• The Journal of the Convergence on Culture Technology
• /
• v.9 no.5
• /
• pp.367-373
• /
• 2023

This study aimed to examine the effect of self-leadership, organizational commitment, nursing work environment on clinical competency of nurses in small and medium-sized hospitals. The participants were 123 nurses working shifts at three small and medium-sized hospitals in Daejeon city and Chungcheongbuk-do. Data analysis were performed by using descriptive statistics, t-test, ANOVA, Pearson's correlation coefficients, and multiple regression analysis. The results showed that organizational commitment and self-leadership were significant predictors of clinical competency, and the overall model explained 15.4% of the variance. Therefore, it is necessary to develop and implement programs aimed at enhancing organizational commitment and self-leadership of nurses working in small and medium-sized hospitals to improve their clinical competency.

• Journal of Korean Clinical Health Science
• /
• v.2 no.3
• /
• pp.158-166
• /
• 2014

Purpose. This study pursued the way for the effective application of the differentiated charge (Nursing grading system) by the nursing manpower which is performed for the nursing service quality improvement to the in-patients in Korea and the minimum employment problem solution of nurses. Methods. For this matter, the status of the nursing grade for 1,452 hospitals (44 high class general hospitals, 259 general hospitals, 265 hospitals, 59 oriental medicine hospitals and 825 recuperation hospitals) was identified which were registered in the Health Insurance Review and Assessment Service in March 2011 status quo. Results. In the most nursing grade by the kind of medical institutions, 70.5% of the nurses were third-graded in upper general hospitals, 38.1% were sixth graded in general hospitals, 62.7% were seventh-graded in oriental medicine hospitals and 40.4% were first-graded in recuperation hospitals. In the nursing grade by the scale of hospitals (in terms of the number of beds), there was a significant difference in general hospitals, but there was no significant difference between oriental medicine hospitals and recuperation hospitals. In the nursing grade by the location of hospitals and the foundation type of hospitals, there was a significant difference between general hospitals and recuperation hospitals. Conclusion. For the effectiveness of applying differentiated nursing fees by the number of nurses, it seems necessary to consider adjusting the present differentiated inpatient-charge system for the better so that small and medium-sized hospitals may induce more nurses.

• Journal of Korean Academy of Nursing Administration
• /
• v.19 no.4
• /
• pp.470-479
• /
• 2013

Purpose: This study was conducted to investigate and compare the characteristics and relations of nursing practice environment, professionalism and job satisfaction among nurses in general hospitals according to hospital size. Methods: The participants included 314 staff and charge nurses who were working in the general medical/surgical nursing units in one large hospital, three medium sized hospitals, and four small hospitals. Data collected through using self-report questionnaire were analyzed using the SPSS and SAS statistical programs. Results: Nursing practice environment and job satisfaction had significant differences according to hospital size. Both of these scales were highest for medium hospitals and lowest for small hospitals. For all hospital sizes there were positive correlations between each of the variables. Multiple regression analysis showed that both nursing practice environment and job satisfaction were affected by hospital size, but professionalism was not. Conclusion: The results of this study indicate that nursing practice environment and job satisfaction vary with the size of the hospital. Therefore, further study is necessary to identify the work environment variables of nurses for performance management and to implement appropriate policies.

• Journal of Korean Academy of Nursing Administration
• /
• v.20 no.5
• /
• pp.576-586
• /
• 2014

Purpose: The purpose of this study was to investigate the factors influencing nurse turnover intention in small and medium sized hospitals in the metropolitan area. Methods: A cross-sectional survey design was used. A questionnaire was distributed to the nurses in small and medium sized hospitals. The data of 209 nurses was analyzed using t-test, ANOVA, Pearson correlation coefficient and multiple regression. Results: Organizational commitment and age were identified as factors influencing turnover intention. These factors explained 56.8% of variance of turnover intention. Conclusion: Results suggest that establishment of organizational commitment needs to be discussed and continuously developed. Further study is also necessary to identify the key mechanism in nurse turnover intention.

• The Journal of Information Systems
• /
• v.20 no.3
• /
• pp.25-40
• /
• 2011

Small and Medium sized hospitals are exposed to severe managerial environments recently. Around 8.0% of the hospitals are bankrupted every year. The adverse managerial environment does not only come from external factors such as patients' preference for larger hospitals, regulations on the medical charges; more serious problems come from the way the medium and small sized hospitals deal with those exogenous changes including lack of management skills, lack of change management skills, lack of managerial decision support systems, etc. This paper aims to support managers to make decisions regarding the exogenous changes. This paper can be interpreted as an attempt of a merge of the two techniques; BSC and system dynamics. Starting with a BSC system, the development of a system dynamics model can take advantages of the BSC information.

• The Korean Journal of Health Service Management
• /
• v.10 no.4
• /
• pp.13-23
• /
• 2016

Objectives : This research used an exploratory approach to identify factors affecting business strategies due to changes in the healthcare market and customer loyalty factors. Methods : The research model was formulated using antecedents divided into diagnosis quality, employee attitudes, and servicescape. Moreover, differences in the structured model were analyzed according to hospital size. The data were gathered through surveys on clients, who has received care at participating hospitals. From the 200 that were distributed, 150 questionnaires were analyzed, to facilitate analysis of the research model. Results : The effects of diagnosis quality, employee attitudes, and servicescape, on customer loyalty were mediated by trust. We also found the differences between small and large hospitals. Conclusions : Customer loyalty in small hospitals was affected by servicescape, whereas that in large hospitals was affected by diagnosis quality and employee attitudes. The research results could be used to develop strategies to improve customer loyalty.

• Health Policy and Management
• /
• v.26 no.2
• /
• pp.135-147
• /
• 2016

Background: The voluntary diagnosis-related groups (DRG)-based payment system was introduced in 2002 and the government mandated participation in the DRG for all hospitals from July 2013. The main purpose of this study is to examine the independent effect of mandatory participation in DRG on various outcomes of patients. Methods: This study collected 1,809,948 inpatient DRG data from the Health Insurance Review and Assessment database which contains medical information for all patients for the period 2007 to 2014 and examined patient outcomes such as length of stay (LOS), total medical cost, spillover, and readmission rate according to hospital size. Results: LOS of patients decreased after DRGs (large hospitals: adjusted odds ratio [aOR], 0.87; 95% confidence interval [CI], 0.78-0.97; small hospitals: aOR, 0.91; 95% CI, 0.91-0.92). The total medical cost of patients increased after DRGs (large hospitals: aOR, 1.22; 95% CI, 1.14-1.30; small hospitals: aOR, 1.22; 95% CI, 1.21-1.23). The results reveals that spillover of patients increased after DRGs (large hospitals: aOR, 1.27; 95% CI, 0.70-2.33; small hospitals: aOR, 1.18; 95% CI, 1.16-1.20). Finally, we found that readmission rates of patients decreased significantly after DRGs (large hospitals: aOR, 0.28; 95% CI, 0.26-0.29; small hospitals: aOR, 0.59; 95% CI, 0.56-0.63). Conclusion: The DRG payment system compared to fee-for-service payment in South Korea may be an alternative medical price policy which can reduce the LOS. However, government need to monitor inappropriate changes such as spillover increase. Since this study also is the results based on relatively simple surgery, insurer needs to compare or review bundled payment like new DRG for expansion of various inpatient-related diseases including internal medicine.

• Journal of Korean Clinical Nursing Research
• /
• v.28 no.2
• /
• pp.177-184
• /
• 2022

Purpose: The purpose of this study was to identify the relationships between variables and factors affecting the intention on retention of nurses in small and medium-sized hospitals. Methods: The participants of this study were 203 nurses working in six small and medium-sized hospitals, and data was collected from August 15 to August 30, 2019 using a structured questionnaire. The collected data were analyzed by t-test, ANOVA, Pearson's correlation coefficients, and multiple regression using IBM SPSS/WIN 24.0. Results: As a result of the study, intention on retention was positively correlated with resilience (r=.40, p<.05) and followership (r=.38, p<.05). Affecting factors of the intention on retention were marital state (married) (β=.21, p=.001), resilience (β=.22, p=.016), and active engagement as a subcartegory of followership (β=.19, p=.034), and the variables explained 20.8% of the nurses' intention on retention. Conclusion: In order to increase the intention on retention of small and medium-sized hospitals nurses, it is necessary to provide an environment in which small and medium-sized hospital nurses are able to have active engagement and independent thinking and to develop a program to promote their resilience.

• Journal of Home Health Care Nursing
• /
• v.27 no.1
• /
• pp.29-41
• /
• 2020

Purpose: This study aimed to investigate the influence of post-traumatic stress on professional quality of life as mediated by cognitive emotion regulation among nurses working in small and medium hospitals who have experienced violence and to develop and test a structural equation model of that professional quality of life. Methods: Participants were 215 nurses who had experienced violence working in medium and small hospitals. They were surveyed using a structured questionnaire. Results: The final model was shown to have good fit with χ² (2.83), GFI (.90), TLI (.90), and CIF (.90). Therefore, the model was selected as the final model, supporting 7 of the 11 hypotheses. Post-traumatic stress, adaptive emotional regulation, and maladaptive emotional regulation had significant impacts on empathy satisfaction (professional quality of life subscale) and empathy fatigue (subscale of professional life quality) among nurses who had experienced violence, and the explanatory power of these variables was 28.7% and 38.6%, respectively. Conclusion: In the development of nursing intervention programs to improve the professional quality of life of nurses who have experienced violence, factors such as post-traumatic stress and cognitive emotion regulation (adaptive and maladaptive) should be considered as they were identified in this study as influencing the professional quality of life of such nurses in medium and small hospitals.

• Journal of Korean Critical Care Nursing
• /
• v.12 no.2
• /
• pp.85-96
• /
• 2019

Purpose : The purpose of this study was to examine the mediating effect of perceptions regarding the importance of patient safety management in the relationship between incident reporting attitudes and patient safety care activities for nurses in small-and medium-sized general hospitals. The objective was to provide a basis for planning tailored training programs aimed at improving patient safety care activities. Methods : This study was conducted with 187 participants in small- and medium-sized general hospitals in K city in South Korea from March 15 to March 31, 2019. The data collected from participants were analyzed using descriptive statistics, a t-test, ANOVA, Pearson's correlation coefficients, and a multiple regression using IBM SPSS/WIN 21.0 software. Results : Patient safety care activities were found to be correlated with incident reporting attitudes (r=.27, p < .001) and perceptions of the importance of patient safety management (r=.59, p < .001). Further, perceptions of the importance of patient safety management had a complete mediating effect (${\beta}=.409$, p < .001) on the relationship between incident reporting attitudes and patient safety care activities. Conclusion : Based on the findings of this study, tailored training programs regarding patient safety care activities focused on boosting perceptions of the importance of patient safety management are highly recommended to improve nurses' patient safety care activities in small- and medium-sized general hospitals.