환자안전 문화와 의료과오 보고에 대한 의사의 인식과 태도

강민아,김정은,안경애,김윤,정진욱,김석화 한국보건행정학회 2005 보건행정학회지 Vol.15 No.4

The objectives of this study were (1) to describe doctors' perception and attitudes toward patient safety culture and medical error reporting in their working unit and hospitals, (2) to examine whether these perception and attitudes differ by doctors' characteristics, such as sex, position, and specialties, and (3) to understand the relationship between overall perception of patient safety in their working unit and each sub-domain of patient safety culture. A survey was conducted with 135 doctors working in a university hospital in Korea. After descriptive analyses and chi-square tests of subgroup differences, a multivariate- regression of overall perception of patient safety in their unit with sub-domains of patient safety culture was conducted. Overall, a significant proportion of doctors expressed negative perception of their working units' patient safety culture, many reporting potentials for patient safety problems to occur in their unit. They also negatively viewed their hospital leadership's commitment on patient safety. Regarding the patient safety in their working unit, doctors were most worried about staffing level and observance of safety procedures. Most doctors did not know how and which medical error to report. They also perceived that medical errors would work against them personally and penalize them. About 22 percent of respondents believed that even seriously harmful medical errors were not reported. The objectives of this study were (1) to describe doctors' perception and attitudes toward patient safety culture and medical error reporting in their working unit and hospitals, (2) to examine whether these perception and attitudes differ by doctors' characteristics, such as sex, position, and specialties, and (3) to understand the relationship between overall perception of patient safety in their working unit and each sub-domain of patient safety culture. A survey was conducted with 135 doctors working in a university hospital in Korea. After descriptive analyses and chi-square tests of subgroup differences, a multivariate- regression of overall perception of patient safety in their unit with sub-domains of patient safety culture was conducted. Overall, a significant proportion of doctors expressed negative perception of their working units' patient safety culture, many reporting potentials for patient safety problems to occur in their unit. They also negatively viewed their hospital leadership's commitment on patient safety. Regarding the patient safety in their working unit, doctors were most worried about staffing level and observance of safety procedures. Most doctors did not know how and which medical error to report. They also perceived that medical errors would work against them personally and penalize them. About 22 percent of respondents believed that even seriously harmful medical errors were not reported.

항공안전데이터 보호제도 도입 방안 연구

김은정 한국항공우주정책⋅법학회 2018 한국항공우주정책·법학회지 Vol.33 No.1

To promote the aviation safety reporting system that is operated to enhance aviation safety and to utilize related information, it should first be preceded by standards for non-punishment and data protection. It is because the purpose of collection and analysis of aviation safety related data through the aviation safety reporting system is to prevent recurrence of accidents by investigating their causes through collection and analysis of diverse types of information related to aviation safety. Both mandatory and voluntary reporting systems are in operation for aviation safety under the current Aviation Safety Act. It is said that they were introduced to survey causes for accidents and to prevent recurrences. In fact, however, it is hard to expect active implementation of the reporting system for aviation safety unless the reporters are firstly exempted from punishment. Therefore, the system should be improved so that it can satisfy its purpose and the purposes of data collection concerning aviation safety through examination of the purposes of the reporting system. One of the matters that needs to be considered to promote the reporting system should be the scope of aviation safety hindrances presupposed under the current institution. The voluntary aviation safety reporting system differs from the systems of ICAO or the key advanced countries, including the USA and the UK as it limits the target accidents subject to reporting to minor aviation safety hindrances only. That being said, improvements should be made by requiring mandatory reporting of aviation safety hindrances based on their severity while recognizing a greater variety of aviation safety concerns like international standards. Safety actions and sharing of information based on collection and analysis of diverse data related to aviation safety will greatly contribute to enhance aviation safety as the purposes of the reporting system are to explore causes for accidents and to prevent their recurrences. What is most important in this regard is strict data protection and non-punishment principles; compliance with them should be secured. We can hardly expect the successful operation of the system unless the reporter is exempted from punishment and the relevant data is protected as promotion of voluntary reporting is an essential factor for enhancing the safety culture. Otherwise, the current system may induce hiding of relevant facts or data to evade punishment. It is true that the regulation for enhancing safety tends to have limitations or blind spots; nevertheless, it should still be enforced strictly and completely. Technological progresses and mistakes of operators appear in different forms based on individual cases. The consequential damages may amount to a truly severe level. Therefore, we have studied and suggested to the methods of activiation and amendments on the aviation safety reporting system, which is referred for one of the proactive safety management systems. The proposed improvement of the reporting system and introduction of non-punishment for collection of aviation safety data for deploying a preemptive prevention system would serve as the backbone for enhancing aviation safety in Korea. 항공안전 증진을 위하여 운영되고 있는 항공안전 보고제도의 경우에는 그 활성화와 관련 정보의 활용을 위해서는 비처벌 및 데이터 보호의 기준이 먼저 선행되어야 한다. 항공안전 보고제도를 통한 항공안전 데이터의 수집 및 분석의 목적은 이러한 항공안전에 관한 다양한 정보의 수집 및 분석을 통하여 사고의 원인 파악과 이를 바탕으로 한 사고 재발 방지에 있기 때문이다. 현행 「항공안전법」 하에서도 항공안전을 위한 의무보고제도와 자율보고제도가 운영되고 있으며, 그 제도의 수립 취지가 사고 원인 파악 및 재발방지에 있다고 한다. 하지만, 그 보고자에 대한 비처벌이 전제되지 않는 한 현실적으로 항공안전에 관하여 보고제도의 활성화를 기대하는 것은 어려운 것이 사실이다. 이에 항공안전에 관한 정보 수집의 목적과 보고제도의 취지를 검토하여 그에 부합될 수 있도록 제도가 개선되어야 할 것이다. 이러한 보고제도의 활성화를 위해 고려되어야 할 사항 중 하나가 현행 제도 상 정하고 있는 항공안전장애의 범위라 할 수 있다. 항공안전 자율보고 제도의 경우 그 보고 대상을 항공안전장애 이외의 경미한 항공안전장애로 한정하고 있다는 점에서 이는 ICAO나 미국 및 영국 등 주요 선진 국가의 제도와 차이를 나타내고 있다. 이에 항공안전장애의 범위를 국제기준과 같이 보다 넓게 인정하되, 항공안전장애의 경우 그 심각성으로 반드시 의무보고를 해야 하는 경우를 정하여 보고제도의 실효성을 담보할 수 있는 개선이 마련되어야 할 것이다. 보고제도의 목적이 사고의 원인 파악 및 재발방지에 있기 때문에 다양한 항공안전에 관한 데이터 수집 및 분석을 바탕으로 한 안전 조치 및 정보의 공유는 항공안전 증진에 크게 기여하게 될 것이라고 본다. 이 때 가장 중요한 것은 엄격한 데이터 보호와 비처벌 원칙이며, 이에 대한 준수가 확보되어야 한다. 자율보고의 활성화는 안전문화 증진에 기본적인 요소 중 하나로 보고자에 대한 면책과 관련 정보의 보호가 담보되지 않는다면 동 제도의 성공적인 운영은 기대하기 어려우며, 오히려 관련 사실이나 데이터를 은폐하여 처벌을 회피하게 하는 기준으로 작용할 수 있기 때문이다. 안전 증진을 위한 규제는 그 엄격성과 완벽성에도 불구하고, 한계나 사각지대가 발생할 수밖에 없는 것이 현실이다. 기술의 진보와 담당자의 실수 등은 사안마다 다른 형태로 나타나게 되며, 그 결과의 피해나 손해는 실로 심각한 지경에 이를 수 있다. 따라서 본 고에서는 항공안전관리 시스템 중 사전적 예방수단으로 논의되고 있는 의무보고제도 및 자율보고제도의 활성화 방안과 안전데이터의 체계적 관리를 위한 개선안에 관하여 다루기로 한다. 사전적 예방제도 구축을 위한 보고제도 개선과 항공안전 데이터 수집을 위한 비처벌에 관한 제도 등의 도입은 우리 항공산업의 안전 증진을 위한 근간으로 작용할 수 있으리라고 본다.

Measurement of Incident-reporting Rate for Developing a Leading Indicator of Safety Culture

김범수,진상은,장성록 한국안전학회 2018 한국안전학회지 Vol.33 No.6

Various leading indicators of safety culture have been advocated for proactive actions as lagging indicators have limitations in reflecting the attitudes and behaviors due to their reactivity and low sensitivity. This study proposes a model of incident-reporting culture (IRC) and determines the influence of the components on incident-reporting rate (IRR) in order to develop proactive indicators of safety culture. A questionnaire survey was administered to 614 workers at a chemical company in Korea, and the internal psychological aspects were explored by using perceptions, attitude, and backgrounds. The relationship between these factors and IRR was quantitatively confirmed. The workers are more reluctant to report injury than property damage, the perception of severity is the most influencing factor, and most property damages are reported regardless of worker’s willingness. These features should be prioritized when improving IRC, and the criteria of IRC need to be aligned with safety culture.

日韓企業会計公示制度の文化的な差異に関する研究 - 21世紀会計情報表現のXBRLの中心

李瓊球(Rhee Kyong-Gu) 실천경영학회 2007 실천경영연구 Vol.2 No.1

  This paper examines the research of XBRL on cultural difference of Japan-Korea accounts reporting system. As for approach to the traditional accounts research, the main object is measure of profit or income, however its object is to expand the information function on the decision making of the global business. Furthermore, as the business language has been expanding the function of accounts reporting in international society and it is one problem in the global business development that the accounts reporting methods need to be standardize. That is, the culture of the accounts reporting system for companies is different according to the respective countries, and especially, in the Japan and Korea is considered occurrence of cultural difference by the economical level. As a result, it is studied about "comparison of the accounts reporting systems in the different culture". This research is examined the XBRL circumstances of the two countries in Japan-Korea, and identified cultural difference by the comparison of accounts reporting system.

절차적 공정성이 안전보고문화에 미치는 영향과 조직냉소주의의 매개효과: 근무부서 간 다집단 분석

박선규,정은경 한국항공경영학회 2023 한국항공경영학회지 Vol.21 No.3

Safety accidents in the aviation industry can lead to catastrophic consequences leading to great damage. Therefore, it is obvious that much effort should be made to prevent safety accidents. After the period of searching for the cause of safety accidents in technical defects, after the 2000s, as the human factor emerged as a cause of safety accidents, safety problems began to be checked at the level of organizational culture. In this process, safety reporting culture was selected as a key factor in preventinf safety accidents. The purpose of this study was to exmaine the impact of precedural justice in the aviation industry on organizational cynicism and safety reporting culture, and to investigate whether there are differences depending of the work department. The study examined the relationship between procedural justice and safety reporting culture, and verified the mediating effect of organizational cynicism. Furthermore, using multi-gruop analysis, the study confirmed that there are different patterns depending on the work department. Data was collected from 526 employees of an Airlines in Korea, and the validity of the variables was confirmed using SPSS 26 and AMOS 26. Mediating effects and multi-group analysis were conducted. The results showed that procedural justice has a significant impact on safety reporting culutre, and the mediating effect of organizational cynicism was also significant. There was partial mediating effect of organizational cynicism. In addition, the impact of procedural justice on cynicism was found to be stronger among frontline workers than among administrative department members. Based on these results, practical implications, limitations, and future research directions were suggested in this study. 항공업에서의 안전사고는 큰 피해로 이어지는 파국적 결과를 가져올 수 있다. 따라서, 안전사고의 예방에 많은 노력을 기울여야 함은 자명하다. 기술적 결함에서 안전사고의 원인을 찾던 시기를 지나 2000년대 이후, 안전사고의 원인으로 인적요소가 대두되면서 조직문화 차원에서 안전 문제를 점검하기 시작했다. 이 과정에서 안전사고를 예방하는 데 있어 안전보고문화가 핵심적인 요소로 꼽히었다. 이러한 안전보고문화를 증진하기 위해서는 조직 구성원들이 안전 문제와 관련한 이슈를 보고했을 때 적절한 대우를 받을 것이라는 기대 즉, 공정함에 대한 인식을 가지는 것이 필수적이다. 더하여 안전보고문화는 조직에 대한 애정과 믿음이 전제되어야 하는데, 구성원들이 조직에 대해 부정 정서를 느끼거나 회의적인 태도를 보이는 조직문화를 가지고 있다면 안전보고문화를 높이는데 장애물이 될 것이다. 따라서, 안전보고문화에 긍정적 혹은 부정적 영향을 미치는 조직 문화적 특성이 무엇이고, 요소 간의 관계를 살펴보는 것이 중요한 과제라고 할 수 있다. 본 연구의 목적은 항공업에서 절차적 공정성이 조직냉소주의와 안전보고문화에 미치는 영향을 확인하고 근무부서에 따른 차이가 있는지 밝히는 데 있다. 이에 따라 절차적 공정성과 안전보고문화의 관계를 살피고, 조직냉소주의의 매개효과를 검증하였다. 그리고 다집단 분석을 통해 근무부서에 따라 절차적 공정성과 안전 보고문화 간의 관계에서 다른 양상을 보이는 것을 확인하였다. 근무부서의 구분은 관리부서와 현장부서로 나누었으며 관리부서의 경우 기획, 여객, 화물의 하위부서로 구성하였으며 현장부서는 캐빈, 정비, 운항의 하위부서로 구성하였다. 국내 모 항공사의 종사자 526명을 대상으로 자료를 수집하였다. 자료의 분석은 SPSS 26과 AMOS 26을 사용하여 변인의 타당성을 확인하고 매개효과 및 다집단 분석을 실시하였다. 그 결과, 절차적 공정성이 안전보고문화에 미치는 영향이 유의미하고, 조직냉소주의가 안전보고문화에 미치는 영향 및 매개효과 또한 유의미한 것으로 검증되었다. 조직냉소주의의 매개효과는 부분매개효과를 보였다. 더하여, 관리부서보다 현장부서 구성원에게서 절차적 공정성이 냉소주의에 미치는 영향이 더욱 강하게 나타났다. 본 연구에서 이러한 연구 결과를 토대로 실무적인 시사점과 한계점 그리고 추후 연구 방향을 제안하였다.

언론사 조직문화와 재난보도 취재 관행

홍은희(Hong, Eun-Hee) 동국대학교 사회과학연구원 2012 사회과학연구 Vol.19 No.2

글로벌 시대를 맞아 국내외 재난이나 재해 현장은 물론 오지, 고산, 해저 등 뉴스 커버리지가 넓어지면서 취재 과정에서 기자들의 정신적, 육체적 안전도 위협받고 있다. 이 연구는 이러한 위험지역에서의 취재관행 실태와 이에 영향을 미치는 언론사의 조직문화를 분석하고자 한 것이다. 이를 위해 데스크급을 포함하여 국내외 대형 재난 취재 경험을 가진 기자 12명을 심층인터뷰 하였다. 연구 결과 위험한 곳에서의 취재관행은 시스템의 지원 없이 취재에서 일상에 이르기까지 모든것을 홀로 해결해야 하는 압박을 받고 있으며, 취재를 위해서는 통제선이나 안전요원의 지시를 어기는 것을 당연시하고, 사전 준비가 충분치 않아 당시 시점의 즉흥적으로 아이템을 개발하여 보도하는 것으로 나타났다. 이러한 취재관행은 언론사의 탑-다운 방식의 의사결정, 타 언론사와의 경쟁에서 비롯한 일체감 문화, ‘기자 정신’으로 포장된 남성주의 문화에 영향을 받고 있는 것으로 분석됐다. Journalists have been threatened both physically and mentally as the reporting victims of disaster and disaster areas are often included overseas dangerous sites in this global era. This study analyzes the reporting routine and its effects on media organization"s culture. For fulling this purpose, the twelve well-experienced reporters with overseas coverage of disaster reporting were interviewed. The results revealed that reporting in disaster sites put too much demand on reporters because little support was provided to the reporters. As a result, the reporter alone had to take care of supporting tasks and reporting tasks; thus, this insufficient support from the news organization put reporters in a dangerous situation and reporters did not have enough time to reporting itself. Based on this reporting routine, top-down decision making process, heavy competition, and masculinity had effects on sustaining this dangerous reporting routine in Korea.

An Research Into The Reactive Safety Action Program for Promoting Aviation Safety Culture

Dae Ho Kim 대한인간공학회 2016 大韓人間工學會誌 Vol.35 No.3

Objective:The objective of this research is to inquire about safety information from the standpoint of its usefulness to suggest the significance of the Reactive Safety Action Program, which serves to promote aviation safety culture. Background: Safety information plays an important role in operating safety programs. Each organization learns lessons from safety information collected from aviation accidents and incidents. When an accident occurs, it is only through safety investigation and a close inquiry on the cause that we can come up with an appropriate countermeasure which would contribute to preventing the recurrence of the same or similar accident. However, the usefulness of safety information produced from unsatisfactory safety investigation is insufficient. Method: This research analyzed the characteristics of aviation accidents, the differences between safety investigations and legal accident investigations in systematic and operative perspectives, and safety culture as a measure to activate reporting systems (compulsory/voluntary). Results: This research defined the investigation scope and processes of safety investigations and legal accident investigations. It also suggested factors such as just culture based on trust, non-punitiveness, confidentiality, the participation of the entire staff through the use of inclusive reporting base, ensuring the independence of the operating organization as a way to promote safety through reporting systems. Conclusion: The organization"s effort is the important aspect in obtaining exact and accurate safety information from accidents/incidents. The separate running of SIB(Safety Investigation Board) and AIB (Accident Investigation Board), the systematization of safety information reporting system, and prescribing (legislating) the composition of related organizations are some representative programs. Application: This research inquired experiences that contributed in promoting aviation safety culture in a reactive perspective, and will serve a role in spreading safety culture by enabling the use of application experiences of the aviation field in other domains.

한국판 공정문화 척도(K-JCAT)의 타당화 연구

이경은(Lee, Kyung-Eun),이재인(Lee, Jae-In),손영우(Sohn, Young-Woo),하유진 대한경영학회 2013 大韓經營學會誌 Vol.26 No.12

국내 항공사 운항승무원의 안전문화가 안전행동에 미치는 영향

김현덕 ( Kim Hyeon Deok ),최연철 ( Choi Youn Chul ) 한국항행학회 2023 韓國航行學會論文誌 Vol.27 No.6

항공기 사고는 다른 교통수단과 비교하여 생존 확률이 낮은 것이 특징이며, 주요 원인으로 규정 위반, 의사소통 등과 같은 인적요인에 의한 것으로 나타나고 있다. 이러한 사고 예방을 위한 안전관리시스템의 활성화는 단순히 운항승무원에게 규정 준수를 강조하기보다는 스스로 안전문화의 중요성을 인식하고, 안전행동에 적극적으로 임하는 것이 중요한 핵심 변수이며, 잘 갖추어진 규정일지라도 안전문화, 안전분위기, 안전행동의 수준에 따라 그 효율성이 달라진다. 본 연구에서는 국내 운항승무원의 안전문화 인식도 조사를 통하여 안전문화가 안전행동에 미치는 상관관계를 검증하였으며, 그 결과 공정문화와 자율보고는 활성화가 미흡하여 안전행동에 유의한 영향을 미치지 않는 것으로 나타났다. 이러한 안전문화와 안전행동의 특성을 확인하여 안전관리시스템의 성과를 제고하고자 한다. Aircraft accidents are characterized by a low probability of survival compared to other means of transportation, and the main causes appear to be human factors such as violation of regulations and communication. In order to activate the safety management system to prevent such accidents, an important key variable is to recognize the importance of safety culture and actively engage in safety behavior rather than simply emphasizing compliance with regulations to flight crew members. Even if there are well-established regulations, safety culture, The effectiveness varies depending on the safety atmosphere and level of safety behavior. In this study, the correlation between safety culture and safety behavior was verified through a survey of domestic flight crew members' awareness of safety culture. The results showed that fair culture and self-reporting were not activated enough to have a significant impact on safety behavior. We aim to improve the performance of the safety management system by confirming the characteristics of safety culture and safety behavior.

화학 공장에서 근로자의 사건 보고 의지에 영향을 미치는 인자

김범수,이종빈,정승래,진상은,장성록 한국안전학회 2019 한국안전학회지 Vol.34 No.3

Lack of incident reporting culture has been pointed out as a potential risk factor across industries. Consequently, comprehensive understanding of the factors affecting the willingness to report (WTR) is necessary. However, our knowledge on the related studies are not enough to date and even most parts of the existing studies have focused on patient safety, which makes it difficult to universally apply the factors to all industries. Therefore, this study aimed to identify WTR factors in chemical plants and evaluate the influence degree of the factors. To do this, 45 candidate factors were summarized throughout the previous studies and surveying plant safety staff. A questionnaire survey was conducted for 614 all employees from 9 chemical plants which belong to one company, and finally 32 WTR factors were identified throughout 520 responses. Of these, 19 factors were consistent with the previous studies and 13 factors were newly identified. The most influential factor was ‘Views on the necessity of incident reporting’, and ‘Reporting practice by outcome severity’, ‘Fear of vilification, conflicts, blame, or sanctions’ were followed. This result not only suggests various WTR factors suitable for chemical plants, but also shows need to derive specific factors that are appropriate to each industry. An empirical study could be expected to increase incident reporting by using these factors and verify its effectiveness on injury rate.