Institutionalization of quality improvement programs in Korean hospitals.

OBJECTIVE To investigate the institutionalization of quality improvement (QI) programs in Korean hospitals, in which organizational efforts to improve the quality of care have been made only recently. DESIGN A cross-sectional study based upon an initial telephone contact and follow-up mail survey. STUDY PARTICIPANTS All hospitals with 400 beds or more, 100 as of 1997, were contacted in the initial telephone survey. The survey questionnaire was then sent to all of 28 hospitals found to have a QI department; 26 hospitals returned the completed questionnaire. RESULTS Hospitals that had larger bed capacities, that provided tertiary levels of care or that were in urban areas were found to have a higher tendency to establish QI departments. These QI departments most frequently cited improvement of patient satisfaction as one of their overall missions. They also reported that their most important responsibilities were monitoring performance and preparing for the two national Korean hospital assessment programs. Participating in these hospital assessment programs helped them to initiate and develop their QI activities. The main difficulties they had in performing their QI programs stemmed from lack of knowledge and resources. These survey findings indicate that hospital assessment programs significantly aided Korean hospitals to institutionalize their QI programs. At the same time, the survey data indicate that the hospital assessment programs may emphasize short-term benefits from QI activities at the expense of long-term QI institutionalization. CONCLUSION QI programs have not as yet been fully institutionalized in Korean hospitals. More support for QI structure and organizational preparation at both the national and organizational levels will be needed.