| Objective:In-depth study of physician workload measurement methods and standard value determination to explore the use of scientific methods to establish a comprehensive physician workload measurement system,accurately measure the physician's workload,so that the physician's labor value is reflected.And by formulating workload standards that are compatible with measurement methods,performance distribution is more reasonable and fair,and the enthusiasm of medical staff is improved to provide reference for hospital performance appraisal.Methods:(1)Literature surveyExtensive search and work volume measurement and standard value determination of the literature,combined with the relevant theory and the objective situation of the physician's work,propose a solution for physician workload measurement and standard value determination.(2)Expert consultationThe workload items of the physicians are defined and screened mainly by panel discussion and expert consultation.(3)Site investigation methodAccording to the purpose and content of the research,a reasonable questionnaire is designed to collect the data of the physician workload project.(4)Analytic hierarchy processAccording to the needs of the research,the analytic hierarchy process is used on the basis of expert consultation to realize the series connection between different types of physician workloads.(5)method of magnitude estimationEvaluate the selected physician workload items to determine the labor value points of the physician workload item.(work RVU)(6)average methodFor the calculated workload of the physician,the simple running average method is used to determine the standard value of the physician's workload.(7)Clustering methodK-mean clustering method to determine the standard value of physician workload.Results:1.Further clarify the concept of physician workload and the application of related theories in physician workload measurement.Starting from the practice of performance management and combining with literature,this paper analyses the connotation and characteristics of physician workload,and defines the concept of physician workload: physician workload refers to physician's time consumption,physical and mental effort in various related activities,as well as the risk degree,technical difficulty and pressure of physician-related activities.At the same time,the application of related theories in the measurement of physician workload and the determination of criteria is clarified by using the method of literature research.The measurement and standard Determination of physician workload is guided by the connotation of performance management theory,the measurement method of physician workload is inspired and guided by RBRVS model theory,and the determination of physician workload standard is guided and inspired by human resource management theory and efficacy coefficient theory.2.Determination of doctor's work itemsThe doctors' work items of the clinical department of a top three hospital in Dalian were classified and defined,and 6 types of 77 doctors' work items were obtained,including 17 items of operation and operation;21 cases of surgery;19 cases of medical record writing;9 items;8 items in daily work;3 items in outpatient department.3.Determination of labor value points of doctors' work itemsThe collected work items are used to determine the labor value points.The results show that the expert coordination coefficient is 0.735,the statistical significance is significant,the expert opinions are consistent,and the value evaluation results are credible;the analytic hierarchy process is used for different types of projects.The value points are serialized and standardized,and the labor value points table of the minimally invasive joint work project is formed.In the analytic hierarchy process,all levels CR=0.008<0.1,indicating that the weights have no logical errors,the matrix has satisfactory consistency,and the result of the calculation is credible.The logarithm of the value points of the single-item items in the labor value points table is normally distributed,the significance level is >0.05,the overall does not show a normal distribution,and the significance level is 0.00,which is in line with the characteristics of the doctor's work,and the research results of Professor Xiao Qinglun meets the.4.Determination of the standard value of physician workloadThe mean value method determines the standard value of the physician's workload.There are two standards.The standard values of the chief physician,attending physician and resident physician in the same period of last year are 1013.98/675.14 and 163.50.The standard values of the chief physician,attending physician and resident physician are respectively 1075.97,712.22,171.02.The eligibility criteria are two standard values simultaneously.The results of the assessment showed that the workload of the three chief physicians,four attending physicians and two resident physicians reached the standard value.The physicians who met the standard value completed their work within the scope of their duties,and the performance appraisal was qualified in terms of workload;one resident The workload did not reach the standard value,and the workload assessment failed.The clustering method was used to determine the standard value of physician workload,and the reliability of cluster analysis results was verified by variance analysis.The results were statistically significant,indicating that the classification processing effect performed by this study is greater than the error analysis,so that you have real between the groups.The difference exists,the cluster analysis results are credible and reliable,and the standard value formulation is persuasive.According to the cluster center,the standard values of the chief physician,attending physician,and resident physician are 1075.97,712.22,and 171.02,respectively.The results of the minimally invasive joint surgery showed that 3 chief physicians,4 attending physicians and 2 resident physicians had reached the standard value level,and the work within their own scope of responsibility was qualified in terms of workload,and one resident did not meet the standard.The performance evaluation of the value and quantity is qualified. |
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