중소병원의 2015 MERS 위기 대응: G병원의 사례

A Small-and-medium-sized Hospital's Crisis Management during 2015 MERS Outbreak: A Case of G Hospital

  • 손희정 (서울대학교 보건대학원) ;
  • 김광점 (가톨릭대학교 의료경영대학원, 의료경영연구소)
  • Son, Heejung (Graduate School of Public Health, Seoul National University) ;
  • Kim, Kwang-Jum (Graduate School of Healthcare Management and Policy, The Catholic University of Korea, Catholic Institute of Healthcare Management)
  • 투고 : 2017.07.31
  • 심사 : 2017.09.26
  • 발행 : 2017.09.30

초록

Purpose: Crisis is inevitable to every organization and therefore, successful crisis management is critical to the organizations' survival and prosperity. With the understanding, this study aims to draw propositions for successful crisis management of hospitals when facing infectious disease outbreak. For the purpose, a case of a small and medium sized hospital's experience of crisis management during 2015 Middle East Respiratory Syndrome outbreak was analyzed. Methodology/Approach: The detailed internal circumstances and experiences of the hospital during the MERS outbreak were identified by in-depth interview as well as the extensive material review, and analyzed under the view of the theories of accident, error, and crisis in relation of organization management Findings: Overall, nine propositions are drawn by the phase of crisis. In pre-crisis phase, for example, 'the hospital preparedness has positive influence on the effective responding to the crisis'. In detection phase, 'the mindfulness of the hospital organizations' as well as the individuals' has positive influence on detecting the crisis signals'. In crisis phase, for example, 'improvising naturally occurs in crisis by the unknown disease, therefore, a component site supervisor coordinating such improvision is important'. Lastly, in post-crisis phase, 'successful crisis responding experience facilitates the positive hospital culture'. Practical implication: From the experience of a small and medium size hospital, it is suggested that proactive system approach oriented by safety is beneficial for effective crisis management.

키워드

참고문헌

  1. Ministry of Health and Welfare, Korean Institute for Health and Social Affairs. 2015 MERS white paper. Ministry of Health and Welfare; 2016
  2. Park J. MERS inside. Kyunggi-do; 2015.
  3. The Korean Society of Infectious Diseases. White paper on chronicles of MERS. The Korean Society of Infectious Diseases; 2017
  4. The Board of Audit and Inspection of Korea. Audit report: MERS prevention and responding. The Board of Audit and Inspection of Korea; 2016
  5. MERS interview team, Ji S. After the virus. Seoul: Sidaebooks; 2016
  6. Reason J. Human Error. Cambridge university press; 1991
  7. Reason J. The human contribution: unsafe acts, accidents and heroic recoveries. Ashgate Publishing; 2008
  8. Reason J. Managing the risks of organizational accidents. Ashgate Publishing; 1997
  9. Perrow C. Normal accidents: living with high risk technologies. New York: Basic Books; 1984
  10. Weick KE, Sutcliffe K, Obstfeld D. Organizing for high reliability. Res Organ Behav 1999;21:81-123.
  11. Weick KE, Sutcliffe KM. Managing the unexpected: resilient performance in an age of uncertainty. 2nd ed. Jossey-Bass; 2007
  12. Linda TK, Janet MC, Molla SD. To err is human: building a safer health system. Institute of Medicine; 2000
  13. Hines S, Luna K, Lofthus J, Michael M, Dana S. Becoming a high reliability organization: operational advice for hospital leaders. Agency for Healthcare Research and Quality; 2008.
  14. Carroll J, Rudolph J. Design of high reliability organizations in health care. Qual Saf Health Care 2006;15(suppl 1):i4-i9. https://doi.org/10.1136/qshc.2005.015867
  15. Chassin MR, Loeb JM. High-reliability health care: getting there from here. Milbank Q 2013; 91(3):459-490. https://doi.org/10.1111/1468-0009.12023
  16. Christianson MK, Sutcliffe KM, Miller MA, Iwashyna TJ. Becoming a high reliability organization. Crit Care 2011;15(6):314. https://doi.org/10.1186/cc10360
  17. Melnyk BM. Achieving a high-reliability organization through implementation of the ARCC model for systemwide sustainability of evidence-based practice. Nurs Adm Q 2012;36(2):127-135. https://doi.org/10.1097/NAQ.0b013e318249fb6a
  18. Roberts K, Madsen P, Desai V, Van Stralen D. A case of the birth and death of a high reliability healthcare organisation. Qual Saf Health Care 2005;14(3):216-220. https://doi.org/10.1136/qshc.2003.009589
  19. Autrey P, Moss J. High-reliability teams and situation awareness: implementing a hospital emergency incident command system. JONA 2006;36(2):67-72. https://doi.org/10.1097/00005110-200602000-00004