The Research Of System For Performance Evaluation For Clinical Departments In Orthopedic Hospital

As our medical and health care reform of public hospitals in deepening the reform has achieved some successes, but the performance evaluation for clinical departments in a orthopedic hospital still focuses on concerns financial indicators and the work quantity ,but ignore the differences of work quantity and the doctors'professional ethics . This will greatly affect the department managers and the Medical staff's initiative, as well as affect the working quality and efficiency improvements in public hospitals. This kind of situation will hinder the balance of the hospital's development, bring negative guide to public benefit. January 2009, the standing committee of state council issued a new round of medical scheme "on deepening the reform of medical care system in opinion" and "2009 ~ 2011 deepening medical health system reform plan", also clearly puts forward to adhere to the people-oriented, to safeguard people's health rights in the first place[23]. The bill Insist on that the center of the medicine health service is to protect people's health, to ensure people's health service. Everyone will have access to basic medical and health services. From reform scheme design, health system established to service system construction should conform to the principle of public welfare, it is very important to work hard to solve the populace to reflect intensely prominent problems, this situation put forward higher request to public benefit. And in practical application, it is found that there is less comprehensive study of scientific for performance assessment and Comprehensive evaluation method, this study is to be expanded [24].Objective:Firstly, to develop exclusive performance assessment index system for this orthopedic hospital; secondly, using the Delphi law and the analytic hierarchy process, to determine weigh of all levels, and using the performance assessment index system to do a synthetic evaluation for the Tangshan second hospital. Methods:Taking the elementary theory of balances scorecard as the instruction, unifying the theories about domestic and foreign in performance appraisal of enterprise and hospital, form the frame of the index system; using the Delphi law, through questionnaires ,the research team had the understanding of assessment and choice of index system in different clinical departments, form the system for performance evaluation for clinical departments in a orthopedic hospital; using the analytic hierarchy process and determine weight of all levels. Method adopts management by objectives to combine with weighted TOPISIS each other, make a performance of comprehensive evaluation.Results:1. Using Delphi method and analytic hierarchy process, will qualitative research and quantitative research, based on combining a quality evaluation, notice priority achievements reflect the differences, relatively reasonable due consideration to fairness principle, construct orthopedic hospital clinical departments performance evaluation index system. The index system composed by 3 indicators, including one class index including efficiency benefit assessment, clinical quality evaluation and civilized services assessment three aspects; Secondary indexes including 10 utilization rate, health supplies cost rate, medical quality assessment, nosocomial infection assessment, patient satisfaction aspects; Level 3 index including patient basic nursing, disinfection and isolation system implementation, legal responsibility system management 53 aspects.2. Using AHP to determine the index proportion, make a hierarchical structure model, ordinary and hierarchic. According to the related principles of Delphi method, construct judgment matrix, then according to the provisions set of scale make both to both quantitative comparisons. On this basis, will convert the judgment matrix with the weight vectors of relevant elements (i.e. weight), to ask for guarantee the AHP analysis concluded rationalization, also carry a judgment matrix consistency inspection3. Combining with the goal management and TOPSIS method, standardized with monthly performance of efficiency and benefit index from efficiency benefits, quality and civilized services, three aspects of orthopedic hospital ,make a comprehensive evaluation on monthly performance for the main clinical departments. The result shows: the foot surgery, rehabilitation and performance level is the highest performance level three top big families, the old bone, ICU, and bone diseases performance level is low.Discussion and Suggestions:1. About the construction of the indicator system: Combined with hospital comprehensive target management requirements, experts in constructing the index system in full consideration of key performance indicator efficiency and benefit, Join the quality evaluation and civilized services assessment, already considering the price and expenses proportion of patients, and income of cost level of economic factors and medical process of the medical and nursing quality given adequate attention to, indexes are enforceable and operability, targeted comprehensive; But the index system is still need to be further perfected, such as independent assessment should be the current research and department development index, and make the hospital's into office in performance assessment work in unified framework of the performance assessment work, more conducive to the operation and department performance improvement.2. Methodology discussion: weighted TOPSIS comprehensive evaluation method in the applicability of performance evaluation.The method make the date by the same trend is changed and normalized, eliminating the influence of dimensional on evaluation results, comparing the full use of original data information, makes evaluation result is more scientific and reasonable. And the method of the sample material no special requirements, use agile and convenient, in benefit evaluation and health management wide fields such as equally applicable to department performance evaluation.3. Suggestion: It is important to establish special hospital performance testing and management department, to make sure the index data consistency and timely availability. Analyzing the rolling monitoring department index data as soon as possible, and help each department found between assessment and change, make the every aspect of the performance management work is actual.