• 중환자간호학회지
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• 제5권2호
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• pp.37-48
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• 2012

Purpose: The purpose of the study was to evaluate how advanced practice nurses (APNs) recognized their work by analyzing nursing outcomes. The ultimate goal was to examine the utility of APNs by connecting their work to the outcomes. Methods: Cross-sectional survey was conducted to collect the data from 59 APNs in a tertiary hospital lovated in Seoul, Korea. The questionnaire with 84 outcome indicators for advanced practice nurses was used. Descriptive statistics were used to analyze the data. Results: Among 84 outcome indicators, 11 indicators were associated with the work of APNs. Majority of these findings were included in the categories of clinical results and satisfaction. Items identified to be associated with the work of APNs were different among oncology nursing area, surgical speciality area, emergency care area, and critical care area. Conclusion: The results of the study indicated that the works of APNs were relevant to education/counseling/training and interpersonal relationship with other health professionals. The results of the study could be helpful to delineate the work characteristics of APNs and increase the utility of APNs in Korea where roles of APNs are not yet clearly delineated in most clinical settings.

• 대한간호학회지
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• 제34권3호
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• pp.552-564
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• 2004

Purpose: This study was to develop a client health status outcome evaluation instrument, and examine content validity, reliability, construct validity, and the acceptability of this instrument. Method: A preliminary list was made of such key information as standards, criteria, indicators and measures, by means of a broad review of literature within the field. After determining the preliminary instruments, the study sought to obtain examination, consensus, and modification of two groups of experts in the home-care field. Finally, the instrument examined content validity, reliability, construct validity, and the acceptability of this instrument. Result: The tool was considered of 13 criteria, 48 indicators, and 167 detail measures. The content validity index of the tool was above 0.8 according to the expert group. Regarding the reliability of the evaluators of standards 1 and 2, the degree of agreement between evaluators was high(96.4% through 98.2%). Construct validity in this study, the difference in the mean score between the baseline point and the follow up point of each of standards 1 and 2 was significant, and the mean score of the follow up point was more than that of the baseline point. After examining the acceptability of this instrument with practice managers and home care nurses in home care institutions, a positive opinion was given of this instrument, and it was indicated that to be useful and applicable in home care practice. Conclusion: The results of evaluating client outcome will contribute to overall outcome-based quality improvement and service marketing in home care by providing a constant gauge of home care effectiveness.

• 간호행정학회지
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• 제4권1호
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• pp.107-127
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• 1998

The purpose of this study was to develop an evaluation tool for the quality of nursing care in abdominal surgery patient. The target subjects of the tool were adult patients having abdominal surgery under general anesthesia. Process-outcome framework was selected for the development of the tool in this study. The results were as follows. 1. Nine standards. 40 criteria and 88 indicators were developed. A standard was summary statement of the ideal level of excellencein a dimension of quality of nursing care. which could be evaluated by criteria. Several criteria indicated a specific standard and each criterion could be measured by observable and measurable indicators. 2. The standards were divided into two dimensions. One was process dimension which contained four standards(23 criteria), the other was outcome dimension which contatined five standards(17 criteria). 3. Average CVI was .985 at 9 standards. .947 at 40 criteria. and .987 at 88 indicators. 4. The evaluation tool for the quality of nursing care in abdminal surgery patients was a criterion-referenced tool. And data collection methods of the tool were investigation of patient's record and interview( or questionnaire) with the patients. 5. Interrater reliabilities of the tool were ; r= .7572 (agreement between two raters), and pI=.8487 (intraclass correlation between five raters who rated the 84 patients). 6. Internal consistency reliability ${\alpha}$ was .6194, which was obtained from 32 criteria. Eight criteria were missed in the analyzing process because of data omission. 7. Scores of the process and the outcome dimensions showed significant. but low correlation(r= .3759, p < .001). 8. There were significant differences in total scores between the hospitals and the departments of surgery(F = 15.233. p .0001). There was also significant interaction effect between hospitals and departments to total score(F = 8.396. p = .0001). Construct validity of the toool was verified by the known-group method. these kinds of difference were expected by the nursing experts participated in the study. From these results, more specific patient classification is suggested for the development of evaluation tool of the quallity of nursing care. And indicators to be used for objective measurement for the quality of nursing care must be developed.

• 산업경영시스템학회지
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• 제35권2호
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• pp.1-8
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• 2012

The primary goal of this study is to develop proper performance indicators for evaluating the results of industrial R&D program. We define R&D results include output, transfer, outcome, and impact in the performance of R&D program. Performance indicators are focused on the results of R&D commercialization, building the industrial foundations as performance proxy of R&D program of Ministry of Knowledge Economy. And we first try to design the coupled structure as logical model between R&D program goals and performance indicators. The coupled structure is represented with objectives of group unit of R&D program, implementation process, R&D practical stage, and the ultimate goal of R&D program.

• 농업과학연구
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• 제45권4호
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• pp.879-888
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• 2018

This research was done to develop a standard management checklist for duck farmers. To this end, experts in commercial duck farming participated in making a blueprint for a standard management checklist. This expert group consisted of ten members which included the researcher, a professor, an extension advisor and leading farmers in commercial duck farming. By collecting knowledge on commercial duck farming from these experts, a management performance index was made, and checking factors were designated. As a result of this expert survey, management outcome indicators and subdivision evaluation indicators were established. To confirm these results, a first stage Delphi expert survey was carried out. As a result, the experts were not in agreement with the farming scale of 1 - 4 levels and 2 levels in the management outcome indicators. Additionally, the experts were not in agreement on the choice of feed in the feeding management and the cooperative management system as well as the utilization of agricultural information in managing the business. The factors that did not have the same opinion among experts were surveyed by a second Delphi survey asking whether experts approve the requested value. As a result of the second Delphi survey, all factors have an approval rate that have a value of more than 90%. Finally, a standard management checklist was established based on the research result.

• 한국의료질향상학회지
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• 제7권2호
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• pp.204-216
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• 2000

Background : There has been a concern that the quality of care provided to end-stage renal disease (ESRD) patients in the United States may not be as good as recommended. This paper illustrates a composite measure to assess, the quality of care received by ESRD patients undergoing in-center hemodialysis by incorporating outcomes for 4 major treatment areas. The 4 treatment areas are: dialysis treatments, anemia control, nutritional management, and blood pressure control. Methods : The major data source for the study was the United States Renal Data System (USRDS) Dialysis Morbidity and Mortality Study Wave 1 (DMMS-1) d Sixteen categories of a composite quality indicator were constructed by combining 4 dichotomous variables (16=2*2*2*2). representing the optimal vs. less than optimal level of outcome for each of the 4 treatment outcome measure respectively. Optimal outcome level for each treatment area was defined based on the recommendation from the National Kidney Foundation: (a) delivered dialysis doses (Kt/V) ${\geq}$ 1.2; (b) hematocrit level ${\geq}$ 30%; (c) serum albumin concentration ${\geq}$ 3.8g/dl ; and (d) blood pressure of <140 / <90mmHg. The 16 quality indicator were ranked according to their relative quality weights, which were estimated from its association with the relative risk of survival, adjusting for patient's baseline severity and dialysis facility characteristics. Results : Out of the entire sample of 2,179 patients, only 229 (10%) meet th recommended outcome levels for all 4 treatment areas. Overall, the study patients were distributed evenly over the 16 quality indicators, indicating a great variation in the quality of ESRD care. It appears that the rank of the 16 quality-indicators is driven by serum albumin concentration, suggesting that serum albumin concentration may be the most powerful predictor of ESRD patient survival among the 4 outcome measures. Conclusion : The developed quality indicator has the advantage of describin a range of care for dialysis patients and thus providing a more complete picture of care as compared to previous studies that have focused on only single or few components of the ESRD care.

• 지식경영연구
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• 제10권2호
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• pp.65-84
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• 2009

The purpose of this study is to develop Meta Evaluation Indicators for Defense R&D Programs in Korea. At first, the four components of this meta evaluation model were designed, which are evaluation context, evaluation input, evaluation process and evaluation outcome. And fifty two indicators for this meta evaluation were developed by experts who performed evaluations for Defense R&D Programs. The reliability of components and items was verified by Cronbach's ${\alpha}$ coefficient. It was over 0.6 in all areas. The validity of components and items was verified by Factor Analysis. Analytic Hierarchy Process method was used in assigning the evaluation weight. The survey of twenty two evaluators participated in Defense R&D Programs showed that the Consistency Ratio was under 0.1 in evaluation components and items. In this study, an objective and reasonable set of Defense R&D Meta Evaluation Indicators was developed to increase the responsibility of Defense R&D Programs and improve the quality of evaluation results.

• 한국의료질향상학회지
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• 제25권1호
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• pp.11-28
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• 2019

Purpose: The purpose of this paper is to derive implication on the adoption of PROMs (Patient-Reported Outcome Measures) to improve quality of care in South Korea. With this purpose, the paper examines the status of PROMs in South Korea and other countries including OECD's PaRIS (Patient Reported Indicators Survey) initiative, and reviews policy cases that have adopted PROMs to improve performance of healthcare system. Methods: We conducted literature review on OECD reports on PaRIS, peer-reviewed journals, and information from the websites of relevant institutions such as ICHOM, NQF and OECD. Results: To identify healthcare services of best values and support patient-centered health system, OECD has initiated PaRIS which develops, collects and analyzes patient-reported indicators for cross-countries comparison. PaRIS is implemented on two work streams: 1) collect, validate and standardize PROMs in the areas where patient-reported indicators already exist such as breast cancers, hip and knee replacement, and mental conditions, 2) develop a new international survey on multiple chronic conditions. Countries like England, U.S., Sweden and Netherlands use PROMs for measuring performance of hospitals and performance evaluation at the national level, and provide the financial incentives for reporting PROMs. Conclusions: The use of PROMs can support the current policy agenda that is the patient-centered healthcare system which has been emphasized to reinforce the primary and the community-based care. For the use of PROMs, it is recommended to actively participate in PaRIS initiative by OECD, select appropriate instruments for PROMs, and continue on standardization of them. This will assure patients' involvement in improving health system performance, systemize information generated in the process of adopting PROMs, and develop a system to evaluate performance.

• 의학교육논단
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• 제15권1호
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• pp.9-18
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• 2013

An outcome-based curriculum is perceived to be one alternative educational approach in medical education. Nonetheless, it is difficult for curriculum developers to convert from traditional curriculum to an outcome-based curriculum because research documenting its development process is rare. Therefore, this study aims to introduce the development process and method of outcome-based curriculum. For the purpose of this study, we used diverse data analyses, such as an existing literature search, development model analysis, and case analysis. We identified five phases from the analysis. First, the curriculum developers analyze the physician's job or a high performer in a medical situation. Second, curriculum developers extract outcomes and competencies through developing a curriculum, affinity diagraming, and critical incident interviews. Third, curriculum developers determine the proficiency levels of each outcome and competency evaluation methods. Fourth, curriculum developers conduct curriculum mapping with outcomes and competencies. Fifth, curriculum developers develop an educational system. Also, it is important to develop an assessment system for the curriculum implementation in the process of developing the outcome-based curriculum. An outcome-based curriculum influences all the people concerned with education in a medical school including the professors, students, and administrative staff members. Therefore, curriculum developers should consider not only performance assessment tools for the students but also assessment indicators for checking curriculum implementation and managing curriculum quality.

• 간호행정학회지
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• 제2권2호
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• pp.59-71
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• 1996

Today, quality management is appearing as a critical issue in the field of health care service, partly because of increasing cost of health care. And qualified health care is also accepted as the right of clients, and the responsibility of health professions. So nursing profession can survive and develop only through the quality management of nursing practice like other health professions. Recently, Consumers of nursing service require the effectiveness and the efficiency of nursing practice. Effectiveness and efficiency of nursing practice can be accomplished by outcome evaluation. The focus of outcome evaluation in nurisng practice is on the change which occures in patient's health status with nurisng intervention. Evaluation of outcome is difficult because of some related problems which should be solved, or managed. These problems could be classified as problems of measurement, and attribution. To solve the problems and to evaluate the outcome in nursing practice more accurately, following tasks were suggested. 1) Outcome indicators, and outcome measurement tools should be developed. For these purpose, outcome variables that nursing interventions can contribute primarily should be found out. Also, outcome variables which are driven from nursing theories should be developed. 2) Outcome researches which can explain the effect of nursing care to patient outcomes should be performed. The outcome researches are the methods which can increase the power of nursing profession. 3) Models which can be used for the systematic and scientific quality management in nursing practice should be developed. The models should include outcome variables, and be able to explain the relationship between structure, process, and outcome aspects of quality management. 4) The method which can make patients participate in the evaluation process of quality of nursing practice should be devised. Because outcome evaluation is client-focused evaluation, the perspectives of patients should be emphasized, and reflected in the process of evaluation.