Hospital performance appraisal and performance pay allocation methods for the implementation of the rules
Hospital performance appraisal and performance pay allocation methods for the implementation of the rules of the hospital operating mechanism reform is one of the main elements of the distribution system reform. The following is the hospital performance appraisal and performance pay allocation methods implementation details that I brought for you, I hope it will help you.
First, the design of the weighting coefficients of the remuneration of various categories of personnel
Weighting coefficients are used to guide the development of all categories of personnel allotted to the total amount of remuneration between the proportionality of the reference value. Determine the weight coefficient of each type of personnel for the design of each type of personnel total remuneration standards for reference. At present, the state of the distribution gap between the various categories of hospital employees does not have a clear specification, there is no quantitative standards, but the design should reflect to the high-risk, high-tech, high-intensity labor and contribution to the positions tilted, and with the management elements, technical elements of the distribution of the combination. In the actual operation of the process, with reference to the following principles:
1, according to the local government documents;
2, according to the local labor department issued by the various types of personnel wage guidance;
3, according to the actual situation of the hospital: the staff's ability to afford the cost of reform of the hospital, the leadership's expectations of the goal.
Second, the design of the annual salary of the director of the clinical department
The annual salary system is an effective incentive to one of the forms of remuneration for managers, is a kind of distribution model that integrates the target task, power, benefits and risks. Because it has a pre-set target pressure, but also the benefits of reaching the goal, while taking risks, managers will be able to have plans and measures for the completion of the target task to play the ability, and the effective use of authority, to maximize the motivation of managers.
Hospitals are clinical and medical departments as an accounting unit. Clinical departments have more relative independence and initiative, the implementation of the annual salary system for managers of clinical departments, to promote the overall development of clinical departments, to promote the clinical departments to increase the two benefits, can be comprehensively driven by the development of medical departments and other departments of the hospital.
The annual salary is composed of two parts, namely the basic annual salary and risk annual salary. The proportion of the two according to the hospital's requirements for departmental managers, the annual salary set high, the risk of annual salary is also high; annual salary set conservative, the risk of annual salary is also a corresponding proportion of lower. Generally, the basic annual salary is not less than the average annual income of employees, the highest basic annual salary is generally not more than 1/2 of the total annual salary. risk annual salary according to the performance appraisal in order to get, belongs to the variable income.
In order to increase the risk, you can also ask the manager to pay a certain amount of risk money, the risk of money with the assessment of up and down.
A hospital clinical director of the basic annual salary and the risk of annual salary accounted for 50%, the basic annual salary distributed monthly, the risk of annual salary assessment according to the results of up and down. It is calculated as follows: X = 1/2W + [1/2W + 1/2W (K-100%)], X for the actual annual salary received, W for the set annual salary, K for the assessment value, set at 100%. When the K value is 100%, the actual annual salary is the set annual salary, when the K value is greater than 100%, the actual annual salary is higher than the set annual salary, when the K value is less than 100%, the actual annual salary is lower than the set annual salary:
Clinical departments also pay a risk fund equal to 50% of the set annual salary, the risk fund is non-interest bearing, and fluctuates up and down according to the appraisal K value. Example: K-value is 115%, risk money floated up 15%; K-value is 82%, risk money floated down 18%.
Three, clinician performance pay design
Doctors are the main producers of hospital survival and development, excellent medical talent is an important resource of the hospital. The allocation of doctors is the core content of the hospital performance assessment, the current state-owned hospital doctor's salary system is basically based on academic qualifications, titles and length of service to determine, and the doctor's actual duties, risks, technology, performance and contribution has little relationship, it is difficult to play a role in incentives. A well-designed pay-for-performance system for doctors should serve the following purposes:
1, to motivate and reward doctors for accomplishing the hospital's strategic goals;
2, to ensure and improve the quality of medical care;
3, to attract and retain talented people;
4, to enhance teamwork;
5, to cultivate the sense of responsibility of doctors.
A people's hospital clinicians performance pay is not a unified program and standards, but according to the characteristics of the clinical departments and managers personal management style to design their own programs, examples are as follows:
Cardiovascular medicine performance allocation program
1, the implementation of the percentage system assessment. Which economic income accounts for 70%, 10% of the quality of service, 10% of labor discipline, 10% of the quality of medical care (mainly in the medical record, diagnosis, treatment, medication rationality, etc.);
2, each case of interventional surgery plus 1 point;
3, regardless of the beds of the doctor (discipline leader) performance coefficient of 1.5, the coefficient of residents 1.2, the coefficient of rotating doctor
For example: a month of cardiovascular medicine doctors performance available for distribution of the total amount of 15,000 yuan, *** 5 doctors to participate in the distribution of which 1 subject leader, 3 residents, rotating section of the doctor 1. Dr. A earns $78,000 for 8 interventional procedures, Dr. B earns $58,000 for 6 interventional procedures, Dr. C earns $49,000 for 2 interventional procedures, and Dr. D earns $12,000. Calculated as follows:
① the performance of the discipline leader: the doctor's total coefficient of 1.5 + 3 × 1.2 + 1.0 = 6.1, each 1.0 coefficient of performance of 15000 ÷ 6.1 = 2459 yuan, the performance of the discipline leader for 2459 × 1.5 = 3688 yuan;
② the performance of the general practitioner's total performance is: 15000-3688 = 11312 Yuan;
③ Score assessment: the economic score is 70 points for the highest income doctor, and other doctors are calculated proportionally based on this doctor's income.
A doctor's score: 70 (economic) +10 (quality of service) +10 (labor discipline) +8 (quality of care) +8 (interventional procedures) = 106 points;
B doctor's score: 58,000/78,000 × 70 +10 +10 +8 +6 = 86.05 points;
C doctor's score: 49,000/78,000 × 70 +10 +8 = 86.05 points;
C doctor's score: 49,000/78,000 × 70 +10 +10 +6 = 86.05 points. 78000 x 70+10+10+10+8+2=73.97 points;
Dr. D's score: 12000/78000 x 70+10+10+10+8=38.77 points;
Total doctor's score: 106+86.05+73.97+38.77=304.79 points;
Average points per score: 11312/304.79=$37.11;
Calculated: 106 points x 37.11=$3934 for Dr. A; $3194 for Dr. B; $2754 for Dr. C; and $1,439 for Dr. D.
Ophthalmologist performance example
An associate director of the doctor's performance salary calculation for a month:
① undergraduate examination income (ophthalmology examination, treatment plus optometry) at a rate of 4% of personal income; (6160.5 yuan + 1179 yuan) × 4% = 293.58 yuan; ② inpatient billing and their own implementation of the operation of the income of the proportion of 5% of personal income; (1460.5 yuan + 1,179 yuan) × 4% = 293.58 yuan; ② inpatient billing and their own implementation of the operation of the income of the proportion of 5 percent of personal income; (14272.94 yuan + 1120 yuan) × 5% = 769.65 yuan; ③ medical *** with the income (counting 50%), 4.88% proportion of personal income; 655 yuan × 50% × 4.88% ÷ 6 (number of doctors) = 2.66 yuan; ④ outside the department of the income allocated to the Department of 7% proportion of personal income; 781.26 × 7% = 54.69 yuan; ⑤ surgical income: 397.82 yuan; ⑥ outpatient surgery income: 2306.33 yuan; ⑦ medical records deduction: 35 yuan; ⑧ drug ratio exceeds the standard deduction: 95.08 yuan; ⑨ various assessment deductions: 1.87 points; ⑩ admitted to hospital admission of 32 patients award 320 yuan;
Personal performance: (293.58 + 796.65 + 2.66 +) 54.64+397.82+2303.33-35-95.08)×(100-1.87)%+320=4436.42 yuan.
General Surgery Physician Performance Example
General Surgery Department*** has 6 physicians (except the director), divided into 2 medical groups, this month's physician performance*** 15,000 yuan. group A this month emergency surgery owed 5,000 yuan, revenue of 140,000 yuan, *** discharged 39 patients, returned 4 red packets, Class A medical record incentive of 800 yuan, the record of moderate defects deducted 100; Group B owes $3,000 for elective surgeries this month, has $120,000 in revenue, *** discharges 33 patients, receives 1 letter of commendation, returns 2 red envelopes, $600 reward for Grade A medical records, and $50 deduction for moderate medical record deficiencies.
The calculation steps for group A and group B leaders are as follows:
1. Calculation of arrears:
Group A deducted 5000×20%=1000 yuan
Group B deducted 3000×40%=1200 yuan;
2. Evening and night shift subsidies:
60×10+60×5=900 yuan;
3. Letter of commendation, return bonus reward:
7×20%=140 yuan;
4. Total performance amount that can be allocated:
15000-900-140-800-600+150+1000+1200=14910;
5. Total doctor's coefficient:
1.4×2+1.2× 2+1.0+0.8=7; the factor of 1.0 is: 14910 ÷ 7=2130; the performance of attending doctors is: 2556 yuan; the performance of residents is: 2130 yuan; the performance of rotating doctors is: 1704 yuan; the performance of the team leader of the total performance: 2130×1.4×2=5964 yuan.
6. Group A leader of the assessment score: 140,000 ÷ 500 + 39 = 319 points; Group B leader of the assessment score: 120,000 ÷ 500 + 33 = 273 points; set 500 yuan of income for 1 point, 1 point for each patient discharged; group leader of the total score: 319 + 273 = 592 points; the average score per: 5964 ÷ 592 = 10.07 yuan; group A leader's performance is: 319 × 10.07 = 3214 yuan; group B leader's performance is: 273 × 10.07 = 2750 yuan;
7. Various rewards and penalties on each doctor's performance to reward and deductions.
Anesthesiologists
The total score of individual monthly workload consists of four parts: anesthesia modality, anesthesia time, extra points for special circumstances and anesthesia quality score:
Anesthesia modality score: general anesthesia intubation: 5 points/table; intravenous general anesthesia: 4 points/table; intrathecal anesthesia: 3 points/table; nerve block anesthesia: 2 points/table; basic anesthesia: 1 point/table; anesthesia time Score: 1 point/table.
Fourth, medical and technical personnel performance design
Medical and technical personnel, including medical and technical examination department, functional examination department and outpatient clinic related departments, the autonomy of its work is relatively weak, the workload is subject to the clinical work of the constraints of the charge is not autonomous, the use of piecework performance pay is more in line with the nature of their work. The piece-rate method is generally based on the actual value of the workload to take direct proportional commission approach, but many of the size of the workload is not proportional to the value of its charges, so you can take the work of quantitative scoring approach to performance appraisal, and then the score will be converted to the amount.
For example:
B ultrasound room performance appraisal program
1, the daily work of the scoring instructions: outpatient ultrasound 0.5 points / person; routine ultrasound 1 points / person; intracavitary ultrasound 1.5 points / person; ultrasound system maternity 2 points / person; cardiac ultrasound 2 points / person; bedside ultrasound 5 points / person; Interventional ultrasound operation (biopsy and treatment) 10 points / visit; middle and night shift 1 point / visit;
2, middle and night shift subsidies: primary 50 yuan / day; intermediate 70 yuan / day; deputy senior 90 yuan / day;
3, the department of the individual distribution method: ① calculation of the individual assessment points, including daily work points, middle and night shift points, out of the study and rewards and punishments points; ② calculation of expenditure part of the salary, including the department of learning and awards and penalties; ③ the department of the individual assessment points, including daily work points, middle and night shift points, out of the study and awards and punishments points. Calculate the expenditure part of the salary, including the basic salary, mid- and evening shift subsidies and further training personnel wages; ③ assessment salary is equal to the total amount of hospital distribution minus the expenditure part of the salary, of which 30% of the title assessment salary, according to the different title coefficients of the assessment and distribution (coefficients: primary 1.0, intermediate 1.2 ~ 1.3, 1.4, 1.8, deputy high, high), the different titles are required to complete the corresponding. Consultation and teaching and other tasks, 70% for daily work scoring allocation; ④ individual final allocation composition: basic salary + 30% title assessment salary + 70% daily scoring salary + middle and evening night shift + other, etc..
Radiology performance appraisal program
1, fixed part
① radiological contact seniority: years ≤ 3 years, 200 yuan / month; 3 years & lt; years ≤ 10 years, 300 yuan / month; 10 years & lt; years ≤ 20 years, 400 yuan & gt; 20 years, 500 yuan / month;
② management fee: that is, to participate in the group within the management, mainly assigned to do piece-rate wage calculation, film and other materials requisition and issuance, diagnostic and technical group of two people, 100 yuan per person / month;
③ teaching fee: diagnostic and technical group of 300 yuan, mainly engaged in the teaching of the group's staff, scientific research and collective reading of the film, etc.;
④ special subsidies: more than 35 years of radiological work for staff, per person per month, another 100 yuan, for the registration room Another 100 yuan for each staff member who has been working in radiology for more than 35 years, 100 yuan per month for each staff member who is engaged in checking the signature of the report and the film number checking in the registration room;
⑤ day shift: that is, daytime work to be engaged in the specific staff to be issued at 20 yuan per day;
⑥ evening and night shifts: to be issued by the main section.
2, piece-rate wage
① Diagnostic group: A every reading of a film, according to the calculation of 1 point (including multi-site); B special examination: esophageal barium swallow, 4 points / visit; barium meal contrast, 6 points / visit; barium enema contrast, 8 points / visit; barium meal, 8 points / visit; uterine tubal contrast, 6 points / visit; sinus tract and fistulae contrast, 6 points / visit; other examinations refer to the The above.
② technical group: A 1 point for each exposure; B 1 point for each washed or printed film; C special: intravenous pyelogram, 6 points / visit; hysterosalpingography review, 3 points / visit; other special tests refer to the above; D paramedical film, calculated in accordance with the above three times.
Laboratory performance appraisal program
1, the combination of personnel:
Split into five groups: biochemistry group, immunology group, clinical group, blood bank group, outpatient 120 laboratory group. Team leader treatment is 120% of the average of the whole department.
2, the workload as the basis for piecework pay. Percentage system is implemented for daily work.
Biochemistry: miscellaneous laboratory tests 1 point / item, electrolytes 1.5 points / item, coagulation and hemostasis 3 points / item, blood gas test 1 point / item, outpatient specimen laboratory tests 1 point / item, on the machine operation 0.4 points / test. Multiplied by the workload to arrive at the daily score;
Immunization group: hepatitis B complete set (2.2/item), hepatitis B surface antigen 1.0 points/item, hepatitis C laboratory tests 1.0 points/item, multiplied by the workload to arrive at the daily score;
Clinical group: divided into body fluids (urinary routine 1 point/item, stool routine 0.5 points/item, ESR and a variety of routines and a variety of staining, etc. 1 point/item), blood and blood gases, blood gas, blood coagulation, blood gas, blood gases 1 point/item, outpatient specimens 1 point/item, on the machine operation 0 point/item. Points / one), routine blood on the machine (30 + 1 × number), reticulocyte red 2 points / one, blood type test (50 + 3 × number), resulting in a daily score;
3, medical quality: according to the quality of the Laboratory Department defects in the management of the program deductions;
4, labor discipline: according to the hospital's Labor Discipline Management Assessment Methods for each lack of 50 yuan;
5, scientific research and teaching : 50 yuan for each lecture;
Example: He Zhangyong (junior title, 2.5 years of work) in September 2006, the assessment, attendance 25 days; biochemistry room to work 1 day 158.6 points, outpatient laboratory to work for 2 days scored 322.2 points, in the clinical room to work for 5 days scored 699.5 points, in the immunization room to work for 7 days scored 1,147.9 points, 1 day of blood bank Score 161 points, 9 days of evening, night, night off score 1693.5 points;
September total score: 158.5 + 322.2 + 699.5 + 1147.9 + 161 + 1693.5 = 4182.7;
Base salary: 200 (basic) + 100 (junior) + 0 (no seniority pay for 3 years) = 300 yuan;
This month's lecture was held in the clinical room, the clinical room, the immunization room, 7 days of work scored 1147.9 points, blood bank, 1 day scored 161 points;
Lecture this month, a prize of 50 yuan, no test quality deductions, no violation of labor discipline. Section 0.76 yuan / points;
Total performance: 300 + 4182.7 × 0.76 + 50 = 3529 yuan.
Fifth, the salary design of the head nurse
The salary design of the head nurse should take into account both the different benefits of the various departments to be different, but also to consider the overall balance of this position in the hospital.
The monthly salary is composed of post salary and performance pay: 1, post salary nurse are set at 1300 yuan / month; 2, performance pay 50% according to the workload allocation, 50% assessment of the quality of work after the allocation.
Specific methods:
The total salary of the head nurse = the average annual salary of the head of the department × 40%; the total amount of performance pay for each head nurse = the total monthly salary of the head nurse - 1300 yuan;
The head nurse scoring method:
1, where the unit A month of critically ill patients per case per day 1 points; 2, in the department of a month of Class I care: patients per case per day 1 points; 3, in the department of a month of patients discharged from the hospital per case 1 points;
Calculation of the value of each point: 50% of the total performance payroll of the entire hospital nurse ÷ the total number of cumulative scores of the entire hospital nurse = yuan / points, the other 50% of the performance payroll assessment of the quality of the work to take a reverse deduction approach.
Example: a hospital ward head nurse 22 people, the total amount of individual pay for 46,000 yuan / year, monthly salary = 46,000 × 80% ÷ 12 = 3066 yuan.
The base salary of 1300 yuan, performance pay available for distribution of 3066-1300 = 1766 yuan, of which 50% that is 883 yuan as the workload assessment after the distribution, the other 883 yuan as the quality of work assessment after the distribution.
Calculated score: a month the number of hospital discharges 2302, the hospital's critically ill, level I care patients *** 2410 days, 883 yuan × 22 people ÷ (2302 + 2410) = 4.12 yuan.
110 discharges from a unit in the month, critically ill, level I care patients*** 253 days, nurse manager scoring 253+110=363 points.
Workload income for the nurse manager on the unit = 363 x 4.12 = $1495.56.
If the nurse manager has no demerits in the quality of work assessment, her salary for the month = $1300 + $883 + 1495.56 = $3678.56.
End of year assessment salary: 20% of the total remuneration of the head nurse is placed at the end of the year and is paid after the assessment. The method is:
1, linked to the economic benefits of the department, accounting for 50%; with reference to the department director of the department's assessment of the annual economic benefits score; the end of the year assessment of the total salary 50% / hospital-wide ward director of the economic benefits score; the total sum × the economic benefits score of the head nurse's department.
2, all levels of personnel on the head nurse satisfaction linked to 50%; 40% of the satisfaction of the director of the section; 10% of the satisfaction of the staff of the Department of Nursing; 30% of the satisfaction of the nurses in their units; 20% of the satisfaction of other departments.
Six, the nurse's pay for performance design
Ward nurses have a number of positions, to the night shift position is the most difficult, the general night shift staff only 1-2 people, to undertake all the department's treatment, observation tasks, in addition to the impact of jet lag in the body, but also need to have a wealth of experience, to bear the heavier pressure and responsibility. Therefore, it should be the highest position when determining performance. Other positions in the nursing team leader also belongs to the more important positions, generally require experienced specialized nurses to undertake, responsible for a group of patients nursing management, is also the focus of allocation considerations. Nurses work because of their creativity and autonomy is not strong, mainly to complete the doctor's orders work and daily nursing tasks, strict three checks and seven pairs, especially important for the implementation of their performance design to the job coefficients based on the coefficients calculated according to the coefficients of the work after determining the amount of performance for distribution.
For example: a month of a section of nurses for distribution of the total amount of performance pay for 12,446 yuan, nurse A (team leader) 24 days of work in the month, the team leader post coefficient is 1.0, her score is 24 × 1.0 = 24 points; nurse B on the evening shift 3, scored 3 × 1.5 = 4.5, day shift 4, 4 × 2.5 = 10 points, the other shifts: 7 × 0.7 = 4.9, 7 × 0.9 = 6.3, 7 × 0.9 = 6.3, the other shifts: 7 × 0.7 = 6.3, 7 × 0.9 = 6.3, 7 × 0.9 = 6.3, 7 × 0.9 = 6.3. 0.9=6.3, 3×1.0=3 points, 28.7 points for the month ****; all nurses in the department accumulated a total of 335.4 points, the value of each point: 12,446 ÷ 335.4=35.44 yuan; Nurse A: 35.44×24=850.56 yuan; Nurse B: 35.44×28.7=1017.22 yuan.
The allocation of non-disease area nurses according to the specific department to take different quantitative scoring method. For example, the operating room nurse performance appraisal program:
Surgical scoring: hand-washing tour (2 points / table for minor surgery, 4 points / table for intermediate surgery, 6 points / table for major surgery); surgical time of 3 points / hour, more than 4 hours per hour increment of 1 point, 1 patient to do two surgeries according to the operation of the high of a type of scoring, no hand-washing nurses on tour plus 1 point; less than 3 years of age pediatrics plus 1 point, rescue patients plus 2 points Lumpectomy plus 2 points, body cycle plus 4 points, infection surgical management plus 1 point. Evening shift 40 points, 10 points in the middle shift, day shift (including rest shift) 20 points, each person to complete 154 hours, overtime plus 3 points per hour, not enough to reduce 3 points per hour.
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