摘要
意义:随着卫生服务改革的持续深入和市场经济的不断发展,人民群众对医疗行业服务需求标准的不断提高,医院发展面临新的挑战,医院间的竞争也更加激烈,从某种意义上讲,医院二级科室的工作运营情况特别是科室负责人的工作绩效直接关系到医院的生存与发展。医院科室负责人绩效是指其取得的工作业绩、工作效率、效益,是科室经营管理状况的客观反映。综合医院二级科室负责人绩效评价考核是医院实施绩效管理的核心内容,通过对科室负责人的绩效评价体系的研究,优选评价指标,并运用科学合理的评价方法,对其一定时期内取得的社会效益、工作效率、服务状况、成本、医疗服务质量、发展潜力等进行定量、定性的对比分析,以做出客观、准确的综合评价,从而推动医院整体管理水平的提高,全面加强医疗质量管理,为患者提供高效、安全的医疗服务,实现医院经济与社会效益的持续增长,因此,是一项现实而有意义的基础性工作。
目的:探讨建立一套科学、实用、可操作性比较强的科室负责人绩效考核评价体系,以对其绩效做出客观、公正的评价,从而促进医院快速健康发展,增强医院综合竞争力。
通过绩效评价体系的研究、建立与实施,加强对医院科室负责人的管理,明确科室发展方向,在科室管理、人才队伍建设、科室运营成本、科研教学工作、医疗服务等方面,引导规范科室工作,综合分析,不断调整改进,提高效率,促进科室工作社会效益和经济效益的不断提高。
方法:本课题的研究方法包括以下方面:通过分析目前综合医院二级科室负责人绩效考核的基本实施情况,查阅(包括一定范围内的现场调查)有关资料,结合综合医院临床科室医疗、教学、科研工作特点,初选绩效考核指标;定量、定性分析相结合,筛选初选指标,采用专家座谈,相关专家打分赋值等,进行绩效评价指标的综合分析。讨论并确定实施绩效考核的具体方法,实施绩效考核的具体步骤与保障措施。
结论:本论文依照科学性、可测试性、系统性、核心性和定量化原则,采用现有资料搜集、专家座谈法,综合分析科主任绩效考核指标,并对如何实施绩效考核的方法和路径进行了综合分析研究。考核评价体系的建立既考虑了科室工作的实际情况,也比较符合医院对科室管理的内在要求,具有较强的系统与可操作性。
该考核评价体系有如下特点:
(1)考核评价设计结构简单,每项指标内涵明确,易于理解;
(2)考核内容简练,评价效度高,具有较强的普遍性;
(3)评价体系中的各项指标均为常用、易获取、可量化的指标;
(4)设计侧重于科主任的绩效评价,忽略不同科室间的功能任务、性质等特征信息,既可用于不同科室的横向比较,也可用于本科室自身发展建设的纵向评价;
(5)绩效考核的方法、途径及保障措施易于操作、实施,符合医院管理特点,具有较强的指导与可操作性。
SAGNIFICANCE
With the development of health care reform and market economy,the public' s expectation of health care standard becomes increasingly higher.The hospital' s development is now facing new challenges and intense competitions.In a sense,the operation and management of the secondary departments is directly related to the existence and development of the hospital.Achievements of the department supervisors include their work performance,working efficiency and effectiveness,and these objectively reflect the operation and management status of those departments.Evaluation of the achievements of the secondary department heads is the core of a general hospital' s achievements management.Evaluation of the achievements of department heads means:to evaluate scientifically and reasonably the social benefit,working efficiency,cost,health care quality and developmental potential of a department head during certain period of time,through qualitative and quantitative analysis and comparison, obtain an objective、accurate and comprehensive conclusion.
Objectives:Establishing a scientific,practical and highly operational achievements evaluation system of clinical department heads,so that their achievements can be evaluated objectively and justly.The achievements evaluation indexes system is designed to strengthen the scientific management of the secondary department heads of the hospital,to clarify the direction of the department development and to guide the clinical practice.Through comprehensive analysis,modifications and improvement to raise working efficiency and increase social and economic benefits of clinical department,so as to spur the rapid and healthy development of the hospital and enforce the general competitive ability of the hospital.
Methods:The existing achievements evaluation system of secondary department heads in general hospitals;initial selection of achievements evaluation indexes through literature review and field investigation,try to reflect health care practice,research and teaching,economic and social benefit;combining quantitative and qualitative analysis,screening the initial indexes to reflect the features of general hospitals and establish achievements evaluation system;adopting rated by related specialists,to assess the achievement evaluation indexes system.
Results:Based on the principle of being scientific,testable, systematic and quantitative,the achievements evaluation indexes system is established by literature review,analysis and optimization, and specialists consultation.It is evident that the establishment of evaluation indexes system not only takes into consideration of the actual practice of clinical department but also meets the hospital' s intrinsic managerial requirement of clinical departments,and is highly systematic and operational.
Characteristics of the indexes system:
(1)simple structure of indexes design,clear connotation of each index,and easily understood;
(2)the content of each index is highly concise and effective,can be well generalized and easily operated;
(3)all indexes in the system are commonly used,easily obtained and can be quantified;
(4)the indexes system can be used in the horizontal comparison between departments,and in the vertical evaluation of the development of the same department;
(5)the indexes design puts more stress on the achievements evaluation rather than the functional tasks and characteristics of different departments.
引文
1.石金涛,顾琴轩,唐宁玉.现代人力资源开发与管理.第二版 上海 上海交通大学出版社 2001.
2.李苏建 战敏康.衡量各临床科室工作强度的一种改进方法.中国卫生统计2002 03.
3.吴倩平.临床科室工作量评价方法及其应用.中国医院管理 2003 06.
4.孙振球等.医院综合评价方法.北京 中国科学技术出版社1994.
5.朱文娟.对综合性医院临床业务科主任绩效考核的思考.中国卫生资源2005(9)221-223.
6.张华宇.建立医院绩效评估体系及其方法的研究进展.医院管理论坛2004;3:50-52.
7.周良荣.设计医院绩效评价指标体系的基本思路.中国医院管理 2002;(11):3-6.
8.张英,董春艳.论医院绩效考核.中国医院管理 2003(12)34-35.
9.张慧莉,蒲景环等.对科室主任医疗质量管理考核的实践与探索.中国医院管理 2004;4:29-31.
10.桂莉.医院职能部门绩效考核指标设计思路.医院管理论坛 2004;4.
11.何惠宇,陈校云等.建立医院绩效评价系统的理论与实践.中国医院管理 2003;6:331-333.2004;11.
12.张泽.卫生服务指标.国外医学卫生经济分册 1997 2.
13.医院管理评价指南.卫生部
14.胡琳.医院综合效益评价指标体系问题.中华医院管理 1993;(9):321.
13.沈婉兰.医院综合效益评价与分析.中国卫生经济1998;17(10):52-53.
15.王桂榕,廖还乡.临床科室医疗质量综合评价方法探讨.中国卫生事业管理 2001 05.
16.黄历智.医院多指标综合评价结果的比较分析.中国医院管理 1998 5(2).
17.陈科.综合评价几种权数的方法.中国卫生统计 1993(10).
18.曾小武.医院综合效益指数评价方法探讨.中国医院统计 2000;7(1):17-19.
19.于海英.医院水平综合评价系统研究.中国医院管理 2003;23(3):13-15.
20.张治国等.襄樊铁路医院绩效改革前后临床科室绩效评价.中国医院管理 2004;1:32-39.
21.肖庆莲,程康.医院绩效评估的实践与探讨.中国卫生事业管理 2004;2:123-124.
22.金新政,李守国.管理决策综合集成.武汉.武汉大学出版社 1999.
23.瞿树悦,吴健.平衡记分卡在国外医院绩效管理中的应用.中国医院管理 2004;4:21-24.
24.金新政,籍国章 医院经营管理绩效考核方法的研究.中国医院统计2004;11.
25.毛静馥,韩淑杰.医院绩效管理功能分析及应用.中国卫生产业 2004;4:13-15.
26.朱国旭(译).医院工作要素评价.国外医学医院管理分册1995.
27.杨海青,陈平雁.医院临床科室成本效益分析的研究现状及问题.中国卫生统计 2006 05期.