'Safety regulations used in airplanes, now essential for hospital industry'
Lee Wang-jun, chairman of Myongji Hospital and president of the Korean Society for Quality in Health Care (KoSQua), has been widely recognized for his leadership in infectious disease responses during the Covid-19 pandemic in Korea.
However, his contributions to medical care span far beyond recent events.
Lee thrice took the helm as the chief of the emergency response unit for the Korean Hospital Association (KHA) during significant infectious disease outbreaks, including the swine flu in 2009, Middle East Respiratory Syndrome (MERS) in 2015, and the Covid-19 pandemic in 2020.
Early in each crisis, he coordinated the infection response systems of hospitals nationwide and maintained close communication with the government and infectious disease authorities.
In addition to his crisis leadership, Lee holds a record as one of the longest-serving infectious disease specialists and advisors at the Korea Disease Control and Prevention Agency (KDCA).
Under his guidance, Myongji Hospital gained renown as a pivotal treatment center for Covid-19, particularly after treating the first Korean patient with the virus.
However, within the medical community, Lee is also revered as a trailblazer in hospital culture reform.
He has been instrumental in enhancing hospital quality and patient safety, often acting as a mediator to resolve internal and external conflicts.
Since 2022, Lee has been leading KoSQua. Previously, he served as vice-chairman of the group for an impressive 14 years.
His dedication to healthcare quality was honored in 2011 when he received a commendation from the Minister of Health and Welfare for playing an instrumental role in the establishment of the Korea Institute for Healthcare Accreditation (KOIHA) in 2010.
Following the establishment of the accreditation center, he took on directorial responsibilities for six years.
Lee also played a crucial role in the enactment of the Patient Safety Act in 2015. He bridged differing opinions between patient groups and the hospital sector to reach an agreement on the current voluntary reporting, information-sharing system and institutionalized patient safety education program.
Speaking in an interview with Korea Biomedical Review, Lee reflected on his achievements and Korea's tremendous strides in healthcare and hospital quality over the past 15 years, ahead of Korea chairing the 39th International Society for Quality in Healthcare (ISQua) Conference.
Question: How did you become interested in healthcare quality and patient safety?
Answer: In the 2000s, medical quality and value emerged as new issues in the medical community.
At that time, the U.S. was already operating the Joint Commission International (JCI), an international healthcare organization accreditation system through the Joint Commission (JC), a non-profit healthcare organization.
In the U.S., while a JCI certification was optional, running a hospital with the certification was nearly impossible.
Therefore, we contacted JC through various channels and visited the site, and became the first Koreans to visit the organization.
After that, I visited JC two or three times and signed a memorandum of understanding (MoU) between JC and the Korean Hospital Association, which naturally led me to play a vital role in the establishment of KOIHA, and I received a commendation from the Minister of Health and Welfare in 2011 for my contribution.
Q: What is the quality of healthcare and patient safety like in Korea?
A: Korea's healthcare system has recently grown to a level that is comparable to that of many of the world's most advanced countries.
Twenty years ago, in 2004, patients who could not be treated in Korea were traveling to the U.S. and other countries for treatment, and we were discussing the need to raise the level of medical care to world-class standards.
As a result, our medical technology and medical system have developed to a global level, and have become so advanced so much that patients come from abroad and physicians in other countries come to Korea for medical training.
However, the quality of healthcare and patient safety side is a different story.
If half of healthcare consists of hardware, such as medical equipment and technology, the other half is software, such as hospital management systems, the core of which is quality management and patient safety.
The problem is that the development of this software part in Korea is very slow.
In Korea, new medical technologies are reimbursed regardless of how expensive the treatments are.
However, there is no reimbursement system or incentives for patient safety or medical quality improvement.
Q: What factors hinder the development of medical quality improvement and patient safety in Korea?
A: In Korea, medical quality assessment is mainly carried out by the KOIHA.
The problem is that the medical quality evaluation system is based on relative evaluation and not absolute evaluation.
In the case of relative evaluation, it is difficult to change the ranking once it is established. Notably, such a system is bound to favor large hospitals with relatively abundant medical resources.
Also, motivation factors are absent for hospitals to improve their quality of care.
This means that even if a hospital makes efforts to improve the quality of care, the subsidies they receive in the form of compensation remain the same, causing them to lose motivation.
Therefore, I believe the medical quality assessment and subsidy system needs improvement.
Also, there must be a section on medical quality management and patient safety when the government establishes healthcare policies.
However, the reality is that while there has been a lot of progress on structural issues and micro-management in the field, it has not been supported by any government-led policies.
For example, the Prime Minister's Committee on Medical Quality and Accreditation is supposed to discuss medical quality and accreditation, but its activities are so low that it is only convened once a year.
Also, to see how much the quality of medical care in Korea has improved, we need to have certain indicators in place and continue to manage and improve them.
However, there are virtually no statistics to evaluate and analyze the quality of medical care.
Q: What are some solutions to resolve such shortcomings?
A: With the opportunity of holding the 39th ISQua World Conference, we should take strategic and policy leadership in healthcare quality and patient safety, and create comprehensive survey statistics for each disease and characteristic, so that they can be referenced and utilized for policy establishment and promotion.
If the government cannot realize this, it is necessary to entrust the job to KoSQua.
The current situation is that hospitals are trying to improve patient safety and medical quality on their own.
However, this can only be motivated through institutional investment and continuous rewards and guidance.
Out of over 80 trillion won($59.7 billion) in health insurance finances, less than 1 trillion won (1.25 percent) is allocated for quality improvement.
If the government expands the investment to at least 5 percent of the total finances, it is possible to change the social perception that a high level of medical quality and patient safety is a must and secure consensus on the policy direction.
Q: Are there any additional remarks you would like to add as president of KoSQua?
A: KoSQua is the largest multidisciplinary society in Korea, with 13,000 individual members and 1,100 institutional members since its founding in 1994.
Over the past 29 years, it has played a pivotal role in improving healthcare quality through various academic, educational, and policy activities, including hospital standardization, the introduction of the accreditation system, and the enactment of the Patient Safety Act.
However, it has been pointed out that in inverse proportion to the expansion and institutionalization of Korea's quality assessment and certification systems, the reality is that hospitals are becoming impoverished by participating in the system, and the staff are becoming exhausted.
As a result, recent quality improvement and patient safety activities do not guarantee good results.
When I took office as the 15th President of KoSQua, I promised to create strategic momentum for a paradigm shift that would make quality improvement and patient safety activities "Joyful, Meaningful, and Beneficial."
I hope that the Mint Festival and the ISQua Conference will catalyze a shift in government and public perception.
I look forward to a new chapter where improving hospital quality and patient safety will become exciting and rewarding.
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'Safety regulations used in airplanes, now essential for hospital industry' - KBR
Lee Wang-jun, chairman of Myongji Hospital and president of the Korean Society for Quality in Health Care (KoSQua), has been widely recognized for his leadership in infectious disease responses dur...
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