의료기관인증의 효과에 대한 체계적 문헌고찰: Balanced Score Card 관점으로

박일태,정연이,박성희,황정해,석승한,Park, Il-Tae,Jung, Yoen-Yi,Park, Seong-Hi,Hwang, Jeong-Hae,Suk, Seung-Han 한국의료질향상학회 2017 한국의료질향상학회지 Vol.23 No.1

Purpose: The purpose of this study was to analyze the impact of healthcare accreditation and to provide empirical evidence to validate positive effectiveness. Methods:Six electronic databases (KERIS, KoreaMed, NDSL, Ovid-medline, Embase, Cochrane library) were accessed in May 2016. Keywords used were 'accreditation' and 'Joint Commission on Accreditation of Healthcare Organization (JCAHO)'. Of the initially identified 3,008 articles, 60 studies on healthcare accreditation were selected based on inclusion criteria that are hospital accreditation, accreditation by disease and clinical center accreditation. These were retrieved and analyzed. Result: The 60 study results were on the impact of healthcare accreditation. Results were classified into four perspectives of Balanced Score Card (Financial, Customer, Internal Process, Learning & Growth). In internal process perspective, results revealed that healthcare accreditation has made a positive impact on "care process and procedure". In learning & growth perspective, healthcare accreditation has made a positive influence on "leadership", "organizational cultures" and "change mechanisms". However, it revealed that healthcare accreditation does not directly affect financial performance. It is also difficult to reach a definitive conclusion that healthcare accreditation programs affect patient satisfaction of customer and clinical outcome of the internal process. Conclusion: Healthcare accreditation programs provide positive impact on change of care process and building communication-oriented hospital culture. However, more rigorous and diverse research is needed on financial effects and clinical outcomes of healthcare accreditation.

평가인증 후 보육시설 종사자의 평가인증에 대한 인식 및 사후 관리 실태

장상란,서현아 한국생태유아교육학회 2009 생태유아교육연구 Vol.8 No.3

The purpose of this study was to bring some data for applying to maintenance and management for successful settlement of an accreditation system. For these, this study found out some changes, effects, methods of improvement for the accreditation system, how directors and teachers of the child care centers made efforts for management after the accreditation and found out actual conditions for maintenance and management according to categories of barometers after the accreditation. The results of study were as follows: First, about recognitions for the accreditation system after the accreditation, most of directors and teachers were opposed to the accreditation to the presentation of an annual report once a year and to the pertinence of revaluation by index. The teachers of national and public child care centers were somewhat opposed according to the types of centers, their scale and their number of years : en particular, were more opposed the centers less than a year in the accreditation and the teachers of the 3rd-5th scale class. But also the percentage of reapplication after expiration was elevated. The reasons why they would not reapply were a working power of child care, a little favor on the accreditation, self-control of the centers, etc. Second, about the effects after the accreditation, most of them were positive in the accreditation system for the improvement of a qualitative level of centers. And there were also an improvement of the centers and their speciality, the positive changes of child care program and educational process, and parents' high recognition in the community. Third, for the methods of improvement after the accreditation, most of them claimed for a continual financial support, a supply of the piece rate for the teachers. In addition, there were imminent complements: reeducation, supervision by the experts, diversity and actuality of certification index, management and inspection after the accreditation. Lastly, it was revealed that the actual condition for maintenance and the management after the accreditation in general made a good management. The centers often made a check making a good use of an accreditation index, and made an effective management to maintain the accreditation sphere, and made various efforts for the management after the fact, trying teachers' education and a self-control, encouraging learning. But it proved that it was difficult to maintain and manage it after the fact: teachers' speciality and their overwork, management of special activities, financial problems, etc. They made efforts comparatively to improve center environments and educational programs for the maintenance of actual conditions of the accreditation. The national and public centers in the types and the 6th-10th class in the scales were evaluated to make a better maintenance and management in seven items by index. And the other factors didn't have almost influenced. 본 연구는 부산지역에 소재한 기관 중 평가인증을 통과한 기관의 시설장 230명과 보육교사 230명을 대상으로 평가인증 이후 제도에 대한 인식, 변화와 효과, 개선점, 그리고 인증 후 관리를 위해 어떤 노력을 하고 있는지와 그에 따른 지표의 영역별 사후 유지관리 실태를 파악하고자 설문 조사를 실시하였다. 연구 결과를 살펴보면 첫째, 평가인증 후 제도에 대한 인식은, 평가인증 유효 기간, 연차보고서 제출, 그에 따른 지표를 활용한 재평가의 적절성 여부에 반대하는 의견을 보였다. 둘째, 인증 후 효과는, 보육시설의 질적 개선과 수준을 향상시켰다고 반응을 하였고, 셋째, 인증 이후 제도의 개선 방안은, 계속적인 지원금 지급과 교사들에게 성과급 지원 등을 요구하는 비율이 높았다. 넷째, 평가인증 후 사후 유지관리 상태는, 인증지표 활용으로 수시로 점검을 하고 있으며, 평가인증 영역을 유지하기 위한 노력으로 효과적 운영 관리 및 필수항목 체크의 준수 철저와 교사교육과 자율장학을 실시하면서 사후 관리를 위해 다양한 노력을 하는 것으로 나타났다.

Accreditation standards items of post-2nd cycle related to the decision of accreditation of medical schools by the Korean Institute of Medical Education and Evaluation

Kwi Hwa Park,Geon Ho Lee,Su Jin Chae,Seong Yong Kim 한국의학교육학회 2023 Korean journal of medical education Vol.35 No.1

Purpose: The purpose of this study is to analyze the accreditation standards items related to the decision of accreditation of medical schools by the Korea Institute of Medical Education and Evaluation (KIMEE). Methods: The subjects are medical schools in Korea that have received post-2nd cycle accreditation from the KIMEE between 2012 and 2016. Analyses were conducted for differences in accreditation decisions according to the characteristics of medical schools, sufficient ratios of basic standards items, and correlation between standards items related to accreditation decisions. Results: After examining differences in accreditation decisions by the medical school’s characteristics, there were no significant correlations between accreditation standard items and accreditation decisions. Second, according to the number of schools that sufficiently or insufficiently met each standard item, from the total of 97 standard items, 20 (20.6%) were sufficiently fulfilled by all medical schools. Standard item 2-5-2 demonstrated the highest insufficiency ratio. Third, with respect to the standard item that had an effect on accreditation decisions, standard item 1-5-1 showed the highest correlation with the sufficiency rate. Conclusion: The validity of accreditation standards items was assured as this study evaluated the post-2nd cycle accreditation standards items regardless of each medical school’s characteristics. The accreditation standards items were found to have a meaningful impact on the development of medical schools and qualitative improvement in medical education. The findings are expected to contribute to guaranteeing the validity and reliability of accreditation decisions and raising the quality of accreditation.

미국 임상시험심사위원회(Institutional Review Board) 인증체계에 대한 연구:

김수정(Soo-Jung KIM) 이화여자대학교 생명의료법연구소 2007 생명윤리정책연구 Vol.1 No.2

The goal of this paper is to introduce the accreditation system of human research protection programs. This paper will trace the origin of AAHRPP and examine its standard for the accreditation, including requirements, guidelines, resources for the accreditation. The overview of its accreditation program includes its detailed information on IRB organization, membership, accreditation procedure, kinds of accreditation, and its benefit. The introduction to AAHRPP will guide our consideration on the introduction of IRB accreditation and its potential benefit in Korea. As shown in the accreditation system of AAHRPP, its success depends on the expertise and effectiveness. Institutions which received AAHRPP’s accreditation claim that they received practical help in improving their human participants protection program. AAHRPP’s tailored approach toward each institution seems to be met each institution’s demand and need. Due to large pool of expertise AAHRPP could identify primary issues and update its resources. AAHRPP’s accreditation system gives us an insight in improving human participant protection program. However, the development of accreditation system in Korea might not be the same as in US. AAHRPP originated from the society which is market-oriented and emphasizes individual autonomy rather than communal values. We need to consider the necessity, possibility, and limit of accreditation system in Korea in order to develop successful accreditation system which contributes to the protection of human participants.

의료기관평가인증의 목표와 과제

이규식,신민경 대한의사협회 2012 대한의사협회지 Vol.55 No.1

Healthcare accreditation program was started in November 2010. The program was operated by newly born institute, Korea Institute for Healthcare Accreditation. Major characteristic of healthcare accreditation program in Korea is spontaneous program that hospitals voluntarily request for accreditation survey. Goals of healthcare accreditation program in Korea are to change the culture of healthcare supply side from supplier oriented to consumer oriented culture and to change regulation for quality improvement from government initiated regulation to self regulated quality improvement activities by hospitals. Objectives of accreditation are to assure the patient safety and to improve quality of healthcare services in hospitals. Korean Association of Hospital Management conducted a survey on the impact of accreditation program on hospital management, the survey was supported by Korea Institute for Healthcare Accreditation. Results of the survey showed that accredited hospital had changed to positive direction in patient safety,decision making process, organizational culture and hospital management. Assignments of accreditation program in Korea to be solved are to develop incentive for active participation of small size hospitals, to improve quality of surveyors and to increase the apprehension of accreditation of general population. Korea Institute for Healthcare Accreditation endeavor to improve quality of surveyors under in depth training program and to advertise accreditation program through radio and TV to the general population. However the incentive program must be developed by government policy.

국내 대학 교육 인증제 관련 연구의 체계적 문헌 고찰: 자체교육인증제를 중심으로

김선희 호남대학교 인문사회과학연구소 2022 인문사회과학연구 Vol.65 No.4

The purpose of this study is to derive implications and research directions for the internal accreditation system by analyzing the research related to the internal accreditation system in higher education. The research questions are what are the general characteristics (by year, accreditation subject, research method), what are specific characteristics (main research methods and keywords for each accreditation subject, result and suggestions) of domestic internal accreditation. Systematic literature review methods were applied to conduct the research. As a result, it was found that the number of research was very insufficient compared to the field-based accreditation system, but in the past two years, the number of that related to the major curriculum, subject, and extracurricular programs have increased rapidly, and most of the research related to accreditation system for extracurricular programs was published, and it was conducted using various research methods. The main issues commonly found are that, first, for the operation (or introduction) of the accreditation system, it is very important to prepare in advance (development of evaluation indicators, various forms, workshop for participants, provision of related regulations and accreditation benefits, etc.) Second, it was found that it was important to prepare a plan to minimize administrative and paperwork related to participation in the certification system. Finally, a research direction was proposed to achieve the original purpose of the internal accreditation system rather than being perceived as a negative factor that increases employee fatigue, and effectively settle in the field. 본 연구는 국내 대학의 자체교육인증제 관련 연구를 분석하여 향후 자체교육인증제 운영을 위한 시사점 및 연구의 방향을 도출하는 것을 목적으로 한다. 연구목표 달성을 위하여 두 가지 연구문제 즉, 국내 자체교육인증 관련 연구의 일반적 특징(연도별, 연구대상별, 연구방법별)과 구체적 특징(인증대상별 주요 연구방법 및 키워드, 제안내용)은 무엇인가를 설정하였다. 체계적 문헌 분석 방법을 적용하여 연구를 수행하기 위하여, 사전에 정의된 포함·배제 기준에 따라 논문을 선정하고, 분석기준에 맞춰 문헌을 분석하였다. 연구결과, 자체교육인증 관련 연구는 현장에서 인증제가 실행되고 있는 것에 비해 연구결과물의 수가 매우 미흡한 것으로 나타났으나 최근 2년간 연구 논문수가 급증하였다. 초기에는 독서 인증제나 인성인증제에 대한 연구가 진행되었고 최근에는 전공이나 교과목, 비교과에 대한 연구가 주를 이루고 있다, 비교과의 경우 다양한 연구방법을 사용하고 있으나 그 외 인증은 주로 타 대학 운영 사례를 분석하거나 집단 간 인식차이를 비교한 연구가 많은 것으로 나타난다. 구체적인 특징을 살펴본 결과 인증대상별로 공통적으로 발견되는 주요 이슈는 첫째, 인증제 운영(또는 도입)을 위해서는 사전 준비(평가지표 개발, 각종 양식, 참여자 대상 설명회, 평가자 및 피평가자 대상 교육, 관련 규정과 인증혜택 마련 등)가 매우 중요하다는 것과 둘째, 인증제 참여에 따른 행정업무를 최소화할 수 있는 방안 마련이 중요함을 발견하였다. 마지막으로 향후 인증제가 구성원의 피로도를 높이는 부정적인 요소로 인식되는 것이 아닌, 인증제 본연의 목적을 달성하고 현장에 효과적으로 안착하기 위한 연구 방향을 제안하였다

의료기관들의 인증평가 준비와 비용지출에 대한 실태분석

김민지 ( Minji Kim ),정유민 ( Yumin Jung ),김경숙 ( Kyungsook Kim ),이선희 ( Sunhee Lee ) 한국병원경영학회 2015 병원경영학회지 Vol.20 No.3

While the influence of healthcare accreditation system to the quality improvement of hospitals has more increased, regarding the preparation costs for healthcare accreditation, it has never been empirically studied about the costs that are actually invested by hospitals. This study is going to determine the difficulties in the preparation process of accreditation and details of accreditation preparation costs for hospitals that participated in the healthcare accreditation system and acquired accreditation. The survey was performed in a self-reported form from February 28 to March 21 2014 for 189 acute hospitals accredited as a hospital from 2011 to February 2014. Of all questionaries of survey participants, 98 were recovered; the response rate was 51.9%. A total of 40 questionnaires were used except for 58 containing insincere answers. Main findings are followings: Firstly, findings showed that advanced general hospitals spent the most statistically significantly highest in terms of equipments and total costs among cost items for accreditation preparation. When accreditation preparation costs items were classified according to classification of hospitals, advanced general hospitals spent the most statistically significantly highest in the equipments and total costs. Also in terms of regional, Gyeonggi, Incheon regions were found to spend statistically significantly higher costs in the equipments costs. Secondly, as a result of the survey in the distribution of the total accreditation preparation costs, advanced general hospitals have disbursed the most out of all. However, the result in hospitals does not show significant difference to the expense of advanced general hospitals and that especially other regional hospitals spent higher costs. As such, all hospitals are under a heavy burden of higher costs on accreditation preparation, especially hospitals. The build-up of infrastructures by hospitals through an accreditation system consequently led to a higher initial investment; if the accreditation system is effective in improving the quality of health care and patient safety, appropriate responses are needed. In other words, financial support for investment costs needs to be given to allow hospitals to actively participate in the accreditation system.

어린이집 평가인증 참여에 따른 평가인증에 대한 보육교사의 인식, 교사효능감 및 직무만족 -강원도 보육교사를 중심으로-

조미환,성은영 한국보육학회 2012 한국보육학회지 Vol.12 No.2

This study is aimed at finding out ways to make child care center accreditation more effectively and meaningfully. For this purpose, the analysis was undertaken to see if teachers' self-efficacy and job satisfaction would change by participation in the accreditation and to examine what would be important changes in teachers' perception of the child care center accreditation. A questionnaire was administered to 187 teachers working in the child care facilities. The questionnaire included teachers’self-efficiency scale, job satisfaction scale and questions which were developed for this research purpose based on the 2006 accreditation criteria for child care centers. The collected data are analyzed through SPSS WINDOWS 18.0. The results of the study were as follows:First, checking the recognition of teachers who participate and do not participate in accreditation with respect to system of accreditation, the former 54.4 % recognized the necessity of system of accreditation higher than the latter 45.6 %. The reason for the necessity of system of accreditation was the improvement of physical environment of child care facilities. Second, in the results of differences in teachers’efficacy and the employees' job satisfaction according to being accreditation system or not, there were statistically significant differences in personal teaching efficacy, overall efficacy teaching efficacy and the satisfaction with social reputation and their overall job according to being accreditation system or not. Third, it is demonstrated that the teacher's positive recognitions of accreditation system of child care facilities has significantly correlations with personal teaching efficacy and the employees' job satisfaction. The teacher's positive recognitions of accreditation system of child care facilities have a positive relationship with teachers' efficacy. The result shows that the teacher's positive recognitions of accreditation system of child care facilities have higher satisfaction with social reputation and their overall job than teachers who was not accredited. 본 연구의 목적은 평가인증 참여여부에 따른 평가인증에 대한 보육교사들의 인식을 알아보고 이에 따라 보육교사의 직무만족도, 교사효능감은 어떠하며, 평가인증에 대한 인식정도는 직무만족, 교사효능감과 어떤 관계를 보이는 지를 파악하는 것이다. 연구대상은 강원도 지역에 근무하는 어린이집 교사 187명이며 연구도구는 선행연구와 문헌을 참고하여 연구목적에 적절하게 제작한 질문지를 사용하였다. 수집된 자료는 빈도분석, 기술통계, 교차분석, t검증, 피어슨의 상관관계를 실시하였다. 본 연구결과는 다음과 같다. 첫째, 어린이집 평가인증제도의 필요성에 대해서는 보육교사의 54.5%가 평가인증이 필요하다고 했으며, 평가인증에 참여한 교사집단은 평가인증이 필요하다고 인식하였고, 비 참여교사집단은 필요하지 않다고 인식한 비율이 높았다. 둘째, 보육교사의 평가인증 참여여부에 따라서는 참여집단이 비 참여집단보다 개인적 효능감과 총효능감이 높았으며, 직무만족 정도는 참여집단이 비 참여집단보다 교수활동지원에 대한 만족과 전반적인 만족 정도가 높았다. 셋째, 평가인증에 대한 인식이 긍정적일수록 일반적 효능감, 개인적 효능감, 총효능감이 높았고 사회적 인식에 대한 만족, 교수활동지원에 대한 만족 정도가 높았다.

대학평가인증제 평가기준의 타당성 검토

곽진숙(Jin-Sook Kwak) 한국교육평가학회 2010 교육평가연구 Vol.23 No.4

본 연구는 공학교육인증제와 경영교육인증제를 중심으로 그 평가기준의 타당성을 검토한 연구다. 타당성은 다양한 측면에서 평가되지만, 특별히 교육프로그램 평가의 메타평가 기준 중 교육본위성 준거에 따른 타당성을 검토하였다. 교육주체의 교육지향성, 교육방법의 적절성, 교육환경의 충실성, 교육성과의 본질성이 그 하위준거다. 인증실무경험자인 각 5개 공과대학, 경영대학 소속교수 10인, 5인과의 인터뷰 자료를 연구대상으로 하였다. 연구결과 두 인증제는 교육주체가 현재의 교육에 만족하지 않고 개선하도록 권장하지만 시스템 구축에 더 초점이 있어 만족도를 확인하거나 향상시키게 하는 면은 자극을 제공하는 정도다. 교육방법의 적절성은 교수-학생의 역동적 상호작용, 학습과정에 관한 충실한 모니터링의 면에서 긍정적이지만, 학생수준에 맞는 교육방법과 매체 활용, 개인별 속도, 스타일에 따른 학습경험 제공에 관해서는 부정적이다. 단계적, 순차적 학습경험의 배열은 공학 분야에서는 이수체계의 강조로 높은 관심을 보이나, 경영학에서는 주된 관심사가 아니다. 교육환경의 충실성은 확인하기는 하나 향후 현황보다 개선방향에 관한 관심으로 전환시켜야 한다. 교육성과의 본질성은 학생 자신의 교육성과를 평가하거나 교수의 교육전문성 신장을 확인하게 하지만, 교육활동에 관한 긍정적 태도 확인은 취약해 교육평가 분야에서 이 기준에 관련한 구체적인 평가방법 등을 제시해야 할 필요가 있다. In this paper, we studied the validity of the accreditation standards of two programs: the engineering education accreditation and the business education accreditation. Among the various meta-evaluation criteria to evaluate the validity of the accreditation standards for the education programs, we chose here the education-centered criteria. This includes the education-directivity, properness of the education method, perfection of the educational environment, and substantial product of the education, as its sub-criteria. The basic research materials consist of the interview data for 10 professors from the 5 colleges of engineering and 5 professors from the 5 colleges of business who have experience in the working group for the accreditation. It was observed that both of the programs promote the improvement of the educational activities. But more emphasis are laid on the construction of the educational system; comparatively, the enhancement of the satisfaction of the subjects of the education were taken care of on the level of providing certain stimulation. On the properness of the education method: they have positive aspects on the interaction of the professors and student, monitoring on the education procedure, while also they have negative aspects on the education method proper to the students' level, usage of medium, progress for each individual, providing the educational experience with appropriate style. On the arrangement of the phased educational experience: the engineering education accreditation program has much interest in the completion of the courses, while the business education accreditation program doesn't due to the characteristic of the scholarly area. On the perfection of the educational environment: they are checking the present situation, but it is required to advance into the improvement. On the substantial product of the education: They are running the self-evaluating programs for students and they are checking the education-expertise of the professors. But we found certain weak points on the checking the professors and students' positive attitude on the educational activities. For the later studies on the education accreditation, it is required to provide concrete accreditation methods for the standards on this aspect.

병원간호사의 의료기관 인증제에 대한 인식, 소진과 이직의도 간의 관계

이정승,박영숙 인문사회 21 2022 인문사회 21 Vol.13 No.4

The Relationships Among Healthcare Accreditation Perception,Burnout, and Turnover Intention of Hospital NursesJeongseung Lee & Youngsuk Park Abstract: This study attempted to identify hospital nurses' perception of healthcare accreditation, burnout, and turnover intention during the third cycle of an optional healthcare accreditation. This study was a cross-sectional survey using the questionnaire of Healthcare Accreditation Perception, MBI, Turnover Intention. The subjects were 236 nurses from two general and two tertiary hospitals, and we collected the data from March to June 2019. Of the nurses surveyed, 84.3% perceived their workload related to healthcare accreditation was high, while 90.3% recognized that the work intensity for accreditation preparedness was higher than that of other occupations. The emotional exhaustion of burnout was the highest, and perception of education and organizational system on accreditation was the lowest among sub-factors. The lower the level of healthcare accreditation perception, the higher the related burnout and turnover intention. Healthcare accreditation perception showed moderate negative correlations with burnout or turnover intention. Burnout and turnover intention showed a high positive correlation. The Healthcare accreditation workload and the work intensity of hospital nurses were high. Therefore, it is crucial to invest resources in staffing, time and reward for nurses, such as relocating accreditation-related tasks at the organizational level, systematic education and support, and verifying the effectiveness. Key Words: Healthcare Accreditation, Hospital, Nurse, Burnout, Turnover Intention 병원간호사의 의료기관 인증제에 대한 인식, 소진과 이직의도 간의 관계이 정 승**ㆍ박 영 숙*** 연구목적: 본 연구는 의료기관 인증제의 자율 평가방식 3주기 시점에서 병원간호사의 의료기관 인증제 인식, 소진과 이직의도의 특성과 관계를 규명하기 위해 시도되었다. 연구 방법: 본 연구는 의료기관 인증제 인식, 소진, 이직의도의 질문지를 이용한 횡단적 조사연구이다. 연구 대상자는 2개 상급종합병원과 2개 종합병원의 간호사 236명으로 자료는 2019년 3월부터 6월까지 수집되었다. 연구 내용: 연구 대상자의 84.3%가 간호사의 인증관련 업무량이 많고, 90.3%가 인증준비 업무강도가 다른 직종보다 높은 것으로 인식하였다. 하부 영역에서 의료기관 인증제의 교육조직체계에 대한 인식이 가장 낮았고, 소진은 정서적 소모의 영역이 가장 높았다. 의료기관 인증제에 대한 인식 수준이 낮은 집단일수록 관련된 소진과 이직의도가 높았으며, 중등도의 음의 상관관계를 나타냈다. 결론 및 제언: 병원간호사는 의료기관의 인증관련 업무량과 인증준비 업무강도가 높은 것으로 인식하였고, 이들의 소진과 이직 의도와 유의한 관계가 있었다. 따라서 인증과 관련된 조직적 차원의 업무조정, 체계적인 교육과 보상, 재원, 인력, 시간 측면의 실효성 있는 지원 및 결과 검증이 필요하다. 핵심어: 의료기관 인증제, 병원, 간호사, 소진, 이직의도 □ 접수일: 2022년 6월 21일, 수정일: 2022년 7월 14일, 게재확정일: 2022년 8월 20일* 이 논문은 주저자의 한국방송통신대학교 대학원 간호학과 석사학위논문을 수정하여 작성한 것임. ** 주저자, 한국방송통신대학교 대학원 간호학과 석사