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

Sunhee Lee, Kui Son Choi, Hye Young Kang, Woohyun Cho, Yoo M.I. Chae

Research output: Contribution to journalArticlepeer-review

55 Scopus citations


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 CQ1 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.

Original languageEnglish
Pages (from-to)383-391
Number of pages9
JournalInternational Journal for Quality in Health Care
Issue number5
StatePublished - Oct 2002

Bibliographical note

Funding Information:
The research upon which this article is based was supported by the Korean Society of Quality Assurance in Health Care.


  • Continuous quality improvement
  • Customer satisfaction
  • Employee empowerment
  • Information system
  • Malcolm Baldridge National Quality Award Criteria
  • Organizational culture


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