Construction Of Performance Appraisal Index System Of Family Physician Team In Shenzhen

Objective: Family physician contract service is an important part of grassroots health service in China,and most of the services are provided in the form of family physician team.The current community health service workers nervous,more than one position,and so on and so forth will cause the team the close cooperation and division of responsibility is not clear wait for a phenomenon,and debates about signing the family physician service research is more "standardized work" and "service effective" indicators to assess basic medical and public health services,and there is no sound of team building,team management and team appraisal system.In 2018,Shenzhen issued the "Standards for Family Doctor Service",which further clarified that family physician teams should formulate detailed team assessment management methods for each service project.At present,the family physician team service mode in Shenzhen has been widely used in the major community health service centers in the city and gradually formed a set of unified and orderly work procedures.However,there is still a lack of in-depth research on the performance assessment index system of family physician team and the internal assessment of the team.Therefore,after a large amount of literature reading and full investigation,this study formulated a set of team performance appraisal plan for family physician in Shenzhen with team operation as the center and team management as the focus.Methods: Through full investigation and literature review,the performance appraisal index system of family doctor team was preliminarily developed,which was divided into two parts.The first part was the performance appraisal index of the superior department for each team,and the second part was the performance appraisal index within the team.Two rounds of Delphi expert consultation were conducted for each of the two parts of performance appraisal indicators.In the first part,16 participants were selected from community health service organization managers,and in the second part,21 participants were selected from community workers such as team leaders,general practitioners,community nurses,public health doctors,pharmacists,and convalesives.The experts evaluated the two rounds of indicators from the importance,familiarity and judgment basis of the indicators,modified the indicators through the boundary value method and combined with expert feedback to get the final assessment index system,and used the analytic hierarchy process to determine the weight of each index and analyze its consistency.Results: In the first part,the positive degree of 16 experts was 100% and 100%respectively.The authority coefficients were 0.89 and 0.90,respectively.The degree of coordination was 0.232 and 0.339,respectively.Combined with the selection result of index threshold value and expert group discussion,a set of performance evaluation indicators for family doctor team by superior departments was finally formed,including 5 first-level indicators,17 second-level indicators and 30 third-level indicators.Analytic Hierarchy Process(AHP)was used to analyze the consistency of indicators at all levels,and the CR value of each index was less than 0.1,indicating satisfactory consistency of all indicators.In the second part,the positive degree of the 21 experts in the two rounds was 100% and 76%respectively.The authority coefficients were 0.91 and 0.91,respectively.The degree of coordination was 0.270 and 0.328,respectively.Combined with the selection result of index threshold value and expert group discussion,a set of internal performance assessment indicators of family doctor team was finally formed,including 6 first-level indicators and 17second-level indicators.Using the analytic hierarchy process,the Cr value of each index is less than 0.1,and each index has a satisfactory consistency.Conclusions:1.In this study,literature review method,expert demonstration,Delphi consultation method and analytic hierarchy process were used to develop the assessment indicators,which is scientific and reasonable to a certain extent.It better covers the focus of the current family doctor team work,details the internal assessment of the team,and promotes team cooperation.2.Although various localities actively explore the establishment of performance assessment indicators for family doctor team services,they are all assessed at the individual or institutional level.From the team level,this study developed a set of performance assessment indicators for family doctors with team operation as the center and team management as the focus.This paper provides reference for the further implementation of family doctor team service in Shenzhen.3.Due to the limited time and energy of this study,it failed to conduct a pilot study on the constructed indicator system.The next step of the study is to select community health service centers in Shenzhen to verify and further improve the performance evaluation index system of family doctor teams,and finally form a performance evaluation index system that can be promoted.