【正文】 e, 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。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。 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。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。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)。醫(yī)院開放床位1050張，腫瘤床位占總開放床位的50%以上。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。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)。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。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。 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。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。但挑戰(zhàn)總是與機(jī)遇并存。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。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)。 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。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。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）。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)。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）。 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。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