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Development of the Model for Total Quality Management and Cost of Quality using Activity Based Costing in the Hospital (병원의 활동기준원가를 이용한 총체적 질관리 모형 및 질비용 산출 모형 개발)

  • 조우현;전기홍;이해종;박은철;김병조;김보경;이상규
    • Health Policy and Management
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    • v.11 no.2
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    • pp.141-168
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    • 2001
  • Healthcare service organizations can apply the cost of quality(COQ) model as a method to evaluate a service quality improvement project such as Total Quality Management (TQM). COQ model has been used to quantify and evaluate the efficiency and effectiveness of TQM project through estimation between cost and benefit in intervention for a quality Improvement to provide satisfied services for a customer, and to identify a non value added process. For estimating cost of quality, We used activities and activity costs based on Activity Based Costing(ABC) system. These procedures let the researchers know whether the process is value-added by each activity, and identify a process to require improvement in TQM project. Through the series of procedures, health care organizations are service organizations can identify a problem in their quality improvement programs, solve the problem, and improve their quality of care for their costumers with optimized cost. The study subject was a quality improvement program of the department of radiology department in a hospital with n bed sizes in Metropolitan Statistical Area (MSA). The principal source of data for developing the COQ model was total cases of retaking shots for diagnoses during five months period from December of the 1998 to April of the 1999 in the department. First of the procedures, for estimating activity based cost of the department of diagnostic radiology, the researchers analyzed total department health insurance claims to identify activities and activity costs using one year period health insurance claims from September of the 1998 to August of the 1999. COQ model in this study applied Simpson & Multher's COQ(SM's COQ) model, and SM's COQ model divided cost of quality into failure cost with external and internal failure cost, and evaluation/prevention cost. The researchers identified contents for cost of quality, defined activities and activity costs for each content with the SM's COQ model, and finally made the formula for estimating activity costs relating to implementing service quality improvement program. The results from the formula for estimating cost of quality were following: 1. The reasons for retaking shots were largely classified into technique, appliances, patients, quality management, non-appliances, doctors, and unclassified. These classifications by reasons were allocated into each office doing re-taking shots. Therefore, total retaking shots categorized by reasons and offices, the researchers identified internal and external failure costs based on these categories. 2. The researchers have developed cost of quality (COQ) model, identified activities by content for cost of quality, assessed activity driving factors and activity contribution rate, and calculated total cost by each content for cost for quality, except for activity cost. 3. According to estimation of cost of quality for retaking shots in department of diagnostic radiology, the failure cost was ₩35,880, evaluation/preventive cost was ₩72,521, two times as much as failure cost. The proportion between internal failure cost and external failure cost in failure cost is similar. The study cannot identify trends on input cost and quality improving in cost of qualify over the time, because the study employs cross-sectional design. Even with this limitation, results of this study are much meaningful. This study shows possibility to evaluate value on the process of TQM subjects using activities and activity costs by ABC system, and this study can objectively evaluate quality improvement program through quantitative comparing input costs with marginal benefits in quality improvement.

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An Analysis of Epidemiological Investigation Reports Regarding to Pathogenic E. coli Outbreaks in Korea from 2009 to 2010 (최근 2년간(2009-2010) 우리나라 병원성 대장균 식중독 역학조사 보고서 분석)

  • Lee, Jong-Kyung;Park, In-Hee;Yoon, Kisun;Kim, Hyun Jung;Cho, Joon-Il;Lee, Soon-Ho;Hwang, In-Gyun
    • Journal of Food Hygiene and Safety
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    • v.27 no.4
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    • pp.366-374
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    • 2012
  • Recently pathogenic E. coli is one of the main foodborne pathogens resulting in many patients in Korea. To understand the characteristics of pathogenic E. coli outbreaks in Korea, the epidemiological investigation reports of pathogenic E. coli outbreak in 2009 (41 reports) and in 2010 (27 reports) were collected in the web site of the Korea Centers for Disease Control and Prevention, reviewed and analysed in this study. The main places of the pathogenic E. coli outbreaks were food catering service area (64.8%) and restaurants (25.0%). The main type of the pathogens were EPEC (44.7%) and ETEC (34.2%). EAEC and EHEC was responsible for 10.5 and 9.2%, respectively. Eight of 68 outbreak cases were caused by more than 2 types of pathogenic E. coli which implicates the complicated contamination pathways of pathogenic E. coli. The incidence rate of pathogenic E. coli was $33.6{\pm}30.5%$ and the main symptoms were diarrhea, stomach ache, nausea, vomiting, and fever etc. The two identified food sources were identified as frozen hamburger pattie and squid-vegetable mixture. To improve the food source identification by epidemiological investigation, food poisoning notification to the agency should not be delayed, whole food items attributed the outbreak should be collected and detection method of the various pathogenic E. coli in food has to be improved. In conclusion, the characteristics between the EHEC outbreaks in the western countries and the EPEC or ETEC outbreaks in Korea needs to be distinguished to prepare food safety management plan. In addition, the development of the trace back system to find the contamination pathway with the improved detection method in food and systemic and cooperative support by the related agencies are necessary.

Development of Nutrient Solution Suitable for Closed System in Substrate Culture of Cucumber (오이 순환식 고형배지경에 적합한 배양액 개발)

  • 노미영;이용범;김회상;이경복;배종향
    • Journal of Bio-Environment Control
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    • v.6 no.1
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    • pp.1-14
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    • 1997
  • This experiment was conducted to find out the compositions of nutrient solution for closed system in substrate culture of cucumber. Cucumber(Cucumis sativus L. cv. Eunsung baekdadagi) plants were grown in the substrates supplied with the nutrient solutions whose strengths were 1/2, 1, and 3/2 of the original concentration developed by National Horticultural Research Station in Japan. By increasing the nutrient concentrations, plant height decreased but leaf length, leaf width, and leaf number showed little differences. A number of marketable fruit and marketable yield were the highest in the concentration of 1 strength. The nutrient compositions of solution developed for closed system in cucumber substrate culture were N 11.4, P 3.3, K 6.0, Ca 4.5, and Mg 3.5 me.$\ell$$^{-1}$ during the vegetative growth period and N 10.4, P 3.3, K 5.0, Ca 4.5, and Mg 3,5 me.$\ell$$^{-1}$ during the reproductive growth period. To examine the suitability of nutrient solution developed in the above experiment, cucumber plants were grown in the substrates supplied with different solutions and concentrations - Yamasaki's nutrient solution(Yamasaki) of 1 S, nutrient solution of Research Station for Greenhouse Vegetable and Floriculture on the Netherlands(PTG) of 1 S, nutrient solution developed in the above experiment(SCU) of 1/2, 1, and 3/2 S. EC and pH in root zone changed little in the all treatments during growing period. As cucumber plants grew, the concentrations of N, P, and K in root zone decreased but Ca concentration increased. Net $CO_2$ assimilation rate of cucumber leaves was high in SCU of 1 and 3/2 S, and Yamasaki of 1 S. Growth of cucumber plants was the lowest in SCU of 1/2 S.

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The Development of Filter for Environmental Improvement in Land Based Seawater Fish Farm III. Purification Efficiency of Rearing Seawater by Screen Filter and Ultraviolet (필터의 개발을 통한 해수 육상수조식 양식장의 환경개선에 관한 연구 III. 스크린필터 및 자외선 등의 운행에 따른 사육수의 정화효과)

  • KANG Ju-Chan;PARK Soo-Il;KIM Seoung-Gun
    • Korean Journal of Fisheries and Aquatic Sciences
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    • v.32 no.4
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    • pp.501-506
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    • 1999
  • This study was conducted to evaluate the purification efficiency in rearing water of the land based fish farm by screen filter and ultra violet (UV) irradiation. Purification efficiency for rearing seawater has been examined with screen filter of 60 $\mu$m pore size and UV irradiation at dose of 0.5 $mWS/cm^2$ for 5 months. Purification efficiency by changing of temperature, salinity, pH, DO, total bacteria and Vibrio species in rearing seawater by filtering and UV irradiation were not significant during 5 months, However, the removing rate of suspended solid and turbidity of rearing seawater were $43.8\~45.6\%$ (average, $44,7\%$) and $29.2\~33.2\%$ (average, $31,3\%$) by filtering, respectively. Also, Purification efficiency for the $NO_3^{-}-N,\;NO_2^{-}-N,\;NH_4^{+}-N$ and $PO_4^{3-}-P$ were $21.3\~21.9\%$ (average, $21.6\%$), $24.1\~25.2\%$ (average, $24.7\%$), $17.6\~17.8\%$ (average, $17.7\%$) and $19.0\~20.4\%$ (average, $19.7\%$) respectively by the system used on this study.

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Quality of Stored Grape (Vitis labruscana) Treated with Ethylene-Absorbent and Activated Charcoal (에틸렌 흡착제와 활성탄 처리에 의한 저장 포도의 품질 특성)

  • Jang, Keum-Il;Lee, Je-Hong;Kim, Kwang-Yup;Jeong, Heon-Sang;Lee, Hee-Bong
    • Journal of the Korean Society of Food Science and Nutrition
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    • v.35 no.9
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    • pp.1237-1244
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    • 2006
  • In order to ensure a stable supply of grapes for consumers and to extend grape storage, we investigated changes in the quality of grapes (Vitis labruscana) stored after treatment with ethylene absorbent (EA) or activated charcoal (AC). We treated harvested 'Sheridan' and 'Muscat Bailey A' grapes with EA and with 0.1, 0.5, 1.0, and 2.0% (w/w) AC, and stored them at $0{\pm}1^{\circ}C$, $90{\pm}2%$ humidity for 60 days. After the EA or AC treatment, the storability of the 'Sheridan' and 'Muscat Bailey A' grapes was increased, as compared with non treatment, and 'Sheridan' kept better than 'Muscat Bailey A'. The quality of the stored grapes maintained with EA or the amount of AC, which decreased the rate of weight loss, abnormal fruit development, berry abscission, saccharinity, and growth of fungi. The free sugar and anthocyanin contents in the pericarp increased gradually in both 'Sheridan' and 'Muscat Bailey A', and increased more in 'Sheridan'. Conversely, the total acidity of 'Sheridan' and 'Muscat Bailey A' decreased with storage, and decreased less in 'Sheridan'. There were no differences in the free sugar content, anthocyanin content, and total acidity among treatments. The changes in grape quality with storage were delayed in the order of EA, 2% AC, 1% AC, 0.5% AC, and 0.1% AC. Ultimately, we postulate that EA and 2% AC best maintain the qualities of grape, and extend the grape storage period.

Position Effect of Axillary Buds on Shoot Multiplication and Rooting in Bud Culture of Quercus acutissima (상수리나무 기내(器內) Axillary Bud의 치상부위(置床部位)에 따른 다경(多莖) 및 발근유도(發根誘道) 효과(効果))

  • Moon, Heung Kyu;Kim, Jae Hun;Park, Jae In
    • Journal of Korean Society of Forest Science
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    • v.76 no.4
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    • pp.370-375
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    • 1987
  • This study was conducted to examine the position effect of axillary buds on shoot multiplication and rooting with 1-year-old seedlings of Quercus acutissima. Shoot multiplication was greatly affected by axillary bud position: Productivity of multiple shoots were decreased in the order of top, mid and basal explants respectively. The best shoot multiplication (mean 6.1 shoots per explant) was obtained on WPM medium containing $1.0mg/{\ell}$ BAP and $0.1mg/{\ell}$ NAA using basal explant after 4-week-culture. Rooting was also greatly influenced by position. Its percentage was increased in the order of top, mid and basal explant respectively. Root initiation was better and more rapid on 1/2MS medium than GD medium. High rooting percentage (100%) was obtained on 1/2MS medium containing $0.2mg/{\ell}$ IBA after 15 days culture. Sucrose concentrations did not effect on rooting. However root development and shoot growth were greatly affected by them. Root was developed shortly on 1-2% levels and shoot growth was getting retarded, whereas both of them did not show significant difference at 3-6% levels. Rotting was decreased on 7-8% levels gradually, but shoot and leaf condition was better than any other concentrations. Survival rate of rooted explants in pot was varied according to the position of explants. Seedlings of top part were survived up to about 50% but most of mid and basal part seedlings did not survive over 4 weeks even in high humidity condition. Seedlings in pots showed normal growth over 10 months but most of them showed the condition of premature leaf shedding.

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A Study on the Growth Environment and Tissue Culture of Gyrophora esculanta MIYOSHI in Korea (한국산(韓國産) 석이(石耳)의 생육환경(生育環境)과 조직배양(組織培養)에 관(關)한 연구(硏究))

  • Kim, Jai Saing
    • Journal of Korean Society of Forest Science
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    • v.78 no.4
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    • pp.333-344
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    • 1989
  • The objectives of this study were to investigate the growth of Gyrophora esculanta and to establish a method of tissue culture of the plant. The results obtained were as follows : 1. The Gyrophora esculanta was found growing mostly on the rock slopes of 722 m to 1915 min elevation on mountains in Korea. 2. Trees growing in the vicinity of the G. esculanta were mainly Quercus spp., Pinus thunbergii, Acer spp. and Lespedeza spp, Especially Quercus spp. was found growing in all of the study site. 3. The average Length of the rock slopes with G. esculanta growing on was 14 m and their aspects were mostly south. 4. The G. esculanta were found growing on rocks of Crystalline Schist, Quartz, Liparite, Granite, ete. Particularly they were mostly found on granites. The gradient of the rock slopes was in the range of 22-90 degrees. 5. The mean number of individuals of G. esculanta per one rock slope ranged from 14 at Mt. Bukhan to 70 at Mt. Jrri. Their mean diameter ranged from 1.8cm at Mt. Munsu to 4.6cm at Mt, Sokri. 6. The average percentage of G. esculanta with fruit body was 17.6%. The highest value was found at Mt. Cheonhwang (24.0%). 7. When the 100 segments of rhizoid of Gyrophora esculanta cultured in Detmer's medium supplemented with kinetine 5mg/l and 2, 4-D 3mg/l, n callus of microspore origins were induced from about 20% of the segments. As the induced n callus was transplanted on the six different types of rocks, it was observed that the juvenile G. esculanta grew best on granite and the development rate of G. esculanta on the granite was about 55%.

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Earthquake impacts on hydrology: a case study from the Canterbury, New Zealand earthquakes of 2010 and 2011

  • Davie, Tim;Smith, Jeff;Scott, David;Ezzy, Tim;Cox, Simon;Rutter, Helen
    • Proceedings of the Korea Water Resources Association Conference
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    • 2011.05a
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    • pp.8-9
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    • 2011
  • On 4 September 2010 an earthquake of magnitude 7.1 on the Richter scale occurred on the Canterbury Plains in the South Island of New Zealand. The Canterbury Plains are an area of extensive groundwater and spring fed surface water systems. Since the September earthquake there have been several thousand aftershocks (Fig. 1), the largest being a 6.3 magnitude quake which occurred close to the centre of Christchurch on 22February 2011. This second quake caused extensive damage to the city of Christchurch including the deaths of 189 people. Both of these quakes had marked hydrological impacts. Water is a vital natural resource for Canterburywith groundwater being extracted for potable supply and both ground and surface water being used extensively for agricultural and horticultural irrigation.The groundwater is of very high quality so that the city of Christchurch (population approx. 400,000) supplies untreated artesian water to the majority of households and businesses. Both earthquakes caused immediate hydrological effects, the most dramatic of which was the liquefaction of sediments and the release of shallow groundwater containing a fine grey silt-sand material. The liquefaction that occurred fitted within the empirical relationship between distance from epicentre and magnitude of quake described by Montgomery et al. (2003). . It appears that liquefaction resulted in development of discontinuities in confining layers. In some cases these appear to have been maintained by artesian pressure and continuing flow, and the springs are continuing to flow even now. In spring-fed streams there was an increase in flow that lasted for several days and in some cases flows remained high for several months afterwards although this could be linked to a very wet winter prior to the September earthquake. Analysis of the slope of baseflow recession for a spring-fed stream before and after the September earthquake shows no change, indicating no substantial change in the aquifer structure that feeds this stream.A complicating factor for consideration of river flows was that in some places the liquefaction of shallow sediments led to lateral spreading of river banks. The lateral spread lessened the channel cross section so water levels rose although the flow might not have risen accordingly. Groundwater level peaks moved both up and down, depending on the location of wells. Groundwater level changes for the two earthquakes were strongly related to the proximity to the epicentre. The February 2011 earthquake resulted in significantly larger groundwater level changes in eastern Christchurch than occurred in September 2010. In a well of similar distance from both epicentres the two events resulted in a similar sized increase in water level but the slightly slower rate of increase and the markedly slower recession recorded in the February event suggests that the well may have been partially blocked by sediment flowing into the well at depth. The effects of the February earthquake were more localised and in the area to the west of Christchurch it was the earlier earthquake that had greater impact. Many of the recorded responses have been compromised, or complicated, by damage or clogging and further inspections will need to be carried out to allow a more definitive interpretation. Nevertheless, it is reasonable to provisionally conclude that there is no clear evidence of significant change in aquifer pressures or properties. The different response of groundwater to earthquakes across the Canterbury Plains is the subject of a new research project about to start that uses the information to improve groundwater characterisation for the region. Montgomery D.R., Greenberg H.M., Smith D.T. (2003) Stream flow response to the Nisqually earthquake. Earth & Planetary Science Letters 209 19-28.

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Development of a Business Model for Korean Insurance Companies with the Analysis of Fiduciary Relationship Persistency Rate (신뢰관계 유지율 분석을 통한 보험회사의 비즈니스 모델 개발)

  • 최인수;홍복안
    • Journal of the Korea Society of Computer and Information
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    • v.6 no.4
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    • pp.188-205
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    • 2001
  • Insurer's duty of declaration is based on reciprocity of principle of the highest good, and recently it is widely recognized in the British and American insurance circles. The conception of fiduciary relationship is no longer equity or the legal theory which is only confined to the nations with Anglo-American laws. Therefore, recognizing the fiduciary relationship as the essence of insurance contract, which is more closely related to public interest than any other fields. will serve an efficient measure to seek fair and reasonable relationship with contractor, and provide legal foundation which permits contractor to bring an action for damage against violation of insurer's duty of declaration. In the future, only when the fiduciary relationship is approved as the essence of insurance contract, the business performance and quality of insurance industry is expected to increase. Therefore, to keep well this fiduciary relationship, or increase the fiduciary relationship persistency rates seems to be the bottom line in the insurance industry. In this paper, we developed a fiduciary relationship maintenance ratio based on comparison by case, which is represented with usually maintained contract months to paid months, based on each contract of the basis point. In this paper we have developed a new business model seeking the maximum profit with low cost and high efficiency, management policy of putting its priority on its substantiality, as an improvement measure to break away from the vicious circle of high cost and low efficiency, and management policy of putting its priority on its external growth(expansion of market share).

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A Study on the Improvement of Treatment Efficiency for Nitrogen and Phosphorus in Livestock Treatment System Using Constructed Wetlands (인공습지 축산폐수처리시스템에서 질소 및 인 처리효율 향상 방안)

  • Seo, Dong-Cheol;Park, Jong-Hwan;Kim, Ah-Reum;Kim, Sung-Hun;Lee, Seong-Tea;Jeong, Tae-Uk;Choi, Jeong-Ho;Lee, Sang-Won;Kim, Hyun-Ook;Cho, Ju-Sik;Heo, Jong-Soo
    • Korean Journal of Soil Science and Fertilizer
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    • v.44 no.3
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    • pp.434-441
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    • 2011
  • To improve T-N and T-P removal efficiencies, removal efficiencies of pollutants in full-scale livestock wastewater treatment plant by natural purification method with water plant filtration and activated sludge beds were investigated under different re-injection rates and injection methods of livestock wastewater. The removal rates of COD, SS, T-N, and T-P in effluent in full-scale livestock wastewater treatment plant were in the order of 30% < 70% ${\leq}$ 100 % at different re-injection rates. The removal rates of pollutants in effluent in full-scale livestock wastewater treatment plant were higher as re-injection rate of livestock wastewater increased. Removal rates of COD, SS, T-N, and T-P by continuous injection were slightly higher than those by intermittent injection method in full-scale livestock wastewater treatment plant. Removal rates of COD, SS, T-N, and T-P by continuous injection method in full-scale livestock wastewater treatment plant with water plant filtration and activated sludge beds were 99.5, 99.8, 99.0 and 99.8%, respectively.