体系建立体系建立健全医院立体化绩效考核评价.doc

建立健全医院立体化绩效考核评价体系 On 3-Dimensioned Performance Assessment and Appraisal System 1、 前言： 1. Preface 在医疗改革呼声日益高涨和医疗市场竞争不断加剧的今天，医院如何改变原有的运行管理模式，适应新形势的变化，提高医院的核心竞争力，是医院管理者不可回避的重要问题。我国医院的发展经历了从设备竞争——技术竞争——服务竞争——战略竞争的过程，目前正向文化竞争发展。竞争就要有目标，目标是医院发展的方向，在当前医疗市场的竞争中，实施目标管理是医疗机构保持竞争实力的最常用方法之一，更是医院管理的最常用手段之一。由于目标管理事先有比较明确的目标作为标准和动力，人们随时进行自我管理，并努力完成既定的工作目标。目标管理辅以绩效考核的手段，可以督促人们在实现目标过程中，及时调整方向进行资源整合，最终达到组织利益的实现。 How can hospital transform the current mode of operation and management? How can hospital adapt itself to the new situation? How can hospital improve its central competitive strength? Those challenges have to be approached by hospital managers today especially when health care reform is earnestly called for by the medical market with intensive competition. The development of hospitals in China has experienced the competition in equipment, technology, service and strategy respectively and now is getting into the cultural competition. Competition, of course, feels like an objective, which is the direction of a hospital. In the medical market competition, however, objective management is the most popular practice for a medical agency to maintain its competitive strength as well as to manage a hospital. As objective management cries out for a definite objective in advance, which serves as a standard and impetus, people can conduct self management at any time and strive to reach their goal. With help of performance appraisal, however, objective management may enhance timely adjustment of the course during realization of the objective to integrate resources and eventually to obtain benefits. 2、 相关背景资料： 2. Background 近十年来，随着国务院及其他政府部门相关医疗政策的出台，以及中国加入WTO 后医疗市场的逐步对外放开，国内的医疗行业状况发生了巨大的变化。民营医院大量崛起，其中有些甚至收购了多家公立医院；外资医院或机构正在大举入侵，其凭借独特的技术和服务优势占得了不小的市场份额；随处可见的私人诊所和药店也如雨后春笋般出现。这些都给公立医院的生存与发展带来了一定的冲击。国家医改方案迟迟不能出台，虽然先后有十套方案相继出炉，却始终未能形成一套适合中国医疗市场的总体改革方案，医疗体制改革举步维艰，公立医院发展前景不明朗。无锡市针对国际国内形势变化，在没有任何经验可借鉴的情况下，在国内率先进行了“政事分开，管办分离”运行机制的改革。卫生局作为行政执法部门对公立医院的经营行为进行监管；由卫生局分离出来的医院管理中心（以下简称医管中心）成为政府“办医院”和“管资产”的责任主体，“办医院”就是在法律法规及政策的框架下，通过优化配置资源，提高医疗质量，提供满足不同层次需求的代表市属医院水平的优质医疗产品。“管资产”就是要确保国有资产保值和效益最大化。在医管中心成立后，将前几年进行的以经济指标考核为主的 “托管制”改革进一步深化为注重对社会效益和工作业绩综合考核的“医疗服务、资产经营委托管理法人代表任期目标责任制”改革，把解决医院建设和运行目标作为重点，探索所有权和经营权分离的模式，达到既尽显公益性特征、又增强医院活力的目的。职能上下放医院经营管理、人事用工和经济分配权，激发医院活力。医院则是专科建设、人才培养、医疗服务与经营的主体。面对医管中心下达的涉及医院管理、医院信息、医疗安全、医疗服务、经济运作、医德医风六个方面内容，八大类17项数百条共1000分的考核标准，医院该如何确立一个符合自身发展需求的总体目标，并能按计划有步骤地加以实施，则显得尤为重要。 As health care policies have been promulgated by the State Council and other governmental bodies and the medical market has been gradually unveiled to outside after China entered WTO in the past 10 years, a great change has happened to Chinese medical industry, where are rising a lot of private hospitals, some even acquisitioned a few public hospitals; meanwhile, many foreign-funded hospitals or agencies are rushing off their head into China and they have a much share of the market thanks to their unique superiority in both service and technology; and on the other hand, private clinics and drug stores have emerged here and there, which, in some degree, is troubling the survival and development of public hospitals. 10 national health-care-reform programs, although published in succession, fail to bring about a general scheme which is suitable for Chinese medical market. In this connection, the health care reform is still far from matured and, as a result, public hospital is still fighting its way to survive and develop. In view of the present situation at home and abroad, Wuxi City has pioneered to undertake the reform on hospital operations mechanism, i.e. “Separating government functions from public institutions and administration from business running” without any experience to be referenced. As an enforcing body, the Bureau of Health of Wuxi City serves to supervise the business of public hospitals; the Hospital Management Center (HMC) separated from the Bureau of Health is a responsible entity of the government to “run hospitals” and “manage assets”. “Running hospital” calls for providing quality medical products on a municipal level which can meet demand from different walks of life by optimizing arrangement of resources and further improving the quality of health care in compliance with laws, rules and regulations. “Managing assets”, however, calls for maintaining state owned assets and maximizing their benefits. After HMC was established, “entrusting system” reform, characteristic of economic index assessment put into practice years ago, has been furthered into the reform of “target responsibility system set for the office term of the legal representative entrusted to manage medical service and assets operation”. This system focuses on comprehensive assessment which is made over the social benefits and business performance and attaches importance to reaching the goal of hospital operations, with a view to exploring a mode of separating ownership and management to realize public welfare and act