【正文】 ts on assessment of faculty and individuals. Some attempts have been made in appraising performance of clinical department directors in some Chinese hospitals and the representative appraisal approaches are application of balance score card to performance appraisal, application of 360degree performance assessment method to assess the director of clinical department, application of the assessment index system out of Key Performance Index (KPI), and application of the method of management by objectives to establish a performance appraisal system. 目前公立醫(yī)院仍然被國(guó)家列為事業(yè)單位，大部分醫(yī)院的績(jī)效考核還在沿用行政機(jī)關(guān)、事業(yè)單位工作人員年度考核制度，醫(yī)院里不論什么專業(yè)、什么層次的人員，都在使用統(tǒng)一的考核標(biāo)準(zhǔn)，所考核的德、能、勤、績(jī)內(nèi)容也很籠統(tǒng)，難以反映不同崗位不同人員的業(yè)績(jī)貢獻(xiàn)。 in 1994, Zhuang Hanguo（9） with Bureau of Health of Zhoushan City, Zhejiang Province probed into hospital’s establishment of a social and economic benefit index system and its appraisal approach and selected 25 basic indices as an appraisal index system. With the theory of management deepened and management mode explored recently, Chen Mingmin and etc. with the General Hospital of Air Force put forward a medical quality appraisal management mode in an extensive form in 2001, whose major index is of bed盡管企業(yè)領(lǐng)域績(jī)效管理的方法已發(fā)展得比較成熟，但在國(guó)內(nèi)醫(yī)療衛(wèi)生領(lǐng)域中比較通用和權(quán)威的績(jī)效考核指標(biāo)還有待更深入的探索。近年來隨著管理理論的深化和管理模式的探索，2001年，解放軍空軍總醫(yī)院陳明敏等提出了粗放型的醫(yī)療質(zhì)量評(píng)價(jià)管理模式，主要指標(biāo)為床日門診指數(shù)、床位利用指數(shù)、CD型率(總病例中復(fù)雜疑難危重病例所占比例)、人均醫(yī)療費(fèi)、病員滿意度等 （10）；2001年，上海第二軍醫(yī)大學(xué)高岱峰、張鷺鷺等采用加權(quán)百分位次累加法建立評(píng)價(jià)模型，構(gòu)建了“醫(yī)院綜合競(jìng)爭(zhēng)力評(píng)價(jià)體系”，指標(biāo)體系分競(jìng)爭(zhēng)力資產(chǎn)、競(jìng)爭(zhēng)力過程、競(jìng)爭(zhēng)力環(huán)境3個(gè)方面；2002年，復(fù)旦大學(xué)胡善聯(lián)、李國(guó)紅等利用現(xiàn)場(chǎng)調(diào)查法和專家咨詢法，從業(yè)務(wù)水平、經(jīng)營(yíng)狀況和病人滿意度方面選出32個(gè)指標(biāo)，建立醫(yī)院績(jī)效評(píng)價(jià)指標(biāo)體系，并提出星級(jí)醫(yī)院評(píng)審的思想（11）。Study on hospital performance appraisal abroad also consists of three levels: one is performance appraisal on hospital as a whole, one is ability appraisal on middlelevel managers, and the other is performance appraisal on employees. Robin S. Turpin has employed the PAJ mode to appraise reasonability of hospital performance index（4）and Total Quality Management (TQM) to study improvement of hospital performance（5）. Meanwhile, he has also studied performance and ability of middlelevel managers and developed an overall tool to appraise ability and performance（6）. For employee appraisal, however, peer appraisal is rather popular at the present（7）. On a whole basis, appraisal on individuals is mostly adopted by targeting physicians, which, however, takes into inadequate consideration a hospital’s position of members in variety. 而在我國(guó)，經(jīng)濟(jì)領(lǐng)域基本上完成了由計(jì)劃經(jīng)濟(jì)向市場(chǎng)經(jīng)濟(jì)的轉(zhuǎn)化，但社會(huì)事業(yè)領(lǐng)域改革相對(duì)滯后，現(xiàn)有的醫(yī)療衛(wèi)生體制是在計(jì)劃經(jīng)濟(jì)理論下建立的。一個(gè)是以醫(yī)院為對(duì)象進(jìn)行績(jī)效評(píng)價(jià)：一個(gè)是對(duì)中層管理人員進(jìn)行工作能力評(píng)價(jià)；最后就是員工的績(jī)效評(píng)價(jià)。其中，“平衡計(jì)分卡”作為績(jī)效管理的一種最新、最有效的管理模式，吸引了眾多的學(xué)者和管理實(shí)踐者。在法國(guó)公司，在“Tableau de Bord”績(jī)效管理模式里，將戰(zhàn)略分解為財(cái)務(wù)與非財(cái)務(wù)指標(biāo)，作為流行的一種作法(2)。 績(jī)效測(cè)量系統(tǒng)的研究，任何單獨(dú)的財(cái)務(wù)方面或經(jīng)營(yíng)方面的測(cè)量系統(tǒng)都不能使管理者在復(fù)雜競(jìng)爭(zhēng)的市場(chǎng)環(huán)境中成功地對(duì)績(jī)效進(jìn)行管理。如何將更科學(xué)的考核體系和良性競(jìng)爭(zhēng)的動(dòng)態(tài)機(jī)制融入到醫(yī)院評(píng)價(jià)比較之中，科室單元內(nèi)部又如何以科學(xué)公正的績(jī)效指標(biāo)評(píng)價(jià)每位人才的價(jià)值和貢獻(xiàn)，目前缺少一套成熟而又實(shí)用的評(píng)價(jià)體系，這是目前各醫(yī)院管理者迫切需要研究與探討的重要課題。As an important way to manage hospitals, performance assessment can impartially and objectively embody realization of management by objectives. Born in mid1950s, management by objectives is a set of management systems formed on the basis of the reasonable management and behavior science theory founded by Frederick Winslow Taylor, which is expected to arouse people’s enthusiasm to involve personally in making the objective. In order to continuously renovate and improve management, it is necessary to establish a reasonable assessment system which focuses on actual performance. Only in this way can appraisal be made fully, equally, objectively and impartially. This is the base point to realize such management. 績(jī)效管理已在發(fā)達(dá)國(guó)家，特別是國(guó)際成功企業(yè)中被廣泛采用，美國(guó)及歐洲一些國(guó)家的醫(yī)院，在各個(gè)層次都成功實(shí)施了績(jī)效管理。作為醫(yī)院管理者，不僅要自己明確醫(yī)院發(fā)展方向，更要讓員工明確奮斗目標(biāo)與前進(jìn)航向，尋求一種職工共同參與、自我管理的方式，同舟共濟(jì)，則是所有醫(yī)院管理者所期盼的。進(jìn)一步提高腫瘤診治水平，完善綜合醫(yī)學(xué)救治能力，滿足廣大病員日益增長(zhǎng)的診治需求，在挽救病人生命與改善病人生活質(zhì)量方面作出不懈地努力，成為名副其實(shí)的蘇南地區(qū)具有影響力的腫瘤中心，是我們大家共同的愿景和重要的任務(wù)。 Molecular Biology Research Institute attached to Suzhou University Life Science School, Wuxi Cancer Prevention and Treatment Research Institute, Wuxi Cardiothoracic Surgery Treatment Center and Wuxi Anesthesia Quality Control Center. Powerful in technology and characteristic of special faculty, this hospital focuses on cancer diagnosis and treatment with other faculties developed in balance. There are 1050 beds, of which those used for cancer faculty account for over 50%. The hospital is staffed with 1250 employees, 430 being physicians and 458 being nurses。醫(yī)院開放床位1050張，腫瘤床位占總開放床位的50%以上。 and on the other hand, private clinics and drug stores have emerged here and there, which, in some degree, is troubling the survival and development of public hospitals. 10 national healthcarereform programs, although published in succession, fail to bring about a general scheme which is suitable for Chinese medical market. In this connection, the health care reform is still far from matured and, as a result, public hospital is still fighting its way to survive and develop. In view of the present situation at home and abroad, Wuxi City has pioneered to undertake the reform on hospital operations mechanism, . “Separating government functions from public institutions and administration from business running” without any experience to be referenced. As an enforcing body, the Bureau of Health of Wuxi City serves to supervise the business of public hospitals。醫(yī)院則是?？平ㄔO(shè)、人才培養(yǎng)、醫(yī)療服務(wù)與經(jīng)營(yíng)的主體。衛(wèi)生局作為行政執(zhí)法部門對(duì)公立醫(yī)院的經(jīng)營(yíng)行為進(jìn)行監(jiān)管；由衛(wèi)生局分離出來的醫(yī)院管理中心（以下簡(jiǎn)稱醫(yī)管中心）成為政府“辦醫(yī)院”和“管資產(chǎn)”的責(zé)任主體，“辦醫(yī)院”就是在法律法規(guī)及政策的框架下，通過優(yōu)化配置資源，提高醫(yī)療質(zhì)量，提供滿足不同層次需求的代表市屬醫(yī)院水平的優(yōu)質(zhì)醫(yī)療產(chǎn)品。民營(yíng)醫(yī)院大量崛起，其中有些甚至收購(gòu)了多家公立醫(yī)院；外資醫(yī)院或機(jī)構(gòu)正在大舉入侵，其憑借獨(dú)特的技術(shù)和服務(wù)優(yōu)勢(shì)占得了不小的市場(chǎng)份額；隨處可見的私人診所和藥店也如雨后春筍般出現(xiàn)。競(jìng)爭(zhēng)就要有目標(biāo)，目標(biāo)是醫(yī)院發(fā)展的方向，在當(dāng)前醫(yī)療市場(chǎng)的競(jìng)爭(zhēng)中，實(shí)施目標(biāo)管理是醫(yī)療機(jī)構(gòu)保持競(jìng)爭(zhēng)實(shí)力的最常用方法之一，更是醫(yī)院管理的最常用手段之一。我國(guó)醫(yī)院的發(fā)展經(jīng)歷了從設(shè)備競(jìng)爭(zhēng)——技術(shù)競(jìng)爭(zhēng)——服務(wù)競(jìng)爭(zhēng)——戰(zhàn)略競(jìng)爭(zhēng)的過程，目前正向文化競(jìng)爭(zhēng)發(fā)展。How can hospital transform the current mode of operation and management? How can hospital adapt itself to the new situation? How can hospital improve its central petitive strength? Those challenges have to be approached by hospital managers today especially when health care reform is earnestly called for by the medical market with intensive petition. The development of hospitals in China has experienced the petition in equipment, technology, service and st