• Korean System Dynamics Review
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• v.12 no.4
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• pp.5-34
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• 2011

The purpose of this paper is to evaluate the policies for reducing private tutoring expenditure in Roh Mu Hyun and Lee Myeong Bak Government using Causal Loop analysis based on the Systems Thinking perspective. The results are as follows. First, high educational achievers receive more private tutoring than lowers and children who have rich parents have better chance to take private tutoring than the others. It reflects the social characteristics which emphasize the academic ability and educational background. Second, two governments implemented educational policies to control the private tutoring expenditure as balancing loops ; strengthening public education, providing after school programs and EBS KSAT teaching and improving the entrance exam of university. Third, they overlooked the unintended feedback loops coming from 1) incongruity between causes and countermeasures of shadow education 2) wrong perception of substitutional relationship between public education and shadow education 3) side effect of the policy increasing the weight of student record 4) problems of diversifying high schools 5) dilemma of easing the burden of testing through admission officer system. The conclusion is that policies of reducing the private education expenses have failed because two governments don't consider unintended Feedback Loops in the process of making education policies. So we have to make policies based on Systems Thinking and reducing private education expenses should not be the purpose of strengthening the public education.

• Quality Improvement in Health Care
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• v.22 no.2
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• pp.43-73
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• 2016

Purpose: The aims of this study were to assess the presence of core patient safety practices in Korean hospitals and assess the differences in reporting and learning systems of patient safety, infrastructure, and safe practices by hospital characteristics. Methods: The authors developed a questionnaire including 39 items of patient safety staffing, health information system, reporting system, and event-specific prevention practices. The survey was conducted online or e-mail with 407 tertiary, general and specialty hospitals. Results: About 90% of hospitals answered the self-reporting system of patient safety related events is established. More than 90% of hospitals applied incidence monitoring or root cause analysis on healthcare-associated infection, in-facility pressure ulcers and falls, but only 60% did on surgery/procedure related events. More than 50% of the hospitals did not adopted present on admission (POA) indicators. One hundred (80.0%) hospitals had a department of patient safety and/or quality and only 52.8% of hospitals had a patient safety officer (PSO). While 82.4% of hospitals used electronic medical records (EMRs), only 53% of these hospitals adopted clinical decision support function. Infrastructure for patient safety except EMRs was well established in training, high-level and large hospitals. Most hospitals implemented prevention practices of adverse drug events, in-facility pressure ulcers and falls (94.4-100.0%). But prevention practices of surgery/procedure related events had relatively low adoption rate (59.2-92.8%). Majority of prevention practices for patient safety events were also implemented with a relatively modest increase in resources allocated. Conclusion: The hospital-based reporting and learning system, EMRs, and core evidence-based prevention practices were implemented well in high-level and large hospitals. But POA indicator and PSO were not adopted in more than half of surveyed hospitals and implementation of prevention practices for specific event had low. To support and monitor progress in hospital's patient safety effort, national-level safety practices set is needed.