Application of General QA Tools to Quality Improvement Activities in a Hospital's Emergency Room

Hwang, Jee In; Hwang, Jeong Hae; Kim, Chang Yup; Shin, Hee Young; Oh, Byung Hee

Journal of Korean Society Quality Assurance Health Care 1999;6(Suppl DB Error: no such field): 136.
Published online May 30, 1999.

응급실에서의 질 향상 기법 적용

황지인¹, 황정해¹, 김창엽², 선희영³, 오병희⁴

¹서울대학교병원 QA전담반
²서울대학교 의과대학 의료관리학교실
³서울대학교 의과대학 소아과학교실
⁴서울대학교 의과대학 내과학교실

Application of General QA Tools to Quality Improvement Activities in a Hospital's Emergency Room

Jee In Hwang¹, Jeong Hae Hwang¹, Chang Yup Kim², Hee Young Shin³, Byung Hee Oh⁴

¹QA team, Seoul National University Hospital
²Dept. of Health Policy and Management, Seoul National University College of Medicine
³Dept. of Pediatrics, Seoul National University College of Medicine
⁴Dept. of Internal Medicine, Seoul National University College of Medicine

Abstract

Background
Although a number of studies are related to QA improvement, there are few studies applied various method of QA tools. This study reviewed the availability of general quality assurance(QA) tools according to ten steps in performing quality improvement activities at emergency room of a tertiary teaching hospital which has more than 1,000 beds.
Methods
All patients in emergency room from 15th Oct. 1997 to 5th Sep. 1998 were surveyed. The survey data based on the patient's records of emergency room were evaluated according to length of stay, and we tried to identify problems with management of emergency room. To solve the problems, our team applied general QA tools(brainstorming, flow chart, nominal group technique, benchmarking, cause-and-effect diagram, run chart, control chart) to quality improvement activities and discussed the availability of the tools.
Results
After the activities such as changes of staffing, the establishment of local area network and chest pain clinic, application of triage and so on, the percentage of patient who had stayed more than six hours was reduced from 56.0% to 46.8%. The mean number of patients per day in emergency room was increased from 49 to 62. But the reporting time for laboratory test was not changed after these activities.
Conclusion
Each QA tool has unique benefit and limitation, but we can implement and evaluate the quality improvement activities more scientifically and systematically by applying these tools to practice according to QA ten steps.

Key words QA tools;Emergency room;Quality improvement activities;