• 간호행정학회지
• /
• 제2권1호
• /
• pp.97-114
• /
• 1996

INSTRODUCTION Service quality is, unlike goods quality, an abstract and elusive constuct. Service quality and its requirements are not easily understood by consumers, and also present some critical research problems. However, quality is very important to marketers and consumers in that it has many strategic benefits in contributing to profitability of marketing activities and consumers' problem-solving activities. Moreover, despite the phenomenal growth of medical service sector, few researchers have attempted to define and model medical service quality. Especially, little research has focused on the evaluation of medical service quality and patient satisfaction from the perspectives of both the provider and the patient. As competition intensifies and patients are demanding higher quality of medical service, medical service quality and patient satisfaction has emerged as a critical research topic. The major purpose of this article is to explore the concept of medical service quality and its evaluation from both nurse and patient perspectives. This article attempts to achieve its purpose by (1)classfying critical service attibutes into threecategories(satisfiers, hygiene factors, and performance factors). (2)measuring the relative importance of need criteria, (3)evaluating SERVPERF model and SERVQUAL model in medical service sector, and (4)identifying the relationship between perceived quality and overall patient satisfaction. METHOD Data were gathered from a sample of 217 patients and 179 nurses in Seoul-area general hospitals. From the review of previous literature, 50 survey items representing various facets of the medical service quality were developed to form a questionnaire. A five-point scale ranging from "Strongly Agree"(5) to "Strongly Disagree"(1) accompanied each statement(expectation statements, perception statements, and importance statements). To measure overall satisfaction, a seven-point scale was used, ranging from "Very Satisfied"(7) to "Very Dissatisfied"(1) with no verbal labels for scale points 2 through 6 RESULTS In explaining the relationship between perceived performance and overall satisfaction, only 31 variables out of original 50 survey items were proven to be statistically significant. Hence, a penalty-reward analysis was performed on theses 31 critical attributes to find out 17 satisfiers, 8 hygiene factors, and 4 performance factors in patient perspective. The role(category) of each service quality attribute in relation to patient satisfaction was com pared across two groups, that is, patients and nurses. They were little overlapped, suggesting that two groups had different sets of 'perceived quality' attributes. Principal components factor analyses of the patients' and nurses' responses were performed to identify the underlying dimensions for the set of performance(experience) statements. 28 variables were analyzed by using a varimax rotation after deleting three obscure variables. The number of factors to be extracted was determined by evaluating the eigenvalue scores. Six factors wereextracted, accounting for 57.1% of the total variance. Reliability analysis was performed to refine the factors further. Using coefficient alpha, scores of .84 to .65 were obtained. Individual-item analysis indicated that all statements in each of the factors should remain. On 26 attributes of 31 critical service quality attributes, there were gaps between actual patient's importance of need criteria and nurse perceptions of them. Those critical attributes could be classified into four categories based on the relative importance of need criteria and perceived performance from the perspective of patient. This analysis is useful in developing strategic plans for performance improvement. (1) top priorities(high importance and low performance) (in this study)- more health-related information -accuracy in billing - quality of food - appointments at my convenience - information about tests and treatments - prompt service of business office -adequacy of accommodations(elevators, etc) (2) current strengths(high importance and high performance) (3)unnecessary strengths(low importance and high performance) (4) low priorities(low importance and low performance) While 26 service quality attributes of SERPERF model were significantly related to patient satisfation, only 13 attributes of SERVQUAL model were significantly related. This result suggested that only experience-based norms(SERVPERF model) were more appropriate than expectations to serve as a benchmark against which service experiences were compared(SERVQUAL model). However, it must be noted that the degree of association to overall satisfaction was not consistent. There were some gaps between nurse percetions and patient perception of medical service performance. From the patient's viewpoint, "personal likability", "technical skill/trust", and "cares about me" were most significant positioning factors that contributed patient satisfaction. DISCUSSION This study shows that there are inconsistencies between nurse perceptions and patient perceptions of medical service attributes. Also, for service quality improvement, it is most important for nurses to understand what satisfiers, hygiene factors, and performance factors are through two-way communications. Patient satisfaction should be measured, and problems identified should be resolved for survival in intense competitive market conditions. Hence, patient satisfaction monitoring is now becoming a standard marketing tool for healthcare providers and its role is expected to increase.

• 마케팅과학연구
• /
• 제20권2호
• /
• pp.173-178
• /
• 2010

这是一家私人, 第三代家族拥有的公司, Boom Technologies 公司(BTI). 对电力设施提供产品和服务的供应商, 通信和承包商的市场,不断进步的出口. 尽管在2008年出口销售只占总收入的5%, BTI已形成了一个完整的出口部门. 他们的出口部门的执行董事揭示了一家私营公司的试验和错误以及他们对成功的海外市场的疑问. 自成立以来, BTI始终相信它最大的资产是它的雇员. 当出口销售因为缺乏战略和方向而挣扎时, BTI为其出口部门雇了一位董事总经理. 在BTI总裁和总经理的领导下, 他们很好的利用了这个部门的技能和知识. 为向海外扩展他们的市场份额, 增加出口销售他们进行了机构调整. 结果就是, 出口销售增加了4倍, 国家的地区经理增加了, 同时成功养成了分销渠道网络. 有时, 由于公司的结构, 收入形成很难决定. 因此, 在1996年, 出口部门重组为有限责任公司. 这使得公司改进收入和费用. 最初, 80%的BTI出口销售来自两个国家;因此,最初在海外出售的方法并没有达到预期目标. 然而, 所做的修改, 使得现在公司 经营, 销售超过80个国家. 总经理指出主要有三个出口扩张挑战 1. 产品和船运—BTI主要障碍是产品装配. 最初, 大多数的产品被聚集在美国, 这增加了运输包装费用. 有这么多的部分指定订购, 很多次定的东西到的时候有些零部件都丢失了. 失踪的零件价值上万美元. 装运这些失踪的部分也花费成千上万的美元, 外加一个延迟交货时间六到八周, 所有的费用都由BTI出. 2. 产品适应—在BTI80个出口国家中, 每个国家的安全, 产品标准都不同. 重量, 特殊证, 产品的规格要求, 测量系统的稳定性, 卡车都会因国别而不同. 作为一种准入障碍,以致很难使产品适应. 技术和安全标准的障碍, 作为一种保护国内产业的方法, 可以阻碍成功的进入外国市场 3. 市场的挑战—分销的重要性给BTI带来了很多挑战,因为他们试图根据他们的分销系统来确定每个国家如何操作. 有些国家已经从一个小的竞争对手, 只生产一种具有竞争力的产品而极具竞争力. 而BTI制造超过100种的产品. 营销资料是另一个BTI所关心的, 因为他们试图对经销商推动销售成本. 从翻译和文化差异的角度, 合适的市场营销资料可能会花费很多. 此外, 美国的纸张大小不同于别的一些国家, 当试图复制相同的布局和设计时, 就会出现许多问题. 分销已经成为BTI所面临的挑战之一, 公司宣称他们的分销网络是他们的竞争优势之一, 因为他们的分销商的位置和名字都是保密的. 另外, BTI每年有两次奉献: 培训分销商一年, 另一个是分销商会议. 产品, 航运, 产品适应性, 营销这些挑战,这些海外市场错综复杂需要时间和耐心. 另一个竞争优势是BTI的摇篮到坟墓的策略, 他们遵循产品销售到它的最终安息地, 无论卡车是出租或购买新的或用过的. 他们对该公司购买或租赁之前的产品都提供服务和设备维护计划和一份详细的费用分析. 扩大海外总是会面临挑战. 如总经理说, "如果你没有耐心(出口业务), 你最好做别的事." 知道如何快速适应提供必要的技能, 适应每个国家的不同需求, 以及独特的挑战, 使他们能够保持竞争力.

• 천문학회보
• /
• 제39권2호
• /
• pp.90-90
• /
• 2014

The Immersion Grating Infrared Spectrometer (IGRINS) is the first astronomical spectrograph that uses a silicon immersion grating as its dispersive element. IGRINS fully covers the H and K band atmospheric transmission windows in a single exposure. It is a compact high-resolution cross-dispersion spectrometer whose resolving power R is 40,000. An individual volume phase holographic grating serves as a secondary dispersing element for each of the H and K spectrograph arms. On the 2.7m Harlan J. Smith telescope at the McDonald Observatory, the slit size is $1^{{\prime}{\prime}}{\times}15^{{\prime}{\prime}}$. IGRINS has a plate scale of 0.27" pixel-1 on a $2048{\times}2048$ pixel Teledyne Scientific & Imaging HAWAII-2RG detector with a SIDECAR ASIC cryogenic controller. The instrument includes four subsystems; a calibration unit, an input relay optics module, a slit-viewing camera, and nearly identical H and K spectrograph modules. The use of a silicon immersion grating and a compact white pupil design allows the spectrograph collimated beam size to be 25mm, which permits the entire cryogenic system to be contained in a moderately sized ($0.96m{\times}0.6m{\times}0.38m$) rectangular Dewar. The fabrication and assembly of the optical and mechanical components were completed in 2013. From January to July of this year, we completed the system optical alignment and carried out commissioning observations on three runs to improve the efficiency of the instrument software and hardware. We describe the major design characteristics of the instrument including the system requirements and the technical strategy to meet them. We also present the instrumental performance test results derived from the commissioning runs at the McDonald Observatory.

• 의료법학
• /
• 제16권1호
• /
• pp.3-82
• /
• 2015

이 논문에서는 미용성형의료관계에서 설명의무의 위반과 시술상 오류로 인한 민사책임에 관한 판결(대법원 2013. 6. 13. 선고 2012다94865 판결, 서울중앙지방법원 2014. 12. 5. 선고 2013가소865646 판결)의 평석적 분석을 통해 설명의무만를 강화하여 책임귀속을 판단한 논지의 법리적 문제점을 지적하고, 다음과 같은 논점을 전개한다. 미용성형도 현행 의료법상 의료행위에 해당한다는 판례(대법원 1974. 11. 26. 선고 74도1114 전원합의체 판결)와 학계의 통용되는 견해는 공법적 관점에서만 타당하며, 적응증이 없는, 즉 질병 치료를 목적으로 하지 않는 순수한 미용성형시술은 의술적으로 신체, 건강 등에 위해를 가할 수 있는 의료법상 의료행위에 해당하지만, 민사책임법에서는 질병치료를 목적으로 하는 진료행위와 구별되어야 한다. 그리고 오늘날 의료생활에서 의료보험의 불가결성에 비추어, - 방법적으로 사회법상 개념 및 규준을 곧바로 민사책임법에 적용되는 것은 아니라는 점을 견지하면서 -, 성형시술에 대한 보험급여에 관한 독일 연방사회법원 판결(BSGE 63, 83, BSGE 72, 96, BSGE, 82, 158, BSGE 93, 252 etc.)을 소개하여 비교한다. 또한 진료계약의 법적 성질에 관한 교조적 논점과 관련하여 독일 연방법원의 판결(BGHZ 63, 306)도 비교적으로 검토한다. 소결적으로 성형의료를 (1) 신체의 물리적 기능의 침해의 교정, (2) 기형(騎形)의 교정, (3) 심인적 침해의 교정, (3) 정상적 체형(體型)의 미화(美化)로 유형적으로 분류하는 관점에서, 적응증 있는 진료계약(수단채무)에 적용하는 책임귀속법리와 달리, (4)의 유형에 해당하는 미용성형시술에는 예외적으로 도급계약의 법리 적용을 긍정적으로 재검토할 것을 제안한다.

• 한국가정과교육학회지
• /
• 제18권3호
• /
• pp.81-95
• /
• 2006

본 연구는 제 7차 교육과정의 초 중등 실과 및 기술가정 교과에 포함된 의생활 교육내용에 대하여 학생들이 인식하는 학습량, 이해도 흥미도 그리고 요구도를 교육 내용 요소별로 분석하여 그 적정성을 평가하였다. 경기도 초중고 남녀학생들을 대상으로 수집된 질문지를 통계 분석한 결과 다음과 같은 결론을 얻었다. 첫째, 초중고 남녀학생들의 50%이상이 초 중등 실과 및 기술가정 교과에 포함된 의생활 교육내용의 학습량은 적당하다고 인식하였다. 그러나 중학교 남학생들은 반바지 만들기 등의 실습과정에 대해 학습량이 많다고 인식하였다. 둘째. 의생활 교육 내용에 대한 초중고 남녀학생들은 모두 뜨개질, 재봉틀, 옷만들 및 생활용품 만들기 등 실제로 작품을 제작해야하는 실습영역에 대해 이해도가 낮았다. 셋째, 초등학교 학생들은 재봉틀을 이용한 실습영역에 대한 흥미도가 낮았으며 이는 학습량이 많다고 하고. 이해도가 낮은 것과 관련이 있다. 중학생들은 학습량이 많고, 이해도가 낮은 반면 흥미도가 높은 것으로 보아 학습내용의 난이도를 조절할 필요가 있었으며 고둥학교 학생들의 흥미도가 보통이었다. 넷째, 학생들의 요구도는 '필요하다'와 '보통'이었으며 교육내용 중 실습관련 내용에의 요구도가 매우 낮았다. 초 중등 실과 및 기술가정 교과에 포함된 의생활 교육내용에 대하여 학생들이 인식하는 학습량, 이해도, 흥미도 요구도 간에는 초등학생과 중학생은 학습량과 이해도, 흥미도, 요구도간에 부적인 상관관계가 있었으며, 이해도. 흥미도. 요구도 간에는 정적인 상관관계가 있었다.

• 항공우주정책ㆍ법학회지
• /
• 제29권1호
• /
• pp.3-32
• /
• 2014

항공안전관리는 항공운용 등에 있어서 승무원, 항공기 및 기타 자원의 안전을 확보하기 위한 항공산업 전반에 대한 관리이다. 국제민간항공기구는 안전한 항공기술의 발전을 위하여 국제 기술표준의 중요성을 인식하고 국제민간항공협약에서 19개 부속서(Annex 19)를 제정하였다. 이에 따라 각 회원국도 국제민간항공기구의 정책에 맞춰 항공법령에 국제표준 및 권고사항을 수용하게 되었으며 2013년 11월 14일부터 적용되는 부속서 19에서는 그간 항공안전에 관한 각국의 의견을 반영하여 항공안전관리체계가 제시되었다. 이 같은 국제적 흐름에 따라 국토교통부는 2012년 1차 항공정책 기본계획으로 사전예방적 안전관리 전략을 추진할 것이라고 공표하였으며 부속서 19의 안전관리에 대한 핵심인 항공안전프로그램(SSP) 및 안전관리시스템(SMS) 등을 통합하여 기술 인적자원 정보공유와 투자우선순위 결정, 항공안전관련 주체들의 협력강화를 하기 위한 정책을 시행 중이다. 부속서 19는 국가항공안전프로그램(SSP), 항공안전관리시스템(SMS), 항공안전감독시스템, 안전정보수집, 공유 및 보호정책에 대한 내용을 포함하며 예방적인 안전관리의 체제로 전환을 유도하고 있다. 항공안전프로그램은 안전 증진을 목표로 정부의 규정과 활동을 통합적으로 관리하는 일련의 활동체계를 의미한다. 본 프로그램의 목적은 항공운송사업자, 항행서비스 공급자, 공항운영자, 훈련 및 정비 기관에서 제공하는 항공 서비스의 허용 가능한 안전 수준을 설정하고 관리하는 것이다. 항공안전관리시스템은 위험정보 통계에 근거하여 예측적인 위험관리가 핵심인바 항공안전관리시스템의 성공적인 운영을 위해서는 풍부한 위험정보의 수집이 필수적이다. 수집되는 정보 중 대형사고는 의무보고제도에 의해 보고를 받게 되지만("항공법" 제49조의 3), 소규모 사고는 자체보고하지 않는다면 진지한 조사가 행해지지 않고서는 알 수 없기 때문에 이에 대한 위험사고 수집이 중요하다고 할 수 있다. 국내 항공교통의 안전확보는 정부의 주요 임무이다. 정부는 국제민간항공기구의 기준과 국내항공법규 요건을 준수하고 안전한 정도를 유지하기 위하여 필요한 전략과 프로세스를 수립 시행하며 이를 지속적으로 개선하여야 한다. 민간항공사는 안전관리의 향상과 안전문화 조성을 위하여 전자적인 안전관리기법을 적용하여 안전제반기능이 구현되도록 노력해야 한다. 항공안전은 항공실무를 토대로 규칙을 제정하여야 하는바 항공안전 규제 사항에 대하여 항공산업계의 의견을 적극 수렴해야 한다. 또한 항공안전 보고제도와 자유로운 정보교환 여건을 조성하여 효율적인 안전관리 실현을 지원해야 하며, 안전과 관련된 문제를 해결하는 과정에서 민간항공사와 공조해야 한다. 항공안전 활동을 위하여 적절한 자원을 배정하고 직원의 교육 훈련을 통해 안전관리에 관한 기량을 유지시켜야 하며, 안전목표의 달성도 평가 및 위험도 평가와 같은 성과기반의 점검과 안전기준 절차이행점검 방식을 병행해야 할 것이다.

• 기록학연구
• /
• 제37호
• /
• pp.189-237
• /
• 2013

표준 기록관리시스템(이하 RMS)이 2007년 중앙행정기관의 도입을 시작으로 현재 지방자치단체, 그 밖의 공공기관에도 도입되어 사용되고 있다. RMS는 전자기록환경에서 기록을 관리하기 위한 필수도구이나, 실제 RMS의 기능들이 표준이나 실무를 잘 반영하고 있는지, 얼마만큼 업무에 활용되고 있는지는 잘 알려져 있지 않다. 본 연구는 이러한 문제의식에서 출발하여, 기록관리시스템에 구현된 기능 중 '기준관리'에 대한 평가와 그 의미를 분석하고자 하였다. '기준관리'는 RMS상 기록관리기준표 기준정보관리 분류체계지정 재분류로 구성되어 있는데, 이것은 기록관리기준표 관리와 관련된, 다시 말해 기록의 분류와 처분일정의 영역이다. 분류와 처분일정은 기록에 대한 지적 통제의 중심이자 기록관리의 핵심영역이므로, 이것이 시스템에서 그 역할을 제대로 하고 있는지 분석하는 것은 중요한 일이다. 본 연구에서는 RMS의 기준관리에 대하여 기능 평가와 이용 평가를 함께 실시하였다. 기능 평가는 국내외 표준에서 제시하는 기능요건을 RMS가 얼마나 구현하고 있는지를 비교분석한 것이다. 그리고 이용 평가는 그러한 기능들을 얼마만큼 실제로 사용하고 있는지, 문제점은 무엇인지 진단한 것이다. 중앙행정기관과 광역 및 기초 지자체를 대상으로 실시한 이러한 평가를 통해 얻은 시사점들을 제도적, 기능 이용적, 행정적 측면으로 구분하여 정리하였다. RMS 기준관리 기능이, 더 나아가 RMS 시스템 전체가 기록관리 실무에서 원활하게 사용되기 위해 중요한 것은 사용자를 비롯한 이해당사자들의 소통임이 연구과정에서 드러났다. 사용자들은 RMS를 이용하면서 발생하는 요구사항을 지속적으로 제기하여야 하며, 중앙기록물관리기관은 그들의 요구사항을 분석 파악하고 이를 시스템에 반영하여, 시스템을 고도화 시키고 개선하는데 많은 노력을 하여야 한다.

• 벤처혁신연구
• /
• 제7권3호
• /
• pp.183-228
• /
• 2024

본 연구는 정보통신기술(ICT)분야 스타트업의 특수한 요구를 반영하는 핵심 인재 역량 평가 척도를 개발하는 것에 목적을 두었다. 기존의 인재 역량 평가 도구들은 대부분 대기업이나 전통적인 중소기업의 환경을 기준으로 설계되어, 기술이 급변하는 스타트업의 역동적인 요구 사항을 충분히 반영하지 못하였다. 특히 소수의 인재가 회사의 성공에 직접적인 영향을 미치는 스타트업에게 핵심인재는 매우 중요한 자산이다. 이에 따라, 본 연구는 스타트업이 직면한 도전과 기회에 적합한 인재 역량을 측정할 수 있는 척도를 마련함으로써, 국내 스타트업이 보다 효과적인 인재 관리 전략을 수립할 수 있도록 하였다. 연구는 문헌 리뷰와 심층 인터뷰를 바탕으로 초기 71개 문항을 선별하였으며 본 연구의 문항 기술에 대해 좀 더 정확하고 명료하게 기술되어야 한다는 전문가 의견을 수렴하여 문항의 기술을 변경하였으며, 총 4차 내용타당도를 거쳐 65개의 문항을 개발하였다. 이후 예비조사 및 본조사를 실시하여 총 58개의 문항을 개발하였으며, 본조사에서는 앞서 예비조사에서 도출된 역량의 대분류 3개 요인인 지식, 기술, 태도로 분류한 것을 기반으로 각각 다시 요인분석을 실시하였다. 그 결과, 총 10개의 잠재요인인 업무이해력 6문항, 실무수행경험(암묵지) 6문항, 협업 6문항, 관리 및 문제해결력 9문항, 현장실무능력 9문항, 자기주도성 4문항, 목표지향성 5문항, 적응성 5문항, 관계지향성 5문항, 조직충성 3문항으로 스타트업에서 필요한 핵심 역량의 요인과 문항을 추출하였다. 개발된 척도는 역량의 다면적 특성을 포괄적으로 다루며, 기술 능력, 팀워크, 혁신성, 리더십 등 스타트업에 필수적인 다양한 역량을 종합적으로 평가할 수 있도록 구성되었다. 따라서 스타트업의 관리자들이 구직자의 역량을 객관적이고 정확하게 평가할 수 있도록 돕는 도구를 제공하였으며, 개발된 척도는 스타트업 내에서 직원들의 성장을 지원하고, 전체 조직의 성과를 극대화하는데 기여할 수 있을 것이다. 이를 통해, 스타트업은 내부적으로 우수한 인재 풀을 구축하고, 직원들의 역량을 지속적으로 강화시켜 조직의 경쟁력을 높일 수 있을 것이다. 결론적으로, 본 연구에서 개발한 인재 역량 평가 척도는 스타트업의 특성에 맞춘 맞춤형 평가 도구로서, 스타트업이 급변하는 시장 환경에서 지속 가능한 경쟁력을 확보하는데 중요한 역할을 할 것이다. 또한 국내 스타트업이 성공적으로 성장하고 시장에서 경쟁력을 유지할 수 있도록 지원하는 실무적인 방향을 제시하며, 스타트업 생태계의 발전과 국가 경제 성장에 기여할 것이다.

• 대한간호학회지
• /
• 제3권1호
• /
• pp.13-40
• /
• 1972

Much has teed changed in the field of hospital administration in the It wake of the rapid development of sciences, techniques ana systematic hospital management. However, we still have a long way to go in organization, in the quality of hospital employees and hospital equipment and facilities, and in financial support in order to achieve proper hospital management. The above factors greatly effect the ability of hospitals to fulfill their obligation in patient care and nursing services. The purpose of this study is to determine the optimal methods of standardization and quality nursing so as to improve present nursing services through investigations and analyses of various problems concerning nursing administration. This study has been undertaken during the six month period from October 1971 to March 1972. The 41 comprehensive hospitals have been selected iron amongst the 139 in the whole country. These have been categorized according-to the specific purposes of their establishment, such as 7 university hospitals, 18 national or public hospitals, 12 religious hospitals and 4 enterprise ones. The following conclusions have been acquired thus far from information obtained through interviews with nursing directors who are in charge of the nursing administration in each hospital, and further investigations concerning the purposes of establishment, the organization, personnel arrangements, working conditions, practices of service, and budgets of the nursing service department. 1. The nursing administration along with its activities in this country has been uncritical1y adopted from that of the developed countries. It is necessary for us to re-establish a new medical and nursing system which is adequate for our social environments through continuous study and research. 2. The survey shows that the 7 university hospitals were chiefly concerned with education, medical care and research; the 18 national or public hospitals with medical care, public health and charity work; the 2 religious hospitals with medical care, charity and missionary works; and the 4 enterprise hospitals with public health, medical care and charity works. In general, the main purposes of the hospitals were those of charity organizations in the pursuit of medical care, education and public benefits. 3. The survey shows that in general hospital facilities rate 64 per cent and medical care 60 per-cent against a 100 per cent optimum basis in accordance with the medical treatment law and approved criteria for training hospitals. In these respects, university hospitals have achieved the highest standards, followed by religious ones, enterprise ones, and national or public ones in that order. 4. The ages of nursing directors range from 30 to 50. The level of education achieved by most of the directors is that of graduation from a nursing technical high school and a three year nursing junior college; a very few have graduated from college or have taken graduate courses. 5. As for the career tenure of nurses in the hospitals: one-third of the nurses, or 38 per cent, have worked less than one year; those in the category of one year to two represent 24 pet cent. This means that a total of 62 per cent of the career nurses have been practicing their profession for less than two years. Career nurses with over 5 years experience number only 16 per cent: therefore the efficiency of nursing services has been rated very low. 6. As for the standard of education of the nurses: 62 per cent of them have taken a three year course of nursing in junior colleges, and 22 per cent in nursing technical high schools. College graduate nurses come up to only 15 per cent; and those with graduate course only 0.4 per cent. This indicates that most of the nurses are front nursing technical high schools and three year nursing junior colleges. Accordingly, it is advisable that nursing services be divided according to their functions, such as professional, technical nurses and nurse's aides. 7. The survey also shows that the purpose of nursing service administration in the hospitals has been regulated in writing in 74 per cent of the hospitals and not regulated in writing in 26 per cent of the hospitals. The general purposes of nursing are as follows: patient care, assistance in medical care and education. The main purpose of these nursing services is to establish proper operational and personnel management which focus on in-service education. 8. The nursing service departments belong to the medical departments in almost 60 per cent of the hospitals. Even though the nursing service department is formally separated, about 24 per cent of the hospitals regard it as a functional unit in the medical department. Only 5 per cent of the hospitals keep the department as a separate one. To the contrary, approximately 12 per cent of the hospitals have not established a nursing service department at all but surbodinate it to the other department. In this respect, it is required that a new hospital organization be made to acknowledge the independent function of the nursing department. In 76 per cent of the hospitals they have advisory committees under the nursing department, such as a dormitory self·regulating committee, an in-service education committee and a nursing procedure and policy committee. 9. Personnel arrangement and working conditions of nurses 1) The ratio of nurses to patients is as follows: In university hospitals, 1 to 2.9 for hospitalized patients and 1 to 4.0 for out-patients; in religious hospitals, 1 to 2.3 for hospitalized patients and 1 to 5.4 for out-patients. Grouped together this indicates that one nurse covers 2.2 hospitalized patients and 4.3 out-patients on a daily basis. The current medical treatment law stipulates that one nurse should care for 2.5 hospitalized patients or 30.0 out-patients. Therefore the statistics indicate that nursing services are being peformed with an insufficient number of nurses to cover out-patients. The current law concerns the minimum number of nurses and disregards the required number of nurses for operation rooms, recovery rooms, delivery rooms, new-born baby rooms, central supply rooms and emergency rooms. Accordingly, tile medical treatment law has been requested to be amended. 2) The ratio of doctors to nurses: In university hospitals, the ratio is 1 to 1.1; in national of public hospitals, 1 to 0.8; in religious hospitals 1 to 0.5; and in private hospitals 1 to 0.7. The average ratio is 1 to 0.8; generally the ideal ratio is 3 to 1. Since the number of doctors working in hospitals has been recently increasing, the nursing services have consequently teen overloaded, sacrificing the services to the patients. 3) The ratio of nurses to clerical staff is 1 to 0.4. However, the ideal ratio is 5 to 1, that is, 1 to 0.2. This means that clerical personnel far outnumber the nursing staff. 4) The ratio of nurses to nurse's-aides; The average 2.5 to 1 indicates that most of the nursing service are delegated to nurse's-aides owing to the shortage of registered nurses. This is the main cause of the deterioration in the quality of nursing services. It is a real problem in the guest for better nursing services that certain hospitals employ a disproportionate number of nurse's-aides in order to meet financial requirements. 5) As for the working conditions, most of hospitals employ a three-shift day with 8 hours of duty each. However, certain hospitals still use two shifts a day. 6) As for the working environment, most of the hospitals lack welfare and hygienic facilities. 7) The salary basis is the highest in the private university hospitals, with enterprise hospitals next and religious hospitals and national or public ones lowest. 8) Method of employment is made through paper screening, and further that the appointment of nurses is conditional upon the favorable opinion of the nursing directors. 9) The unemployment ratio for one year in 1971 averaged 29 per cent. The reasons for unemployment indicate that the highest is because of marriage up to 40 per cent, and next is because of overseas employment. This high unemployment ratio further causes the deterioration of efficiency in nursing services and supplementary activities. The hospital authorities concerned should take this matter into a jeep consideration in order to reduce unemployment. 10) The importance of in-service education is well recognized and established. 1% has been noted that on the-job nurses. training has been most active, with nursing directors taking charge of the orientation programs of newly employed nurses. However, it is most necessary that a comprehensive study be made of instructors, contents and methods of education with a separate section for in-service education. 10. Nursing services'activities 1) Division of services and job descriptions are urgently required. 81 per rent of the hospitals keep written regulations of services in accordance with nursing service manuals. 19 per cent of the hospitals do not keep written regulations. Most of hospitals delegate to the nursing directors or certain supervisors the power of stipulating service regulations. In 21 per cent of the total hospitals they have policy committees, standardization committees and advisory committees to proceed with the stipulation of regulations. 2) Approximately 81 per cent of the hospitals have service channels in which directors, supervisors, head nurses and staff nurses perform their appropriate services according to the service plans and make up the service reports. In approximately 19 per cent of the hospitals the staff perform their nursing services without utilizing the above channels. 3) In the performance of nursing services, a ward manual is considered the most important one to be utilized in about 32 percent of hospitals. 25 per cent of hospitals indicate they use a kardex; 17 per cent use ward-rounding, and others take advantage of work sheets or coordination with other departments through conferences. 4) In about 78 per cent of hospitals they have records which indicate the status of personnel, and in 22 per cent they have not. 5) It has been advised that morale among nurses may be increased, ensuring more efficient services, by their being able to exchange opinions and views with each other. 6) The satisfactory performance of nursing services rely on the following factors to the degree indicated: approximately 32 per cent to the systematic nursing activities and services; 27 per cent to the head nurses ability for nursing diagnosis; 22 per cent to an effective supervisory system; 16 per cent to the hospital facilities and proper supply, and 3 per cent to effective in·service education. This means that nurses, supervisors, head nurses and directors play the most important roles in the performance of nursing services. 11. About 87 per cent of the hospitals do not have separate budgets for their nursing departments, and only 13 per cent of the hospitals have separate budgets. It is recommended that the planning and execution of the nursing administration be delegated to the pertinent administrators in order to bring about improved proved performances and activities in nursing services.

• 항공우주정책ㆍ법학회지
• /
• 제9권
• /
• pp.85-143
• /
• 1997

The main purpose of the investigation of an accident caused by aircraft is to be prevented the sudden and casual accidents caused by wilful misconduct and fault from pilots, air traffic controllers, hijack, trouble of engine and machinery of aircraft, turbulence during the bad weather, collision between birds and aircraft, near miss flight by aircrafts etc. It is not the purpose of this activity to apportion blame or liability for offender of aircraft accidents. Accidents to aircraft, especially those involving the general public and their property, are a matter of great concern to the aviation community. The system of international regulation exists to improve safety and minimize, as far as possible, the risk of accidents but when they do occur there is a web of systems and procedures to investigate and respond to them. I would like to trace the general line of regulation from an international source in the Chicago Convention of 1944. Article 26 of the Convention lays down the basic principle for the investigation of the aircraft accident. Where there has been an accident to an aircraft of a contracting state which occurs in the territory of another contracting state and which involves death or serious injury or indicates serious technical defect in the aircraft or air navigation facilities, the state in which the accident occurs must institute an inquiry into the circumstances of the accident. That inquiry will be in accordance, in so far as its law permits, with the procedure which may be recommended from time to time by the International Civil Aviation Organization ICAO). There are very general provisions but they state two essential principles: first, in certain circumstances there must be an investigation, and second, who is to be responsible for undertaking that investigation. The latter is an important point to establish otherwise there could be at least two states claiming jurisdiction on the inquiry. The Chicago Convention also provides that the state where the aircraft is registered is to be given the opportunity to appoint observers to be present at the inquiry and the state holding the inquiry must communicate the report and findings in the matter to that other state. It is worth noting that the Chicago Convention (Article 25) also makes provision for assisting aircraft in distress. Each contracting state undertakes to provide such measures of assistance to aircraft in distress in its territory as it may find practicable and to permit (subject to control by its own authorities) the owner of the aircraft or authorities of the state in which the aircraft is registered, to provide such measures of assistance as may be necessitated by circumstances. Significantly, the undertaking can only be given by contracting state but the duty to provide assistance is not limited to aircraft registered in another contracting state, but presumably any aircraft in distress in the territory of the contracting state. Finally, the Convention envisages further regulations (normally to be produced under the auspices of ICAO). In this case the Convention provides that each contracting state, when undertaking a search for missing aircraft, will collaborate in co-ordinated measures which may be recommended from time to time pursuant to the Convention. Since 1944 further international regulations relating to safety and investigation of accidents have been made, both pursuant to Chicago Convention and, in particular, through the vehicle of the ICAO which has, for example, set up an accident and reporting system. By requiring the reporting of certain accidents and incidents it is building up an information service for the benefit of member states. However, Chicago Convention provides that each contracting state undertakes collaborate in securing the highest practicable degree of uniformity in regulations, standards, procedures and organization in relation to aircraft, personnel, airways and auxiliary services in all matters in which such uniformity will facilitate and improve air navigation. To this end, ICAO is to adopt and amend from time to time, as may be necessary, international standards and recommended practices and procedures dealing with, among other things, aircraft in distress and investigation of accidents. Standards and Recommended Practices for Aircraft Accident Injuries were first adopted by the ICAO Council on 11 April 1951 pursuant to Article 37 of the Chicago Convention on International Civil Aviation and were designated as Annex 13 to the Convention. The Standards Recommended Practices were based on Recommendations of the Accident Investigation Division at its first Session in February 1946 which were further developed at the Second Session of the Division in February 1947. The 2nd Edition (1966), 3rd Edition, (1973), 4th Edition (1976), 5th Edition (1979), 6th Edition (1981), 7th Edition (1988), 8th Edition (1992) of the Annex 13 (Aircraft Accident and Incident Investigation) of the Chicago Convention was amended eight times by the ICAO Council since 1966. Annex 13 sets out in detail the international standards and recommended practices to be adopted by contracting states in dealing with a serious accident to an aircraft of a contracting state occurring in the territory of another contracting state, known as the state of occurrence. It provides, principally, that the state in which the aircraft is registered is to be given the opportunity to appoint an accredited representative to be present at the inquiry conducted by the state in which the serious aircraft accident occurs. Article 26 of the Chicago Convention does not indicate what the accredited representative is to do but Annex 13 amplifies his rights and duties. In particular, the accredited representative participates in the inquiry by visiting the scene of the accident, examining the wreckage, questioning witnesses, having full access to all relevant evidence, receiving copies of all pertinent documents and making submissions in respect of the various elements of the inquiry. The main shortcomings of the present system for aircraft accident investigation are that some contracting sates are not applying Annex 13 within its express terms, although they are contracting states. Further, and much more important in practice, there are many countries which apply the letter of Annex 13 in such a way as to sterilise its spirit. This appears to be due to a number of causes often found in combination. Firstly, the requirements of the local law and of the local procedures are interpreted and applied so as preclude a more efficient investigation under Annex 13 in favour of a legalistic and sterile interpretation of its terms. Sometimes this results from a distrust of the motives of persons and bodies wishing to participate or from commercial or related to matters of liability and bodies. These may be political, commercial or related to matters of liability and insurance. Secondly, there is said to be a conscious desire to conduct the investigation in some contracting states in such a way as to absolve from any possibility of blame the authorities or nationals, whether manufacturers, operators or air traffic controllers, of the country in which the inquiry is held. The EEC has also had an input into accidents and investigations. In particular, a directive was issued in December 1980 encouraging the uniformity of standards within the EEC by means of joint co-operation of accident investigation. The sharing of and assisting with technical facilities and information was considered an important means of achieving these goals. It has since been proposed that a European accident investigation committee should be set up by the EEC (Council Directive 80/1266 of 1 December 1980). After I would like to introduce the summary of the legislation examples and system for aircraft accidents investigation of the United States, the United Kingdom, Canada, Germany, The Netherlands, Sweden, Swiss, New Zealand and Japan, and I am going to mention the present system, regulations and aviation act for the aircraft accident investigation in Korea. Furthermore I would like to point out the shortcomings of the present system and regulations and aviation act for the aircraft accident investigation and then I will suggest my personal opinion on the new and dramatic innovation on the system for aircraft accident investigation in Korea. I propose that it is necessary and desirable for us to make a new legislation or to revise the existing aviation act in order to establish the standing and independent Committee of Aircraft Accident Investigation under the Korean Government.