The RBRVS Introduction Of Hospital Administration And Logistics Staff Performance Appraisal

Objective：RBRVS assessment system is a performance appraisal evaluation method based on the accounting ofworkload, focusing on the control of quality assessment, and carried out through a comprehensiveevaluation means. With the introducing of RBRVS assessment system，the allocation principle of“efficiency first; equity considered; quantum meruit” can be truly reflected. Upon the reasonablemeasurement of the administrative and logistic staff’s workload, with the determination of the positionsetting, combined with the position risk, the performance of the administrative and logistic staff can beobjectively calculated, their vocational identity can be largely raised, their enthusiasm greatly enhanced,and their motivation to participate in management largely improved. The author expects this thesis canprovide reference for the later performance appraisal of hospital administrative and logistic staff.Methods：Adopting the cluster sampling method, the survey was conducted among277administrative andlogistic staff of the First People’s Hospital of Kaifeng City. A questionnaire made in combination of theauthor’s own work experience and the reference to a large number of relevant literatures was given to these277staff to complete. The questionnaire mainly includes: the staff’s attitude toward the reform ofallocation system; the focus of the performance appraisal; the cognition of the allocation scheme, thedetermination of post coefficient, the disparity of income, and the setting of position risk; the satisfactiondegree of target management, performance appraisal, performance management, bonus distribution, andpersonal income, etc. The research was carried out by some trained undergraduate and graduate students.The statistical analysis software SPSS11.6was applied to establish a database and the statistical analysismethod of frequency analysis and chi-square test were mainly employed in this research.Results:1. In2011, the hospital operating income has seen an average increase of16.93%since2009; themedical income an average increase of26.64%; the human cost an average increase of24.44%; the hospitalaverage bonus an average increase of25.19%; the total bonus an average increase of30.21%. The datashows that the fastest growth falls on the total bonus while the relative least increase is in operating income,which proves that the current performance appraisal methods can not fully motivate the hospital staff.Furthermore, the facts that the human cost and the total bonus grows faster while the operating incomegrows slower result in a reduction in the net operating income and lead the operation into a non-virtuouscircle.2. The data on the administrative and logistic staff’s cognition of the performance appraisalmanagement shows that: among the277people surveyed79think that there is an urgent need for thehospital to reform the allocation system, accounting for28.52%;136think that there is a need to reform theallocation system, accounting for49.10%;152approves the implementation of the allocation reform withinthe hospital, accounting for54.87%. Thus it can be seen that there is a necessity or even an urgent need forthe reform in the performance appraisal system of hospital administration and logistics staff. 3. From the survey of associated factors in comprehensive performance management, it can be seenthat the top three satisfied items are: the satisfaction of the execution of the hospital leading groups(65.34%); the satisfaction of the hospital’s completion of annual objectives (63.54%); the satisfaction of thesecondary allocation of hospital departments (49.46%). In addition,47.65%of people surveyed aresatisfied with the quality assessment;41.52%are satisfied with the management efficiency;45.49%aresatisfied with the cost control of hospital departments. Only32.85%of people surveyed are satisfied withthe transparency of bonuses accounting, and just26.71%are satisfied with personal income. The lowestsatisfaction falls on the item “Are satisfied with your personal income compared with the staff of sameposition from hospitals of the same class in Henan province?”, only9.75%express satisfaction.4. As for the focus of performance appraisal,41.52%of people surveyed believe it should be thereasonable setting of positions;19.13%think it should be the quantification of assessment indicators;14.08%think it should be the determination of the assessment indicators. Moreover,63.90%of peoplesurveyed think that the income of different personnel from different departments should be transparent. Thedata clearly shows that the reasonable setting of positions, the quantification of assessment indicators andthe determination of the assessment indicators should be taken fully into account by the administrative andlogistic staff when doing the performance appraisal. It also shows that most staff expect the transparency ofincome. When developing an evaluation system, the staff’ views should be fully considered, which makesthe performance appraisal assessment system more complete, more recognized by the administrative andlogistic staff, therefore enhance the enforceability of the performance appraisal system.5. On the aspect of income,53.43%of people surveyed think that the existing income gap is too large,which is unaccepted;59.21%think that the proportion of the highest income and lowest income should belimited. This requires a reasonable setting of position coefficient and a careful balancing of the highest andthe lowest income. The income should both reflects the principle of “good work deserves good pay” andmake the staff accept from their hearts.6. The core of RBRVS is taking the workload, the cost and the opportunity cost of taking professionaltraining into resource consumption factors and objectively calculating the remuneration for personalservices. The introducing of RBRVS assessment system into the performance appraisal of hospitaladministrative and logistic staff can be an effective solution to the fairness problem of allocation. Settingdifferent coefficient for different position, taking position risk into account, this new performance appraisalsystem makes the staff get what they deserve and fully reflects the principle of “good work deserves goodpay; better work deserves better pay; fairness comes the first”.7. According RBRVS assessment system, the position coefficient varies with the difference in the jobnature of different departments, the difficulty of techniques, and the level of risks. Considering theacceptance of the staff, this new assessment system sets the maximum and the minimum positioncoefficient less than3times. On one hand, it can reflect the value of competent staff, reasonably extend theincome gap, on the other hand, it can further motivate the staff to complete their work in a better way.8. From the satisfaction survey of the administrative and logistic staff, it can be seen that byintroducing RBRVS assessment system, the hospital staff’s satisfaction level of bonus allocation scheme increases from22.61%to44.38%; the satisfaction level of the reflection of “good work deserves good pay;better work deserves better pay” in the bonus allocation scheme increases from43.24%to60.57%; thesatisfaction level of personal income increases from26.67%to45.86%; the satisfaction level of the fairnessin bonuses accounting scheme increases from32.15%to52.67%; the satisfaction level of the transparencyin bonuses accounting increases from32.77%to53.98%; the satisfaction level of the secondary allocationof departments increases from49.49%to63.21%; the satisfaction level of personal income compared withstaff from other departments increases from36.35%to56.31%.Conclusions：Hospital administrative and logistic staff is not satisfied with the current performance appraisal system.The overall satisfaction level is38.86%.77.62%of people surveyed indicate that there is a need to reformthe current performance appraisal method. They believe that the focus of the performance appraisal is thequantification of performance assessment indicators, the reasonable setting of positions as well as thedetermination of assessment indicators. In addition, they also expect the transparency of income. Theimplementation of the new health care reform and the hospital administrative and logistic staff’s needs forthe reform of the current performance appraisal create favorable condition for the introducing of RBRVSassessment system. The introducing of such a system can truly reflect the allocation principle of “efficiencyfirst; equity considered; quantum meruit”. It can also make the performance appraisal system morescientific and more reasonable and better improve the motivation of the administrative and logistic staff.After the implementation of RBRVS assessment system in hospital administrative and logistic staff, thesatisfaction level largely increases, from which can be drawn that there is a certain feasibility forintroducing of RBRVS assessment system.