• 한국병원경영학회지
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• 제6권3호
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• pp.46-68
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• 2001

The study was to examine the relationships among those variables related to total quality management and to reveal those variables affecting total quality management in Health-Care Organizations. To study the relationship, a questionaire was designed and sent to 220 hospitals of which the number of beds is over 200 beds. Out of 660 questionaire, 263 questionaire were collected. Data analysis were conducted by using t-test, ANOVA, Pearson correlation coefficients and stepwise multiple regression. The result were as follows: 1. TQM was significantly different according to activities of QI, department of QI, age, and position. 2. Leadership was significantly different according to activities of QI, department of QI, age, and position. 3. Significant differences in the level of satisfaction of employee were found according to activities of QI, department of QI, age, position, and duration of employ. 4. Significant differences in the level of participation of employee were found according to activities of QI, department of QI, and position. 5. Education trainning was significantly different according to amount of bed, activities of QI, department of QI, level of education, kind of job, and position. 6. Medical technique was significantly different according to activities of QI, department of QI, and position. 7. Quality of work was significantly different according to activities of QI, department of QI, age, and position. 8. Significant differences in the level of investigation's system in satisfaction of client were found according to activities of QI, department of QI, kind of job, and position. 9. Positive correlations were observed between TQM and those variables related to TQM. 10. TQM was significantly predicted by the level of satisfaction of employee(40.9%), participation of employee(7.0%), investigation's system in satisfaction of client(2.7%), leadership(1.4%), and medical technique(1.1%), respectively.

• 한국콘텐츠학회논문지
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• 제17권10호
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• pp.19-29
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• 2017

본 연구는 공공병원 질 관리 전담자들의 병원 진료부문과 전반적 질 향상 활동의 경험 탐색을 통해 공공병원 질 향상 활동 방안을 수립하고자 수행되었다. 공공병원의 질 관리 전담자 10명을 대상으로 질 향상 활동 경험에 대해 포커스 그룹 면담을 수행하였다. 질 향상 경험 면담을 통해 '진료 부문과 전반적 의료질 향상 활동에 대한 성공과 실패', '현재 질 향상 활동의 활성화 정도', '공공병원 질 향상 활동의 특성' 그리고 '향후 질 향상 활동의 활성화를 위해 필요한 것들'의 범주화를 통해, '공공병원 고유의 특성에 따른 질 향상 활동의 성공', '리더십과 역량강화를 통한 공공병원 질 향상 활동의 활성화', '공공병원의 지역 중점 병원의 역할 재정립'의 주제를 도출하였다. 공공병원 진료 부문의 질 향상 활동은 의사의 참여가 중요하며 이러한 의사참여를 이끌어내기 위해서는 의사의 질 향상 활동의 성공적 경험을 공유하고 질 향상 활동에 필요한 지식을 제공하여 질 향상 전문성과 자율성을 보장하는 지원들이 필요하다. 또한 공공병원의 질 관리 전담자는 국가 의료 질 향상을 위한 핵심위치에서 질 향상 활동의 견인역할을 하고 지역 의료기관간 협력적 소통을 통해 의료 질 향상 활동을 이끌어가야 한다.

• 한국의료질향상학회지
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• 제8권2호
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• pp.172-185
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• 2001

Background : This study was carried out to assess the quality improvement(QI)activities in Korean hospitals. Methods : A mailed questionnaire survey was conducted between September 15 and October 30, 2000. The staffs being charge of QI each of the hospitals with 400 beds or more responded to the questionnaire. Of the 108 hospitals eligible for inclusion in our study, 69 participated, yielding a response rate of 63.9%. Results : Based on these survey, 87.3 percent of the responding hospitals were performing QI projects and 54 percent of the hospitals had a separate department for QI activity. About 62 percent of hospitals performing QI activity (QI hospitals) had a QI manager and 58 percent had a separate budget for QI activities. Among the QI hospitals, 85 percent had cross-functional or cross-departmental teams as the major mechanisms for doing QI projects, 94 percent had one or more educational programs on QI. The level of physician's participation level for QI projects was lower than other staff(CEO, nurses and other administrators). Conclusion : The majority of the hospitals have undertaken activities in QI. For the successful implemented QI, the involvement of and education for employees(including physicians and other health professionals)are needed as well as management strategy and leadership. Understanding of other hospitals experience would be helpful for health care managers to plan and initiate QI activities.

• 한국의료질향상학회지
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• 제5권2호
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• pp.312-323
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• 1998

Background : Evaluation of patient's satisfaction is one of the most important aspects of quality improvement. If the patient highly satisfies with the medical service provided in the hospital, he/she will be likely to visit the same hospital again. Patient's satisfaction of a particular hospital is directly correlated with hospital profits as well as reputation in the community. For this reason, various kinds of survey measuring satisfaction level have been performed and many kind of QI activities for enhancing the profits as well as reputation in the community. For this reason, various kinds of survey measuring satisfaction level have been performed and many kind of QI activities for enhancing the patient's satisfaction. This study is to find the effect of hospital QI activities on the patent's satisfaction level. Methods: After questionnares were developed, survey of measuring satisfaction level was performed in August, 1998. On the basis of survey results, QI activities were carried out to attain the target point of 4.0 and subsequent survey was done in November, 1998. Results: With three main principles of "problem solving approach with kindness". "helping patient to participate in medical procedure with sufficient information", and "putting employees into practice of attitude with human respect", the average level of satisfaction was enhanced from 3.45 to 3.55 level. Also kindness level of employees was increased from 3.71 to 3.82. Level of dissatisfaction about insufficient explanation and unkind attitude was dropped from 69% to 48% and from 82% to 46% respectively. Conclusion: With the result of this study overall satisfaction level was enhanced. In order to keep these advantages a operation of Quality Improvement Task Force Team in each subject will be required.

• 보건행정학회지
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• 제11권4호
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• pp.54-69
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• 2001

This study was conducted to assess factors associated with the degree of performance of qualify improvement(QI) activities. A mailed questionnaire survey was conducted between September 15 and October 30, 2000, with the staffs being charge of QI at each of the hospitals with 400 beds or greater. Of the 108 hospitals eligible for inclusion in our study, 79 participated, yielding a response rate of 73.1%. After excluding 12 hospitals that did not perform any QI activities, 117 responses from 67 hospitals were used for the analysis. Using the Malcolm Baldrige National Quality Award Criteria(MBNQAC), perceived performance of QI was measured in terms of the improvement of the quality of clinical practice, clinical supporting department, administrative procedure of receiving care, customer satisfaction, efficiency and standardization of work process. Factors evaluated for the association were the extent of QI implementation, compliance to 5 QI principles, participation of hospital CEOs, budget allocation, history of QI, and bed size. Path analysis was performed to assess the relationship between QI performance and these factors. Major findings of this study are as follows. Hospitals showing higher degree of QI implementation (path coefficient=0.5967, p<0.001)) and better compliance with the basic principes of QI(0.5736, p<0.05) tended to achieve better performance. Path analysis results showed that interest and participation of hospital CEOs(0.1954, p<0.05) and compliance with the basic principes of QI(0.4028, p<0.0001) indirectly affected the outcomes of QI by influencing the intermediate variable of the level of QI implementation. This study results suggest that having employees have a good orientation of the basic concept and principes of QI through relevant training be the most important requirement to achieve better outcomes from QI activities. In addition, to educate leaders of hospitals the need of active implementation of QI is important to encourage their participation and draw strong support for QI programs.

• 한국간호교육학회지
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• 제5권1호
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• pp.133-141
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• 1999

Recently there are increasing concerns on quality improvement activities related to difficult economic situations, more competitive environment, health professional's emphasis on quality, and customer's needs in health care. The purpose of this study was to identify educational needs in the quality improvement for staff nurses. Study setting was an acute care hospital having more than 1000 bed in Seoul, Korea. The subjects were 40 staff nurses who participated in the first Quality Assurance(QA) inservice education. Data were collected by self-administered questionnaire which consisted of four parts : QA knowledge and attitude(ten items, by five Likert scale), contents of QA education(ten items, by setting the priority), evaluation of the program(structure, time allocation, place, educational method), and general characteristics of respondents (age, duration to work for hospitals etc.) The response rate was 85%(34/40), Most had positive perspective and attitude about QI/QA activities, but 9% had negative impression and knowledge about this activities. Also they'd like to know the plan of hospital-level QI/QA activities, QI/QA current practice, general hospital system, the role of QA specialist and so on. Consequently, for building the quality improvement activities that is customer-focused, coordinated, outcome-oriented, resource-efficient, collaborative in Korea, at first the education about philosophy, theory, and implementation process of QI/QA should be conducted, and then that on QI/QA terminology, quality indicators development, the analysis and presentation of quality-related data and so forth be followed.

• 치위생과학회지
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• 제13권4호
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• pp.359-368
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• 2013

본 연구에서는 치과의료 QI 활동이 활발할 가능성이 있는 21개 대표적인 의료기관을 선정하여 QI 활동의 개괄적인 현황을 조사하고, 동시에 그 기관에 근무하는 치과위생사 전체를 대상으로 치과의료 QI 활동의 시행 실태 및 QI 활동시행 후 개선효과에 대한 만족도를 조사하고 QI 활동의 활성화 요인과 저해요인 등을 알아봄으로써 치과의료 QI 활동의 현황을 파악하고 이에 따른 발전 방안을 제시하고자 하였다. 주요 결과는 다음과 같다. 1. QI 활동 주제별 시행률은 외부고객만족 주제가 59.9%로 가장 높았고 비용절감 59.4%, 의료의 질 향상 58.8%, 위험관리 52.8%, 업무효율성 향상 46.5%의 순으로 나타났다. 2. QI 활동 시행 후 개선 효과에 대한 만족도 점수는 비용절감 3.68점, 의료 질 향상 3.66점, 위험관리 3.65점, 외부고객만족 3.61점, 업무 효율성 향상 3.45점 등의 순으로 나타났다. 3. 의료기관 종류별 비교에서는 일반(종합)병원의 QI 활동 시행률이 유의하게 높았고 만족도 점수에서는 치과대학병원이 여러 항목에서 낮은 만족도 점수를 보였다. 4. 가장 많은 응답자가 지적한 QI 활동을 활성화 하는 요인은 병원종사자들의 적극적인 참여도, 저해하는 요인으로는 QI 활동의 인력과 예산 부족이 있다. 결론적으로 치과의료 QI 활동은 외부고객만족도 등 가시적인 효과가 용이하게 나타나는 주제에 집중되는 반면 복잡하고 가시적인 효과가 빠른 시간 내에 나타나기 어려운 주제에 대한 QI 활동은 소홀한 경향이 있으므로 균형 있는 사업 시행을 도모하고 QI 활동을 활성화하기 위해서 노력하여야 할 것으로 생각된다.

• 한국의료질향상학회지
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• 제8권2호
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• pp.146-159
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• 2001

Background : To propose effective strategies for successful implementation of QI in health care institutions, by identifying facilitating factors and barriers to conducting QI programs. Methods : In order to examine empirical evidence on the success factors or barriers to QI implementation in hospitals, a literature study was performed on the basis of MEDLINE search. Among the identified literature. 13 provided reliable findings and basis comprehensive discussion on this issue and thus were selected for in-depth analysis. A mailed questionnaire survey was conducted for hospital CEOs and QI directors of hospitals with 400 beds or greater to investigate what attributes of their organizations they perceived as success factors or obstacles to QI implementation. Result : The analysis of selected literature and survey results presented that the primary factors considered to be most important as successful implementation of QI were: strong support from hospital CEOs, setting higher priority for QI activities, continuous and persistent efforts in QI activities, and active participation of clinical staffs. The barriers identified in this study were : the lack of orientation and understanding of QI concepts, low level of interest and participation of physician in QI programs, the lack of evaluation and rewarding system for QI activities. Conclusion : By identifying factors that affect facilitation of QI, the study results will be of great use for either institutions being in the early stage of evolving QI or those looking for better strategies to achieve more active and persistent QI implementation in their institutions.

• 한국의료질향상학회지
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• 제5권2호
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• pp.278-294
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• 1998

This study was planned to provide basic data for activating quality improvement by genera hospital with more than 400 beds across the country, of which 65 coordinators answered. Main results of the study are as follows.. 1. Job satisfaction and organizational commitment by individual characteristics were compared. It was revealed that the sense of self-efficacy was related to job satisfaction positively. But job satisfaction and organizational commitment by locus of control showed no significant difference. 2. In terms of the characteristics of QI activities, the active participation of QI coordinators in QI planning process and smooth communication among hospital staffs were showed positive relationship to job satisfaction significantly. 3. Also support system was proposed as most significant variable related to the job satisfaction and the organizational commitment of QI coordinators. Especially support to QI activities by CEO's, seniors, and other hospital staff was a factor to enhance the job satisfaction and organizational commitment of QI coordinators. 4. In the aspect of organizational culture, culture which were tendency to be recognized high autonomy in their work and organizational identity strongly and to operate reasonable compensation system were related to job satisfaction and organizational commitment positively. The more formalized climate, supportive communication, cooperative teamwork and promoting creative/risk take behavior, it showed the higher organizational commitment. 5. For the aspect of QI job characteristics, QI coordinators' job satisfaction was high when QI office was arranged for independent department which was exclusively in charge of QI activities and their role is exclusively in charge of QI. It can be concluded that organizational support in the aspect of relation and finance and efforts of encouraging their motivation and providing on the job training program are need.

• 대한한의학원전학회지
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• 제20권2호
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• pp.147-174
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• 2007

"Theory on the Sufficiency of Yang and the Deficiency of Yin(陽有餘陰不足論)" mainly instituted as follows: The 'Yang Qi(陽氣)' of the heaven(天) has changed to 'Qi(氣)', and the 'Yin Qi(陰氣)' of the earth(地) has changed to 'Xue(血)', 'Qi(氣)' is always sufficient and 'Xue(血)' is always deficient. 'The Always Sufficient Qi(氣常有餘)' means 'the fire always exists(常有火)', and 'the fire(火)' is 'the premier fire(相火)'. 'The premier fire(相火)' is always in men's body and causes 'activities(動)' which is the core characteristic in men's life, and in other side it always has opportunities to be made symptoms by 'the abnormal activities of the premier fire(相火妄動)'. In 'the always deficient Xue(血常不足)' , 'Xue(血)' is the 'Yin Qi(陰氣)' of liver and kidneys[肝腎] which is attached by 'the premier fire(相火)', as it means 'Xue(血)' and 'Jing(精)'. He suggested that 'the premier fire(相火)' is the power of human life, but if 'the premier fire(相火)' is not based on 'Yin Qi(陰氣)', it can not fulfill its function. So he thought that the maintenance and fulfillment of 'Yin Qi(陰氣)' is very important. In conclusion, "Theory on the Sufficiency of Yang and the Deficiency of Yin(陽有餘陰不足論)" explains the basic character of men's life which 'Dong Duo Jing Shao(動多靜少)', so 'the premier fire(相火)' which control 'the activities(動)' is always being and 'Jing Xue(精血)' which control 'Jing(靜)' is always scare.