사람은 자신이 소유한 지식정보에 근거하여 의사결정을 하게 되므로 변화하는 새로운 지식정보에 대한 지속적인 교육과 훈련을 통해서 능력을 개발해야 조직생활에서 쉽게 적용하고 성공할 수 있다.
이태리, 그리스 등의 남유럽을 시발점으로 세계경제가 위기 상황으로 빠져들면서 국내 경기도 그 경기침체의 영향을 크게 받고 있다는 사실을 부정할 수가 없다. 최근 국내 대학병원과 대형병원도 계속 외래환자가 줄고 주5일제 여파로 주말 병상가동률이 떨어져 울상이다. 게다가 건강보험 수가인상폭도 병원계의 기대에 턱없이 낮기 때문에 병원 살림의 앞날을 더욱 난감하게 하고 있다. 이러한 상황에서 활로를 모색하고 있는 의료기관들은 장기적인 안목에서 병원 인력의 경쟁력이 병원의 경쟁력이라고 판단, 경영 마인드 제고를 중심으로 한 직원교육을 활발히 실시해 향후 병원경영에서 원동력으로 삼고 있다. 특히 독자가 쉽게 알 수 있도록 내용을 표와 그림을 삽입하고 간추려서 체계적으로 이해가 되도록 노력을 하였다.
최근 병원에서의 직원 교육은 종전의 서비스 교육에서 탈피해 병원 경영목표는 물론 리더십, 병원마케팅, 회계 및 재무관리 등 경영 전문성 확보를 목표로 하고 있어 병원직원 교육에서 새로운 전기가 마련됐다. 이러한 현실에서 임상검사실 운영관리에 다소 도움이 되고자하여 새로운 경영관리 기법들을 도입하기 위하여 최신의 “임상검사 경영관리”를 출판하게 되었다.
조직의 주어진 목적을 달성하기 위해서는 조직 내에서 질적인 경영관리 지식에 의존해야 한다. 진단검사의학 분야도 예외일 수 없기 때문에 질적 검사서비스의 제공과 효율적인 검사결과를 산출하기 위해서는 경영관리 원칙들을 철저하게 응용해야 한다. 대한진단검사의학회에서도 수련의 목표지침서에서 검사실 운영관리 교육을 실시하도록 규정하고 있으며, 보건대학에서도 강의가 개설되어 있어 제대로 된 한글판 참고서의 필요성이 높았다.
진단검사의학 분야는 병원의 다른 부서들에 비하여 과학적인 경영관리기술의 응용과 실전이 늦은 편이다. 진단검사의학의 환경도 기술적, 사회적, 경제적, 법률적 환경의 변화로 수차례 격동의 시대를 겪어왔다. 이럴 때일수록 환자중심의료, 원가관리, 재무관리, 인적자원문제, 정도관리 등을 다루기 위한 관리자와 구성원들의 역할이 증대하고 있다. 또한 조직의 효율성과 효과성을 향상시키기 위해서 경영관리 기술이 필요한 시점이다. 그 구성원들에게 일을 잘하라고 말하지만 올바른 일을 올바르게 처리하고 과학적인 의사결정에 관련된 경영관리 기술을 교육을 하고 훈련했을 때 진단검사의학과의 유효성이 향상될 수 있다.
환자들의 기대를 충족시키기 위해서 직원들에게 임무를 부여해주고 참여시켜서 그들의 능력과 재능을 최대한 발휘하도록 조직 환경을 조성하고 관리하는데 필요한 모든 경영관리 기법들을 책자에 포함시키고자 노력하였다. 대학에서 임상검사 경영관리의 기초와 실전적인 교육을 하는데 이해가 쉽도록 핵심적인 내용으로 구성하고, 업무현장에서 근무하는 직원들이나 관리자의 위치에 있는 사람들에게도 필요한 지식정보를 제공하도록 이론과 실전적인 내용들을 포괄적으로 포함하였으며, 특히 외국의 진단검사의학 수련의 과정이나 대학들에서 사용하는 100여권의 교제들을 참고하여 우리의 실정에 맞도록 재구성하였다.
책자의 핵심내용은 임상검사 경영관리학의 본질, 운영관리, 인적자원개발, 인적자원관리, 원가관리, 재무관리, 마케팅관리, 환자중심의료, 괸리적 리더십, 6시그마 정도관리, 임상검사정보체계(LIS), 의사소통, 의료보험관리, 검사실 경제, 기기관리 등인데 위기를 성공의 기회로 도전하는데 필요한 기법들을 모두 포함시켰다.
각자의 조직들은 각기 다른 자원들로 구성되어 있으므로 각기 다른 문제들을 가지고 있다. 검사시스템을 개선하고 생산성을 향상시키려면 직장에서 출현하는 문제들을 과거의 사고방식으로는 풀리지 않으므로 새로운 지식정보의 활용으로 해결해야 한다. 오늘날의 무한 경쟁의 현실에서는 새로운 지식정보를 끊임없이 배우고 행동으로 옮기는 사람이나 조직만이 경쟁에서 살아남을 수 있고, 위기를 피하기보다는 도전하여 성공의 기회로 만들어야 성공할 수 있다. 임상검사실을 책임지고 있는 진단검사의학 전문의와 검사실장, 실무를 담당하는 임상병리사들에게 필수적인 임상검사실 운영 지침서로 역할을 할 수 있을 것이다. 또한 진단검사의학을 공부하는 전공의나 보건대학에서 공부하는 학생들에게는 참고서로 구실을 할 수 있을 것으로 사료된다. 특히 임상검사 경영관리학의 기초편은 학생들이 졸업 후 실무에 신속하게 적응하고 흥미를 느낄 수 있도록 내용을 배려하였다. 그리고 임상검사 경영관리의 원칙은 병원 내 다른 부서와 큰 차이가 없기 때문에 이들 부서의 근무자나 진단검사 시약이나 검사장비 공급자에게도 많은 도움이 될 것으로 확신한다.
책자에 대한 내용 구성과 방향을 제안하여 주시고 임상검사 경영관리에 대한 많은 책자를 기증해 주신 펜실베이니아 주립대학의 밀턴 S 헬시 의료원(Pennsylvania State University, Milton S.Hershey Medical Center) 진단검사의학과에 계시는 William O. Umiker 교수님께 깊은 감사를 드리며, 일본후생성 병원경영관리원의 임상검사경영관리 자료들을 제공하여 주신 일본 동경 SRL검사센터의 게지 하야마(Kenji Hayama) 경영이사님, 인적자원관리 분야의 책자를 기증해 주신 전남대학교 경영대학 박성수 교수님과 김종재 교수님께 감사를 드립니다.
인적자원개발학회(ASTD), 미국임상검사경영관리학회(CLMA), 미국품질학회(ASQ), 미국병원협회(AHA), 미국병원경영정보관리학회(HIMSS)의 출판물을 담당하신 분들의 도움을 많이 받았습니다. 이미 작고하셨습니다만 야망과 도전정신을 심어주신 미국 UCLA, Center for the Health Science에 근무하셨던 John M. Adams, MD, PhD 교수님의 은혜를 잊을 수 없습니다. 여러 가지로 도움을 주신 서울대학병원 김철우 교수님, 고려대학교 구로병원 강은영 교수님, 전남대학병원 양동욱 교수님과 고 유주용 교수님, 을지보건대학 박정오 교수님께 깊은 감사를 드립니다.
그리고 직무분석과 인적자원관리 자료를 주신 경북대학병원 이영순 박사님, 이해순 박사님, 김천대학 류재기 교수님께 감사를 드리며, 보다 더 좋은 책을 만들기 위해서 다양한 재능과 능력을 발휘해준 참여저자 분들에게 감사를 드립니다. 더욱이 미국의 업무현장에 대한 최근의 임상검사경영관리 분야의 흐름에 대한 지식정보를 주신 정수경 박사님과 강명남 실장님께 감사를 드립니다.
정도관리 자료를 주신 한국바이오협회 양재혁 실장님과 일본의 주 임상경로와 마케팅 자료를 주신 오흥백 실장님 그리고 김대근 실장님께 감사를 드리며, 관리자로서 업무현장의 지식정보를 제공해주신 서울대학병원 주세익 실장님, 한양대학병원 이귀순 실장님, 부산 좋은강안병원 이진매실장님, 문헌정보학측면에서 기초자료를 분리정리해준 장로사 박사와 그 외에도 여러 가지 형태로 도움을 주신 선생님들께 감사를 드립니다.
2013년 5월 1일
장 상 우·문 해 란·조 현 찬·김 영 권
조현찬 문해란 교수 대표이사 강동성심병원, 진단검사의학과 에스엘에스 김영권 김대식 학장 및 교수 학과장 및 교수 건양대학교, 보건과학대학, 임상병리과 동남보건대학, 임상병리과 장상우 정동진 검사실장 및 외래교수* 검사실장 및 외래교수* 서울의대, 암연구소, 바이인프라 계명대학교 동산의료원, 진단검사의학과 건양대학교* 대구보건대학* 최완수 차경호 교수 감독 동의과학대학, 임상병리과 서울성모병원, 진단검사의학과, 임상화학검사실 정우복 오정도 교수 감독 동남보건대학, 임상병리과 경북대학병원, 진단검사의학과, 혈액검사실 최종태 백병윤 검사실장 감독 분당제생병원, 진단검사의학과 서울아산병원, 진단검사의학과, 임상화학검사실 김동찬 강경령 검사실장 검사실장 서울대학교병원 강남센터 강동성심병원, 진단검사의학과 김양호 서한익 기획실장 및 교수 검사실장 광양대학, 임상병리과 이원의료재단, 진단검사부 |
제1장 임상검사경영관리학의 본질 / 문 해 란.장 상 우.김 동 찬 . 임상검사경영관리의 개념과 성립배경 ··························································· 1 . 경영관리의 현대적 접근방법·······································································6 . 검사실의 생산시스템·················································································9 . 경영의 행동원칙(Principles of Management Behavior)······································ 11 . 경영관리 기능(Management Function)·························································· 13 . 관리자의 역할(Role of Manager) ······························································· 20 . 기업경영관리기술의 응용········································································· 26 . 의료환경의 변화(Change of Medical Environment)·········································· 29 . 전략적 검사실 경영관리사고(Strategic Laboratory Management Thinking) ··········· 34 . 시나리오 전략(Scenario Strategy) ······························································ 44 . 관리자의 경영관리지식 ··········································································· 47 제2장 운영관리 / 조 현 찬.김 영 권.장 상 우 . 검사실 조직구조와 관리 ·········································································· 51 . 검사실 설계(Laboratory Design) ······························································· 68 . 운영방침과 실행과정(Operation Polices and Practical Progress) ······················ 78 . 생산성과 수행도 평가(Production and Performance Assessment) ···················· 87 . 21세기의 검사실(The 21st Century Laboratory) ············································ 102 제3장 임상검사정보체계 / 최 종 태.최 완 수.장 상 우 . 병원 컴퓨터의 활용(Use of Hospital Computer) ············································ 113 xv . 병원정보체계(HIS: Hospital Information System) ············································ 116 . Data Base ·························································································· 121 . 총괄적 전산시스템(Total Computer System) ··············································· 123 . 병원정보체계의 기능(Hospital Information System: HIS) ································· 123 . 임상검사정보체계의 핵심(Key Points of LIS) ················································ 127 . 컴퓨터 작업시스템(Computer Work system) ··············································· 132 . 자동화의 이익과 생산성 ········································································ 135 . 검사실의 자동화 시스템(Total Laboratory Automation) ·································· 137 . 지식 경영(knowledge management) ························································ 150 제4장 인적자원관리 / 김 대 식.오 정 도.정 동 진.김 양 호 . 인적자원관리의 기초·············································································· 167 . 인적 자원 관리의 절차············································································ 170 . 인적 자원의 수급 계획············································································· 171 . 모집과 선발(recruitment and selection)······················································· 180 . 교육 훈련과 계발(Educational training and development)································ 194 . 인사고과(Merit rating)············································································· 198 . 인사이동 및 이직··················································································200 . 직무기술서 및 직무 명세서(Job Description and Job Specification)····················202 . 충원과 일정 계획(Staffing and Scheduling)··················································208 . 노사관계(Labor Relation)········································································· 219 . 경청과 상담(Listening and Counselling)······················································ 222 제5장 검사실 회계 관리 / 조 현 찬.백 병 윤.최 완 수 . 검사원가의 정의(Definition of Laboratory Cost)··············································233 . 검사 원가관리의 핵심·············································································234 . 검사실회계(Laboratory Accounting)···························································236 . 검사원가계산의 목적(Goal of Lab Cost Accounting)·······································239 . 검사원가의 종류(Types of Lab Cost Accounting) ·········································240 . 검사 원가개념의 기초(Basic Concept of Lab Cost)········································ 241 xvi . 검사에서 발생되는 주원가비용 ································································245 . 감가상각(Depreciation) ··········································································246 . 검사원가의 유형(Types of Lab Cost)··························································249 . 활동원가기준(Activity Based Costing; ABC) ·················································258 . 검사실 예산(Laboratory Budget)································································263 제6장 검사실 재무 관리 / 김 영 권.백 병 윤.김 대 식.장 상 우 . 재무관리의 본질··················································································· 273 . 검사실 비율분석(Ratio Analysis in Laboratory)·············································· 279 . 손익분기점분석(Break-Even Point Analysis)················································282 . 물품 및 재고관리(Material and Inventory Management)···································288 . 재고자산의 관리···················································································292 . 재고관리시스템의 기본유형····································································· 297 . 사후정산품목과 Cock System··································································302 . 재고조사기법·······················································································303 제7장 검사실 마케팅 관리 / 장 상 우.차 경 호.정 우 복 . 마케팅의 의의······················································································309 . 마케팅의 중요성··················································································· 310 . 고객행동(Customer Behavior)··································································· 314 . 서비스 마케팅(Service Marketing)····························································· 315 . 기능적 마케팅전략(Functional Marketing Strategy)········································· 317 . 검사실 판매(Laboratory sales)··································································329 . 마케팅 환경의 조사(Marketing Environment Review)······································339 . 시장분석(Market Analysis)·······································································340 . 시장세분화 전략(Market Segmentation Strategy)···········································343 . 검사 서비스 개발(Laboratory Product Development)······································345 . SWOT 마케팅전략·················································································348 . 데이터베이스 마케팅(Data Base Marketing)·················································356 . SCAP 마케팅 전략················································································356 xvii 제8장 의사소통 / 김 영 권.장 상 우.차 경 호.최 완 수 . 지각과정·····························································································363 . 지각(Perception)···················································································363 . 지각의 핵심························································································· 372 . 초감각적 지각(Extra Sensory Perception)···················································· 373 . 의사소통(Communication)········································································ 373 . 의사소통의 경로··················································································· 375 . 미국경영관리학회의 효과적인 의사소통방법················································ 376 . 의사소통의 장애요인 - 전달자, 수신자, 심볼, 전달경로··································· 377 . 조직 내 의사소통의 개선방향···································································378 . 비공식 조직(Informal system)의 활동·························································· 381 . 의사소통의 요약···················································································382 . 간추린 의사소통(Simple Communication)·····················································385 . 경청자의 자기평가분석···········································································388 제9장 환자중심의료 / 조 현 찬.장 상 우.박 점 기 . 고객만족경영의 발전··············································································395 . 환자안전과 위험관리(Patient Safety and Risk Management)·····························396 . 고객만족경영의 의의·············································································· 397 . 고객만족의 기본개념··············································································399 . 고객을 확인(Identify customer)··································································403 . 고객만족의 개선과정(improvement process for customer satisfaction)················406 . 고객만족경영의 효과와 시스템의 관계························································409 . 환자만족의 고정관념의 탈피····································································· 411 . 환자만족경영······················································································· 414 . 환자만족 프로그램의 개발······································································· 418 . 환자중심의 검사실(Customer-Focused Laboratory)·······································422 . 통합진료 전달체계(Integrated Delivery System : IDS)의 구축····························425 . 환자중심 검사실의 확장 ·········································································430 . 진료중심 검사체계················································································434 . 환자만족의 측정(Measuring Customer Satisfaction)········································440 xviii 제10장 관리적 리더십 / 정 동 진.문 해 란.장 상 우.김 동 찬 . 관리자가 참고해야 할 사항······································································445 . 동기부여(Motivation)··············································································· 451 . 리더쉽(Leadership)················································································469 . 갈등관리(Conflict Management)································································487 . 직장회의의 기본적 이해와 태도································································497 . 개구리종말증후군(Boiling Frog Syndrome)의 교훈·········································503 . 다루기 어려운 사람을 다루는 기술····························································505 . 응대하기 힘든 상사를 대하는 방법(Dealing with difficult boss)··························· 513 . 문제해결과 의사결정(Problem Solving and Decision Making)··························· 522 . 중요한 의사결정을 하는 방법(W.O. Umiker,MD)·············································526 . 권한위양의 범위에 따른 의사결정 ····························································529 . 비지니스 프로세스 리엔지니어링(Business Process Reengineering)··················534 . 비즈니스 프로세스 벤치마킹(Business Process Benchmaking)·························539 . 지도력 테스트······················································································546 제11장 식스시그마 정도관리 / 정 우 복.박 점 기.장 상 우 . 정도관리의 기초지식·············································································· 551 . 6시그마의 개념정의(Concepts Definition of Six Sigma) ···································560 . 경제적인 정도관리(Economic Quality Control) ··············································568 . 6시그마의 평가 척도(Six Sigma Metrics)······················································ 572 . 6시그마의 비전(Six Sigma Vision)······························································ 575 . 제3세대 6시그마(Generation 111 Six Sigma)··················································578 . 6시그마의 성공요인들(Six Sigma Program Success Factors)··························· 581 . 공정능력지수(Process Capacity Index : PCI)················································587 . 검사공정수행도의 설계방법·····································································593 . 21세기의 의료 질 개념들(Concepts of New Quality in 21st Century)··················· 600 xix 제12장 인적자원개발 / 정 동 진.김 영 권.박 점 기.장 상 우 . 지식경영의 필요성················································································603 . 신경세포의 의사전달방법(Neurons Communication Way)································605 . 우뇌와 좌뇌의 역할(Role of Right & Left Hemisphere)·····································608 . 잠재능력의 개발··················································································· 610 . 인적자원개발의 유래(Origin of Human Resource Development)························ 614 . 인적자원개발의 정의(Definition of Human Resource Development)···················· 615 . 훈련의 유형(Type of Training)·································································· 617 . 교육(Education)···················································································· 619 . 직원개발(Staff Development)····································································620 . 경력개발(Career Development)································································· 627 . 임상병리사의 인적자원개발(병리사의 경력개발)············································630 . 조직개발(Organizational Development)·······················································634 제13장 의료 보험과 원무 관리 / 장 상 우.강 경 령.백 병 윤.서 한 익 . 의료 보험 관리(Medical Insurance Management)·········································· 641 . 원무 관리의 정의··················································································650 . 진료관리·····························································································654 . 진료비 관리·························································································659 . 진료비 청구와 수납···············································································663 . 진단검사의학과의 도전적인 위협(Challenging Threats to Laboratory Medicine)·····665 . 미래의 검사실 환경(Future Laboratory Environment)······································667 제14장 검사실 경제 / 문 해 란.정 동 진.차 경 호.김 양 호 . 경제 원리의 기초··················································································669 . 수요와 공급이론(Demand and Supply Theory)············································· 672 . 검사실 경제의 응용(Application of Laboratory Economics)······························· 681 . 생산기능의 경제(Economics of Production Fumction)·····································688 . 기타 경제이론들(Other Economics Theories)················································695 xx 제15장 기기관리 / 백 병 윤.강 경 령.서 한 익 . 자동 분석기의 역사(History of Autoanalyzer)················································703 . 장비 보전(Equipment Maintenance)···························································704 . 장비 도입 시에 고려하여야 할 점······························································706 . 예방 보전의 실행 방법············································································ 710 . 검량보정(calibration)··············································································· 713 . 실증적 검량보정 수동 검량보정(Manual Calibration)······································· 715 . 기기 관리의 핵심(Core Points of Equipment Management)·······························717 . 미국 병리학회의 예방 보전 요건(preventive Maintenance Requirements of CAP)·· 723 . 기기의 검증 및 보전 지침 (Guideline of Verification and Maintenance for Instruments)······························ 724 . 검사실 안전관리(Lab Safety Management)·················································· 728 참고문헌 / 739 찾아보기 / 749 INDEX / 767 |
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