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Qual Improv Health Care > Volume 22(2); 2016 > Article
Quality Improvement in Health Care 2016;22(2): 43-73.
DOI: https://doi.org/10.14371/QIH.2016.22.2.43    Published online December 30, 2016.
우리나라 병원의 환자안전 향상을 위한 활동 현황
황수희, 김명화, 박춘선
건강보험심사평가원 심사평가연구소
Patient safety practices in Korean hospitals
Soo-Hee Hwang, Myung-Hwa Kim, Choon-Seon Park
Health Insurance Review and Assessment Research Institute, Health Insurance Review and Assessment Service
Correspondence  Choon-Seon Park ,Tel: +82-33-739-1004, Fax: +82-33-811-7442, Email: parkcs@hira.or.kr
Received: November 15, 2016  Revised: December 21, 2016  Accepted: December 21, 2016
Abstract
Purpose
The aims of this study were to assess the presence of core patient safety practices in Korean hospitals and assess the differences in reporting and learning systems of patient safety, infrastructure, and safe practices by hospital characteristics.
Methods
The authors developed a questionnaire including 39 items of patient safety staffing, health information system, reporting system, and event-specific prevention practices. The survey was conducted online or e-mail with 407 tertiary, general and specialty hospitals.
Results
About 90% of hospitals answered the self-reporting system of patient safety related events is established. More than 90% of hospitals applied incidence monitoring or root cause analysis on healthcare-associated infection, in-facility pressure ulcers and falls, but only 60% did on surgery/procedure related events. More than 50% of the hospitals did not adopted present on admission (POA) indicators.
One hundred (80.0%) hospitals had a department of patient safety and/or quality and only 52.8% of hospitals had a patient safety officer (PSO). While 82.4% of hospitals used electronic medical records (EMRs), only 53% of these hospitals adopted clinical decision support function. Infrastructure for patient safety except EMRs was well established in training, high-level and large hospitals.
Most hospitals implemented prevention practices of adverse drug events, in-facility pressure ulcers and falls (94.4-100.0%). But prevention practices of surgery/procedure related events had relatively low adoption rate (59.2-92.8%). Majority of prevention practices for patient safety events were also implemented with a relatively modest increase in resources allocated.
Conclusion
The hospital-based reporting and learning system, EMRs, and core evidence-based prevention practices were implemented well in high-level and large hospitals. But POA indicator and PSO were not adopted in more than half of surveyed hospitals and implementation of prevention practices for specific event had low. To support and monitor progress in hospital's patient safety effort, national-level safety practices set is needed.
Key words Patient safety, Quality improvement, Self report survey


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