The Study On Indicator System Of Performance Assessment In One Tertiary Hospital In Shanghai

[Backgroud]The performance assessment is one of the effective means for scientifical management and is an important part of the reform in hospital human resources management. Effective performance assessment plays a very important role in promoting the improvement in hospital management and motivating hospital staff. In recent years, with the new management concepts appearing one after another, the hospital scientifical management is demanded more and more. How to effectively inspire employees for providing better health care services is an increasingly urgent issue. Meanwhile, traditional Chinese medicine has its own characteristics and it is necessary to study performance assessment of clinicians in the Hospitals specialized in Chinese Medicine and to establish a scientifical assessment system to facilitate the human resources management anad to meet the requirements in the era of knowledge economy.[Contents]The study took one tertiary hospital in Shanghai as an example and introduced the concept of Balanced Scorecard to build the performance assessment indicator system for clinician, starting from the hospital’s vision and strategic objectives. In the study, export consultation, key informant interview, analytic hierarchy process and other methods were used. In addition, the representative clinical departments (department of gastroenterology, department of respiration, department of cerebral surgery, department of orthopedics and department of acupuncture) in this hospital were selected to test the effectiveness of the performance assessment indicator system.[Methods]This study adopted literature review, expert consultation, site surveys, key informant interviews, focus group discussions and analytic hierarchy process to establish the performance indicators for clinicians, to determine the weights and standards of the indicators. The data were analyzed by using Exce12003and SPSS17.0. [Results]1. Determination of indicators On the bases of a systematic analysis of the hospital strategic objectives and current status and literature review, introduced the,34assessment indicators from four aspects (finance, internal processes, customer, and learning and growth) were selected according to Balanced Scorecard theory. And through30experts’two-round consultation,24assessment indicators for the clinician appraisal were finally determined.2. Determination of indicator weights The study used analytic hierarchy process (AHP) to determine the weights of each indicators at all levels. The test of logical consistency showed that the indicator system met the consistency requirement and the CR values were less than0.1, which indicated that the indicator weights at all levels were scientifical and objective.3. Determination of standards After carefully studing on the hospital assessment standards developed by Shanghai Shen Kang Hospital Development Center and the health administration departments in our governments, reviewing national and international related literature, considering hospital situation and its development strategy, and consulting with the30experts, the standards for each assessment indicator were determined. And then the relevant departments that were responsible to provide the data necessary for the performance assessment were determined.4. Application The performance indicator system for clinician assessment was applied in5representitive departments, including department of gastroenterology, department of respiration, department of cerebral surgery, department of orthopedics and department of acupuncture. Comparing to the old performance assessment, the new performance indicater system had better discrimination. The distribution of total assessment score was close to normal distribution. In addition, the study showed that clinicians in deverent departments and with different professional titles had different assessment scores.[Discussion and recommendations]Implementation of performance assessment can not only improve objective management and management level as a whole in hospitals, but also is an inevitable requirement for the modernization in hospital management. Balanced Scorecard can well overcome the weeknesses of traditional performance assessment, makes the performance assessment system coordinate with control system, and is an effective way to achieve the hospital strategic goals.This study attempts to introduce the Balanced Scorecard theory, using analytic hierarchy process to construct the clinician performance evaluation index system.The indicator system based on the actual situation of the hospital, can comprehensively, objectively reflects the general situation of medical teaching and research,conform to the hospital development strategy guide and the characteristics of Hospital of TCM.It is a demonstration for the Human resource management and performance appraisal on the tertiary hospital clinicians as well as other professional and technical personnel.