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International Journal for Quality in Health Care 14:383-391 (2002)
© 2002 International Society for Quality in Health Care

Paper

Assessing the factors influencing continuous quality improvement implementation: experience in Korean hospitals

SUNHEE LEE1, KUI-SON CHOI2, HYE-YOUNG KANG3, WOOHYUN CHO4 and YOO MI CHAE5

1Department of Preventive Medicine, College of Medicine, Ewha Womans University
2National Cancer Center Research Institute
3Graduate School of Health Science and Management and
4Department of Preventive Medicine, College of Medicine, Yonsei University
5Korean Medical Association, K-RBRVS Research and Planning Team, South Korea

Objective. To assess the extent of continuous quality improvement (CQI) implementation in Korean hospitals and to identify its influencing factors.

Design. Cross-sectional study by mailed questionnaire survey.

Study participants. One hundred and seventeen staff members with responsibility for CQI at 67 hospitals with >=400 beds.

Main outcome measures. The degree of CQI implementation was measured using the Malcolm Baldrige National Quality Award Criteria (MBNQAC). Factors related to the degree of CQI implementation were the four components of the CQI pyramid, namely the cultural, technical, strategic, and structural attributes of individual hospitals.

Results. The average CQI implementation score across the seven dimensions by MBNQAC was 3.34 on a 5-point scale. The highest score was achieved in the dimension of ‘customer satisfaction’ (3.88), followed by ‘information/analysis’ (3.59), and ‘quality management’ (3.35). Regression analysis showed that hospitals which better fulfilled technical requirements, such as improving information systems (P < 0.05), using more scientific CQI tools, and adopting systematic problem-solving approaches (P < 0.01), tended to achieve higher degrees of CQI implementation. Although statistically insignificant, positive trends were observed for group/developmental culture and the degree of employee empowerment, and the use of prospective strategy.

Conclusion. It appears that the most important contributing factors to active CQI implementation in Korean hospitals were the use of scientific skills in decision-making and the adoption of a quality information system capable of producing precise and valid information.

Keywords: continuous quality improvement, customer satisfaction, employee empowerment, information system, Malcolm Baldrige National Quality Award Criteria, organizational culture


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