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20xx年醫(yī)學(xué)專題—體系建立體系建立健全醫(yī)院立體化績效考核評價-資料下載頁

2024-11-19 05:20本頁面
  

【正文】 o specific assessment index, only when employees do not violate the relevant regulation can they meet the corresponding standard up to eligibility, which is likely to cause a mediumbiased trend. For this reason, it is necessary to bring in petition(15). As mentioned in Reflection of Performance Assessment on Director of Clinical Faculty in a Comprehensive Hospital(16)and Practice amp。 Reflection on Establishment of Performance Assessment on Hospital Managers(17), motivation is made for promoting personal management ability, operating ability, overall coordinating ability and other qualities in management, guided by the hospital management value. A performance assessment system for director of clinical faculty is established to ensure that the post as director of clinical faculty enables a modern hospital to meet the requirements on standardized reasonable management。 the strategic objectives of a hospital are distributed to each clinical business office so as to specify the onjob responsibilities of clinical department director。 the director of each department is made to more efficiently exercise his/her management functions and acplish the tasks of medical, training, research, financial and talents management。 the key index on performance of director of each faculty is effectively quantifiable during his/her office term so as to improve his/her performance。 the potentials of each faculty director can be given full play in the hope that they work hard to improve their performance and meet their objective。 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。 treatise, new technology and business assessment by means of 3dimensioned framework according to basic index, business index, research and training index. They selected 56 items specific index in total covering three kinds of function: one is to appraise performance of physicians in a faculty, quantitatively specify their performance and select excellent talents for this faculty。 one is to appraise behavior of the appraisal subject is controlled by means of appraisal on the actual performance so as to lead him/her to approach the set objective。 the other is that the management department can timely and dynamically mand the current situation, not only see clearly the superiority and specialty of talents in this organization as a whole, but also find out the existing problems and disadvantages, detect their cause and timely solve them so as to provide scientific evidence for decision making(20). Meanwhile, a large number of studies have been made in the literature such as Establishment and Application of the Doctor’s Performance Assessment Model(21), Improving Medical Workers Skill by the Assessment System(22), Determination of Assessment Index and Marking Criterion(23) and Observation Method by Having Employees’ Behavior in MultiAngled View(24).在公立醫(yī)院,績效考核的目的在于體現(xiàn)醫(yī)護(hù)人員的工作量,減少浪費(fèi),提高醫(yī)院運(yùn)行效率,但目前的方式難以奏效。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(jìn)行了探索。由于不同級別的醫(yī)院情況不同,績效考核辦法也不同,目前大家都處于摸索階段。國內(nèi)外學(xué)者建立了數(shù)百種綜合評價方法,但至今尚無一種全球通行的考核評價方法。衛(wèi)生部規(guī)財司領(lǐng)導(dǎo)指出,建立一個比較科學(xué)的績效評價體系有一定難度,在現(xiàn)行制度下應(yīng)該研究一個既合理,又簡單的評價方法(25)。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??冃гu價與管理體制關(guān)系很大,如果僅考慮效率按項目收費(fèi),會出現(xiàn)過度服務(wù)的問題;如果按病種收費(fèi),要考慮醫(yī)療質(zhì)量的問題。我國大部分公立醫(yī)院基本上都是自主收支、自負(fù)盈虧,國家財政只能補(bǔ)償極少部分,公立醫(yī)院必須依靠增加收入,進(jìn)行成本核算來提高效益,以使自己在市場中占有一席之地。從當(dāng)前公立醫(yī)院資源配置和管理的實際狀況來看,很多醫(yī)院也已經(jīng)開始進(jìn)行提高經(jīng)濟(jì)效益、進(jìn)行成本核算、拉開職工收入差距等方面的嘗試。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(jī)構(gòu)的績效提升和醫(yī)療質(zhì)量的持續(xù)改進(jìn)能起到強(qiáng)有力的推動作用。但是由于長期受計劃經(jīng)濟(jì)體制的影響,加之醫(yī)療服務(wù)行業(yè)的特殊性,相對于其他單位而言,公立醫(yī)院的各方面改革步伐都是比較滯后的,有效的競爭激勵機(jī)制和自我約束機(jī)制還沒有完全形成。 In public hospitals, performance assessment is designed to indicate the work load of medical staff, reduce waste and improve hospital running efficiency, but the current practice can’t meet this goal. How can we establish an effective performance assessment approach? It is difficult to get an overall and systematic assessment scheme covering three levels in so many study reports, which, mostly, probe into a certain aspect. Different in the hospitals on different levels, performance assessment approach is still under exploit. Hundreds of appraisal approaches have been established by scholars at home and abroad, but none of them is in practice around the world. As pointed out by a leader at Ministry of Health Financial Planning Department, it is difficult to build a rather reasonable performance assessment system and it is a must to work out a simple and reasonable approach practicable in the current system (25). Therefore, some experts suggest an overall appraisal approach based on the method gathering as a prehensive appraisal system. Performance appraisal has much to do with management system: there may be overservice if payment is collected as per items in consideration of efficiency only。 medical quality shall be taken into account if payment is collected as per illness classification. Most of public hospitals in China handle revenue and expenditure by themselves and take sole responsibility for their profit and losses, only a small part of which is pensated through financial appropriation. For that reason public hospitals shall improve their benefits by increasing revenue and making cost accounting so as to surviv
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