본 연구는 의료기관인증제도 도입에 따른 환자안전과 의료서비스의 질이 병원경영활동에 미치는 복합영향을 확인하고 조직문화의 매개효과를 파악하고자 하였다. 이를 위해, 2014년 6월말까지 의료기관인증을 획득한 대구 경북지역에 위치하는 300병상 미만과 300병상 이상, 6개 의료기관 종사자를 대상으로 2014년 9월 22일부터 4주간 설문조사 하였다. 해당 병원에서 1년 이상 근무한 377명을 연구대상으로 하였다. 연구결과, 300병상 미만 중소병원과 300병상 이상 병원 및 종합병원 모두, 환자안전과 의료의 질, 조직문화와 병원경영활동은 변수 간 정(+)의 상관관계가 있는 것으로 나타났다. 환자안전과 의료의 질, 병원경영활동 사이에 조직문화가 부분 매개효과가 있는 것으로 나타났으며 인과효과가 높았다. 따라서 의료기관인증제도 도입에 따른 환자안전과 의료의 질 향상 활동은 병원경영활동을 증진시키는데 효과가 있다 여겨진다.
The purpose of this study was to confirm the complex relationship between patient safety-medical quality and hospital management activities to observe the mediating effect of organizational culture in the relationship due to healthcare accreditation adoption. For this, we conducted a 4 weeks survey, from September 22, 2014 to October 17, 2014 to the employees of 6 hospitals that could accommodate less than 300 patients or more than 300 patients located in Daegu and Gyeongbuk. The study includes 377 participants who have worked for more than one year in the hospital. All of hospital with less than 300-beds or more than 300-beds, such as patient safety-medical quality, organizational culture, hospital management activities found a positive correlation among variables. The mediating effect of organizational culture in the relationship between patient safety-medical quality and hospital management activities was shown by the partial mediating effect and high causal effect. Therefore, these study suggest that patient safety-medical quality due to healthcare accreditation adoption has the potential to improve hospital management activities.
Korea Institute for Healthcare Accreditation. DOI: https://www.koiha.or.kr/home/notice/doList.act
Yeong-Hun Kim, "Analysis of effectiveness on hospital management by accreditation system. Korea Institute for Healthcare Accreditation", 2011.
Bok-Ju Hwang, Jae-Yeol Kim, "The causal relationship between healthcare accreditation system and business performance in medical service organizations. Journal of Korean academic society of accounting", Vol. 20, No. 1, pp.209-232, 2015.
Dana A. Telem, Mark Talamini, Maria Altieri, Jie Yang, Qiao Zhang, Aurora D. Pryor, "The effect of national hospital accreditation in bariatric surgery on perioperative outcomes and long-term mortality. American Society for Bariatric Surgery", Vol. 5, No. 14 pp.213-215, 2014. DOI: http://10.1016/j.soard.2014.05.012
Leblebicioglu H1, Erben N2, Rosenthal VD3, Sener A4, Uzun C5, "Surgical site infection rates in 16 cities in Turkey: findings of the international nosocomial infection control consortium (INICC). American Journal of Infection Control", Vol 43, No. 1, pp. 48-52, 2015. DOI: http://10.1016/j.ajic.2014.09.017
Pomey MP, Contandriopoulos AP, Francois P, Bertrand D., "Accreditation: A tool for organizational change in hospitals?, International Journal of health Care Quality Assurance", Vol. 17, No. 3, pp. 113-124, 2004.
Young-Hwan Lee, Jung-Do Lim, "Relationship between changes of patient safety & medical service quality and changes of management activity after Medical Institution Accreditation : mental hospitals and geriatric hospitals. The Korea Contents Society", Vol. 15, No. 1, pp. 286-299, 2015.
Moon-Ju Shin, "The Effects of hospital accreditation program to the organizational culture, job satisfaction, financial performances and patient safety at geriatric hospital : about Busan metrocity. The Journal of Digital Policy & Management", Vol. 12, No. 10, pp. 455-466, 2014.
Su-Hyung Choi, Duk-Young Cho, "Tae-Ho Hong, A study on the relationship between organizational culture, job characteristics and organization citizenship behavior in hospitals. Korean Academy of Human Resource Management", Vol. 13 No. 4, pp. 191-207, 2006.
Jin-Ho Chun, Jong-Hwa Lee, Jin-Yeong Yoo, "The effect of organizational culture types on organizational commitment and organizational citizenship behavior in small and medium hospitals. The Journal of Digital Policy & Management", Vol. 11, No. 7, pp. 289-296, 2013.
Hee-Lae Kim, "The impact of healthcare accreditation on patient safety and improvement of healthcare quality, organizational culture, hospital administrative activities. Master's Thesis, pp. 65-69, Yonsei university. 2012
Robert E. Quinn, Beyond rational management, mastering the paradoxes and competing demands of high performance. Jossey Bass Publishers, 1991
Robert S. Kaplan, David P. Norton, Transforming the balanced scorecard from performance measurement to strategic management part I. Accounting horizons", Vol. 15, No. 1, pp. 87-104, 2001.
Young-Ran Yeun, "The impact of healthcare accreditation on patient safety and quality, job satisfaction and organizational commitment: about a general hospital. Journal of the Korea Academia-Industrial cooperation Society", Vol. 14, No. 4 pp. 1820-1829, 2013.
Jung-Sik Woo, Young-Hoon Kim, Byoung-Jun Yoon, Hae-Jong Lee, Han-Sung Kim, Young-Jin Choi, Whie-Jong Han, Seo-Jung Yoon, "The effects of accreditation program to the leadership, organizational culture, hospital management activities and performances-focused on perception of accredited hospital professions. Korean journal of hospital management", Vol. 18 No. 2, pp. 33-56, 2013.
Hee-Tae Lee, "The Effects of the Hospital Accreditation System on Quality Management Systems in Hospitals. Social Science Research", Vol. 29 No. 3, pp. 307-328, 2013.
Hye-Seung Lee, Yu-Jeong Yang, "The effects of the healthcare accreditation on hospital employees' satisfaction level and hospital management performance. The Journal of Digital Policy & Management", Vol. 12 No. 1, pp. 431-442, 2014.
Woo-Sok Han, Jae-Yeol Kim, "The effect of the hospital evaluation programme to business performance in medical service organizations. The Journal of The Academic Association of Business Administration", Vol. 21 No. 6, pp. 2549-2580, 2008.
Ga-Eon Yi, " study on the recognition of mid sized hospital employee about the hospital evaluation. Master's dissertation", pp. 5-67, Catholic University of Busan. 2009.