【正文】 用目標管理的方法建立績效評估體系。盡管企業(yè)領(lǐng)域績效管理的方法已發(fā)展得比較成熟，但在國內(nèi)醫(yī)療衛(wèi)生領(lǐng)域中比較通用和權(quán)威的績效考核指標還有待更深入的探索。眾多文章都是從不同的角度對醫(yī)院績效進行評價，建立醫(yī)院績效評價指標體系時均有自己的側(cè)重點，而且在實際工作中也的確起到了促進醫(yī)院持續(xù)穩(wěn)定發(fā)展、提高醫(yī)院核心競爭力的作用。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)量評價管理模式，主要指標為床日門診指數(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、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價模型，構(gòu)建了“醫(yī)院綜合競爭力評價體系”，指標體系分競爭力資產(chǎn)、競爭力過程、競爭力環(huán)境3個方面；2002年，復(fù)旦大學(xué)胡善聯(lián)、李國紅等利用現(xiàn)場調(diào)查法和專家咨詢法，從業(yè)務(wù)水平、經(jīng)營狀況和病人滿意度方面選出32個指標，建立醫(yī)院績效評價指標體系，并提出星級醫(yī)院評審的思想（11）。根據(jù)中文科技期刊數(shù)據(jù)庫檢索，自1989年2008年2月，涉及醫(yī)院績效的相關(guān)文章共有567篇，有關(guān)“績效考核”的文章共有129篇，符合“績效管理”檢索主題詞要求的文章有122篇，而建立績效考核評價體系的文章僅26篇。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，經(jīng)濟領(lǐng)域基本上完成了由計劃經(jīng)濟向市場經(jīng)濟的轉(zhuǎn)化，但社會事業(yè)領(lǐng)域改革相對滯后，現(xiàn)有的醫(yī)療衛(wèi)生體制是在計劃經(jīng)濟理論下建立的。另有一些對中層管理人員工作和能力評價的研究，并嘗試開發(fā)了綜合性的能力與工作評價工具（6），而員工評價目前比較盛行的是同級評價 （7）。一個是以醫(yī)院為對象進行績效評價：一個是對中層管理人員進行工作能力評價；最后就是員工的績效評價。 according to the study on performance measuring system, any single measuring system in neither finance nor operation can enable managers to successfully control performance in a plicated market falling in the acute petition. Therefore, multiindex starts service gradually to measure performance: some are “hard index”, including various kinds of financial and nonfinancial measures and some are “soft index”, including quality, attitude and the similar criteria. The existing literature shows that, besides application of information developed or provided by the system, the heated study on performance measuring system includes study of action and effect of performance measuring system on an organization and study on performance management mode. In Britain, the new performance management mode always includes nonfinancial measures, which represents a trend of performance management oriented by strategy. Under the “Tableau de Bord” performance management mode in French panies, strategy is divided into financial index and nonfinancial index, which acts as a popular practice (2). A study on munity hospital conducted in USA is related to development of a strategic operation amp。其中，“平衡計分卡”作為績效管理的一種最新、最有效的管理模式，吸引了眾多的學(xué)者和管理實踐者。該研究在使人們對戰(zhàn)略操作管理決策有了更進一步理解的同時，確定了在操作決策過程中的一些因果關(guān)系及在醫(yī)院績效方面的作用。在法國公司，在“Tableau de Bord”績效管理模式里，將戰(zhàn)略分解為財務(wù)與非財務(wù)指標，作為流行的一種作法(2)?，F(xiàn)有文獻表明對績效測量系統(tǒng)的研究熱點除系統(tǒng)開發(fā)及系統(tǒng)所提供信息的利用以外，還有關(guān)于績效測量系統(tǒng)對組織作用及影響的研究和績效管理模式的研究。 績效測量系統(tǒng)的研究，任何單獨的財務(wù)方面或經(jīng)營方面的測量系統(tǒng)都不能使管理者在復(fù)雜競爭的市場環(huán)境中成功地對績效進行管理。 hospitals, however, basically serve to heal the wounded and rescue the dying and take into account cost accounting only under the premise seeking for social results. A hospital shall handle performance appraisal and management by applying the applicable practice of an enterprise to its own line according to the fact. Right now it still cries out for a mature and practicable assessment system to approach how to roll a more reasonable assessment system and a dynamic mechanism with virtuous petition into hospital appraisal and parison and how to assess each talent’s performance with help of reasonable and impartial performance index in different units of a department. This is the subject calling for an immediate solution offered by hospital managers. 有關(guān)衛(wèi)生組織績效測量的研究正在開展，績效測量標準的研究是鑒于衛(wèi)生保健機構(gòu)沒有一個標準的績效測量系統(tǒng)，美國俄亥俄州大學(xué)的一項研究(1)在回顧有關(guān)醫(yī)療組織績效文獻的基礎(chǔ)上，提出了衛(wèi)生保健機構(gòu)績效測量的總體框架。如何將更科學(xué)的考核體系和良性競爭的動態(tài)機制融入到醫(yī)院評價比較之中，科室單元內(nèi)部又如何以科學(xué)公正的績效指標評價每位人才的價值和貢獻，目前缺少一套成熟而又實用的評價體系，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。不同的是企業(yè)講利潤最大化，追求的是經(jīng)濟效益；而醫(yī)院首先講救死扶傷，并只能在追求社會效益的前提下，講成本核算。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. 績效管理已在發(fā)達國家，特別是國際成功企業(yè)中被廣泛采用，美國及歐洲一些國家的醫(yī)院，在各個層次都成功實施了績效管理。目標管理于20世紀50年代中期出現(xiàn)，是以泰羅的科學(xué)管理和行為科學(xué)理論為基礎(chǔ)形成的一套管理制度，可以調(diào)動人們親自參加工作目標制定的積極性。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與前進航向，尋求一種職工共同參與、自我管理的方式，同舟共濟，則是所有醫(yī)院管理者所期盼的。挑戰(zhàn)是全方位的，壓力也是前所未有的。進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)。 times e for emergency or as outpatient in a year, of which there are 28,000 discharged patient 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。年門、急診量60萬人次。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)院技術(shù)力量雄厚，專科特色明顯。 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 publ