다양한 환자 욕구 반영 도구로서의 환자경험평가

천자혜 건강보험심사평가원 심사평가연구소 2017 HIRA 정책동향 Vol.11 No.3

낙상위험요인 평가 및 낙상예방활동 임상진료지침

천자혜,김현아,곽미정,김효선,박선경,김문숙,최애리,황지인,김윤숙,Chun, Ja-Hae,Kim, Hyun-Ah,Kwak, Mi-Jeong,Kim, Hyuo-Sun,Park, Sun-Kyung,Kim, Moon-Sook,Choi, Ae-Lee,Hwang, Jee-In,Kim, Yoon-Sook 한국의료질향상학회 2018 한국의료질향상학회지 Vol.24 No.2

Purpose: Falls are one of the most frequent health events in medical institutions, however, they can be predicted and prevented. The Quality Improvement Nurse Society clinical practice guideline Steering Committee developed the Clinical Practice Guideline for the assessment and prevention of falls in adult people. The purpose of this study was to assess the risk factors for falls in adults aged 19 years and older, to present an evidence for preventing falls, formulate a recommendations, and indicators for applying the recommendations. Methods: This clinical practice guideline was developed using a 23-step adaptation method according to the Handbook for clinical practice guideline developer (version 1.0) by National Evidence-based Healthcare Collaborating Agency. Evidence levels and recommendation ratings were established in accordance to SIGN 2011 (The Scottish Intercollegiate Guidelines Network). Results: The final 15 recommendations from four domains were derived from experts' advice; 1) assessment of risk factor for falls in adult 2) preventing falls and reducing the risks of falls or falls-related injury 3) management and reassessment after a person falls 4) leadership and culture. Conclusion: This clinical practice guideline can be used as a basis for evaluation and prevention of fall risk factors for adults, to formulate recommendations for fall risk assessment and fall prevention, and to present monitoring indicators for applying the recommendations.

QA활동과 식스시그마

천자혜,이환모,정재복 한국의료QA학회 2008 한국의료질향상학회지 Vol.14 No.2

의료 이용도 조사

천자혜 한국의료QA학회 1998 가을학술대회 Vol.1998 No.-

일 의료원의 통합 고충처리센터 접수 내용과 이에 대한 해결방안 분석

탁관철,천자혜,박현주,문주영,최미영,김현주,강진경 한국의료QA학회 1999 가을학술대회 Vol.1998 No.-

본 연구의 결과에서 3개월간 본 의료원을 이용하는 고객의 고층 및 불만족, 건의, 신고 등으로 317건이 접수되었으며 이들 신고 내용을 분석한 결과 주차 및 부대시설(14.5%), 병실(10.7%), 접수 및 수남(10.7%), 대기 환경(8.8%), 간호사 및 보조원(7.6%), 의사(6.6%)에 관한 신고 순이었으며, 각 과별 분류에서는 간호부서(9.8%), 정신과(4.7%), 이비인후과(4.4%), 입원원무과(4.1%). 시설과(4.1%)를 대상으로 한 건의와 신고 순이었다. 수집, 분석된 고객의 요구는 데이터베이스로 구축되어 의료원 전체의 정보로서 공유하고 있으며 부서별로 해당 내용을 통보하여 신속한 대응과 해결책을 모색하고 있다. 이로부터 발생하는 모든 신고와 처리결과의 집계는 적정진료관리위원회, 임상과장회의, 행정과장회의에 정기 보고하여 전직원의 참여의식을 고취하고 효율적이면서도 총체적인 의료서비스 질 향상을 위한 CQI활동의 지표로 사용하고 있다. 효과적 고객 만족 전략을 운영하기 위해서는 첫째, 시대의 변화에 따른 고객의 가치를 이해하고 고객의 요구에 신속하게 대처할 수 있는 조직 개선, 둘째, 접수된 고객의 소리에 대한 데이터베이스를 구축하여 정보를 공유할 수 있는 다양한 시스템 개발, 셋째, 발견된 문제점에 대한 지속적 CQI 활동. 넷째, 전직원의 참여가 이루어지는 조직 문화 조성, 마지막으로 최고경영자의 의지와 비전 수립 노력이 곁들여 이루어질 때 총체적으로 고객만족을 성공적으로 성취해 낼 수 있을 것이다.

Joint Commission International 인증의 의미

이환모,천자혜 대한의사협회 2012 대한의사협회지 Vol.55 No.1

Recently many hospitals in Korea have become interested in JCI (Joint Commission International) accreditation. As the medical market opens to medical tourism and to attract foreign patients, JCI accreditation has become the prime object. It is compatible with government policy for upgrading the medical industry and necessary to strengthen compatibility with foreign hospitals. JCI accreditation means that the medical services provided by a hospital are equivalent in quality and patient safety to medical services internationally. It also means that the hospital is reliable in treating patients according to international policies and regulations. The most important meaning of JCI accreditation is that the staff in the hospital have promised to provide safe patient care according to the hospital policies and bylaws made and approved by the staff members. During the process for JCI accreditation, the hospital staff’s concept regarding patient safety has been changed and many of them are now voluntarily involved in quality improvement and patient safety activities in the hospital.

투약 오류 건에 대한 근본원인분석 시행

송명희,천자혜,고홍,김기준,Song, Myeng Hee,Chun, Ja Hae,Koh, Hong,Kim, Ki Jun 한국의료질향상학회 2012 한국의료질향상학회지 Vol.18 No.1

문제: 투약오류는 의료기관 전반에서 가장 많이 발생하는 오류의 하나이며, 환자에게 중대한 위해를 초래하기도 한다. 특히 고농축전해질은 문제발생의 가능성과 위험성이 높아 지속적인 관리 및 교육을 필요로 하고 있다. 목적: 발생한 투약오류 건에 대한 근본원인분석을 시행함으로써 유사사례가 발생하는 것을 예방하여 환자안전을 도모하고자 한다. 의료기관: 연세대학교 세브란스병원 질 향상 활동: 투약오류 건에 대해 근본원인분석 시행 후 고위험약물 관련 내규를 보완하였고, 고위험약물에 대한 Alert System 개발, 고위험약물 라벨 부착, 약 처방 관련 의료진 교육을 시행하였다. 개선효과: 고위험약물 투여와 관련된 시스템 개선 활동 이후 유사사례는 발생하지 않았고, 의료진 교육을 통하여 환자안전에 대한 인식과 중요성을 더욱 증가시켰다.

JCI(Joint Commission International) 인증 경험

정재복,이환모,천자혜,Chung, Jae Bock,Lee, Hwan Mo,Chun, Ja Hae 한국의료질향상학회 2008 한국의료질향상학회지 Vol.14 No.1

CPR Contest를 적용한 섬폐소생술 교육의 효과

정재복,이환모,천자혜,안수진,김효진,박유석,조준호 한국의료QA학회 2008 가을학술대회 Vol.2008 No.3

일 의료원의 통합 고충처리센터 접수 내용과 이에 대한 해결방안 분석

탁관철,박현주,천자혜,강은숙,문주영,최미영,김현주,강진경,Tark, Kwan-Chul,Park, Hyun-Ju,Chun, Ja-Hae,Kang, Eun-Sook,Moon, Ju-Young,Choi, Mi-Young,Kim, Hyun-Ju,Kang, Jin-Kyung 한국의료질향상학회 2000 한국의료질향상학회지 Vol.7 No.1

Background : A continuous healthcare quality improvement is needed to provide high quality healthcare service as well as to maintain trust in terms of satisfying the needs of the patients. Recently it also became an essential issue. in hospital management, recognized for it's competitive potentiality among healthcare organization groups. This study was conducted to analyze patient complaints and issues received by the Quality Improvement Department. Its purpose is to improve healthcare qualities within the hospital, as well as establish policies and appropriate strategies in hospital management. Method : From July 1st to September 30th of the year 1999, we analyzed all complaints and issues made by various patients and their families, which were received through 24 hour phone consultation, numerous suggestion boxes, letters and E-mails, The issues were classified into 16 different categories based on a Patient Satisfaction Assessment Tool. All data were segregated according to the departmental frequencies and their contents. To come up with for environmental and patient satisfaction improvement, all complaints or issues were communicated with hospital administrators, medical and nursing staff and employees. Comprehensive customer satisfaction activities including improving phone etiquette were discussed in Customer Satisfaction Team, CQI Team and each Department. All opportunities for improvement were implemented. Feedback actions were discussed. Results : A total of 317 cases were collected. Issues regarding parking and other accommodation facilities were most common complaints that were 14.5% of total. Issues regarding admission rooms (10.7%), admission procedures (10.7%), waiting room environment (8.8%), nurses and nurse assistants (7.6%), physicians (6.6%) and others (23%) followed. Thirteen of 45 departments received more than 8 complaints. The Nursing Department had the most complaint, receiving 9.8% of total complaints. Complaints regarding the Nursing Department were predominantly related to the environment of patient rooms. The Department of Psychiatry for phone etiquette (4.7%), Department of Otolaryngology for the nursing staff's attitude and phone etiquette (4.4%), and the Admission Department followed. As a part of efforts to improve patient satisfaction, a new parking structure was built and reallocation of the parking space was done. Renovation of other accommodation facilities were carried out by hospital administration, Monthly phone call and answering attitude survey was done by QI Department. Based on this survey we made a phone etiquette manual and distributed throughout the hospital. Compare to the last year, Patient Satisfaction Index measured by Korea Productivity Center using National Customer Satisfaction Index was improved 7 points. According to our organization's own study, we confirmed the phone etiquette was improved 11% than last year. Conclusions : Issues related to parking and other accommodation facilities ranked first followed by complaints made regarding the patient care area, the admission and cashier process, and nurses' and doctors' attitude. The Nursing and Psychiatry Departments need improvement regarding phone etiquette. Results were shared and played a vital role in policymaking and strategic planning of the hospital. It is imperative that we keep our database updated by listening to and solving the needs of each patient. The CQI activities can be achieved only by full commitment of the hospital top management supported by related personal.