【正文】 rategy respectively and now is getting into the cultural petition. Competition, of course, feels like an objective, which is the direction of a hospital. In the medical market petition, however, objective management is the most popular practice for a medical agency to maintain its petitive strength as well as to manage a hospital. As objective management cries out for a definite objective in advance, which serves as a standard and impetus, people can conduct self management at any time and strive to reach their goal. With help of performance appraisal, however, objective management may enhance timely adjustment of the course during realization of the objective to integrate resources and eventually to obtain benefits. 相關(guān)背景資料：2. Background近十年來，隨著國務(wù)院及其他政府部門相關(guān)醫(yī)療政策的出臺，以及中國加入WTO 后醫(yī)療市場的逐步對外放開，國內(nèi)的醫(yī)療行業(yè)狀況發(fā)生了巨大的變化。無錫市針對國際國內(nèi)形勢變化，在沒有任何經(jīng)驗可借鑒的情況下，在國內(nèi)率先進行了“政事分開，管辦分離”運行機制的改革。職能上下放醫(yī)院經(jīng)營管理、人事用工和經(jīng)濟分配權(quán)，激發(fā)醫(yī)院活力。 meanwhile, many foreignfunded hospitals or agencies are rushing off their head into China and they have a much share of the market thanks to their unique superiority in both service and technology。以腫瘤診斷治療為重點，其他學(xué)科協(xié)調(diào)發(fā)展。My employer, Wuxi Fourth People’s Hospital (WFPH), is one of the first lot of grade 3 prehensive hospitals certified by Ministry of Health of the People’s Republic of China, which integrates health service, training, research, illness prevention and health care. It simultaneously serves as Wuxi Cancer Hospital and Fourth Hospital Attached to Suzhou University. Meanwhile, this hospital also houses Clinical Cancer amp。 times. 經(jīng)過三十年的建設(shè)，我院已成為一所區(qū)域性的腫瘤診治中心。但挑戰(zhàn)總是與機遇并存。持續(xù)改進與提高管理水平需要制訂科學(xué)合理、注重實績的考評體系，才能進行全面、客觀、公正、公平的評價，這是落實管理的基點。醫(yī)院在進行績效評估與績效管理時，應(yīng)采取揚棄的態(tài)度，充分借鑒企業(yè)的做法與經(jīng)驗，并注重結(jié)合本行業(yè)的實際，實事求是地進行績效評估與績效管理。該框架中的績效測量包括內(nèi)部與外部評價兩個方面，每個方面都有成本／財務(wù)績效及質(zhì)量績效兩個評價維度。在英國，新的績效管理模式往往包括非財務(wù)措施，它代表了一種以戰(zhàn)略為導(dǎo)向的績效管理趨勢。該研究還找出了在變化著的醫(yī)療服務(wù)環(huán)境中有助于提高社區(qū)醫(yī)院績效的關(guān)鍵戰(zhàn)略決策。 management mode（3）, which gets connected longterm equipment and service choice, middlelevel decision support and munity hospital performance which has taken structural confinement into consideration. While helping further understand decision over strategic operation management, the abovementioned study determines some causeeffect relations and their action on hospital performance in the course of decision on operation. Furthermore, this study also finds out a key strategic decision helping improve performance of munity hospital in the changing environment of medical service. Among them, the “balance score card” is the latest and most effective mode for performance management, which is attracting a number of scholars and management workers. 對于醫(yī)院績效評價研究，國外醫(yī)院績效評價研究也包括三個層面。但從整體看，對個人的評價多為針對醫(yī)師類的，較為單一，對醫(yī)院內(nèi)多種成員組成的現(xiàn)狀考慮不足。早在1993年西安第四軍醫(yī)大學(xué)胡琳、于爽等制訂了“醫(yī)院綜合效益評價體系”，指標按投入、產(chǎn)出分成兩大類，包括人員、設(shè)備、物資、經(jīng)費、社會效益和經(jīng)濟效益6個方面（8）；1994年浙江省舟山市衛(wèi)生局莊漢國（9）對綜合性醫(yī)院的社會、經(jīng)濟效益指標體系的設(shè)置及評價方法等問題作了探討，篩選出基本指標25項，作為評價指標體系。醫(yī)院績效評價體系是一個復(fù)雜的評價系統(tǒng)，目前國內(nèi)采用的指標大多從業(yè)務(wù)、財務(wù)等方面分類考核，而專家咨詢法是篩選指標的方法。In China, transition has been pleted from planning economy to market economy, but reform on social institutions is still relatively lagging behind, where the current health care system was born under the planning economy. As a reasonable system, performance management is having much attention from hospital managers on different levels in China, which is mostly discussed in three layers, . hospital, faculty and its managers, and individual employees. My searching the database of technological periodicals written in Chinese indicates that there are 567 papers on hospital performance published from 1989 to February 2008, 129 relating to “performance assessment”, 122 satisfying the key word of search for hospital performance and only 26 papers on establishment of performance assessment and appraisal system. As early as 1993, Hu Lin, Yu Shuang and etc. with Fourth Military Medical University based in Xi’an built a “hospital prehensive benefit appraisal system”, whose index is divided into two groups as per input and output, including 6 aspects: personnel, equipment, supplies, funds, social benefits and economic benefits（8）。 in 2001, Gao Daifeng, Zhang Lulu and etc. established a “hospital prehensive petitiveness appraisal system” by means of weight hundredthplace addition in accumulation and the index system consists of petitiveness assets, petitiveness process and petitiveness environment。用這類考核結(jié)果作為對員工一年來的工作評價，并以此作為年終獎金或來年工資發(fā)放、聘任、晉升等方面的依據(jù)。通過建立臨床業(yè)務(wù)科主任績效考評體系從而實現(xiàn)使臨床業(yè)務(wù)科主任崗位設(shè)置能更好地符合現(xiàn)代醫(yī)院規(guī)范化科學(xué)管理的要求；醫(yī)院戰(zhàn)略目標分解到各臨床業(yè)務(wù)科室，明確臨床業(yè)務(wù)科主任崗位職責(zé)；使每位科主任更高效地行使管理職能，完成醫(yī)療管理、教學(xué)管理、科研管理、經(jīng)濟管理、人才管理的目標任務(wù)；對每位科主任任期內(nèi)的關(guān)鍵績指標進行有效的量化，從而提高績效；充分發(fā)揮每位科主任的潛能，期為提高績效和達成目標而積極主動工作；吸引留住科主任群體中的優(yōu)秀人才，為醫(yī)院長遠發(fā)展奠定堅實的人力資源基礎(chǔ)。主要是三方面功能：一是鑒定科室的醫(yī)師績效，定量區(qū)分其績效水平．選拔出優(yōu)秀的科室人才 ；二是利用實際績效的評價對被評價對象的行為加以控制，引導(dǎo)其向目標靠近 ；三是管理部門能及時動態(tài)地掌握情況，既可以清楚地看到本單位人才整體優(yōu)勢與特色，又可以看到問題與劣勢，并找出產(chǎn)生問題的原因，及時加以解決，為決策提供科學(xué)的依據(jù)（20）。 the strategic objectives of a hospital are distributed to each clinical business office so as to specify the onjob responsibilities of clinical department director。 excellent talents among the group of faculty directors are attracted so as to lay a solid foundation of human resources for the hospital’s longterm development. Lu Donghuan（18）, however, employed a systematic approach and principle to assess and measure the work behavior and oute of employees on their post, check and appraise employees’ fulfillment of their duties as stipulated by their post. Performance assessment is designed to improve the performance of employees, see whether they are petent by making overall appraisal on employees, and make itself a fundamental basis of human resources management for a hospital so as to reach its business objectives as well as improve employees’ satisfaction and sense of success in the future. Zheng Xichuan and etc.（19）have established index containing natural information of clinical physicians and their personal quality, efficiency, work quality, economic benefit, thesis amp。那么，如何建立真正有效的績效考核方法?在大量的研究報告中，難以找到全面、系統(tǒng)包含三層面的考核方案，更多的是在某一方面進行了探索。所以有專家提出，開展基于方法集的組合評價方法（26）來作為綜合的評價體系。國內(nèi)外理論研究和實踐探索表明，一套規(guī)范的外部評價體系，對醫(yī)療機構(gòu)的績效提升和醫(yī)療質(zhì)量的持續(xù)改進能起到強有力的推動作用