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A Study for Improvement of Nursing Service Administration (병원 간호행정 개선을 위한 연구)

  • 박정호
    • Journal of Korean Academy of Nursing
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    • v.3 no.1
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    • pp.13-40
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    • 1972
  • Much has teed changed in the field of hospital administration in the It wake of the rapid development of sciences, techniques ana systematic hospital management. However, we still have a long way to go in organization, in the quality of hospital employees and hospital equipment and facilities, and in financial support in order to achieve proper hospital management. The above factors greatly effect the ability of hospitals to fulfill their obligation in patient care and nursing services. The purpose of this study is to determine the optimal methods of standardization and quality nursing so as to improve present nursing services through investigations and analyses of various problems concerning nursing administration. This study has been undertaken during the six month period from October 1971 to March 1972. The 41 comprehensive hospitals have been selected iron amongst the 139 in the whole country. These have been categorized according-to the specific purposes of their establishment, such as 7 university hospitals, 18 national or public hospitals, 12 religious hospitals and 4 enterprise ones. The following conclusions have been acquired thus far from information obtained through interviews with nursing directors who are in charge of the nursing administration in each hospital, and further investigations concerning the purposes of establishment, the organization, personnel arrangements, working conditions, practices of service, and budgets of the nursing service department. 1. The nursing administration along with its activities in this country has been uncritical1y adopted from that of the developed countries. It is necessary for us to re-establish a new medical and nursing system which is adequate for our social environments through continuous study and research. 2. The survey shows that the 7 university hospitals were chiefly concerned with education, medical care and research; the 18 national or public hospitals with medical care, public health and charity work; the 2 religious hospitals with medical care, charity and missionary works; and the 4 enterprise hospitals with public health, medical care and charity works. In general, the main purposes of the hospitals were those of charity organizations in the pursuit of medical care, education and public benefits. 3. The survey shows that in general hospital facilities rate 64 per cent and medical care 60 per-cent against a 100 per cent optimum basis in accordance with the medical treatment law and approved criteria for training hospitals. In these respects, university hospitals have achieved the highest standards, followed by religious ones, enterprise ones, and national or public ones in that order. 4. The ages of nursing directors range from 30 to 50. The level of education achieved by most of the directors is that of graduation from a nursing technical high school and a three year nursing junior college; a very few have graduated from college or have taken graduate courses. 5. As for the career tenure of nurses in the hospitals: one-third of the nurses, or 38 per cent, have worked less than one year; those in the category of one year to two represent 24 pet cent. This means that a total of 62 per cent of the career nurses have been practicing their profession for less than two years. Career nurses with over 5 years experience number only 16 per cent: therefore the efficiency of nursing services has been rated very low. 6. As for the standard of education of the nurses: 62 per cent of them have taken a three year course of nursing in junior colleges, and 22 per cent in nursing technical high schools. College graduate nurses come up to only 15 per cent; and those with graduate course only 0.4 per cent. This indicates that most of the nurses are front nursing technical high schools and three year nursing junior colleges. Accordingly, it is advisable that nursing services be divided according to their functions, such as professional, technical nurses and nurse's aides. 7. The survey also shows that the purpose of nursing service administration in the hospitals has been regulated in writing in 74 per cent of the hospitals and not regulated in writing in 26 per cent of the hospitals. The general purposes of nursing are as follows: patient care, assistance in medical care and education. The main purpose of these nursing services is to establish proper operational and personnel management which focus on in-service education. 8. The nursing service departments belong to the medical departments in almost 60 per cent of the hospitals. Even though the nursing service department is formally separated, about 24 per cent of the hospitals regard it as a functional unit in the medical department. Only 5 per cent of the hospitals keep the department as a separate one. To the contrary, approximately 12 per cent of the hospitals have not established a nursing service department at all but surbodinate it to the other department. In this respect, it is required that a new hospital organization be made to acknowledge the independent function of the nursing department. In 76 per cent of the hospitals they have advisory committees under the nursing department, such as a dormitory self·regulating committee, an in-service education committee and a nursing procedure and policy committee. 9. Personnel arrangement and working conditions of nurses 1) The ratio of nurses to patients is as follows: In university hospitals, 1 to 2.9 for hospitalized patients and 1 to 4.0 for out-patients; in religious hospitals, 1 to 2.3 for hospitalized patients and 1 to 5.4 for out-patients. Grouped together this indicates that one nurse covers 2.2 hospitalized patients and 4.3 out-patients on a daily basis. The current medical treatment law stipulates that one nurse should care for 2.5 hospitalized patients or 30.0 out-patients. Therefore the statistics indicate that nursing services are being peformed with an insufficient number of nurses to cover out-patients. The current law concerns the minimum number of nurses and disregards the required number of nurses for operation rooms, recovery rooms, delivery rooms, new-born baby rooms, central supply rooms and emergency rooms. Accordingly, tile medical treatment law has been requested to be amended. 2) The ratio of doctors to nurses: In university hospitals, the ratio is 1 to 1.1; in national of public hospitals, 1 to 0.8; in religious hospitals 1 to 0.5; and in private hospitals 1 to 0.7. The average ratio is 1 to 0.8; generally the ideal ratio is 3 to 1. Since the number of doctors working in hospitals has been recently increasing, the nursing services have consequently teen overloaded, sacrificing the services to the patients. 3) The ratio of nurses to clerical staff is 1 to 0.4. However, the ideal ratio is 5 to 1, that is, 1 to 0.2. This means that clerical personnel far outnumber the nursing staff. 4) The ratio of nurses to nurse's-aides; The average 2.5 to 1 indicates that most of the nursing service are delegated to nurse's-aides owing to the shortage of registered nurses. This is the main cause of the deterioration in the quality of nursing services. It is a real problem in the guest for better nursing services that certain hospitals employ a disproportionate number of nurse's-aides in order to meet financial requirements. 5) As for the working conditions, most of hospitals employ a three-shift day with 8 hours of duty each. However, certain hospitals still use two shifts a day. 6) As for the working environment, most of the hospitals lack welfare and hygienic facilities. 7) The salary basis is the highest in the private university hospitals, with enterprise hospitals next and religious hospitals and national or public ones lowest. 8) Method of employment is made through paper screening, and further that the appointment of nurses is conditional upon the favorable opinion of the nursing directors. 9) The unemployment ratio for one year in 1971 averaged 29 per cent. The reasons for unemployment indicate that the highest is because of marriage up to 40 per cent, and next is because of overseas employment. This high unemployment ratio further causes the deterioration of efficiency in nursing services and supplementary activities. The hospital authorities concerned should take this matter into a jeep consideration in order to reduce unemployment. 10) The importance of in-service education is well recognized and established. 1% has been noted that on the-job nurses. training has been most active, with nursing directors taking charge of the orientation programs of newly employed nurses. However, it is most necessary that a comprehensive study be made of instructors, contents and methods of education with a separate section for in-service education. 10. Nursing services'activities 1) Division of services and job descriptions are urgently required. 81 per rent of the hospitals keep written regulations of services in accordance with nursing service manuals. 19 per cent of the hospitals do not keep written regulations. Most of hospitals delegate to the nursing directors or certain supervisors the power of stipulating service regulations. In 21 per cent of the total hospitals they have policy committees, standardization committees and advisory committees to proceed with the stipulation of regulations. 2) Approximately 81 per cent of the hospitals have service channels in which directors, supervisors, head nurses and staff nurses perform their appropriate services according to the service plans and make up the service reports. In approximately 19 per cent of the hospitals the staff perform their nursing services without utilizing the above channels. 3) In the performance of nursing services, a ward manual is considered the most important one to be utilized in about 32 percent of hospitals. 25 per cent of hospitals indicate they use a kardex; 17 per cent use ward-rounding, and others take advantage of work sheets or coordination with other departments through conferences. 4) In about 78 per cent of hospitals they have records which indicate the status of personnel, and in 22 per cent they have not. 5) It has been advised that morale among nurses may be increased, ensuring more efficient services, by their being able to exchange opinions and views with each other. 6) The satisfactory performance of nursing services rely on the following factors to the degree indicated: approximately 32 per cent to the systematic nursing activities and services; 27 per cent to the head nurses ability for nursing diagnosis; 22 per cent to an effective supervisory system; 16 per cent to the hospital facilities and proper supply, and 3 per cent to effective in·service education. This means that nurses, supervisors, head nurses and directors play the most important roles in the performance of nursing services. 11. About 87 per cent of the hospitals do not have separate budgets for their nursing departments, and only 13 per cent of the hospitals have separate budgets. It is recommended that the planning and execution of the nursing administration be delegated to the pertinent administrators in order to bring about improved proved performances and activities in nursing services.

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Distributors' Preference for the Flextime System (유통업체 종사자의 유동근무제에 대한 선호성향에 대한 연구)

  • Lee, Won-Haeng
    • Journal of Distribution Science
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    • v.10 no.4
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    • pp.13-20
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    • 2012
  • The "flextime" system, which was initially designed to maintain a balance between work and personal life, has recently received much attention as an alternative form of work, enabling employees to fully exert their creativity. Most studies show that the effects of flextime on performance, productivity, attitude toward the organization, absenteeism, and turnover differ between managerial and non-managerial workers. This suggests that workers' personal characteristics affect their preference for flextime by directly or indirectly influencing its result variables. As most Korean companies have not adopted the flextime system, little research has been conducted on it in Korea. Recently, Korean companies have been discussing flextime as one of several measures for enhancing international competitiveness. Therefore, this study aims to offer a theoretical framework for the introduction of the system by analyzing the effects of the precedent factors on the preference for flextime. Though not statistically significant, a higher preference for flextime is noted among workers over the age of 36. Older workers usually are more conservative and less adaptable to change but here the older Korean workers may be anxious and resistant. Additional research on workers in different types of businesses using improved research methods will lead to more meaningful results. Married workers display a lower preference to flextime than single workers. In Korea, the current atmosphere focused on a happy home encourages married workers to prefer regular work hours, enabling them to go to and from work on a regular schedule. This means that normal working hours, from morning to evening, are preferred as it is the most suitable system for families. However, this is not so in the case of single workers. Unmarried singles tend to prefer flextime for investing in self-development toward future prosperity, over the benefits of regular working-hours. Flextime is designed to meet their needs to some extent as it is helpful in maintaining a balance between work life and self-development. If flextime is selected, workers can spend mornings on self-development and work in the afternoons. Therefore, when flextime is introduced in Korea, it would be desirable to start with unmarried workers, to increase corporate creativity and productivity and develop individual potential. In particular, when the five-day workweek, the main concern for companies and labor unions, is adopted, synergy with flextime could be expected and a gradual implementation of flextime will be effective. Gender difference shows similar results to marital status with male workers displaying a higher preference for flextime. It is inferred that male workers' attitudes toward flextime are more favorable than female workers' because flextime enables self-development and work life to coexist. A relatively weak, though statistically significant, correlation exists between control position and flextime preference with inner-control-oriented workers displaying favorable attitudes toward flextime. Generally, inner-control-oriented workers tend to attribute the consequences caused by any person or partner relationship to themselves. Thus, when a new system is introduced they are likely to have less reluctance and fear than outer-control-oriented workers, because they think it is important to deal with the new system. A weak but slight correlation exists between the desire for achievement and flextime preference. People who have a higher desire for achievement are willing to consider the new system, especially if significant success is reasonably expected. This result is derived from a reasonable judgment that flextime offers an individual the time for self-development while the organization benefits from the resulting creativity and performance enhancements. Although not the primary analysis, a high correlation is found between control position and the desire for achievement, which is consistent with the results of previous research. The regression analysis not only supports the preceding ANOVA and correlation analysis but also shows the existence of a causal relationship. Married workers have a weak preference for flextime, which is consistent with the results of the preceding ANOVA. Relative to men, women have a weak preference for flextime. No statistically significant correlation was noticed for age. Inner-control-oriented workers prefer flextime more than outer-control-oriented workers as the former view the consequences of change to be their own responsibility. However, the preference for flextime seems to be weak. As expected, people with a higher desire for achievement have a stronger preference for flextime, presumably because the greater the desire for achievement, the stronger the spirit of challenging an uncertain future. No significant correlation exists between job satisfaction and flextime preference.

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A Study on the Impact of Artificial Intelligence on Decision Making : Focusing on Human-AI Collaboration and Decision-Maker's Personality Trait (인공지능이 의사결정에 미치는 영향에 관한 연구 : 인간과 인공지능의 협업 및 의사결정자의 성격 특성을 중심으로)

  • Lee, JeongSeon;Suh, Bomil;Kwon, YoungOk
    • Journal of Intelligence and Information Systems
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    • v.27 no.3
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    • pp.231-252
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    • 2021
  • Artificial intelligence (AI) is a key technology that will change the future the most. It affects the industry as a whole and daily life in various ways. As data availability increases, artificial intelligence finds an optimal solution and infers/predicts through self-learning. Research and investment related to automation that discovers and solves problems on its own are ongoing continuously. Automation of artificial intelligence has benefits such as cost reduction, minimization of human intervention and the difference of human capability. However, there are side effects, such as limiting the artificial intelligence's autonomy and erroneous results due to algorithmic bias. In the labor market, it raises the fear of job replacement. Prior studies on the utilization of artificial intelligence have shown that individuals do not necessarily use the information (or advice) it provides. Algorithm error is more sensitive than human error; so, people avoid algorithms after seeing errors, which is called "algorithm aversion." Recently, artificial intelligence has begun to be understood from the perspective of the augmentation of human intelligence. We have started to be interested in Human-AI collaboration rather than AI alone without human. A study of 1500 companies in various industries found that human-AI collaboration outperformed AI alone. In the medicine area, pathologist-deep learning collaboration dropped the pathologist cancer diagnosis error rate by 85%. Leading AI companies, such as IBM and Microsoft, are starting to adopt the direction of AI as augmented intelligence. Human-AI collaboration is emphasized in the decision-making process, because artificial intelligence is superior in analysis ability based on information. Intuition is a unique human capability so that human-AI collaboration can make optimal decisions. In an environment where change is getting faster and uncertainty increases, the need for artificial intelligence in decision-making will increase. In addition, active discussions are expected on approaches that utilize artificial intelligence for rational decision-making. This study investigates the impact of artificial intelligence on decision-making focuses on human-AI collaboration and the interaction between the decision maker personal traits and advisor type. The advisors were classified into three types: human, artificial intelligence, and human-AI collaboration. We investigated perceived usefulness of advice and the utilization of advice in decision making and whether the decision-maker's personal traits are influencing factors. Three hundred and eleven adult male and female experimenters conducted a task that predicts the age of faces in photos and the results showed that the advisor type does not directly affect the utilization of advice. The decision-maker utilizes it only when they believed advice can improve prediction performance. In the case of human-AI collaboration, decision-makers higher evaluated the perceived usefulness of advice, regardless of the decision maker's personal traits and the advice was more actively utilized. If the type of advisor was artificial intelligence alone, decision-makers who scored high in conscientiousness, high in extroversion, or low in neuroticism, high evaluated the perceived usefulness of the advice so they utilized advice actively. This study has academic significance in that it focuses on human-AI collaboration that the recent growing interest in artificial intelligence roles. It has expanded the relevant research area by considering the role of artificial intelligence as an advisor of decision-making and judgment research, and in aspects of practical significance, suggested views that companies should consider in order to enhance AI capability. To improve the effectiveness of AI-based systems, companies not only must introduce high-performance systems, but also need employees who properly understand digital information presented by AI, and can add non-digital information to make decisions. Moreover, to increase utilization in AI-based systems, task-oriented competencies, such as analytical skills and information technology capabilities, are important. in addition, it is expected that greater performance will be achieved if employee's personal traits are considered.

The Effects of Self-Determination on Entrepreneurial Intention in Office Workers: Focusing on the Dual Mediation of Innovativeness and Prception of the Startup Support System (직장인의 자기결정성이 창업의지에 미치는 영향: 혁신성과 창업지원정책인식의 이중매개를 중심으로)

  • Lim, Jae Sung
    • Asia-Pacific Journal of Business Venturing and Entrepreneurship
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    • v.19 no.1
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    • pp.75-91
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    • 2024
  • Recently, global business environment is changing dramatically along with the acceleration of technological innovation amid the war, climatic change, and geopolitical instability. Accordingly, it is difficult to predict or plan for the future as the volatility, complexity, ambiguity, and uncertainty of the industrial ecosystem continue to increase. Therefore, organizations are undergoing inevitable restructuring in accordance with their survival strategy, for instance, removing marginal businesses or firing. Accordingly, office workers are seeking a startup as an alternative for their continuous economic activity amid rising anxiety factors that make them think they would lose their jobs unintentionally. Here, this study is aimed to verify through what paths office workers' self-determination influences the process of converting to a startup. For this study, an online survey was carried out, and 310 respondents' valid data were analyzed through SPSS and AMOS. To sum up the results, first, office workers' self-determination did not have significant effects on entrepreneurial intention. However, it was confirmed that self-determination had positive (+) effects on innovativeness and perception of the startup support system. This result shows that their psychology works to prepare step by step by accumulating innovative experiences and increasing perception of the startup support system from a long-term life path perspective rather than challenging startups right way. Second, innovativeness is found to have positive (+) effects on entrepreneurial intention. Also, perception of the startup support system had positive (+) effects on entrepreneurial intention. This implies that when considering startups, they are highly aware of the government's various startup support systems. Third, innovativeness is found to have positive (+) effects on perception of the startup support system. It is judged that perception of the startup support system is valid for prospective founders to exhibit their innovativeness and realize new ideas. Fourth, it was confirmed that innovativeness and perception of the startup support system mediated correlation between self-determination and entrepreneurial intention, and perception of the startup support system mediated correlation between innovativeness and entrepreneurial intention, which shows that it is a crucial factor in entrepreneurial intention. Although previous studies related to startups deal with students mostly, this study targets office workers who form a great part in economic activities, which makes it academically valuable in terms of being differentiated from others and extending the scope of research. Also, when we consider the fact that the motivation for self-determination alone fails to stimulate entrepreneurial intention and the complete mediation of innovativeness and the startup support system, it has great implications in practical aspects such as the government's human and material support systems. In the selection and analysis of samples, this study exhibits a limitation that the problem of common method bias is not completely resolved. Also, additional definitive research is needed on whether entrepreneurial intention is formed and converted into startup behavior. Academically and practically, this study deals with the relationship between humans' psychological motives and startups which has not been handled sufficiently in previous studies. The conversion of office workers to startups is expected to have effects on individuals' economic stability and the state's job creation; therefore, it needs to be investigated continuously for its great value.

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