Township health center performance appraisal rules

Third, the basic principles

(a) adhere to the principle of consistency

In the county-wide scope of the assessment, the content and standards of the assessment is basically the same, the assessment method is consistent.

(ii) adhere to the principle of objectivity and impartiality, fairness and transparency

objectively reflect the actual situation of health centers, the same level of development of health centers to adopt the same assessment standards, and public assessment results.

(C) adhere to the principle of system building and capacity building

Through the assessment, to further improve the township health center management system, improve the work of grass-roots health personnel enthusiasm, and promote the harmonious and healthy development of the township health center.

Fourth, the goal

(a) the overall goal:

1, the establishment of four mechanisms. Gradually establish a good government investment subsidy mechanism, job competition, can be up and down the employment mechanism, reward the good and punish the bad, more work more pay distribution mechanism and social democratic supervision mechanism. The quality and efficiency of the unified, coordinated work evaluation mechanism, to promote the completion of the township health center work objectives, and enhance the sense of achievement and collective honor of the workers.

2, to realize five changes. Township health centers focus on medical services to public **** health services, from passive to active service changes, from a single sector evaluation to multi-sector and the masses **** the same evaluation changes, from the pursuit of economic benefits to focus on the social benefits of the change from the subsidies to pay for the results of the service according to the staff change.

3, to achieve a purpose. To safeguard the health rights and interests of farmers as the center, to provide farmers with safe, effective, convenient, inexpensive public **** health and basic medical services, improve the health of the people.

(B) specific objectives

In accordance with the township health center service content and health services to determine the performance assessment index framework, the establishment of the number of services, quality of service and residents' satisfaction as the main secondary indicators of the individual performance assessment program, select the appropriate third-level indicators within the framework, the development of a set of scientifically sound, simple and easy to implement in the hospital's personal performance appraisal index system. Among them, for individual performance appraisal, it is emphasized that different appraisal indexes are determined according to factors such as service content, labor intensity and technical characteristics, and the quantity of service, quality of service and residents' (patients') satisfaction are highlighted as the main indexes to be appraised on a regular and irregular basis. Introduced the concept of standardized service volume, in order to approve the amount of personal services.

Fifth, the basic situation

Ledu County is located in northeastern Qinghai Province in the middle reaches of Huangshui River, with a total area of 3,050 square kilometers, the lowest elevation of 1,850 meters, the highest elevation of 3,400 meters, the county is divided into the brain mountain, mountain, ditch, Sichuan water four kinds of terrain. County jurisdiction 7 townships and 12 townships, 354 administrative villages; the total population of 288,000 people, of which the rural population of 239,000 people.

The county **** there are all kinds of health institutions 438, including: county-level health institutions 6, township health centers 21, village health room 359, private hospitals 4, non-government-run community health service station 9, individual clinics 39. As of the end of May 2012*** there are 226 regular employees, including health professionals and technicians*** 207 people, township health centers*** there are 124 regular beds, per 1,000 people with the number of beds 0.52, per 1,000 people with the number of health care personnel 0.87 people.

Six, implementation steps

(a) the establishment of the organization

According to the requirements of the program, the establishment of the Ledu County township health hospitals health performance appraisal leading group, Ledu County township health hospitals health performance appraisal expert group, responsible for supervising and checking the township health hospitals performance appraisal work.

(2) the development of assessment rules

the development of Ledu County township health center external performance appraisal evaluation rules, clear performance indicators and assessment of rewards and punishments, to determine the township health center specific performance assessment indicators, and with the annual work of the combination of strict inspection and assessment to ensure that the results of the assessment. Authenticity and reliability, to be open and transparent, fair and equitable, to achieve the purpose of promoting the work, improve the effectiveness and improve the service.

(C) training

In order to further do a good job in Ledu County Rural Health Development Project township health center performance appraisal work, and effectively improve the business level of township health centers and the ability to provide services, township health center performance appraisal training courses were held, the training object of all township health center director, the second area of the project experts, the county hospital, the county hospital, the county office of the New Agricultural Cooperative Office, county CDC, county maternal and child health station related personnel, part of the health center staff representatives, detailed explanation of township health center performance appraisal external assessment and township health center internal assessment procedures and methods, to seek advice, improve the assessment program.

(D) the implementation of township health center internal performance management

October 2009 the county medical reform office to review and determine the township health center internal performance appraisal approach to the quality of health services construction and management as the focus, actively carry out the rational use of medication interventions, the use of clinical diagnostic and treatment norms, the technical operation norms, the norms for writing prescriptions, the norms for writing medical records, the basic drug directory, nosocomial infections control measures, etc., to strengthen the quality control of health care services in health centers, to develop quality control measures to ensure medical safety, and to improve the ability of health centers to provide health services through the development of internal performance management activities.

(E) carry out daily supervision

According to the requirements and arrangements of the "Ledu County township health center performance appraisal implementation plan", the county health care reform office organized the Ledu County township health center performance appraisal evaluation team of experts, under the leadership of the county health bureau, on November 5?17, 2009, divided into two groups, 21 townships in our county to carry out the supervision of health centers. Township health center performance appraisal by the county health administrative departments to form the leading group of the assessment work, unified organization and arrangements, every six months for an assessment, the assessment work is completed after the unified assessment of the performance appraisal results.

VII, assessment indicators

(a) the basic public **** health service effectiveness

1, quantitative indicators:

basic vaccine and expanded vaccine throughout the vaccination rate

newborns within 24 hours of the Hepatitis B vaccine vaccination rate

the rate of timely reporting of statutory infectious diseases

the coverage of health education to meet the needs of the community.

Health education coverage rate of 66 core knowledge of health

Resident health record filing rate; dynamic management rate of

Chronic diseases, people with disabilities, the elderly and other key populations filing rate

Hypertension patient management rate

Diabetes filing and management rate

Mental illness filing and management rate of

Older people Health record standardization and management rate

Maternity hospitalization and delivery rate

Maternal and child system management rate

High-risk maternal management rate; high-risk pregnancy hospitalization and delivery rate

Mobilization of pregnant women to go to the township health centers and above for five prenatal checkups

Children under the age of 3 years of age systematic management rate

The rate of special case management of frail children reached

2, quality indicators:

Vaccine-targeted disease morbidity rate control within the national target

Behavioral formation rate reached;

Management of cases of blood pressure control rate;

Management of cases of blood glucose control rate;

Neonatal mortality rate;

(B) the effectiveness of basic health care services

Outpatient antibiotic use rate

Outpatient hormone use rate

Outpatient intravenous infusion rate

Admission and discharge diagnosis compliance rate

Inpatient irrational referral rate

Inpatient cure (improvement) rate

Outpatient prescription writing rate

Inpatient chart writing rate

Outpatient outpatient cost per outpatient visit

Outpatient blood glucose control rate

Inpatient blood glucose control rate

Inpatient blood glucose control rate

Inpatient blood glucose control rate

Average inpatient cost

Bed occupancy rate

Proportion of outpatient prescriptions for basic medicines

Nursing care of ? Three Checks and Seven Checks

Medical waste disposal in accordance with the norms

The number of medical disputes

(C) management and operation effectiveness

The implementation of the relevant management system of the township hospitals

Asset and financial management

Funds operation and balance of revenues and expenditures

The hospital equipment intact and the use of the

The hospital performance

The hospital performance of the hospitals and the use of the equipment and the use of the equipment

The hospital performance of the hospitals and the use of the hospitals

Performance appraisal of the hospital

Management and guidance of village health rooms

Hospital and personal hygiene environment

Satisfaction of patients and the general public with the medical and public **** health services

Staff satisfaction

VIII. Assessment

(I) Appraisal content

The content of the performance appraisal of township health centers is closely integrated with the annual work objectives and interlinked.

(2) assessment procedures

1, health center external performance appraisal

Township health center performance appraisal by the Health Bureau to form the leading group of the appraisal work, the unified organization and arrangements, the Health Bureau to draw the medical office, the CDC, maternal and child health care stations, health supervision, township health centers, composed of the assessment work group, every six months to carry out the appraisal, the appraisal work is completed after the unified assessment of performance appraisal. After the completion of the unified assessment of performance appraisal results.

2, health center internal performance appraisal

Health center internal individual performance appraisal in accordance with the township health center internal performance appraisal methods, the establishment of a performance appraisal team, from the number of services, quality of service and satisfaction with the township health center staff to conduct a comprehensive assessment of the three aspects, the implementation of the principle of the assessment of the post, the implementation of different staff of the different performance appraisal programs.

The performance appraisal of clinicians or general practitioners in health centers can select core indicators for assessment. For example, the number of general outpatient visits, the number of emergencies, the number of visits, the number of pre-hospital emergencies, the number of inpatient bed days (including rehabilitation of the disabled), the number of surgical services (only those who have carried out such surgical services), etc.; in terms of service quality, the percentage of outpatient antibiotics 2 or more combined prescription, the percentage of outpatient prescription of hormones, outpatient prescription writing pass rate and the cost of outpatient visits, etc.; in terms of patient satisfaction, the percentage of outpatient antibiotics 2 or more combined prescription, the percentage of outpatient prescriptions hormone, outpatient prescription writing pass rate and the cost of outpatient visit. In terms of patient satisfaction, the number of complaints, disputes and overall satisfaction were selected.

The performance appraisal of public **** health personnel can be selected core indicators for assessment. In the number of services can be selected from the number of people vaccinated (including a class of vaccines and two types of vaccines), the number of women's health care, the number of children's health care, hypertension, diabetes, mental illness, AIDS, tuberculosis standardized management of the number of patients, the number of health checkups, the number of new files, the number of days of work in the guidance of health education, the number of suspected statutory infectious disease reports and the number of emergency treatment of public health emergencies, etc.;

Performance assessment of the public health personnel can be selected core indicators to assess the. The number of people, etc.;

In the quality of service and resident satisfaction can be selected service log record integrity, service management standardization, complaints, disputes, the number of times and comprehensive satisfaction, etc..　　　　　　　 For the township health center to carry out part of the service, need all kinds of staff collaboration to complete the situation, the calculation of its service volume in accordance with the standard service volume of the service project approved by the equivalent value of the calculation. For example, if a clinician goes to the village to assist the public **** health personnel to carry out health education guidance for 1 day, then according to the standard service volume approved by the public **** health personnel for this service to be accounted for, that is, 12 standard service volume.

The performance appraisal of nursing staff is complicated by the work content and measurement of nursing staff, coupled with the overall shortage of nursing staff in township health centers, and the prevailing method is to refer to the clinical, general practice, or prevention of doctor's appraisal standards. The actual situation of each township health center can be based on the actual situation of the hospital, to develop the assessment program.

Patient satisfaction assessment can use questionnaires, telephone follow-up, etc., can also be used to select the assessment object of a period of time (can be selected for a quarter) of patient satisfaction as the benchmark value, continue to use a period of time (usually a quarter), and then combined with the assessment object of the recent complaints, disputes, the number of appropriate adjustments, in order to reduce the workload of the monthly patient satisfaction survey.

At the end of the appraisal, according to the job performance value of the comprehensive evaluation of their work objectives to achieve performance pay.

(C) assessment methods

1. Check the documents. Check the township health center's statistical reports, work records, prescriptions, medical records and other relevant documents.

2. On-site inspection. Check the internal setup and service process of the health center.

3. Visiting the public. Survey at least 20 farmers or patients to find out the satisfaction of the public.

(D) assessment results

1, performance value calculation

Quantitative indicators of performance value calculation method is divided into two kinds: Where the requirements of the increase or growth of positive control indicators, such as hospital delivery rate, indicators of performance value according to the formula: performance value = actual completion value / target value? The standard score; where the requirements of a reduction in the reverse control indicators, such as the infant mortality rate, the performance value of the indicator is calculated according to this formula: performance value = target value / actual completion value? The standard score.

Qualitative indicators in accordance with the specific scoring method of the assessment project to deduct the corresponding standard score, the actual performance value.

The sum of the performance value of each individual work is the total performance value of the assessed health center.

2, the assessment results

The assessment results are divided into three levels: performance score of 85 points or more is excellent, 84-60 is qualified, less than 60 is unqualified.

Nine, evaluation

Quarterly performance evaluation, cash performance pay. At the end of the year to carry out a township health center performance evaluation annual analysis and evaluation, targeting problems, adjusting the program.

1. Evaluation method:

Internal evaluation combined with external evaluation.

2, data collection and statistical methods:

All of the evaluated township health center performance data data obtained through on-site investigation, quantitative information based on a variety of work records, on the lack of records of the data, require face-to-face verification of the implementation of the specific clerk. The qualitative information is judged on the basis of a uniform caliber and basis, adhering to a uniform standard for evaluation.

After the completion of data collection, the omission of data, by the groups of investigators are responsible for telephone call back for data.

Quantitative indicators of performance value calculation method is divided into two: Where the requirements of the increase or growth of positive control indicators, such as hospital delivery rate, the indicator performance value is calculated according to this formula: performance value = actual completion value / target value? The standard score; where the requirements of a reduction in the reverse control indicators, such as the infant mortality rate, the performance value of the indicator is calculated according to this formula: performance value = target value / actual completion value? The standard score.

Qualitative indicators in accordance with the specific scoring method of the assessment project to deduct the corresponding standard score, the actual performance value.

The sum of the individual performance values is the total performance value of the hospital being assessed.

Ten, the establishment of township health center performance appraisal fund, for the implementation of performance appraisal work to provide a guarantee

Before 2006, Ledu County township health center for the difference in budgetary institutions, township health center part of the salary and operational funds mainly rely on business income to make up for the income of health centers, health centers, income growth, but at the same time, large prescriptions, The abuse of antibiotics, the abuse of hormones and other medical services tend to behavior is also increasingly serious.

In 2007, in order to maintain the survival and development of medical institutions, and to correct the deviation from the nature of the basic medical and health services of the public interest of the profit-seeking behavior; Ledu County Health Bureau in a timely manner to report to the county government to achieve the county township health centers full salary allocation.

In 2009, according to the "State Council on deepening the implementation of the reform of the medical and health system," the spirit of the government-led coordination of the county finances to the health sector to invest 30,000 yuan each year for the township health centers external performance evaluation incentive fund, performance evaluation scores ranked in the top five township health centers to give a 5,000 yuan reward for the director of its township health center to give a 1,000 yuan reward; and each of the 10% of the surplus of each township health center's approved income and expenditure as its own internal performance appraisal incentive fund, thus ensuring financial support for the internal and external performance appraisal of township health centers. In addition, 8% of the surplus of the income and expenditure of the county township health centers is used for the township health center development fund, which is used for the county township health center house maintenance, equipment maintenance, etc., and is coordinated by the Health Bureau.

In 2010, on the basis of the 2009 performance appraisal, the three pilot townships in Hongshui, Fengdui, Zhongling, the government incentive funds, 10% of the balance of income and expenditure of township health centers, in accordance with the results of the performance appraisal of the performance of the payroll.

In 2011, on the basis of the three pilot townships of Hongshui, Fengdui and Zhongling, the government incentive funds, 10% of the surplus of the township health centers after the approval of the income and expenditure, the personal work allowance of the employees, and the thirteenth month of incentive pay bundled and integrated use of the township health centers based on the results of the external assessment and internal assessment of the township health centers were cashed in to the units and individuals.

XI, township health center internal performance appraisal

The implementation of the director of the system of responsibility of the township health center of internal performance management, employee salary performance pay system, the implementation of performance-based, taking into account other elements involved in the distribution of labor compensation distribution system, and the workload of the employees, the quality of health services, the attitude of the service, the medical ethics and medical style, degree of risk, compliance with the law, medical safety, etc., that is, the usual payment of basic salary, Qinghai allowance and living allowances, withdrawal of wages in the work allowance and monthly average of the previous year-end one-time bonuses linked to performance, the abolition of purely with the business income, to ensure the mobilization of staff motivation and to maintain the healthy development of health undertakings in tandem, in order to control the unreasonable charges and the excessive growth of medical costs has laid a The first step is to make sure that you have a good understanding of what you are doing and how you are doing it.

1, the internal performance appraisal rules by the township health centers in conjunction with the actual development of the unit, the rules shall be by the health center staff and mass representatives to participate in the discussion, by the vote of all employees through the formation, and reported to the Health Bureau archives.

2, township health center employees to implement the file salary and the actual wage separation, that is, the national provisions of the employee's salary as the file salary retained, monthly only the file salary of the basic salary, Qinghai allowance and living allowances, the Health Bureau monthly withdrawal of health center employees in the file salary of the work of the allowances and the monthly average of the previous year-end one-time bonuses included in the performance pay, after the external, internal performance appraisal by the township health center for redistribution.

3, the principle of internal performance appraisal of health centers: adhere to the priority of efficiency, taking into account the fairness, the establishment of performance pay and the number of work, quality of work, work performance, professional ethics, public satisfaction, etc. as the main indicators of the assessment of the distribution of the method, so that the staff income and the level of technical skills, quality of service and labor contribution linked to a reasonable distribution of the grades, and to fully mobilize the staff's enthusiasm for the work. Township health centers in the job setup on the basis of each position in accordance with the responsibilities, tasks, risks, social benefits to determine the distribution coefficients of the positions, the contribution of large, technically demanding, high risk, social benefits of the positions should be determined by higher distribution coefficients, reasonable distribution coefficients of the grades to break the egalitarianism.

4, the internal performance appraisal of health centers should include the scope of personnel: the existing staff of the health center (excluding the director of the health center, township birth control personnel, temporary staff, ? The three support a help? Personnel, western volunteers, seconded personnel).

5, township health centers performance appraisal of the total amount of wages to determine:

The total amount of performance pay = the total number of internal performance appraisal? (working allowance + monthly average of the previous year's year-end lump sum bonus)

Average total performance pay per person = total performance pay / total number of internal performance appraisal

Total performance pay per unit = number of personnel involved in the appraisal of the health center? Average total performance pay per person? External performance value? Conditional performance value

Calculation of external performance value: County Health Bureau quarterly based on the township health center performance appraisal results to calculate the external performance value, 21 township health centers from the assessment of the first to the twenty-second place, respectively, based on the three grades to determine the value of the external performance, 1-8 external performance value of 1.24, 1.21, 1.18, 1.14, 1.10, 1.06, respectively, 1.03, 1.01; 9-11 external performance value of 1.0; 12-21 external performance value of 0.97, 0.95, 0.93, 0.9, 0.85, 0.8, 0.75, 0.7, 0.65, 0.6, respectively.

Conditional Performance Value Principle: Based on the per capita number of people served by the township hospitals, the radius of the service, and the township's natural economic conditions were discussed and determined as four categories. Discussed and determined as four categories, including Gao Miao, Gao Dian, Yurun, Gangou, Grinber, Hongshui for a class, the condition performance value of 1.0; Shoule, Cingsheng, **** and, Fengdui, Zhongling, Qu Tan for the second category, the condition performance value of 1.02; Ma Ying, Lijia, pro-income, Luhua, Putai, Taohongying for the third category, the condition performance value of 1.04; Chenggtai, Mafang, Shimaying, Dala, Zhongba for the fourth category. Conditional performance value is 1.06.

6, the determination of individual employee performance pay:

Individual employee performance pay = total unit performance pay / unit performance appraisal number? Internal assessment performance value? Post performance value

Note: internal assessment performance value, post performance value by the township health center assessment, discussion to determine, and reported to the county health bureau archives.

7, the director of the health center performance pay by the county health bureau unified assessment payment, its performance pay = personal performance pay? External performance value? Conditional performance value.

8, internal performance pay must be strictly in accordance with the results of the internal performance appraisal of health centers for distribution, and reported to the Health Bureau for review, unified distribution.

9, on the occurrence of major petition cases, the comprehensive incident and medical disputes, the implementation of a one-vote veto (by the Department of Health directly withholding the party's performance pay).

10, the results of the internal performance appraisal for the annual evaluation of priority, title promotion and employment, the main basis for staff mobilization.

11, performance appraisal of the lack of funds by the county financial support to solve.

12, performance pay by the County Health Bureau of Finance Center unified management, performance pay the balance can only be used as a performance appraisal of the incentive funds, shall not be diverted to other uses.