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The effect of mental hospital inpatient's perceived service quality on satisfaction and customer loyalty (정신병원 입원 환자가 인지하는 의료서비스 품질이 만족도와 충성도에 미치는 영향)

  • Jeong, Jin-Hong;Kwon, Ho-Jang;Lee, Sang-Gyu
    • Korea Journal of Hospital Management
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    • v.17 no.1
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    • pp.23-42
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    • 2012
  • The purpose of this study is to identify the inpatient service quality at mental hospitals and to examine the effect of service quality on patient's overall satisfaction and customer loyalty. Data collection was done through conducting a survey of inpatients in three mental hospitals located in Chungnam, Korea using self administered questionnaire. The questionnaire included the modified version of 'service satisfaction scale for psychiatric patients' invented by Chul Kwon Kim and other members, which consists of five dimension of service quality: staff attitude, treatment quality, ward environment, access/cost and ward rule. Total 236 questionnaires were gathered and 219 were used for analysis. The data was analyzed by using version SAS9.2 and path analysis model was applied to test our hypothesis. As a result, the four factors of service (staff attitude, treatment quality, ward environment and ward rule) were extracted, which counted for 62.89% of the common variance. Moreover, Cronbach Alpha showed relatively high internal consistency of answer, all exceeding 0.6. According to the study, ward environment and treatment quality turned out to have direct influence on the patient's satisfaction. In addition, staff attitude and overall satisfaction directly influenced the customer loyalty while ward environment and ward rule indirectly had influence using overall satisfaction as a medium. In conclusion, in order to enhance the satisfaction and customer loyalty in mental hospitals, efforts in improving environmental service quality in particular is highly demanded.

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A Study of Staffing Estimation for Nursing Manpower Demand in Hospital (병원간호인력의 수요추정에 관한 연구 -환자분류체계에 의한 간호인력 수요추계의 방법을 중심으로-)

  • 김유겸
    • Journal of Korean Academy of Nursing
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    • v.16 no.3
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    • pp.108-122
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    • 1986
  • Changing concepts of health care, are stimulating the demand for health care, thereby orienting society to health care rights to such an extent that they are deemed as fundamental ones inalienable to man. Concomitantly, qualitative as well as quantative improvement is being sought in the nursing service field. Today, efforts are being made in various areas, especially to qualitatively improve nursing services. A second issue concerns proper staffing. It is important to study staffing, in as much as it continues to be the most persistent and critical problem facing hospital nursing administrators today. It involves quantity, quality, and utilization of nursing personnel. A great deal of attention has been focused on this problem since mid 1930's when nursing services began to be felt as an important segment of hospital operation representing the largest single item of hospital budgets. Traditionally, the determination and allocation of nursing personnel resources has relied heavily on gloval approaches which make use of fixed staff-to-patient ratios. It has long been recognized that these ratios are insensitive to variations between institutions and among individual patients. Therefore, the aim of this thesis is to point to the urgent need for the development of methodology and criteria suited to the reality of Korea. The present research selected one place, the W Christian Hospital, and was conducted over a period 10 days from January, and nurses who were them on duty in their unit. The total num-her of patients surveyed was 1,426 and that of 354. The research represents many variables affecting the direct patient care time using the result from the direct observation method, then using a calculation method to estimate the relationship between the patients care time and selected variables in the hospital setting. The amount of direct patient care time varies with many factors, such 89 the patients age. diagnosis and time in hospital. Differences are also found from hospital, clinic to clinic, ward to ward, and even shift to shift. In this research, the calculation method of estimating the required member of nursing staff is obtained by dividing the time of productive patient care activity(with the time of patient care observed), by the sum of the productive time that each the staff can supply, i.e., 360 minutes, which is obtained by deducting the time for personal activities. The results indicate a substantial difference between the time of productive patient care observed directing and the time of the productive patient care estimated using calculating method. If we know accurately the time of the direct patient care on a shift, there required number of staff members calculated if the proper method can be determinded should be able the time of the direct patient care be estimated by the patient classification system, but this research has shown this system to be in accurate in Korea. There are differences in the recommended time of productive patient care and the required number of nursing staff depending upon which method is used. The calculated result is not very accurate, so more research is needed on the patient classification system.

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Development of Performance Measurement Indicators in S Hospital (S병원 성과평가지표 개발에 관한 연구)

  • Lee, Hee-Won;Yu, Seung-Hum;Lee, Hae-Jong;Park, Chang-Il
    • Korea Journal of Hospital Management
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    • v.5 no.1
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    • pp.1-23
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    • 2000
  • This study was undertaken to develop performance measurement indicators in S Hospital, which is the largest component of Y Medical Center which implemented the Responsible Management System in 1993. To begin, strategic initiatives for S Hospital were reestablished based on Y Medical Center's goals and objectives. The BSC(Balanced Scorecard) was used to develop performance measurement indicators after validity checks by specialists. The results were that total 16 indicators were developed to measure performance for strategic initiatives. Those included the growth rate of patient revenues, operating profit to gross revenues, reduction rate in administrative expenses from a financial perspective; average medical expenses per adjusted patient, patient satisfaction survey for inpatients and outpatients and emergency room patients, return rate for treatment results from the customer's perspective; reduction rate in average length of hospital stay, expenses for lost cases of medical disputes, rate for contracted employees, the number of published reports per faculty member from an internal perspective; educational expenses for training medical staff and full time employees, adjusted patient per medical staff, and the number of cases implemented which were proposed by employees. Any organization needs to have its own explicit objectives to grow and develop and it is absolutely necessary to measure performance to accomplish them. The performance measurement indicators developed by this study are expected to be used as a tool to attain the objectives of S Hospital.

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Changes in Public Hospital Employees' Perceptions Following the Introduction of the New Diagnosis-Related Groups (DRG)-Based Payment System in the Republic of Korea (공공병원 직원들의 신포괄수가제 참여 전후 인식변화)

  • Kim, Hyun Joo;Lee, Jin Yong
    • Quality Improvement in Health Care
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    • v.27 no.2
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    • pp.30-44
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    • 2021
  • Purpose: The aim of this study was to investigate the changes in perception of the New Diagnosis-Related Group (DRG)-based payment system, make overall evaluation after participation, and examine opinions on further policy improvement among employees of a public hospital participating in the pilot project in Korea. Methods: We investigated changes in perception of the New DRG-based payment system before and after participation in the pilot project using a qualitative research method. We conducted individual in-depth interviews with the management and healthcare professionals and Focus Group Interviews (FGIs) with the staff in the nursing and administrative departments. Results: Before implementing the pilot project of the New DRG-based payment system, the management was in favor of participating in the pilot project, whereas the healthcare professionals were strongly opposed to participation in the pilot project, and the staff in the nursing and administrative departments were slightly opposed to participation. After implementing the pilot project, there were remarkable changes in the perception of the New DRG-based payment system among healthcare professionals and the administrative staff. Healthcare professionals' perception was altered in a positive way, while the administrative staff's perception of the system became negative. Conclusion: There were no restrictions on clinical practice or deterioration of quality of care observed in association with the participation in the New DRG-based payment system. However, certain unintended consequences of the New DRG-based payment system may arise as well. Therefore, the government needs to examine the problems identified in this study to reflect on and improve the New DRG-based payment system for stable expansion.

Factors that Impact on Safety Activities of Personnels in Oriental Medicine Hospital of University (대학부속 한방병원 교직원의 안전활동에 영향을 미치는 요인)

  • Lee, Jung-Woo
    • Korea Journal of Hospital Management
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    • v.22 no.3
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    • pp.61-73
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    • 2017
  • Purposes : The purpose of this study is to identify factors that have effects on safety activities of hospital personnels by investigating causality between patient safety culture, job stress, safety system and safety activities of faculty and staff member who are working for oriental medicine hospital of university. Methodology : The subjects were 246 employees working in 4 oriental medicine hospitals of university in Daejeon and Chungcheongnam-do. The data were collected from January 16 to January 25, 2017 using a structured questionnaire. For data analysis, descriptive statistics, Pearson correlation coefficient, t-test, ANOVA and Duncan test with SPSS 22.0 were used. Findings : The activity score for patient safety of faculty and staff member, who were experienced at job training program after joining a company and regular training course for qualification or license, was meaningfully higher than that of group who had no job training experience. The result indicated that the higher there is level of safety culture and safety system and the lower there is work stress, the more the activity has positive effect on patient safety. The level score of awareness for safety culture of faculty and staff member in C hospital, which is facing financial crisis in business circumstances recently, showed average value of 3.29. It was significantly lower than that of the other three hospital. Also, The activity score for patient safety was markedly lower than that of the other three hospital. This result become interested in the process of linking non-financial performance and financial performance. The level score of safety activity in A hospital which obtained healthcare accreditation was remarkably higher than that of the other three hospital which didn't certify healthcare accreditation. Pratical Implications : Subjects about Q.I or patient's experience management must be included in curriculum of Oriental medicine. It is necessary to get the effect of job training program for faculty and staff member through the process of preparation for obtaining healthcare accreditation. When the hospital director is appointed, it must be considered that he/she has the ability to attach importance to analysis and management of the factors creating safety accident, and has business mindset for healthcare delivery of customer- centricity. This research showed that financial performance of hospital, which of business environment is favorable; located in metropolitan city and having large scale of hospital and quality of residence rating but low-level of safety culture and safety activity, was lower than that of general hospital situated in small and medium-sized cities. More research needs to be done for answering this result.

The Development fo Occupational Stress Measurement Tool for Psychiatric Nurses (정신과 간호사의 업무 스트레스 측정을 위한 도구 개발 연구)

  • Bai, Jeong-Yee
    • The Korean Nurse
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    • v.28 no.1
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    • pp.77-88
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    • 1989
  • The purpose of this study is to propose the baseline data for -developing the occupational stress measurement tool for Psychiatric nurses Working in the hospital. 135 staff nurses in psychiatric unit of 11. hospital were participated during the period from August 1 to August 20, 1988. Though the pretest and literature review a questionnaire was coristructed with 88 stressors which were experienced by the psychiatric nurses in the hospital. Subjects were given instruction to rate 1~6 likert type scale according to the level of stress experienced by each stressor described. Reliability of the tool was tested by Cronbach's Alpha and the reasult was ${\alpha}=0.94871$. Factor analysis was applied to organize 88 items together: As the result, 14 factors were obtained. The factors were; 1) Administration problem 2) Work overload 3) Role conflict as a profession 4) Lack of professional knowledge and skill 5) Conflict with nurses 6) Conflict with other health teams 7) Conflict in nurse-clint relationship 8) Conflict with supervisor 9) Conflict with suborinate 10) Low reward 11) Scheduling probrem 12) Inappropriate physical environment 13) Staff inadequate 14) Inadequate of equipment.

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A Study on Clinical Competence and Education Needs of Hospital Nurses (일 대학병원 간호사의 실무능력과 실무교육 요구도)

  • Han, Su-Jeong
    • Journal of Korean Academy of Nursing Administration
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    • v.13 no.3
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    • pp.302-310
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    • 2007
  • Purpose: This study was designed to identify clinical competence and education needs of hospital nurses. Method: A questionnaire was used for data collection which was done form July 1 to July 30, 2005. The respondents were 165 staff nurses in a university hospital. The study instrument were clinical education need scale and Lee(2002)'s clinical competence scale. The data were analyzed using percentages, means, t-test, ANOVA with SPSS-WIN 10.0 program. Result: The results of this study are summarized as follows: The total mean score for clinical competence was 2.57 and education need was 3.30 on a 4 point scale. There was a significant difference in clinical competence according to individual factors of age, marital status, preceptorship experience, present ward, job satisfaction, and total clinical experience. also there was a significant difference in education needs according to preceptorship experience and present ward. Conclusions: Conducting a education needs and clinical competence assessment can provide valuable information that will plan education program and improve staff competence.

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A Simulation Analysis for the Shortening of the Patients' Stay Time in the Emergency Department (응급실 체류시간 단축을 위한 시뮬레이션 분석)

  • Lee, Jung-Man;Kim, Mi-Yi;Kim, Dong-Hyun;Lee, Jong-Il;Kim, Ki-Man;Lee, Young-Hoon;Kim, Seung-Ho;Park, Yu-Suk
    • Journal of Korean Society of Industrial and Systems Engineering
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    • v.32 no.4
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    • pp.17-24
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    • 2009
  • The purpose of this research is to find the reasons of overcrowding in the emergency department of an hospital, then to shorten the total stay time of patients. The fact that main causes of the overcrowding exist in the process of the emergency department was discovered by analysis of the data. In order to improve these process, simulation model was developed by ARENA 7.0. Staff's service time, staff's organization, process ratio, and patient's waiting time were estimated in the simulation model in consideration of the decision of the patient's course of action. Several scenarios such as the simplification of the process, the setup of dedicated pathology lab, and mixed method were suggested and evaluated. Total stay time of the patients would be reduced up to 28.45%.

A Study on Cognition of Oriental Medical Hospital Employees on the Oriental Medical Institution Assessment (한방의료기관평가에 대한 한방의료기관 근무자의 인지도)

  • Jeon, Hyun-Sook;Jung, Sang-Hyuk;Yu, Seung-Hum;Jung, Woo-Sang
    • The Journal of Korean Medicine
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    • v.29 no.4
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    • pp.114-122
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    • 2008
  • Objectives: To determine the factors affecting the assessment of Oriental medical institutions under the Oriental Medical Institution Assessment System and thereupon, provide for some basic data and alternative measures for assessment of Oriental medical institutions. Methods: The researcher sampled 320 people employed by 26 Oriental medical institutions designated as model Oriental medical institutions subject to assessment in 2008 and 2009 and thereupon, used a structured and open-ended survey table for them to collect the data. The size of the final sample was n=302. Results: The Oriental medical institution staff were highly aware of the Oriental medical institution assessment (OMIA), After adjusting the other factors by multiple regression, the factors affecting such recognition were different significantly depending on age (those in their 30's), types of job (nurses and treatment assistants) and locations of hospital (GyeongSang-do). The staff expected the OMIA could helpful for improving facilities and system of hospitals, thus promoting satisfaction of patients. To do so, they felt it necessary to develop an assessment scale reflecting the special conditions besetting the Oriental medical institutions as well as the indices for improvement of Oriental medical service quality. Conclusion: It is hoped that this study will be followed up by future studies which will comparatively analyze Oriental medical institution staff's perception of the assessment system before and after its operation and thereby, suggest some ideal policy alternatives for assessment of the Oriental medical institutions. Furthermore, future studies are requested to research into Oriental medical institution staff's needs and consumers' needs as well in consideration of the characteristics of the Oriental medical institutions and thereupon, suggest some alternatives for continued education, development of the assessment tools, methods and policies.

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Consumer expectation and consumer satisfaction before and after health care service (의료이용 전.후 기대와 만족수준 비교)

  • Park, Jang-Soon;Yu, Seung-Hum;Sohn, Tae-Yong;Park, Eun-Cheol
    • Korea Journal of Hospital Management
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    • v.8 no.1
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    • pp.112-134
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    • 2003
  • The purpose of this study is to analyze the consumer's expectation before the health care service and the consumer's satisfaction after it. The participants of the study are inpatients in a general hospital located in Seoul. The resources were collected from the self-administration questionnaire survey run parallel with face to face interview. In order to measure the degree of the consumer's expectation, 349 samples were collected from the first questionnaire survey on the date of admission to the hospital. The second questionnaire survey was carried out on the date of discharge to the hospital with the participants responding to the first questionnaire survey. There are 154 samples collected from this survey. The results from the analysis of these resources are as follow. First, the survey shows that one of the highest consumers' expectations was about the generosity, kindliness and sincerity from the staff at the hospital, specially from doctors. Second, according to the analysis of the factors affecting the expectations of the consumers, with regard to path of admission to a hospital relating to patient's features, outpatient who gets into a hospital expected good medical care much more than the other patients. In regard of doctor's features, patients usually and highly expect good medical care from doctors who have good carrier and much experience. Third, according to the second questionnaire survey, what patients are satisfied most with is about the generosity and sincerity from staff at a hospital, especially from doctors and their gem attitudes. The results from survey show that the differences among the degree of consumers' satisfaction are very variable, depending on surrounding environments and facilities. The only fact that expectation didn't meet with satisfaction appeared to the case about technology and skill of medical care and the case about updated medical skills and equipments. Fourth, comparing the degree of expectation with the degree of satisfaction of consumers, correlative analysis was concerned significantly and specifically about the part of overall cleanliness relating to facilities and surrounding environments, the items about medical examination and test plan procedure relating to skill of medical care, professional specialties and convenience for procedure, and the items about satisfying explanations and concern about patients from doctors relating to staff's generosity and sincerity. Fifth, the analysis of the factors affecting the degree of how much patients are satisfied with shows that relating to sociodemographical features, patients are not satisfied with the case when the time and process of medical treatment are getting longer. It is surveyed that consumer were satisfied with the motivation to visit a hospital and the insurance type in patient's feature and so were the medical department and the factor of the degree of the expectation in disease's feature. Sixth, according to analysis based on the survey, patients would join again a hospital when they get satisfaction from the medical care and also they want to come again regarding to doctor's capability. For example, when doctors are old, have a good carrier and much experience, patients would come again. As seen from the above, consumers are usually satisfied with the medical treatment more than that they expected before. They would intend to use again when they get satisfaction from the medical care provided at a hospital. Patients and consumers highly expect good attitude as well as capacity from medical doctors and they are also generally satisfied with those things. Therefore, in order to increase the degree of consumer's satisfaction and their intention to come again, the hospital staff would have to commit themselves to achieve high quality service continuously and would have to make an effort to offer the finest quality service.

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