Research On The Construction Of Performance Appraisal Index System In Clinical Departments Of Q Hospital

BackgroundIn 2009,a new round of medical and health system reform was officially launched,and medical reforms have entered the deep water area.During this period,many reform difficulties and pain points are still faced.Public hospitals are an important part of my country's medical and health services,and its development faces many challenges,such as competitive pressures,sustainable development and other outstanding issues.The reform of performance evaluation in public hospitals is especially a hard bone to eat.Performance reform is one of the important contents of establishing a modern hospital management system and an important starting point.At present,public hospitals are in a new environment and situation.How can they mobilize the enthusiasm of medical staff,but also reduce costs and improve efficiency,improve service quality,and improve economic and social benefits,thereby promoting the permanent and sustainable development of hospitals.The major problems faced.Using performance appraisal as a mean to improve these problems,and to improve hospital performance,we need to start with the performance evaluation of clinical departments.Clinical departments are the core components of public hospitals.Direct implementation of diagnosis,treatment and nursing for patients is a key department.Strengthening their performance evaluation,evaluation and management is the key content of establishing a modern hospital management system.However,my country's performance evaluation program for clinical departments is still not mature enough,and there is no unified performance evaluation system for clinical departments.Therefore,it is particularly urgent to construct a scientific and reasonable performance evaluation system for clinical departments.PurposesBased on the relevant theories of public hospital performance appraisal,by analyzing the existing problems of Q hospital's current performance appraisal plan,a set of performance appraisal index system that meets the actual situation of Q hospital clinical department is designed,and the application evaluation is carried out in Q hospital to further do it Provide a reference plan for good clinical department performance management.MethodsIn this study,a semi-structured qualitative interview method was used to conduct in-depth interviews with 15 hospital management personnel(directors,directors of functional departments)and 20 medical personnel(directors of clinical departments,doctors,and nurses)of Q hospital to understand their Recognizing the current performance evaluation plan of clinical departments,analyze the status of the performance evaluation of clinical departments of Q hospital.This study also used the combination of expert consultation and analytic hierarchy process to determine the performance evaluation indicator system of clinical departments of Q hospital after two rounds of expert consultation on 20 selected experts.Use the analytic hierarchy process to determine the weight of each indicator in the indicator system,that is,to formulate a judgment matrix of relative importance between indicators at the same level,conduct the third round of expert consultation,and calculate the final index of each indicator according to the results of the expert judgment matrix.Combine weights.In the application evaluation,the TOPSIS comprehensive evaluation method was used to evaluate the performance of the Q hospital clinical department.Results(1)Through qualitative interviews,it is found that Q hospital does not have a deep understanding of the performance assessment program,ignores the role of performance assessment,lacks timely feedback and communication on the assessment content and results,attaches too much importance to economic indicators,and the assessment content is complex.(2)The preliminary selection of the performance appraisal indexes after two rounds of expert consultation,combined with the ratings and comments,according to the screening criteria,excluded eight level 3 indicators into the indicator system(class a medical record rate,emergency and severe cases rescue success rate,complication rate of surgery patients,outpatient visits,hospital patients,the number of medical disputes accident proportion,the management fees accounted for the proportion of the total score),established the Q hospital clinical department performance evaluation index system,covering the public welfare of the department,internal business,finance,sustainable development 4 first-level indicators,subdivided into 9 second-level indicators and 32 third-level indicators.(3)The combined weight of each index among the first,second and third level indexes is calculated by the chromatographic analysis method.After the consistency test,the consistency ratio CR value is less than 0.1.Among them,the secondary indicators,such as patient satisfaction,cost burden,medical quality,medical safety,and business income and expenditure,have a large weight.(4)The identified index system was applied to the performance evaluation of the clinical departments of Q hospital(12 internal medicine clinical departments and 15 surgical clinical departments).The department of gastroenterology of the eastern hospital ranked the first in internal medicine with a comprehensive evaluation value of 0.552497,while the department of neurosurgery ranked the first in surgery with a comprehensive evaluation value of 0.563544.(5)Feedback the newly constructed index system and application evaluation results to the director of the clinical department with the person in charge of the quality management department,the vast majority believe that the source of the assessment indicators is traceable,the indicators are reasonable,the content is concise,the levels are clear,and the weights are set scientifically.Conclusions and SuggestionsThe contents of the Q hospital's current performance evaluation plan are too complicated,the employees do not understand it enough,the evaluation results are not open enough,and the evaluation focuses on economic indicators.To this end,the index system of clinical departments of Q hospital was rebuilt,and weights were set for each index to quantify the evaluation index system.The established index system compares the performance evaluation of the clinical department of Q hospital with the original evaluation results.The constructed index system has certain feasibility.The evaluation results are basically consistent with the actual situation of the hospital.The new evaluation index system has proven sources It can be followed,the content is concise,the level is clear,and the weights are accurate.It is in line with the characteristics of clinical departments and has a guiding significance for improving the performance of the hospital.Regarding the existing problems of Q hospital performance assessment and the process of index construction,we propose the following suggestions:(1)It is necessary to improve the performance evaluation indicators and evaluation system of clinical departments continuously and dynamically in public hospitals.(2)It is necessary to strengthen public hospital managers and medical personnel's understanding of performance management.(3)The functional departments responsible for performance evaluation should strengthen communication and feedback with clinical departments.(4)The specific application of performance evaluation results should be strengthened and expanded.