【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(guó)務(wù)院及其他政府部門相關(guān)醫(yī)療政策的出臺(tái)，以及中國(guó)加入WTO 后醫(yī)療市場(chǎng)的逐步對(duì)外放開，國(guó)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(duì)國(guó)際國(guó)內(nèi)形勢(shì)變化，在沒有任何經(jīng)驗(yàn)可借鑒的情況下，在國(guó)內(nèi)率先進(jìn)行了“政事分開，管辦分離”運(yùn)行機(jī)制的改革。職能上下放醫(yī)院經(jīng)營(yíng)管理、人事用工和經(jīng)濟(jì)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(diǎn)，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(jī)遇并存。持續(xù)改進(jìn)與提高管理水平需要制訂科學(xué)合理、注重實(shí)績(jī)的考評(píng)體系，才能進(jìn)行全面、客觀、公正、公平的評(píng)價(jià)，這是落實(shí)管理的基點(diǎn)。醫(yī)院在進(jìn)行績(jī)效評(píng)估與績(jī)效管理時(shí)，應(yīng)采取揚(yáng)棄的態(tài)度，充分借鑒企業(yè)的做法與經(jīng)驗(yàn)，并注重結(jié)合本行業(yè)的實(shí)際，實(shí)事求是地進(jìn)行績(jī)效評(píng)估與績(jī)效管理。該框架中的績(jī)效測(cè)量包括內(nèi)部與外部評(píng)價(jià)兩個(gè)方面，每個(gè)方面都有成本／財(cái)務(wù)績(jī)效及質(zhì)量績(jī)效兩個(gè)評(píng)價(jià)維度。在英國(guó)，新的績(jī)效管理模式往往包括非財(cái)務(wù)措施，它代表了一種以戰(zhàn)略為導(dǎo)向的績(jī)效管理趨勢(shì)。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(jī)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(duì)于醫(yī)院績(jī)效評(píng)價(jià)研究，國(guó)外醫(yī)院績(jī)效評(píng)價(jià)研究也包括三個(gè)層面。但從整體看，對(duì)個(gè)人的評(píng)價(jià)多為針對(duì)醫(yī)師類的，較為單一，對(duì)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(píng)價(jià)體系”，指標(biāo)按投入、產(chǎn)出分成兩大類，包括人員、設(shè)備、物資、經(jīng)費(fèi)、社會(huì)效益和經(jīng)濟(jì)效益6個(gè)方面（8）；1994年浙江省舟山市衛(wèi)生局莊漢國(guó)（9）對(duì)綜合性醫(yī)院的社會(huì)、經(jīng)濟(jì)效益指標(biāo)體系的設(shè)置及評(píng)價(jià)方法等問題作了探討，篩選出基本指標(biāo)25項(xiàng)，作為評(píng)價(jià)指標(biāo)體系。醫(yī)院績(jī)效評(píng)價(jià)體系是一個(gè)復(fù)雜的評(píng)價(jià)系統(tǒng)，目前國(guó)內(nèi)采用的指標(biāo)大多從業(yè)務(wù)、財(cái)務(wù)等方面分類考核，而專家咨詢法是篩選指標(biāo)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(duì)員工一年來的工作評(píng)價(jià)，并以此作為年終獎(jiǎng)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(jī)效考評(píng)體系從而實(shí)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(biāo)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(jì)管理、人才管理的目標(biāo)任務(wù)；對(duì)每位科主任任期內(nèi)的關(guān)鍵績(jī)指標(biāo)進(jìn)行有效的量化，從而提高績(jī)效；充分發(fā)揮每位科主任的潛能，期為提高績(jī)效和達(dá)成目標(biāo)而積極主動(dòng)工作；吸引留住科主任群體中的優(yōu)秀人才，為醫(yī)院長(zhǎng)遠(yuǎn)發(fā)展奠定堅(jiān)實(shí)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(jī)效，定量區(qū)分其績(jī)效水平．選拔出優(yōu)秀的科室人才 ；二是利用實(shí)際績(jī)效的評(píng)價(jià)對(duì)被評(píng)價(jià)對(duì)象的行為加以控制，引導(dǎo)其向目標(biāo)靠近 ；三是管理部門能及時(shí)動(dòng)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(shì)與特色，又可以看到問題與劣勢(shì)，并找出產(chǎn)生問題的原因，及時(shí)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(jī)效考核方法?在大量的研究報(bào)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(jìn)行了探索。所以有專家提出，開展基于方法集的組合評(píng)價(jià)方法（26）來作為綜合的評(píng)價(jià)體系。國(guó)內(nèi)外理論研究和實(shí)踐探索表明，一套規(guī)范的外部評(píng)價(jià)體系，對(duì)醫(yī)療機(jī)構(gòu)的績(jī)效提升和醫(yī)療質(zhì)量的持續(xù)改進(jìn)能起到強(qiáng)有力的推動(dòng)作用