Journal of the Korea Academia-Industrial cooperation Society (한국산학기술학회논문지)

The Korea Academia-Industrial cooperation Society (한국산학기술학회)
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Change in patient safety, quality of medical care, organization culture and hospital management performance after healthcare accreditation system for convalescent hospital

요양병원 의료기관인증제 시행 후 환자안전, 의료의 질, 조직문화 및 병원경영성과의 변화

  • Seo, Young-Ho (Department of Public Health, Graduate School of Kyungpook National University) ;
  • Kim, Keon-Yeop (Department of Public Health, Graduate School of Kyungpook National University) ;
  • Kim, Myeong-Seon (Department of Public Health, Graduate School of Kyungpook National University)
  • 서영호 (경북대학교 대학원 보건학과) ;
  • 김건엽 (경북대학교 대학원 보건학과) ;
  • 김명선 (경북대학교 대학원 보건학과)
  • Received : 2018.06.18
  • Accepted : 2018.09.07
  • Published : 2018.09.30
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Abstract

This study was conducted to investigate the effects of implementation of the healthcare accreditation system on patient safety, quality of medical care, organization culture and management performance of convalescent hospitals. Ten hospitals were selected at random from among 36 convalescent hospitals in Daegu that had obtained accreditation until September 2015. To accomplish this, hospital staff were surveyed from 15 February to 25 March, 2016 using a questionnaire with 253 objects. We investigated how the healthcare accreditation system has influenced patient safety, service quality, organization culture and performance of hospital management. The change in the treatment support system showed the highest score of 3.93 among quality change and medical service items, while that of personnel source culture showed the highest score of 3.78 points among organization culture items, and that of internal process view, study and growth view showed the highest score of 3.71 among management performance items. Multiple regression analysis revealed that factors positively changing hospital management performance were nurses, employees and managers, basic value systems, organization culture, personnel source culture, open system culture, hierarchical culture, and production oriented culture. The quality of patient safety and medical care was positively influenced by changes in the quality of convalescent hospitals after implementation of the healthcare accreditation system. However, among the four types of organizational culture, the financial perspective was relatively low compared to other perspectives.

이 연구는 요양병원 의료기관인증제 시행 후 요양병원의 환자안전, 의료의 질, 조직문화 및 경영성과에 미친 영향을 파악함에 목적이 있다. 2015년 9월 말까지 요양병원 의료기관인증을 획득한 대구지역의 36개 요양병원 중 10개 기관을 임의로 선정하였으며 2016년 2월 15일부터 2016년 3월 25일까지 요양병원 종사자들에게 설문조사를 하여 253명을 최종분석 대상자로 선정하였다. 설문조사 내용으로는 일반적 특성, 인증이후 환자안전과 의료의 질 향상, 조직문화, 경영성과의 변화가 포함되어 있다. 연구결과 환자안전과 의료의 질 향상의 변화정도에서는 진료지원체계가 3.93점으로 가장 높았으며, 조직문화의 변화정도에서는 인적자원문화가 3.78점으로 가장 높았고, 요양병원의 경영성과 부분에서는 내부프로세스 관점, 학습 및 성장관점이 3.71점으로 가장 높게 나타났다. 병원경영성과에 영향을 미치는 요인을 파악한 결과 직종이 행정직보다 간호직, 직급이 국장보다 사원이거나 과장, 환자안전과 질 향상에서 기본가치체계가 개선되었다고 생각하는 경우, 조직문화에서 인적자원문화, 개방체계문화, 위계서열문화, 생산중심문화가 개선되었다고 생각하는 경우 병원경영성과를 긍정적으로 변화시키는 영향 요인이라 응답하였다. 요양병원 의료기관인증제 시행 후 환자안전과 의료의 질 향상에는 높은 변화를 보여 긍정적 영향을 미쳤으나, 조직문화의 4가지 유형 중 위계서열문화와 생산중심문화는 보통수준의 변화를 보였으며 병원경영성과 중 재무관점은 다른 관점에 비해 상대적으로 낮은 변화를 보였다.

Keywords

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