• Title/Summary/Keyword: improvement of medical quality

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Implementing Medical Education Continuous Quality Improvement Using Design-Based Research (설계기반 연구를 통한 의학교육 Continuous Quality Improvement 운영 경험)

  • Lee, Aehwa;Park, Hye Jin;Kim, Soon Gu;Kim, Jin Young;Kang, Yu Na;Lee, Se Youp;Baek, Won-Ki
    • Korean Medical Education Review
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    • v.22 no.3
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    • pp.189-197
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    • 2020
  • The goal of this study is to present efficient measures to improve the quality of medical education through using a developed and applied continuous quality improvement (CQI) model suitable for medical education. To achieve this purpose, we developed a theoretical CQI model through a review of the literature according to the design-based research method. Through repetitive productive cyclical processes and professional reviews, we finally deduced an appropriate CQI model for medical education. The most important results of this study are as follows: First, the CQI model for medical education is defined as a quality management system with a cyclical course of planning, implementation, evaluation, and improvement of medical education. Second, the CQI model for medical education is composed of quality management activities of educational design, work, and evaluation. In addition, each activity has the implementation strategies of planning, doing, checking, and improving based on the PDCA model (Plan-Do-Check-Act model). Third, the CQI model for medical school education is composed of committees related to medical education doing improvement activities, as well as planning, implementing and evaluating it with CQI. As a result, we can improve teaching by using the CQI model for medical education. It is more meaningful because this gives us organized and practical measures of quality management and improvement in medical education as well as in the educational process.

The Quality Improvement of Medical Tourism Education Service Applying Kano Model (Kano 모델을 적용한 의료관광교육서비스 품질개선에 관한 연구)

  • Byun, Ha Rim;Park, Jong Woo
    • Journal of Korean Society for Quality Management
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    • v.48 no.2
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    • pp.309-328
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    • 2020
  • Purpose: The purpose of this study is to find a way to improve the quality of medical tourism education services in Korea. Methods: This study used a method of conducting a survey of students who have completed medical tourism education and customer satisfaction coefficient and potential customer satisfaction index were calculated by applying the Kano model. Results: The results of this study are as follows; First, Eight medical tourism education service quality factors were classified as an attractive quality attribute. Second, Thirteen medical tourism education service quality factors were classified as an one-dimensional quality attribute. Third, Online education operation factor was classified as an indifferent quality attribute. Fourth, Instructor quality factor and physical environment quality factor showed relatively high better and high worse coefficients. Finally, According to the PCSI index, it was found that the scope of improvement was the largest when focusing intensively on the quality factors of instructors. Conclusion: This study suggests strategic implications for nurturing excellent professional manpower through quality improvement of education services by identifying the quality factors of major medical tourism education services perceived by students.

Quality Improvement Priorities for Cosmetic Medical Service Using Kano Model and Potential Customer Satisfaction Improvement Index (Kano 모델 및 잠재적 고객만족 개선 지수를 이용한 미용성형의료서비스 품질 개선 우선순위)

  • Park, Youyoung;Jung, Hunsik
    • Journal of Korean Society of Industrial and Systems Engineering
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    • v.42 no.3
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    • pp.176-183
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    • 2019
  • The environmental changes in the Korean cosmetic medical service industry in the $21^{st}$ century are forming intense competition among medical institutions due to the quantitative expansion of its market. For stable growth of the cosmetic medical service industry, continuous quality improvement is necessary based on empirical research on the quality of cosmetic medical services rather than external expansion. The purpose of this study is to classify the quality attributes of cosmetic medical service using Kano model and to derive the degree of satisfaction and dissatisfaction of each quality attributes through Customer Satisfaction Coefficient (CSC). Through this, the study identified strategic priorities and suggested specific step-by-step approaches and quality improvement priorities that can increase customer satisfaction using the Potential Customer Satisfaction Improvement Index (PCSI Index). Based on SERVPERF, this study used measurement tools consisting of five dimensions : tangibles, reliability, responsiveness, assurance, and empathy. In addition, it was used of measurement items reconstructed into positive, negative, and satisfaction questions for Kano model analysis, CSC analysis, and PCSI Index analysis. A total of 300 medical consumers who experienced cosmetic medical services for the past one year in medical institutions such as plastic surgery and dermatology were collected with convenient sampling. As a result, urgent items for improving the quality of service using the PCSI Index, 'Consideration for customer benefits' in empathy category was followed by 'Immediate help' and 'Sincere response' in responsiveness category, and 'Understanding customer needs' in empathy category, respectively. That is, it is required to improve human service quality attributes such as empathy and responsiveness rather than physical service quality attributes. This study contributes practically in that it provides specific and discriminatory approaches to improve customer satisfaction on cosmetic medical service quality and suggests improvement priorities.

Current Trend of Accreditation within Medical Education (의학교육 평가인증의 국제적 동향)

  • Ahn, Ducksun
    • Korean Medical Education Review
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    • v.22 no.1
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    • pp.9-15
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    • 2020
  • Currently, accreditation within medical education is a priority on the agenda for many countries worldwide. The World Federation for Medical Education's (WFME) launch of its first trilogy of standards in 2003 was a seminal event in promoting accreditation within basic medical education (BME) globally. Parallel to that, WFME also actively spearheaded a project to recognize the accrediting agencies within individual countries. The introduction of competency-based medical education (CBME) with the two key concepts of "entrusted professional activity" and milestones has enabled researchers to identify the relationship between patient outcomes and medical education. Recent data driven by CBME has been used for the continuous quality improvement of trainees and training programmes as well. The goal of accreditation has shifted from the single purpose of quality assurance to balancing quality assurance and quality improvement. Even though there are a plethora of types of postgraduate medical education (PGME), it may be possible to accredit resident programmes on a global scale by adopting the concept of CBME. In addition, the alignment of the accreditation for BME and PGME, which center on competency, will be achievable. This argument may extend the possibility of measuring the outcomes of the accreditation itself against patient outcomes as well. Therefore, evidence of the advantages of costly and labor-consuming accreditation processes will be available in the near future and quality improvement will be the driving force of the accreditation process.

Quality Improvements of Breast Specimen Fixation for Histopathology Test (병리검사를 위한 유방검체 고정의 질 향상 활동)

  • Cho, Seong-Il;Choi, Myung-Sup;Bae, Moon-Hwan;Lee, Moon-Jung;Woo, Hee-Suck;Park, Soon-Chae;Cho, Eun-Yoon
    • Korean Journal of Clinical Laboratory Science
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    • v.42 no.3
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    • pp.149-154
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    • 2010
  • To improve accuracy of the immunohistochemical testing and fluorescence in situ hybridization (FISH) study as well as a routine histology diagnosis in breast cancer, quality improvement for optimal tissue handling is mandatory. We evaluate fraction defective of 7107 blocks from 349 breast cancer patients, who underwent surgical treatment at Samsung Medical Center Seoul, Korea from January 1, 2009 to March 31, 2010. We decided pre-improvement period from January, 2009 to June, 2009. In the first quality improvement period (July, 2009 to September, 2009) we made improvements in protocol of gross examination. In the second quality improvement period (October, 2009 to December, 2009) we attempted more effective formalin fixation such as frequent exchange of formalin and use of separate fixation container for each case. In the third quality improvement period (January, 2010 to March, 2010) improvement of tissue processor was performed. We achieved a marked reduction of fraction defective (9-16%) through efforts to improve quality of formalin-fixed, paraffin-embedded blocks when compared to pre-improvement period.

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Application of Quality Statistical Techniques Based on the Review and the Interpretation of Medical Decision Metrics (의학적 의사결정 지표의 고찰 및 해석에 기초한 품질통계기법의 적용)

  • Choi, Sungwoon
    • Journal of the Korea Safety Management & Science
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    • v.15 no.2
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    • pp.243-253
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    • 2013
  • This research paper introduces the application and implementation of medical decision metrics that classifies medical decision-making into four different metrics using statistical diagnostic tools, such as confusion matrix, normal distribution, Bayesian prediction and Receiver Operating Curve(ROC). In this study, the metrics are developed based on cross-section study, cohort study and case-control study done by systematic literature review and reformulated the structure of type I error, type II error, confidence level and power of detection. The study proposed implementation strategies for 10 quality improvement activities via 14 medical decision metrics which consider specificity and sensitivity in terms of ${\alpha}$ and ${\beta}$. Examples of ROC implication are depicted in this paper with a useful guidelines to implement a continuous quality improvement, not only in a variable acceptance sampling in Quality Control(QC) but also in a supplier grading score chart in Supplier Chain Management(SCM) quality. This research paper is the first to apply and implement medical decision-making tools as quality improvement activities. These proposed models will help quality practitioners to enhance the process and product quality level.

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

  • Chae, Yoo Mi;Lee, Sun Hee;Choi, Kui-Son
    • Quality Improvement in Health Care
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    • v.8 no.2
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    • pp.232-243
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    • 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.

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Statistical Process Analysis of Medical Incidents

  • Suzuki, Norio;Kirihara, Sojiro;Ootaki, Atsushi;Kitajima, Masanori;Nakamura, Shinobu
    • International Journal of Quality Innovation
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    • v.2 no.2
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    • pp.127-135
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    • 2001
  • Personnel engaged in the medical field have implemented continual improvement by team activities in an effort to construct a system that reduces the risks involved in medical care. Knowledge in total quality management (TQM), especially statistical quality control (SQC) developed for industry, seems to be applicable to medical care. This paper describes the application of SQC to continual improvement in medical care.

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A Study on the Goal-Orientation of QI Performers in the Medical Centers (의료기관 QI 담당자의 목표추구몰입에 관한 연구)

  • Kim, Mi-Sook;Park, Jae-Sung
    • The Korean Journal of Health Service Management
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    • v.2 no.1
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    • pp.105-124
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    • 2008
  • The purpose of this research is to provide the data base for the activation of Quality Improvement operation through investigating the status of Quality Improvement operation, and finding out factors influencing on the goal-orientation of QI performers in the medical centers of more than one hundred beds where are practicing Quality Improvement operation. In order to reach the purpose, document study was carried out grounded on the proceeding researches and formulated statistical data in relation with the status of Quality Improvement performers, and proof study was carried out through questionnaire survey. The subjects of the survey were the Quality Improvement performers working in seventy three medical centers in Pusan-Gyeongnam, Daegu-Gyeongbuk, and Ulsan. Among eighty three Quality Improvement performers, fifty, five were questionnaire surveyed, on the result of which Reliability Analysis, Factor Analysis, and Multiple Regression Analysis were made, using statistical program. The the results of the proof analysis on this research are as follows. First, in the factors influencing the devoting to goal pursuit of QI performers, organization-goal contribution(0.44) had significant positive effects, while organization conflict(-0.25) had significant negative effects. In other words, the higher the organization-goal contribution was, the higher the devoting to goal pursuit was, while the less the organization conflict was, the higher the devoting to goal pursuit was, which was statistically significant.(p<0.05). Second, in the aspect of goal performance types of QI performers, the process-centered type showed high level of the devoting to goal pursuit, which was statistically significant.(p<0.05). Third, in the aspect of QI performance degree, the higher the devoting to goal pursuit was, the higher the QI performance degree was, which was statistically significant.(p<0.05). In addition, the performers who perceived their workplaces organic structure showed much higher QI performance degree, which statistically significant.(p<0.05). Generalizing the results of this research, it is possible to offer a few suggestions as follows. First, as the competition among the medical centers is more severe recently owing to medical center evaluation system, medical centers are practicing various Quality Improvement operation in all of medical services such as clinical performance and management performance, to reach the purpose of both cost-cutting and medical quality improvement. Thus in order to practice Quality Improvement operation more efficiently in medical centers, it is essential to nuke use of problem-solving methods and statistical members. This as the willingness of chief executives and positive attitude and recognition of organization members. This requires the installation of divisions in charge and disposition of persons in charge, not to speak of persistent training of Quality Improvement. Second, the divisions in charge of QI carry out Quality Improvement operation at the medical center level, and take the role of generalizing and adjusting QI performances of various departments. Owing to this role, the division in charge of QI is considered indispensable organization in the QI operation of medical centers along with medical QI committee, while it contributes to the government's goal of reducing quality level gaps among medical centers. Therefore it is necessary for government and QI organizations to give institutional support and resources for the sake of QI operation of medical centers, besides to supply systematic trainning and informations to the divisions and persons in charge of QI. Third, it is certain that disposition of persons in charge should be determined in view of the scale and the scope of QI operation in medical centers.

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A study on care, infection management and education for quality management of dental care of elderly patients by dental hygienists (치과위생사의 노인환자 치과치료 질 관리를 위한 케어, 감염 관리 및 교육에 관한 연구)

  • Hye-Mi, Lee;Seol-Hee, Kim
    • Journal of Korean Academy of Dental Administration
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    • v.10 no.1
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    • pp.22-32
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    • 2022
  • This study investigated factors affecting care for elderly patients, management of systemic disease, infection management, improvement of medical care quality, and educational requirements, and provide basic data for quality care for elderly patients with systemic diseases. An online survey was conducted among dental hygienists working at dental institutions and data of 172 individuals were analyzed using the SPSS 21.0 program. Descriptive statistics was performed for general characteristics. For factor analysis by general characteristics, t-test and ANOVA were performed. For differences between groups Scheffe verification was performed. A correlation analysis between factors was performed using Pearson's correlation analysis, and a factor analysis affecting the improvement of healthcare quality was performed using multiple linear regression analysis. Care for elderly patients was 52.33/75, management of systemic disease was 12.65/17, and infection management was 96.92/130. Improvement of medical quality (institutional effort) was 22.87/35, and improvement of medical quality (personal effort) was 22.72/35. The most common educational needs were "necessary". Analysis revealed a positive correlation between factors.. Factors affecting improvement of medical quality (personal effort) were age, final academic background, place of work, and the presence or absence of annual medical examinations. The findings of this study indicate that there is a significant correlation between factors. For the qualitative care of elderly patients, education programs related to elderly characteristics, systemic diseases, and infection management should be actively conducted by dental hygienists, and interest and research on geriatric dental hygiene is needed, centering on associations and educational institutions.