Development of Nursing Home Quality Management Index & Application in the Field

노인간호요양시설의 QMI 개발과 현장 실태분석

Purpose: Expecting a new system of nursing security for elderly in operation in 2007, a substantial expansion of nursing facilities for elderly and quality management of those facilities are imperative now. Therefore. specific quality management measures or schemes which could be used for the operation of small-scale nursing homes are in urgent need. The purpose of this study was to develop a Quality Management Index(QMI) to guide Nursing Home management. Method: This study developed a QMI for small-scale nursing homes, which focused on quality management in structural dimensions such as environment, staffs, local community network, atmosphere, and quality management in process dimensions such as nursing, communication, resident satisfaction. The QMI developed in this study is based on extensive review of literature and the actual experiences of nursing home operation. It consists of 7 dimensions, 39 components and 148 indexes, which have been verified by three times validity tests of experts group. Then the QMI was used to evaluate the quality management levels of nursing homes in Korea. Result: In sum, after analyzing all nursing homes in Korea operated by nurses, this study found that there were significant differences of quality management level among facilities in several dimensions such as environment, staffs, local community connections, communication. In dimensions such as nursing, atmosphere, resident satisfaction, however, little differences of quality management level among facilities were reported. It is considered that this result has to do with several factors like the size of facilities, operation expenses, operation forms, the disposition of professional human resources, and philosophy and management policy of the owners. As far as generalization is concerned, however, it needs to be noted here that the sample size for this study is not statistically big enough to generalize the results. Conclusion: Having Developed a QMI for small-scale nursing home with 7 dimensions, 39 components and 148 indexes, this study is expected to be used in developing more elaborated quality evaluation tools for nursing homes, and also function as a practical guide of quality management for those who are opening and managing nursing homes. I hope this quality index could lead to further development of a standardized quality management index, and eventually contribute to quality improvement of nursing homes.