• 제목/요약/키워드: Quality improvement program

검색결과 983건 처리시간 0.023초

만성폐질환자를 위한 가정 호흡재활 단기 프로그램의 효과 (Effects of a Short-term Home-based Pulmonary Rehabilitation Program in Patients with Chronic Lung Disease)

  • 오의금;김순희;박희옥;방소연;이춘화;김소희
    • 대한간호학회지
    • /
    • 제33권5호
    • /
    • pp.570-579
    • /
    • 2003
  • Purpose: The purpose of this study is to exam the effects of a short-term pulmonary program on lung function, exercise tolerance, and quality of life in chronic lung patients. Method: Randomized controlled pre-post test design was used. The outcome measures were forced expiratory volume in one second (FEV1, % predicted), 6 min walking distance (6MWD), Borg score after 6MWD, and Chronic Respiratory Disease Questionnaire (CRDQ). Experimental group performed the 4-week home-based pulmonary rehabilitation program composed of inspiratory muscle training, upper and lower extremity exercise, relaxation, and telephone visit. Patients in control group were only given education about self-management strategies. Thirty four patients with moderate-to-severe respiratory impairment were recruited, and 28 patients (19 in experiments, 15 in control) completed the study. Result: Significant improvements in lung function, exercise tolerance, and health related quality of life were found only in the experiment group. Conclusion: This study yielded evidence for the potential and beneficial effects of home-based pulmonary rehabilitation program in patients with moderate to severe chronic lung disease. The program could be adequately utilized for improvement of health related quality of life in chronic lung patients.

SERVQUAL 모델을 이용한 간호 서비스 질 측정 (Measurement of Nursing Service Quality using SERVQUAL Model)

  • 임지영;김소인
    • 간호행정학회지
    • /
    • 제6권2호
    • /
    • pp.259-279
    • /
    • 2000
  • This study is a descriptive analytic research measuring nursing service quality, using SERVQUAL model, to make fundamental data and strategies for nursing service improvement. Data were collected by self-reported questionnaire from 202 patients and 142 nurses, from June 7 to 14, 1999. The reliability of instrument were adequate(Cronbach ${\alpha}=.94$). SAS program was utilized for statistical analysis of collected data. The results were as follows; 1. There was a gab between patient's expectation and perception on nursing service(Gap B). Gap D was indicated an affecting factor to decide nursing service quality. Gap C was indicated an indirect affecting factor of nursing service quality. Because it was not statistically significant in total item analysis, but in individual item analysis, 7 items were appeared statistically significant. Gap A was not a gap occurrence factor of nursing service quality. 2. Focuses of nursing service quality improvement strategies were; (1) to direct qualitative improvement of nursing service in order to correspondence patient's nursing service expectation. (2) to make nurse's service activity modified because nurse's practice were not reached patient's expectation level. (3) to need internal, external factor analysis affecting nurse's service activity. 3. Nursing service quality was decided by rather environmental inappropriateness provided nursing service than itself. Therefore, to make nursing service quality improvement, it is required to improve nursing service environment. For this, followings are required; (1) to strengthen nurse's education on lower part of nursing service satisfaction and QI activities. (2) to balance demand and supply of nursing personnel. 3) to fix computerized system for reducing other duties weight except nursing care through analysis of nursing activity. (4) to construct rational cooperating system among related departments. 4. The important parts for nursing service quality improvement were indicated as follows: (1) Gap B: 'prompt reaction', 'examination symptom before patient's complaint', 'hearted nursing service reducing patient's dissatisfaction', 'explanation goals of nursing activities', 'having special Knowledge enough', 'maintenance position comfortably', 'management of patient's physical hygiene'. (2) Gap C: 'maintenance physical safety', 'explanation about hospital rules and facilities'. (3) Gap D: 'tender, safe injection and wound care'. Because above items are mostly improved through nurse's attitude change and quality improvement, it is required to establish nursing standardization and to strengthen nurse's clinical education. As the based on above results, followings are suggested; 1. SERVQUAL model is very useful to make strategies for nursing service quality improvement because it indicates multiple factors affecting hap occurrence. 2. At individual items analysis of Gap C, statistically significant 7 items appeared higher nurse's perception level than patient's perception level on nursing service were trouble perception level on nursing service quality improvement. So. it need further research to analysis about these difference occurring factors. 3. At analysis of Gap D, it is indicated that in nursing service performance process, multiple factors lowing nursing service quality were intruded. So it needs further research to analysis what these factors are and how each factors affect on nursing performance process. 4. nursing service quality measurement is changeable according to sample select time or sampled subject's characteristics. So to develope strategy for nursing service quality improvement is based on the results of periodical analysis.

  • PDF

그래픽프로그램을 이용한 SPC 시스템 개발 (The Development of SPC System by the use of Graphic Program)

  • 이관훈;송병석;천성일;장현덕;홍원식;김경묵;오영환
    • 한국신뢰성학회:학술대회논문집
    • /
    • 한국신뢰성학회 2000년도 춘계학술대회 발표논문집
    • /
    • pp.123-129
    • /
    • 2000
  • SPC is the quality improvement technique of gathering since Motorola of U.S.A. have used SPC technique as a statistical process control method for promoting 6-sigma quality improvement strategy in 1988. In Korea, small and medium-sized enterprises are needed building of a system for statistical production control . In the present study, the methods of building SPC system with a moderate cost using a graphic programs of easy-to-use and high flexibility for small and medium-sized enterprises were inquired. The SPC system which enables statistic marking (maximum, minimum, mean, standard deviation, process capability index) and graph marking (X-Y coordinates and histogram) using LabVIEW 5.0, the graphic program by National Instrument Co., Ltd. was implemented in this study.

  • PDF

보건소 노인 영양 개선 사업 : 영양밀도와 섭취 식품군의 다양성에 의한 노인 영양 평가 (Elderly Nutrition Improvement Program in the community health center : Nutritional evaluation of the elderly using the Index of Nutritional Quality and food group intake pattern)

  • 임경숙
    • 대한영양사협회학술지
    • /
    • 제3권2호
    • /
    • pp.182-196
    • /
    • 1997
  • Physiological changes that affect nutrient absorption and utilization occur in older adults, and the collection of nutritional information is an important part of examining the nutrition and health issue. A nutritional survey using the 24-hour recall method was performed to identify nutritional quality and leading patterns of food group intake for protein, vitamin C, P and Fe were over 1, whereas those for vitamin A, $B_1$, $B_2$, niacin and Ca were below 1. The MAR(Mean Adequacy Ratio) was relatively low(0.75). The percentage of energy from carbohydrate, protein, and fat was 65.1, 15.6, and 19.5, respectively, thus the quantities of energy source were ideal. The Older subjects revealed poorer nutrition quality than the younger subjects did. The food group intake pattern of the elderly was not diverse, only 9% of them consumed all food groups in a day. These results suggest that nutritional guidelines for older Koreans should focus on the maintenance of adequate energy intake. In addition, selection of foods with high protein and calcium, such as dairy food, should be emphasized, particularly in the older elderly. Nutrition programs should target individuals at risk of not receiving enough nutrients, like the oldest elderly, and persons with lower education.

  • PDF

국내 의료기관의 질 향상 사업주제 (Study on Quality Improvement Activities in Korean Hospitals)

  • 채유미;이선희;최귀선
    • 한국의료질향상학회지
    • /
    • 제8권2호
    • /
    • pp.232-243
    • /
    • 2001
  • Background : the hospitals in Korea are in a situation of a severe competition than the past. This situation was resulted from the increase in the number of hospitals and also from the government policy controlling the medical insurance fee. Moreover, consumer's desire for the high quality medical service g\has been significantly increased. Many programs to improve the quality of medical services are being performed in hospitals since the middle of 1990's. Studies up to now reported that more than 10 programs are being performed per hospital in Korea. So far studies have been performed to measure only the number of such programs in a hospital. The purposes of this study are to examine a specific area involved in the programs designed to improve the medical service quality and to suggest a future direction of the such programs. In addition, we hope that the results from this study could assist the programs for the medical service quality. Methods : A mailed questionnaire survey of the QI staffs at hospitals with 400 beds or more was conducted between September 15 and October 30, 2000. Of the 108 hospitals eligible for inclusion in our study, 69 participated, yielding a response rate of 63.9%. Excluding 7 hospital which are not responsed about activities of hospital then 62 hospitals were used for the analysis. Result : The total number of programs was 1,081 from the 62 hospitals participated in the survey. The highest number (24.8 programs) was found in the hospital having more than 800 beds and performing the programs more than 5 years. The 1,081 programs were consisted of 445 from the medical examination area, 343 from the medical examination support area, and 296 from the management area. Conclusion : This study showed the present situation of hospitals in Korea regarding to the quality improvement programs. The results from this study suggest that the pattern of the program for the medical service improvement is being changed to service process and result-centered programs from the structural area.

  • PDF

중소기업 근로자 보건관리대행기관 QA 평가지표의 개발과정 (The Development of the Evaluation Tool of Group Occupational Health Program for Workers of Small and Medium Sized Industries)

  • 조수헌;김선민;김창엽;홍윤철;하은희
    • 한국의료질향상학회지
    • /
    • 제2권2호
    • /
    • pp.72-111
    • /
    • 1996
  • Background: Group occupational health program by non-for-profit agency, started five years ago, for management of health problems in small and medium sized industries, is one of the measures to cope with limited human and financial resources in occupational health. The program has been rapidly expanding to include 54 participating institutions, private as well as public, all over the country. In spite of its potential impact on health of employees and practice of occupational health in small and medium sized industries, comprehensive evaluation in terms of quality has not been tried. Objectives : The aim of this study are to develop and apply criteria to assess quality of newly developed Korean group occupational health program. Methods : By defining occupational health services, in particular for small and medium sized industries, as one of the primary health care, we included followings as core elements of sound occupational health program; accessibility, continuity, intersectoral collaboration, comprehensiveness, community participation, technical quality, adequacy, focus on preventive services, acceptability, and workers' satisfaction. Again we divided each elements into five major components of national health system infrastructures developed by World Health Organization; development of health resources organized arrangement or resources, delivery of health care, economic support, and management. In turn, we categorized each component into input, process and outcome aspects. After discussions in expert panel, several criteria were selected for evaluation of program. The criteria were modified according to each group of interviewees. Results: We developed five sets of questionnaire that evaluate the quality of 'Group occupational health program'. Conclusion : The refining of the measurement tool and the continuing evaluation process for the 'Group occupational health institute' should be done further.

  • PDF

졸업생 취업률 변화를 중심으로 본 지방대학혁신역량강화(NURI)사업의 평가 (An Evaluation of NURI(New University for Regional Innovation): Focusing on Changes in Graduate Employment)

  • 이삼호;김희삼
    • KDI Journal of Economic Policy
    • /
    • 제30권2호
    • /
    • pp.157-183
    • /
    • 2008
  • '지방대학 혁신역량 강화사업' 혹은 'NURI(New University for Regional Innovation)사업'은 지역발전혁신전략의 한 주체로 설정된 지방대학의 발전을 도모하는 사업이다. NURI사업은 학부 졸업생 수준의 중견전문인력을 양성하는 지방대학의 기능을 강화하고자 하는 목적으로 시행되었다. 본 논문은 졸업생 취업률의 변화를 중심으로 노동시장에서 나타난 NURI사업의 성과를 평가하고자 한다. 이를 위해 우리는 한국교육개발원의 졸업생 취업률 통계조사 자료를 활용하여 NURI사업단과 NURI사업에 지원하였으나 미선정된 사업단의 취업률을 비교하였다. 이를 바탕으로 NURI사업이 시행된 이후 취업률의 개선이 나타났는지를 이중차감법을 이용하여 검증하였다. 검증 결과, NURI사업단의 취업률은 미선정 사업단에 비해 빠르게 상승하였으며, 기간이 지남에 따라 취업률 개선 정도의 차이가 더욱 크게 나타났다. 그러나 이러한 차이는 통계적으로 유의한 수준은 아니므로 취업률 개선효과를 단정할 수 없다. 더구나 취업률의 변화를 관찰한 기간이 충분히 길지 않다는 점에서 NURI사업의 효과성을 단정적으로 평가하기는 더욱 어렵다. 또한 어느 정도의 취업률 개선이 이루어졌다 하더라도 투입된 예산규모가 상당히 크다는 점 등을 고려할 때 NURI사업이 기대한 만큼의 성과를 거두고 있다고 단언하기는 어렵다. 따라서 차후에도 지속적인 검증이 필요할 것이다.

  • PDF

유역-호소 연계모형을 이용한 상류 오염원 관리에 따른 담수호 수질영향평가 (Assessment of Estuary Reservoir Water Quality According to Upstream Pollutant Management Using Watershed-Reservoir Linkage Model)

  • 김석현;황순호;김시내;이현지;전상민;강문성
    • 한국농공학회논문집
    • /
    • 제64권6호
    • /
    • pp.1-12
    • /
    • 2022
  • Estuary reservoirs were artificial reservoir with seawalls built at the exit points of rivers. Although many water resources can be saved, it is difficult to manage due to the large influx of pollutants. To manage this, it is necessary to analyze watersheds and reservoirs through accurate modeling. Therefore, in this study, we linked the Hydrological Simulation Program-FORTRAN (HSPF), Environmental Fluid Dynamics Code (EFDC), and Water quality Analysis Simulation Program (WASP) models to simulate the hydrology and water quality of the watershed and the water level and quality of estuary lakes. As a result of applying the linked model in stream, R2 0.7 or more was satisfied for the watershed runoff except for one point. In addition, the water quality satisfies all within 15% of PBIAS. In reservoir, R2 0.72 was satisfied for water level and the water quality was within 15% of T-N and T-P. Through the modeling system, We applied upstream pollutant management scenarios to analyze changes in water quality in estuary reservoirs. Three pollution source management were applied as scenarios, the improvement of effluent water quality from the sewage treatment plant and the livestock waste treatment plant was effective in improving the quality of the reservoir water, while the artificial wetland had little effect. Water quality improvement was confirmed as a measure against upstream pollutants, but it was insufficient to achieve agricultural water quality, so additional reservoir management is required.

Non-Value-added Activity 개선을 통한 간호업무 효율성 향상 (Case study on improvements in non-value-added nursing activities to increase the efficiency of nursing care)

  • 박양희;권인각;박계숙;장혜정;송미라;김희진
    • 한국의료질향상학회지
    • /
    • 제19권2호
    • /
    • pp.68-80
    • /
    • 2013
  • Background: This study investigates improvements in non-value-added nursing activities in clinical work, in order to improve the efficiency and quality of nursing activities. Methods: The study was performed as a quality improvement project at a tertiary general hospital. The nursing activities that needed improvements were categories into admission care, discharge care, supply management, diagnostic work-up related activities, and others. The nursing time and frequency of non-value-added activities were compared across nine nursing units before and after implementation of the quality improvement program. Post-implementation patient and nurse satisfaction were subsequently analyzed. Result: Post-implementation, the time spent on non-value-added nursing activities was reduced and patients and nurses were satisfied with the improvements. Discussion: Reducing non-value-added activities in nursing can increase the work efficiency and ensure time for patient care, thus improving the quality of nursing care. For further study, accurate surveys on nursing activities based on nursing time are required.

COPQ dashboard 개발 사례 (A case study of designing the COPQ dashboard)

  • 도기영;허원석;김동준;장중순
    • 한국경영과학회:학술대회논문집
    • /
    • 한국경영과학회 2004년도 추계학술대회 및 정기총회
    • /
    • pp.35-38
    • /
    • 2004
  • Global competitive pressures are asking industrial companies to find the best way to meet their customer's requirements, reduce the costs of products, and increase productivity. Quality improvement has been proposed and implemented as a primary means of achieving these purposes. The quality improvement usually includes a goal of reducing the costs due to poor quality. While these costs of poor quality (COPQ) are not known precisely, they are known to be very high. Also, they may be underestimated by the hidden costs due to non-value activities, such as potential lost sales, costs of redesign due to quality reasons, and extra manufacturing costs due to defects, etc. In any manufacturing or service operation, all actions and resource expenditures of a company should be focused on creating value for customers. Any activity or resource of not creating the value for customers could be regarded as waste, which consequently causes the COPQ. Some companies did use dashboards to understand and identify value added or non-value added activities in order to reduce or eliminate wastes. These dashboards must be properly designed to consider inherent differences in manufacturing or service operations among business organizations. In addition, a structured quality improvement program such as the Six Sigma must support these dashboards. In this paper, a case study of designing dashboards for evaluating and reporting the COPQ in business units is presented.

  • PDF