safety and quality of healthcare service, data collection and analysis, and education, etc. and for this, competencies such as communication, leadership, and teamwork were required.

• 보건의료산업학회지
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• 제11권4호
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• pp.189-202
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• 2017

Objectives : This study aims to present a new classification system using evaluation standards to ensure the safety of transport ventilators used in Korea. Due to the rapid advancement of technology, various types of ventilators have been developed and as the range of application increases, so does demand. With quick access to information and a growing economy, the technology used in Korean hospitals is equivalent to that of other countries; however, regulatory and safety consciousness are still lagging in Korea. Methods : Based on researching overseas cases, reference data and standards for improving the current system in Korea are proposed. Results : According to the review of transport ventilator use in Korea, it was found that concerns about safety is due to the absence of a standardized classification system for evaluating the safety and effectiveness of transport ventilators. Conclusions : In order to improve the safety of patients and the quality of medical care, it is essential to establish guidelines and assessment standards guaranteeing the safety of transport ventilators in Korea. Clear definitions and classifications for devices must precede the application of such standards. In addition, effective evaluation standards should be developed in order to resolve problems and improve upon the current system through continuous validation.

• 한국의료질향상학회지
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• 제27권1호
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• pp.51-57
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• 2021

As expectations for medical service have increased recently, the interest in medical quality improvement and patient safety has increased. In addition, as part of efforts to improve the training environment of the residents, the working hours of the residents are reduced which means that the medical workforce is expected to change significantly in the future. As a result, in hospital care of surgical patients, it is inevitable to change the patient care system by surgeon-residents to the new system. For this, the introduction of a surgical hospitalist system is proposed as an alternative. This article is an introduction to the process of introducing a surgical hospitalist system in a single institution and describes in detail the considerations This is the first case of the introduction of surgical hospitalist in Korea. Through this case, we intend to lay the groundwork for the successful implementation of the surgical hospitalist in Korea.

• 한국의료질향상학회지
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• 제22권1호
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• pp.41-57
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• 2016

Objectives: This study aimed to investigate how many healthcare professionals experienced near misses, what types of near misses occurred most often, and healthcare professionals' opinions about near misses at one university hospital in Korea. Methods: The authors developed a questionnaire including 26 core types of near misses and 4 questions about preventability and reporting barriers. The survey was conducted from Oct. 31st to Nov. 18th 2011, about 3 weeks, using a self-administrated questionnaire that was administered to 697 healthcare professionals (registered nurses, pharmacists, technicians, and nurses aides) who worked at a university hospital. Medical doctors and employees working in the department of administration were excluded. Results: About half of hospital workers experienced at least one or more near misses during the past one year. The drug dispensing process was the most common subcategory of near misses. Among the 26 items, patient falls was highest. Over 95% of respondents reported that the near miss they experienced was preventable. Also, more than half of respondents did not report the near miss and the main reason for omission was fear of blame. Conclusion: Regarding patient safety issues, a near miss is a very significant factor because it can be a potential adverse event. Therefore, we should grasp the size of the problem through tracking and analyzing near misses and should make an effort to reduce them. To do so, we should check whether our reporting system is well designed and functioning.

• 한국의료질향상학회지
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• 제28권2호
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• pp.30-38
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• 2022

Purpose: The Health Insurance Review and Assessment Service (HIRA) in South Korea initiated a quality assessment (QA) program for blood transfusion healthcare services in 2020 to ensure patient safety and appropriate blood use. This study examines the quality of blood transfusion services since the first national QA program for blood transfusion services in Korea. Methods: We analyzed HIRA claims and QA investigation data based on inpatient medical records from all tertiary, general, and primary hospitals between October 2020 and March 2021. The target population was patients aged 18 years and older who received either total knee arthroplasty or red blood cell transfusion. The QA indicators for transfusion healthcare service consisted of four quality indicators and four monitoring indicators. Results: We analyzed the results of QA indicators for transfusion service from the medical records of 189,668 patients from 1,171hospitals and expressed indicators as proportions. The average results for evaluation indicators were as follows: transfusion checklist presence, 64.8%; irregular antibody tests, 61.8%; transfusions in which the hemoglobin levels before transfusion met the transfusion guidelines for patients undergoing total knee arthroplasty, 20.6%, and transfusions in patients undergoing total knee arthroplasty, 59.3%. The average results for monitoring indicators were as follows: transfusion management implementation in medical institutions, 56.9%; preoperative anemia management in anemia patients undergoing total knee arthroplasty, 43.9%; one-unit transfusions, 82.5%; and the transfusion index. Conclusion: The quality of blood transfusion healthcare varied and the assessment revealed that there is scope for improvement. Hospitals require more effective blood transfusion management and this can be facilitated by providing feedback on the QA results about blood transfusion healthcare services to medical institutions, and by disclosing the results to the public.

• 한국의료질향상학회지
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• 제28권1호
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• pp.45-54
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• 2022

Purpose: The study aims to identify the theme list and priority criteria of patient safety theme reports in South Korea. Methods: The survey was conducted twice, and the importance of each criterion and theme was measured on a nine-point scale using the Delphi technique by a panel of 19 patient safety experts. The criteria included severity, universality, preventability, and organizational-social impact. Descriptive statistics such as frequency, percentage, mean, standard deviation, median, and interval quartile range were used to analyze the data. Results: The parameters were assigned a weighted average of 35% for severity, 20% for universality, 30% for preventability, and 15% for organizational-social impact, respectively. The final top three rankings were surgery safety, blood transfusion safety, and medication safety. In addition to expert opinion, for the theme that is selected based on the priority ranking, one to five sub-topics can be derived from the theme based on the priority ranking, societal demands, or the yearly priority list of patient safety incidents. Conclusion: It is recommended that the official patient safety center distribute the report in the form of a summary that can be utilized nationwide at medical institutions, government institutions, and other places. Updates, as well as accumulated theme reports, will serve as the baseline data for the proposal of the system and for the policy designed to implement and improve institutions' safety practices as a standard of domestic patient safety practice guidelines.

• 디지털콘텐츠학회 논문지
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• 제19권9호
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• pp.1751-1758
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• 2018

통합 의료 정보 시스템은 의료 서비스의 질과 고객 만족도 향상, 환자의 안전을 우선으로 하는 시스템으로 다른 환경으로 구성된 단위 시스템을 통합하는 기능이 제공되어야 한다. RBAC 기반 의료 정보 시스템은 직종과 직책, 규칙에 따라 사용자는 접근 권한을 부여 받게 된다. 본 논문에서는 CRM 상담 서비스를 중심으로 한 멀티 채널 IPCC 컨택 센터의 플랫폼을 구현 하였다. 이를 통해 SMS MO, 진료 예약 및 취소, 상황별 통계, CRM/EMR 연동 서비스가 멀티 채널을 사용하여 상담원의 도움없이 통신 서비스가 가능하며 예약 환자의 부도율을 감소 시킬 수 있으며, 시스템 내부적으로는 RBAC 기반 CRM 상담 서비스는 권한 관리가 미리 생성되어 되어 있는 정보 테이블의 column을 조사하여 해당 테이블을 호출하는 procedure 및 object를 생성하고, 환자 정보를 나타나게 하여 개인 정보 보호를 전제 조건으로 접근 권한의 rule에 따라 환자별 상담 이력정보에 접근할 수 있으며, 의료 정보 사용 현황별 통계화면을 통해 추출된 정보들을 중심으로 상황별 운영 관리에 필요한 중요 지표를 관제 할 수 있어서 통합 의료 정보시스템의 운영 개선 서비스로의 확대 뿐만 아니라 환자에게 중요한 의사 결정시 의료진과 환자 및 가족에게 도움 줄 수 있다.

• 한국엔터테인먼트산업학회논문지
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• 제14권8호
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• pp.255-264
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• 2020

본 연구는 의료기관 인증 제도를 받은 요양병원 내부 구성원과 양방병원의 내부구성원 297명을 대상으로 설문조사를 실시한 후 SPSS 26.0을 이용하여 인증을 받은 전과 후 차이를 비교 분석하여 구성원 만족도, 직무스트레스, 의료서비스향상이 병원운영 효과에 미치는 영향을 파악하고자 하였다. 요양병원의 병원운영효과는 구성원 만족도와 의료 서비스향상이 높을수록, 병원운영효과는 높아짐을 볼 수 있으며, 양방병원의 경우, 구성원 만족도와 의료 서비스 향상이 높을수록, 직무스트레스는 낮을수록 병원운영효과는 높아짐을 볼 수 있다. 의료기관인증제도의 기본가치 체계가 환자 안전과 의료의 질 향상인 만큼 요양병원은 의무적 인증으로 인증제의 효과가 양방병원보다 높게 나타났을 것으로 사료된다.