• 품질경영학회지
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• 제37권4호
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• pp.71-86
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• 2009

The healthcare environment today is changing rapidly with factors of healthcare consumers in selecting medical institutions also altering at a fast pace under the circumstances. In this study, the theory of consumption values established by Sheth in 1991 is adopted in order to examine particular value affecting consumer selection of healthcare institutions. For the purpose of this study, healthcare consumers were surveyed using questionnaires developed based on the five values of Sheth supplemented by value of effort to acquire hospital information and value in health. Consequently, 24 consumption values affecting selection process were confirmed through discriminant analysis. As a result of regression analysis on factors affecting consumer selection of healthcare institution, effort to acquire hospital information and age among demographic characteristics of respondents are determined important predictors for consumer selection of general hospitals over clinics or small-sized hospitals. Further, service, reputation scale of healthcare institution among functional values and importance of health and effort to acquire hospital information among value in health are identified as significant predictors for consumer selection of large-sized general hospitals over clinic or small-sized hospitals. This study suggests not only vital implications for marketing strategy of healthcare institutions, but also methods to promote positive image for healthcare providers. In addition, this study closely examines the cause of the leaning phenomenon of healthcare comsumers toward large-sized general hospitals.

• 한국의료질향상학회지
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• 제3권1호
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• pp.94-103
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• 1996

Background : Blood pressure is an important indicator in diagnosis and assessing treatment of a patient. Clinical staffs use blood pressure on the assumption that measured value is accurate and reliable. However, whether measured blood pressure is accurate has been rarely investigated in Korea. Objectives : The aims of this study are to evaluate clinical staffs' knowledge and technique as well as accuracy of sphygmomanometer. Also the program to improve the measurement is developed. Methods : Seventy-three registered nurses were asked nine multiple choice questions including Korotkoff sound, cuff size, and deflation rate. Simultaneously characteristics of nurses were examined, age, working place, duration of employment and academic degree. A testing videotape(Standardizing Measurement Video-Tutored Course) was used for evaluating the accuracy of measurement. Testees were to read and record the 12 cases of blood pressure measurement, watching a falling mercury column and hearing Korotkoff sounds. After 10 minutes' education, they were again tested with the same cases. Additionally, 83 mercury sphygmomanometers were checked to find defects such as inaccurate calibration and zero setting, leaky bladder, etc. Results: For the knowledge testing correct response rate was 41.1%. They were the lowest in selecting the proper cuff size and Korotkoff sound. In examining accuracy of blood pressure with videotape, nurses had 67.7% correct response rate. The correct response rate was significantly improved by a session of education. About 23% of sphygmomanometers was without discernable defects. Conclusion : The knowledge and skill of clinical staffs along with the accuracy of equipment have to be improved. A properly designed education program would contribute to the accuracy improvement of blood pressure measurement. Also, more concerns should be given to the precision and maintenance of equipment.

• 한국의료질향상학회지
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• 제21권2호
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• pp.40-56
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• 2015

Objectives: To outline overall duties of quality improvement (QI) performers within a health care organization, thus describing their key tasks, including task element-related frequency, importance and difficulty in enough detail. Methods: A DACUM (Developing A CurriculUM) workshop took place to outline overall job activities of QI performers. To examine the scope of their duty and task, we performed a questionnaire survey of 338 QI performers from 111 hospitals. Results: The results of our survey showed that for the task assigned to each QI performer, there were 10 duties, 31 tasks and 119 task elements. Respondents cited a project planning as the most frequent/important duty, and a research was the highest level of difficulty in their duty. They also said that the most frequent task was index management, the most important task was a business plan, and the highest level of difficulty was a practical application of QI research. QI performers added that the most frequent task element was receipt of patient safety reporting in patient safety system, the most important task element was an analysis for patient safety and its improvement, and the highest level of difficulty was a regional influence analysis related to the patient safety and its improvement. Conclusion: To ensure that QI performers play a pivotal role as a manager to better improve patient safety and the quality of health care services, proper training program for them should be developed by reflecting the results of our study.

• 한국식품영양학회지
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• 제23권3호
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• pp.411-418
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• 2010

The objective of this study was to analyze the effects of non-offered meal on waste reduction in foodservice. To this end, the quantity of non-offered meal before and after Quality Improvement(QI) activity was analyzed, and employee satisfaction with foodservice was investigated. Statistical data analyses can be summarized as follows: The daily quantity of non-offered meal decreased significantly after QI(p<0.001)($27.80{\pm}3.14\;kg$ before QI and $7.22{\pm}4.17\;kg$ after QI). Among 7 items related to employee satisfaction, kindness of meal service staffs improved significantly after QI(p<0.05)($4.05{\pm}0.74$ before QI and $4.21{\pm}0.17$ after QI). No significant difference was found in the variety of menus, or cooking/seasoning of food, and there seemed to be greater satisfaction with taste of food after QI.

• 한국병원경영학회지
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• 제10권2호
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• pp.45-63
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• 2005

The purposes of this study are to understand the doctors' attitude and satisfaction about the review system of national health insurance claim in Korea and to suggest the way to improve this system This study conducted a survey of the doctors registered in the medical association in Seoul city. The survey was performed as a form of self-administered questionnaire from January 2004 to February 2004. The contents of questionnaire dealt with doctors' attitude and satisfaction about the review system of medical service claim. Totally, 1,037 members replied to our survey and we analysed 981 doctors' data, excluding incomplete responses. As a result, 89.7% of repliers showed a negative attitude about the influences of the review system on improvement of medical service quality, 98.0% of repliers have had experiences that they have given distorted insufficient medical services in order to evade the curtailment of service claim. Also, 91.6% of repliers stated that they have had experiences of intentional modification or alteration of diagnostic code to shun the curtailment. Most of the doctors showed negative attitude to the curtailment procedure and the review system of service claim originally intended to be one of the quality control methods of medical service in Korea also, the development of both scientific and reasonable parameters and criteria for claim is needed. 'Through the improvement of review system for appropriate medical service, there is a need of a way to increase the satisfaction of medical service providers, and to encourage the motivation for quality control. Also, education is strongly needed to provide doctors with sufficient information about review criteria and curtailment cases.

• 한국병원경영학회지
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• 제26권1호
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• pp.55-70
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• 2021

Purpose: The purpose of this study was to examine the influencing factors of the patient leaning phenomenon in tertiary hospitals. Based on the results of this study, we intended to find implications for improving the problems of the delivery system imbalance in tertiary hospitals caused by patient leaning phenomenon. Methodology/Approach: Qualitative studies were conducted, using focus group interviews and in-depth interviews. The focus group interviews were conducted for 12 users of tertiary hospitals by 2 groups. And in-depth interviews were conducted for 6 tertiary hospital managers. This was considered to be the most effective approach to gather diverse and in-depth information about the influencing factor of patient leaning phenomenon in tertiary hospitals. Findings: In focus group interviews, the reason for choosing tertiary hospitals was the reliability of the hospital(physician, reputation, etc.). And the effect of the policy to strengthen coverage of National Health Insurance and private medical insurance was relatively small. In other words, we found that the individual's desire to receive medical services suitable for one's health status and disease condition was the biggest factor, rather than the cost and policy factors. Practical Implications: We suggested that the appropriate medical care provision should be strengthened according to the role and function of medical institutions. In addition, the education system needs to be reorganized to activate the referral program, expand community medical capabilities, and foster quality primary medical care.

• 한국비블리아학회지
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• 제30권3호
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• pp.291-314
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• 2019

본 연구는 병원 내 도서관 이용자의 만족도를 제고시키고 향후 병원 내 도서관의 활성화 방안을 고찰하기 위해, 이용자와 비이용자를 대상으로 장서, 시설 및 환경, 직원, 서비스, 프로그램 등의 만족도 및 수요도를 조사하여, 이용자가 만족하는 도서관의 운영 방안을 모색하고자 하였다. 그 결과, 병원 내 도서관 활성화 방안으로 첫째, 최신성을 갖춘 다양한 주제의 장서 수 확대가 필요하다. 둘째, 병원 내 도서관의 직원 수확대가 시급하며, 이와 함께 의학 전문 지식 기반 의사소통 능력 향상 및 이용자 요구에 대한 신속한 대응 능력이 필요하다. 셋째, 시설 및 환경으로 병원 내 도서관 규모 확대와 편의시설 확대가 필요하다. 넷째, 서비스 질 향상과 다양한 서비스 제공이 필요하며, 이용자 대상에 따라 전문가는 주제검색서비스, 의학관련 정보원 제공 서비스를, 일반인(환자 및 보호자 등) 건강정보서비스 등을 제공해야 한다. 마지막으로 프로그램 운영을 위한 인프라 확대와 대상의 다양화, 프로그램 지속성 등이 확보되어야 한다.

• 한국의료질향상학회지
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• 제4권2호
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• pp.210-221
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• 1997

Background : Willingness to satisfy patients(WSP) among nurses is essential to promoting patient satisfaction which is a critical component in the quality of health care and its outcomes. This study was carried out to empirically find out the affecting factors of WSP among nurses in hospital settings. Methods : The model contains seven job relating determinants and two intervening variables as follows: i) job relating variables of professional status, task requirements, pay, physician-nurse interaction, nurse-nurse interaction, organizational policies, and autonomy, ii) intervening variables of job satisfaction and organizational commitment. Data were collected from 205 nurses in two general hospitals owned by one foundation located in Pusan, Korea, using a structured and self-administered questionnaire. Results : The major results were as follows: First, the results of ANOVA on WPS by personal characteristics showed a statistically significant relationships between WPS and hierarchical orders(p<.01) ana tenure(p<.10). Comparing with the lower orders and shorter tenure, the higher orders and the longer tenure showed better WPS. Second, the results of simple correlation analysis between WPS and determinants and intervening variables showed the following variables, in order of importance, were statistically significant(p<.01): work satisfaction(+), organizational commitment(+), task requirements(+), nurse-interaction(+), professional status(+), physician-nurse interaction(+). Third, the results of path analysis showed that two intervening variables of job satisfaction and organizational commitment, and three determinants of task requirements, professional status, and nurse-nurse interaction had a positively significant direct effect to WPS. Conclusion : The results suggest that nurses who are more satisfied with task requirements, status, nurse-nurse interaction, overall job satisfaction, and organizational commitment, will behave in ways that patients find more satisfied.

• Journal of Hospice and Palliative Care
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• 제22권3호
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• pp.105-116
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• 2019

목적: 소아청소년 호스피스 완화의료(이하 소아완화의료)는 생명을 위협하는 질환을 가진 소아청소년의 삶의 질을 향상시기 위한 총체적 돌봄 철학이자 실무의 표준이다. 국내에서는 2018년 7월 국가 지원의 소아완화의료 시범사업을 도입하였는데, 소아완화의료의 발전 방향을 제시하기 위해 국외 선진국의 소아완화의료 제공체계를 고찰하였다. 방법: 소아완화의료 제공 수준을 검토하여 영국, 미국, 일본, 싱가포르를 대상으로 선정하였다. 소아완화의료 제공체계를 다룬 국내외 학술지 등 문헌을 통합적으로 고찰하고 현지 전문가의 자문과 현지 방문조사를 수행하였다. 1990년 이후 영어, 일본어로 발간된 문헌을 중심으로 PubMed, Google, Google Scholar에서 검색하여 학술지, 정책보고서 등을 참고하였다. 각국의 소아완화의료 발전과정, 정책, 재정 모델, 대상 기준, 전달 체계, 질 관리 체계에 대해 분석하였다. 결과: 영국은 지역사회의 독립형 소아전문 완화의료기관이 일차 의료체계와 협력하며 어린이병원의 전문 소아완화의료 자문팀과 의뢰와 자문을 주고받는다. 미국은 병원기반의 전문 소아완화의료 자문팀을 중심으로 지역사회의 호스피스기관, 가정의료기관이 네트워크를 구축하고 돌봄 코디네이터를 지정하여 소아완화의료를 제공한다. 일본은 완화의료, 재택의료, 장애아동 및 만성질환아동 지원체계에서 완화의료 성격의 서비스를 제공한다. 싱가포르는 소아전문 가정 완화의료 단체가 어린이병원의 전문 자문팀과 협력하여 높은 지리적 접근성을 토대로 중추적으로 완화의료를 제공한다. 결론: 국외의 제공체계를 참고하고 국내의 현장의 요구를 반영하여 소아완화의료의 제공체계를 정비하여 미충족 요구가 발생하지 않도록 한국 소아청소년 호스피스완화의료를 최적화해 나가야 한다.

• 한국병원경영학회지
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• 제13권1호
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• pp.42-64
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• 2008

This study was conducted to evaluate the quality in medical records by analyzing its completeness through setting up the level of record on the patient's past history and through examining the actual medial records. Targeting the information on the patient's past history in interns' records, residents' records and nurses' records toward 403 inpatients who were admitted first in 2004 at an university hospital due to stomach cancer. We analyzed whether the charts were recorded or not, recording level, the satisfaction with the expectant level of the records in the hospital targeted for a research and the level of agreement. The results were as follows; first, as for the rate of recording those each items, they were high in the chief complaint & present illness and the past illness history. Depending on the group of recorders, the recording rate showed big difference by items. Second, as a result of measuring the level after dividing the recording level of items for the patient's past history from Level 1 to Level 4 by each item, the admission history, the past illness history, and the family history were about Level 3, and the smoking history, the medication history, the chief complaint & present illness, the drinking history and allergy were about Level 2. In the admission department, it was excellent in the interns' records for the medical department. Third, as a result of its satisfactory level by comparing the expect level of a record and the actual record by item in information on the patient's past history, which was expected by the medical-record committee members of the hospital targeted for a study. And forth, we analyzed the level of agreement with Kappa score in the level of 'Yes' or 'None' related to the corresponding matter in Level 1, in terms of information on the past history in the intern's record, the resident's record, and the nurse's record. The level of agreement in the resident's record & the nurse's record, and in the intern's record & the resident's record was from "excellent" to "a little good". There were differences in the level of completeness and in reliability for the information on the past history by the recorder group or by the admission department. The encounter process that was performed by the admission department or the recorder group, indicated the result that was directly reflected on the quality of medical records, thus it was required further study about the medical record documentation process and quality of care. The items that showed the high recording rate quantitatively were rather low, consequently we'd should develop the tool for the qualitative inspection and evaluate the medical records further. And the items were needed to be detailed in the record level were rather low, and hence there needed to be a documentation guideline and education by the clinical departments.