• 제목/요약/키워드: medical quality improvement

검색결과 1,056건 처리시간 0.031초

의료의 질 개선 전문가 양성을 위한 체계 개발 연구 (Research of the Development of Training Program for Quality Improvement Experts)

  • 박성희;황정해;최윤경;이순교
    • 한국의료질향상학회지
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    • 제21권1호
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    • pp.12-31
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    • 2015
  • Objectives : The purpose of this study was to develop the qualification system for training of Quality improvement professionals who work for improving patients' safety and healthcare quality. Methods : Based on the various laws and regulations, and the operational status of other professionals' qualification systems, a basic plan of professional qualification system of QI was drawn. And through meetings with QI experts, the final scheme of the concrete qualification system was developed. Results : For management of professionals's certification or qualification, fairness and reliability are important. To do this, setting the official standard, providing a standardized training program and having appropriate qualification test are required. In order to operate the qualification system strategically, 1) the introduction step, 2) dissemination and expansion step, and 3) fusing step should be considered. As a governing body for QI specialists' qualification, 'QI professionals' qualification Center (tentative)' must have the committee to assure fairness, professionalism, and reliability. In addition, 'QI Experts Certification Department (tentative)" to develop standards for the qualification tests and conduct the tests program,' QI experts Education Department (tentative name)" must be able to operate and maintain the QI training for professional qualifications. QI professional qualification exam must be taken by everyone regardless of age, gender, race, occupation, education, and work experience. The examination should include management, leadership, strategic planning and design, quality management, health care information, patient safety culture. Practical training courses can have three step programs; beginning, intermediate and special level. Conclusion : The QI qualification system need strategic approaches for the experts working for healthcare quality improvement and patient safety. It should include the program of standardized contents and test, and operating protocol of the qualificaton system.

The Malcolm Baldrige Award 수상 의료기관 비교연구: 2007-2016년 (A Comparative Study of The Malcolm Baldrige Award Recipients in Healthcare Institutions: 2007-2016)

  • 이돈희
    • 품질경영학회지
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    • 제46권4호
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    • pp.983-1000
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    • 2018
  • Purpose: The purpose of this study is to provide academic and practical implications based on the analysis results of similarities and differentiation of Malcolm Baldrige National Quality Award (MBNQA) in healthcare institutes from 2007 to 2016. Methods: This study examined the characteristics and similarities, the changes made for the most importantly considered, a degree of improvement of patient satisfaction, and employee retention rate of the MBNQA awarded 8 healthcare institutes announced by NIST during the period of 2007-2016. Results: First, the MBNQA awarded 8 healthcare institutes that maintained and implemented effective plans for a long period of time to improve the quality of care services. Second, these organizations were selected among the top 10% of the institutional evaluations in the medical field in the United States. Third, they have tried to continuously improve patient and potential customer and employee satisfaction. Fourth, it is shown that the quality improvement efforts have made long-term and continuous improvement efforts on average 4-5 years. Lastly, the increased number of patients and the improved organizational performance are twice higher than those of other healthcare institutions. Conclusion: The results of this study suggest that common and differentiation strategies of healthcare institutions should be a good benchmarking model for other competitive healthcare institutions.

타임스케줄을 이용한 임플란트 수술의 지연 개선 (Prevention of delay in implant services using time schedule)

  • 박지연
    • 대한치과의료관리학회지
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    • 제10권1호
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    • pp.1-8
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    • 2022
  • This study introduces research on the quality of medical services, optimization of medical services, dental medical services, implant medical services, and time schedules, as well as the effective process of dental implant medical services, which is expensive and requires a long treatment period. For improvement, it is suggested to evaluate using a time schedule. In this method, a time schedule is prepared in which each step, starting from the patients appointment until the completion of the treatment process, is allotted a certain time. This schedule was finalized in consultation with the employees. When performing all implant operations, the starting time of each item was checked to evaluate the degree of compliance and to understand any reasons for delay in each step. After identifying the causes for delay at each step, suitable steps to rectify the drawbacks were developed, and an optimal plan for patient management was determined. Changes in waiting time and human resource utilization were shown as concrete data, suggesting that such a schedule is meaningful as a decision-making support tool.

항우울제 복용환자에 대한 한의치료와 M&L심리치료 활용 2례보고 (A Case Report of 2 Patients Taking Antidepressants who were Treated by Korean Medical Treatments and M&L Psychotherapy)

  • 황선혜;박아름;송건의;임교민;모민주;박세진
    • 동의신경정신과학회지
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    • 제28권2호
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    • pp.73-81
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    • 2017
  • Objectives: The purpose of this study is to show that patients taking antidepressants significantly respond to Korean medical treatments and M&L psychotherapy. Methods: We treated two patients with Korean medical treatments (acupuncture, moxibustion and Herbal Medicine) and psychotherapy including M&L psychotherapy and Li-Gyeung-Byun-Qi therapy. The patients were diagnosed based on DSM-IV diagnostic criteria for MDD. Beck's Depression Inventory (BDI), Beck's Anxiety Inventory (BAI), State-Trait Anxiety Inventory (STAI), Pittsburgh Sleep Quality Index (PSQI), and Visual Analogue Scale (VAS) were used to evaluate the patients. Results: The following observations were made after treatments: Case 1: the patient showed significant improvement in Beck's Depression Inventory (BDI), Beck's Anxiety Inventory (BAI), and Visual Analogue Scale (VAS). Case 2: the patient showed significant improvement in Beck's Depression Inventory (BDI), State-Trait Anxiety Inventory (STAI), Pittsburgh Sleep Quality Index (PSQI), and Visual Analogue Scale (VAS). Conclusions: These results suggest that Korean medical treatments and M&L psychotherapy might be effective for treating patients suffering from MDD.

Westgard Multi-Rules의 효율적 적용과 조치사항의 개선 (Efficient Application of Westgard Multi-Rules and Quality Control Implementation Improvement)

  • 정흥수;오윤정;배진수;백진영;황보라;신용환
    • 핵의학기술
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    • 제21권1호
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    • pp.60-64
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    • 2017
  • 검사의 질 향상과 국제표준화의 상용화 정도관리물질을 이용한 Westgard multi-rules 적용의 유용성은 이미 알려져 있다. 그러나 핵의학 체외검사의 특성상 정도관리물질과 환자검체의 동시 계측으로 인한 측정횟수의 증가에 따라 Westgard multi-rules법을 적용함에 있어 어려움이 있다. 이에 본 연구는 핵의학 체외검사에서 상용화 정도관리물질을 이용한 Westgard multi-rules 적용의 유용성과 보완, 개선을 통해 내부정도관리의 효율성 향상을 조사하였다. 2013년 01월부터 2016년 06월까지 삼성서울병원 핵의학과 체외검사실 통합의료시스템에 기록된 총 282건의 적용된 계통오차 multi-rules (22s, 101s)과 117건의 조치사항 기록을 분석하였다. 조치사항은 multi-rules 중 계통오차의 규칙이 적용 되었을 때 기록하는 원인분석으로 정도관리물질 오류, 실험과정 오류, 검사키트 로트번호 관리 오류, 기타 등 총 4개의 대분류로 구성하였다. Westgard multi-rules 적용을 통해 조치사항을 분석한 결과 정도관리물질 오류가 62건, 실험과정 오류가 24건, 검사키트 로트번호 관리오류가 18건, 기타 13건으로 분류되었다. 정도관리물질 오류를 방지하고자 개선사항으로 기존에 각 검사자마다 사용하던 방식을 담당자 지정 방식으로 변경하여 모든 검사의 하루 소비량을 분주하여 공동사용을 하였고, 나머지 오류를 방지하고자 검사 전후 모든 과정을 표준화 하여 검사실내 어느 검사자가 시행 하더라도 일원화할 수 있게 하였다. 정도관리물질 오류를 개선한 결과 해동 후 2일 이내 신선한 물질을 사용 가능하였고 같은 물질을 사용하는 검사끼리 비교가 가능해져 물질에 의한 오류인지 명확해짐으로 계통오차 발생원인이 정도관리물질 오류로 기록하는 건수가 줄어들었다. 또한 정도관리물질의 로트번호 변경 시 교체시기가 같아 관리가 용이해졌고, 물질 사용량의 감소로 경제적 효과를 얻을 수 있었다. 그리고 검사표준화 적용 후, 계통오차의 규칙인 22s와 101s의 발생건수가 개선 전 보다 월 평균 2건 이상 줄어드는 결과를 보였다. Multi-rules의 적용을 통한 계통오차의 빠른 확인을 위해 정도관리물질의 체계적인 관리와 목표값과 표준편자의 설정 및 관리가 바탕이 되어야하며, 계통오차 발생 시 검사의 원인분석을 통한 조치사항을 기록하는 것이 중요함을 확인하였다. 본 실험의 결과로 Westgard multi-rules 적용 분석을 통해 발생 오류의 기재와 원인을 효율적으로 분석함으로써 핵의학 검사 내부정도관리의 질적 향상과 정확하고 신속한 결과보고에 기여할 것으로 사료된다.

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병원서비스코디네이터 교육과정이 교육만족과 의료서비스 품질에 미치는 영향 (The Effect of Hospital Service Coordinator Education Curriculum on the Education Satisfaction and the Quality of Medical Service)

  • 최은경;박창식;서종범
    • 보건의료산업학회지
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    • 제2권1호
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    • pp.137-154
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    • 2008
  • The increase of the supply of medical service and the increase of hospitals have intensified the competition of hospitals, and the advancement towards internationalization in the opening of medical industry has triggered the infinite competition of medical profession. In addition, the high expectation of customers and quality improvement in the medical care in accordance with the improvement of overall income, and the change of active role of medical consumers according to the popularization and the improvement of rights awareness reflect the customer needs and choice in the medical service. Customers wanted to receive the kind and pleasant service under the up-to-date medical service. Therefore, as a solution, hospital coordinators were emerged for the purpose of smooth treatment and customer satisfaction by generalizing all service of hospital. Accordingly, this thesis attempted to investigate the effect of hospital coordinator education curriculum on the education satisfaction and the quality of medical service. In order to solve the purpose of this study, I, author reviewed the existing literatures, established hypothesis, and verified hypothesis by using the variety of statistics techniques such as reliability, validity, frequency analysis, and regression analysis. The verification of hypothesis is as followings: First, among education training factors of hospital coordinators, the quality of instructor significantly affects the satisfaction of hospital coordinator education training. Second, among training factors of hospital coordinator, the attitude of trainee significantly affects the training satisfaction of hospital coordinator. Third, among education training factors of hospital coordinator, education course significantly affects the training satisfaction of hospital coordinator education. As the qualities of instructor are better equipped, the satisfaction of education becomes higher. It indicates that the education method of instructors is important as an index to represent the qualities of instructor such as the appropriateness of education method, preparation, passion, visual materials, the adequacy of education procession, and specialized knowledge, and it has important effect on the satisfaction of education. In order to enhance the satisfaction of hospital coordinator education, the creation of education environment, making trainee concentrate on the education, is required by appropriately allocating programs, arousing interest in education, based on the attitude of trainee, discussion, and preliminary programs, preparation, ahead of enforcement of education. Fourth, the satisfaction of hospital coordinator education training significantly affects the reliability among the qualities of medical service. Fifth, satisfaction of hospital coordinator education training significantly affects hospitality I kindness among the qualities of medical service. If the education satisfaction of trainee is high, it is effective in the practical application such as dealing with complaints, the duty performance for the patients, and so on in offering the medical service, related to reliability and furthermore, we can find the positive change in the attitude change of medical professions related to the reliability of hospital coordinator. In addition, in the process of offering medical services such as the kind explanation on the duty, rapid response to the customers inquiry, and tidy uniform, practical effect was verified. Sixth, the education training factor of hospital coordinator significantly affects the reliability among the quality of medical service. Seventh, the education training factors of hospital coordinator significantly affect hospitality/kindness. In the education of hospital coordinator, the methods to attract the interest of trainee by emphasizing reliability should be sought and for gaining the practical effect of hospital coordinator education, the sufficient preparation and investigation on the education curriculum should be prerequisite and under this condition, intensified discussion on the instructor and education course is needed. In the design of education course, more education hours and subjects should be allocated in the part of hospitality in order to improve the practical application of hospitality. Therefore, it is meaningful in a sense that this study newly approached the components of hospital coordinator education and the need to modify the quality components of medical service in accordance with the study subjects was raised. This study also finds its meaning in that it provides basic materials for the study of future hospital coordinator education by suggesting the system development model of hospital coordinator education through preliminary study of education training. In addition, this study is meaningful in the aspect that it suggested the direction of education training by showing how the hospital coordinator education training would applied to the hospital coordinator course of the Continuing Education Center at Pusan and Kyungnam National University to some extent. Since all investigation of this study was approached from the side of hospital coordinator, the thoughts of patients who are beneficiaries of medical service, and care givers cannot be identified. Therefore, the satisfaction of patients and care givers through the experience of medical service, which is the essential prerequisite of medical service, should be importantly considered and investigated. Accordingly, The study of comparing and analyzing the views of both patients and care givers should be carried out in the future.

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인체척도 적용에 의한 중소규모 의원의 물리치료실 계획에 관한 연구 (A Study on Applying the Human Scale for Physical Therapy Room Plan in Mid-sized Medical Clinic)

  • 이성아;김문덕
    • 의료ㆍ복지 건축 : 한국의료복지건축학회 논문집
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    • 제17권3호
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    • pp.35-42
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    • 2011
  • Efficient space plans are built upon relations of both human and physical compositions, and the standard of the interaction is basically the human scale. Especially in medical areas, the character of the users within human scale design environment is quite significant. Unlike large hospitals with great plans and scalability performed by experts, mid-sized clinics tend to have limited space, designed by non-specialists who highlight aesthetics over functionality in floor plans which leads to poor quality in medical service. For this reason, this study will include the application of human scale based therapy rooms within the clinic from a physical standpoint and will further analyze and pinpoint any room for improvement to further enable more efficient ergonomic space planning. In this study, theoretically will contemplate over human scale, mid-sized clinic, therapies, and therapists, while the case study will include status of the recent human scale based mid-sized clinic from a physical viewpoint, classification and analysis amongst human and physical compositions chosen by discretion from either a newly opened or a newly re-modeled clinic within the last 2 years, which has 15 beds or more, minimum 3 physical therapists, with more than 5 different therapy facilities in the metropolitan area in order to measure the human scale of therapy rooms in a mid-sized clinic. As a result, the area where improvement can practically be applied is the physical composition, which does not include human scale like human composition factors as therapists and patients, and hence, I suggest the human scale applied efficient medical space plan become the base of this study and look forward to subsequent improvement in the quality of medical services.

소아 교통사고 환자의 한방치료 만족도 조사 (A Survey Examining Satisfaction with Korean Medical Treatment in Pediatric Patients Recovering from Traffic-Accident Injuries)

  • 심수보;이현희;이혜림
    • 한방재활의학과학회지
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    • 제31권4호
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    • pp.145-156
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    • 2021
  • Objectives This study aims at using information about treatment satisfaction obtained from surveying pediatric traffic-accident patients to guide future improvement in the quality of traditional Korean medical services. Methods The survey included 95 pediatric patients treated for traffic-accident injuries at a traditional Korean medical institution. The questionnaire was developed from a similar satisfaction survey for adult traffic-accident patients and approved by a traditional Korean pediatrician. The year-long survey ran from April 2020 to April 2021. The collected data were analysed using t-tests, one-way analysis of variance, and cross-tabulation. Results Of the pediatric traffic-accident patients surveyed, the highest percentage of children were aged between 1 and 7 years (70.5%). Just over half the patients (55.8%) complained of sleeping difficulties, and 54.7% exhibited symptoms of anxiety and fear. Almost all the patients surveyed (97.9%) reported an improvement in their symptoms after undergoing traditional Korean medical treatment. The degree of satisfaction with the treatment correlated with the alleviation of symptoms. Approximately 83.2% of respondents reported 'difficult-to-administer treatment for children' and rated their satisfaction degree comparatively lower than those patients with no reported treatment difficulties. The most struggling treatment was herbal medicine (42.1%), highlighting the need for improvement in the adaptability of herbal medicine to the treatment of pediatric patients. Conclusions Treatment acceptance by pediatric traffic-accident patients affects reported treatment satisfaction. It is important to improve treatment experience and adaptability to pediatric patients to improve the perceived quality of traditional Korean medical services.

한방임상사용 의료기기의 실태 조사를 통한 개선방향 제시 (Actual Condition Survey and Improvement of Medical Devices in Korea Traditional Medicine)

  • 문진석;김종열;류연희;송낙근;김혁주;이정림;이재원;최선미
    • 한국한의학연구원논문집
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    • 제11권1호
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    • pp.119-125
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    • 2005
  • We conduct a survey of actual condition of medical devices in korea traditional medicine on 157 oriental medicine doctors and 183 manufacturers. The 61% percent of doctors indicate the trouble in use of medical devices which is applied to korea traditional medicine. The manufacturers replied that devices have a problem with diagnosis(53%) and treatment(36%). To overcome these problems, it is necessary to develop devices based on the study of basic oriental medicine and the reliable clinical research. This study contributes the improvement of quality and the revision of rules on medical devices.

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의료서비스 마케팅을 위한 품질지각과 만족에 관한 연구 (A Study on Qulity Perceptions and Satisfaction for Medical Service Marketing)

  • 유동근
    • 간호행정학회지
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    • 제2권1호
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    • pp.97-114
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    • 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.

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