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


METHODS
Cross-sectional study by mailed questionnaire survey.


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


METHODS
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.


CONCLUSIONS
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.
Lee
Sunhee
S
Choi
Kui-Son
KS
Kang
Hye-Young
HY
Cho
Woohyun
W
Chae
Yoo Mi
YM
D019985:Benchmarking; D003258:Consumer Behavior; D003430:Cross-Sectional Studies; D006302:Health Services Research; D006739:Hospital Administration / Q000592:standards*; D006745:Hospital Bed Capacity, 300 to 499; D006746:Hospital Bed Capacity, 500 and over; D006751:Hospital Information Systems; D006801:Humans; D007723:Korea; D015279:Organizational Culture; D011209:Power, Psychological; D015397:Program Evaluation; D019984:Quality Indicators, Health Care; D011795:Surveys and Questionnaires; D017749:Total Quality Management / Q000458:organization & administration / Q000706:statistics & numerical data*