Detailed rules for the implementation of hospital performance appraisal and performance salary distribution method One of the main contents of hospital operation mechanism reform is the reform of distribution system. The following are the detailed rules for the implementation of hospital performance appraisal and performance salary distribution methods that I brought to you, hoping to help you.

First, design the salary weight coefficient of all kinds of personnel.

Weight coefficient refers to the reference value used to guide the formulation of the proportion between all the total wages allocated to all kinds of personnel. Determine the weight coefficient of all kinds of personnel for reference when designing the total salary standard of all kinds of personnel. At present, there is no clear standard or quantitative standard for the distribution gap among all kinds of hospital employees, but the design should reflect the inclination to posts with high risk, high technology, high intensity labor and great contribution, and be combined with the distribution of management factors and technical factors. In the actual operation process, refer to the following principles:

1, as stipulated in local government documents;

2, according to the local labor department issued all kinds of personnel salary guidance;

3. According to the actual situation of the hospital: the endurance of employees, the reform cost of the hospital, the expectations of leaders, etc.

Second, the annual salary design of clinical director

Annual salary system is one of the effective salary forms to motivate managers, and it is also a distribution model that integrates goals, tasks, powers, interests and risks. Because it has pre-set target pressure, benefits and risks after reaching the target, managers can exert their best ability to complete the target task in a planned and measured way, and can effectively use their powers to stimulate managers' enthusiasm to the maximum extent.

Hospitals take clinical and medical departments as accounting units. However, clinical departments are more independent and active. Implementing the annual salary system for clinical department managers can promote the all-round development of clinical departments and increase the two benefits of clinical departments, which can comprehensively promote the development of medical technology departments and other departments in hospitals.

Annual salary consists of two parts, namely basic annual salary and risk annual salary. The ratio of the two depends on the hospital's requirements for department managers. The annual salary is high, and the risk annual salary is also high. The annual salary is conservative, and the risk annual salary is correspondingly low. The basic annual salary is generally not lower than the average annual salary of employees, and the highest basic annual salary is generally not more than 1/2 of the total annual salary. Risk annual salary can only be obtained according to performance appraisal, which belongs to indefinite income.

In order to increase the risk, managers can also be required to pay a certain risk premium, which also fluctuates with the evaluation.

The basic annual salary and risk annual salary of clinical department directors in a hospital account for 50% and 50% respectively. The basic annual salary is paid monthly, and the risk annual salary fluctuates according to the assessment results. The calculation method is: x =1/2w+[1/2w+1/2w (k-100%)], where x is the actual annual salary, w is the set annual salary and k is the appraisal value, and it is set as/kloc-0. When the value of k 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 value of k is less than 100%, the actual annual salary is lower than the set annual salary:

The clinical department also pays a risk fund equivalent to 50% of the annual salary. The risk fund does not contain interest and fluctuates according to the evaluation K value. Example: the k value is 1 15%, and the risk premium rises15%; The value of k is 82%, and the risk premium decreases 18%.

Thirdly, the performance-based salary design for clinicians.

Doctors are the main producers for the survival and development of hospitals, and excellent medical talents are important resources for hospitals. The allocation of doctors is the core content of hospital performance appraisal. At present, the salary system of doctors in state-owned hospitals is basically determined according to the doctor's education, professional title and length of service, which has little to do with the doctor's actual responsibility, risk, technology, performance and contribution, and it is difficult to play an incentive role. Designing a good doctor performance compensation system should achieve the following goals:

1. Encourage and reward doctors to achieve the strategic goals of the hospital;

2. Guarantee and improve medical quality;

3. Attracting and retaining outstanding talents;

4. Enhance team spirit;

5. Cultivate doctors' sense of responsibility.

People's hospitals have no unified scheme and standard for clinicians' performance pay, but design their own schemes according to the characteristics of clinical departments and managers' personal management methods, such as:

Performance distribution scheme of cardiovascular medicine

1, the implementation of percentile assessment. Among them, economic income accounts for 70%, service quality accounts for 10%, labor discipline accounts for 10%, and medical quality accounts for 10% (mainly in medical records, diagnosis, treatment, rationality of drug use, etc. );

2, each case of interventional surgery plus 1 minute;

3. The performance coefficient of doctors (academic leaders) regardless of beds is 1.5, that of residents is 1.2, and that of rotating doctors is 1.0.

For example, the total performance of doctors available for distribution in a month is 1.5 million yuan, and there are ***5 doctors participating in the distribution, including 1 academic leaders, 3 residents and rotation doctors 1 doctors. Among them, Dr. A earned 78,000 yuan, 8 cases underwent interventional surgery, 58,000 yuan for Dr. B, 49,000 yuan for Dr. C, and 2 cases underwent interventional surgery, 1.2 million yuan ... The calculation is as follows:

① Performance of academic leaders: the total coefficient of doctors is1.5+3×1.2+1.0 = 6.1.0, and the performance of each coefficient is15000 ÷.

② The total performance of general practitioners is15000-3688 =11312 yuan;

③ Scoring assessment: The doctor with the highest income scored 70 points, and other doctors were calculated according to the doctor's income.

Doctor A's score is: 70 (economy)+10 (service quality)+10 (labor discipline) +8 (medical quality) +8 (interventional surgery) =106;

The score of Doctor B: 58,000/78,000× 70+10+10+8+6 = 86.05;

Doctor C's score: 49000/78000× 70+10+10+8+2 = 73.97;

The score of Doctor D:12000/78000× 70+10+/kloc-0+8 = 38.77;

Total doctoral score:106+86.05+73.97+38.77 = 304.79;

Average score:11312/304.79 = 37.11yuan;

After calculation, the score of Doctor A is106× 37.11= 3934 yuan; Doctor B is 3 194 yuan; Doctor c 2754 yuan; Dr. d 1439 yuan.

Examples of ophthalmologists' performance

Calculation of one-month performance salary for a deputy chief physician;

(1) undergraduate examination (ophthalmic examination, treatment, optometry) income according to the proportion of 4% included in personal income; (6 160.5 yuan+1 179 yuan) ×4%=293.58 yuan; (2) The income from self-billing and self-operation of inpatients shall be included in personal income at the rate of 5%; (14272.94 yuan+1 120 yuan) ×5%=769.65 yuan; (3) The same income as medical treatment (50%) is included in personal income at the tax rate of 4.88%; 655 yuan ×50%×4.88%÷6 (number of doctors) =2.66 yuan; (4) Income from external departments allocated to undergraduate courses is included in personal income at the tax rate of 7%; 78 1.26×7%=54.69 yuan; ⑤ Operation income: 397.82 yuan; ⑥ Outpatient operation income: 2306.33 yuan; ⑦ Medical record deduction: 35 yuan; ⑧ Deduction for drug proportion exceeding the standard: 95.08 yuan; 9. Deduction points for each assessment: 1.87 points; Participate in the 320 yuan Award for 32 inpatients;

Personal performance: (293.58+796.65+2.66+54.64+397.82+2303.33-35-95.08) × (100-1.87)%+320 = 4,436.408.

Examples of general surgeons' performance

There are 6 doctors (except the director) in general surgery, which are divided into 2 medical groups. The doctor's performance this month is *** 15000 yuan. Group A owes 5,000 yuan for emergency surgery this month, with income of140,000 yuan, 39 discharged patients, and 4 red envelopes returned. Class A medical records are rewarded to 800 yuan, and moderate defects in medical records are deducted 100 yuan; Group B owes 3,000 yuan for elective surgery this month, with an income of 1 20,000 yuan. There were 33 discharged patients, who received letters of commendation1letter, and returned 2 red envelopes. 600 yuan was rewarded for Grade A medical records, and 50 yuan was deducted for moderate defects in medical records.

The calculation steps of group A and group B leaders are as follows:

1. Calculation of arrears:

Group A will be deducted 5000×20%= 1000 yuan.

Group B will be deducted 3000×40%= 1200 yuan;

2. Night shift allowance:

60× 10+60×5=900 yuan;

3. Commendation letter and red envelope reward:

7×20%= 140 yuan;

4. Total distributable performance:

15000-900- 140-800-600+ 150+ 1000+ 1200= 149 10;

5. The total coefficient of doctors:

1.4×2+ 1.2×2+ 1.0+0.8=7; The coefficient of 1.0 is14910 ÷ 7 = 2130 yuan; The performance of the attending doctor is: 2556 yuan; Residents' performance is: 2 130 yuan; The performance of rotating doctors is: 1704 yuan; Total performance of team leader: 2 130× 1.4×2 = 5964 yuan.

6. The assessment score of Group A leader is:140000 ÷ 500+39 = 319; The assessment score of group B leader is:120000 ÷ 500+33 = 273; We assume that 500 yuan's income is 1, and every 1 patient is1; Total score of team leader: 3 19+273=592 points; Average score: 5964÷592= 10.07 yuan; Team leader A's performance is: 319×10.07 = 3214 yuan; The performance of group B leader is: 273× 10.07=2750 yuan;

7. All rewards and punishments are rewards, which are deducted from the performance of each doctor.

anaesthetist

The total score of individual monthly workload consists of four parts: anesthesia mode, anesthesia time, extra points under special circumstances and anesthesia quality score:

Anesthesia mode score: general anesthesia intubation: 5 points/set; Intravenous general anesthesia: 4 points/set; Intraspinal anesthesia: 3 points/set; Nerve block anesthesia: 2 points/set; Basic anesthesia: 1 min/set; Anesthesia time score: 1 minute/set.

Fourth, the performance design of medical technology department personnel

Medical technology department personnel include medical technology laboratory, functional laboratory and outpatient department. Their work autonomy is weak, their workload is restricted by clinical work, and their fees are not autonomous. Piece-rate performance pay is more in line with the nature of their work. Piece-by-piece method generally adopts the method of direct proportional commission according to the actual value of workload, but the size of many workloads is not directly proportional to their charging value, so we can use quantitative scoring method to conduct performance appraisal, and then convert the scores into amounts.

Examples are as follows:

Performance evaluation scheme of B-ultrasound room

1, description of daily work score: 0.5 for outpatient B-ultrasound/person; Routine color Doppler ultrasound 1 minute/person; Intracavity color Doppler ultrasound 1.5 min/person; Color Doppler ultrasound system physical examination 2 points/person; Heart color Doppler ultrasound 2 points/person; Bedside color Doppler ultrasound 5 points/person; Interventional ultrasound surgery (biopsy and treatment) 10 score/person; Mid-night shift 1 minute/person-time;

2. Mid-night shift subsidy: primary 50 yuan/day; Intermediate 70 yuan/day; Subtropical high 90 yuan/day;

3. Calculation method of personal distribution of departments: ① Calculate personal assessment scores, including daily work scores, middle and late shift scores, study abroad and reward and punishment scores; (2) Calculate the expenditure part of the salary, including the basic salary of the department, the subsidy for middle and late classes and the salary of the trainees; (3) The assessment salary is equal to the total allocation of the hospital minus part of the expenditure salary, of which 30% is the professional title assessment salary, which is distributed according to different professional title coefficients (coefficients: primary 1.0, intermediate 1.2 ~ 1.3, secondary high 1.4, high positive). ④ Individual final distribution composition: basic salary +30% professional title evaluation salary +70% daily grading salary+middle and late shift+others, etc.

Performance evaluation scheme of radiology department

1, fixed part

① Length of service of radiation exposure: years ≤3 years, 200 yuan/month; 3 years

(2) Management fee: that is, the management personnel who participate in this group are mainly assigned to apply for piece-rate wage calculation, film and other materials, and two people in the diagnosis and technology group, each person 100 yuan/month;

(3) Teaching fee: Diagnosis and Technology Group is located in 300 yuan, mainly engaged in teaching, scientific research and collective film reading;

④ Special allowance: 65,438+000 yuan per person per month for those who have been engaged in radiation work for more than 35 years, and 65,438+000 yuan per person per month for those who have been engaged in signature and film number of inspection reports in the registration room;

⑤ Day shift: those who work during the day will be paid according to 20 yuan/day;

⑥ Night shift: issued by the General Department.

2. Piece rate

① Diagnosis group: A, each film is watched with a score of 1 (including multiple films); B special examination: barium swallowing in esophagus, 4 points/person; Barium meal radiography, 6 points/person; Barium enema, 8 points per person; Full barium meal, 8 points/person; Hysterosalpingography, 6 points per person; Sinus fistula angiography, 6 points/person; Please refer to the above contents for other inspections.

② Technical group: A every exposure 1 time, calculated as 1 minute; B 1 film for each development or printing, and the score is1; C special: intravenous pyelography, 6 points/person; Hysterography review, 3 points/person; See the above for other special inspections; D bedside film, calculated according to the above 3 times.

Clinical laboratory performance evaluation scheme

1, personnel combination:

Divided into five groups: biochemical group, immune group, clinical group, blood bank group, outpatient 120 laboratory group. The treatment of the team leader is 120% of the average of the whole department.

2. Take the workload as the basis of piece rate. Implement a 100% system for work every day.

Biochemical room: miscellaneous test 1 minute/item, electrolyte 1.5/item, coagulation and hemostasis 3/item, blood gas test 1 minute/item, outpatient specimen test 1 minute/item, computer operation 0.4/item. Multiply the workload separately to get the daily score;

Immunization group: a complete set of hepatitis B (2.2 pieces/piece), hepatitis B surface antigen 1.0 points/piece, and hepatitis C detection 1.0 points/piece, respectively multiplied by the workload to get the daily score;

Clinical group: divided into body fluid (urine routine 1 min/piece, stool routine 0.5/piece, erythrocyte sedimentation rate and various routine and various stains 1 min/piece), blood routine computer (30+ 1× number), omentum red 2/piece, blood group test (50)

3. Medical quality: deduct points according to the quality defect management plan of the clinical laboratory;

4. Labor discipline: According to the hospital's labor discipline management assessment method, he deducted 50 yuan every time;

5. Scientific research and teaching: reward 50 yuan for each lecture;

For example: He (junior title, 2.5 years working experience) was examined in September 2006, and he worked for 25 days; Work in biochemical laboratory 158.6 points, work in outpatient laboratory for 2 days, work in clinical laboratory for 5 days, work in immune room for 7 days 1 147.9 points, and work in blood bank16/kloc-0 points.

Total score in September:158.5+322.2+699.5+147.9+1+1693.5 = 4182.7;

Basic salary: 200 (basic)+100 (junior)+0 (no seniority salary within 3 years) =300 yuan;

Give 50 yuan to give lectures this month, and check the quality without deducting points and violating labor discipline. 0.76 yuan/minute;

Total performance: 300+4 182.7×0.76+50=3529 yuan.

Five, the head nurse's salary design

The salary design of head nurses should not only consider the different welfare benefits of each subject, but also consider the overall balance of this position in the hospital.

The monthly salary consists of post salary and performance salary: 1, post salary of head nurse 1300 yuan/month; 2. 50% of performance pay is allocated according to the workload, and 50% is allocated after assessing the quality of work.

Specific measures:

Total salary of head nurses = average annual salary of department directors × 40%; Total performance salary of head nurses = total monthly salary of nursing soil-1300 yuan;

Head nurse scoring method:

1, and each critically ill patient in the department within one month is counted as 1 minute every day; 2. First-level care in the department within one month: every patient 1 minute every day; 3. The number of people discharged from the hospital within one month is1;

Calculate the scores: 50% of the total performance salary of head nurses in the hospital ÷ the total cumulative score of head nurses in the hospital = yuan/minute, and the other 50% will be deducted from the quality of performance salary assessment.

For example, there are 22 head nurses in a hospital ward, with a total personal salary of 46,000 yuan/year and a monthly salary of 46,000× 80%12 = 3,066 yuan.

The basic salary is 1.300 yuan, and the performance salary available for distribution is 3066- 1.300 = 1.766 yuan, of which 50%, that is, 883 yuan, is allocated after the workload assessment, and the other 883 yuan is allocated after the work quality assessment.

Calculation score: 2,302 people were discharged from the hospital in one month, and the critical patients and I-level nursing patients in the hospital ***24 10 days, 883 yuan ×22 people ÷ (2302+2410) = 4.12 yuan.

This month, a department was discharged 1 10, and critically ill patients and grade I nursing patients were ***253 days. The head nurse scored 253+ 1 10=363.

The head nurse's workload income = 363× 4.12 =1495.56 yuan.

If the head nurse's work quality assessment is not deducted, her monthly salary is = 1300 yuan +883 yuan+1495.56 yuan = 3678.56 yuan.

Assessment salary at the end of the year: 20% of the head nurse's total salary will be paid at the end of the year after assessment. The method is as follows:

1, linked to the economic benefits of the department, accounting for 50%; Refer to the annual economic benefit score in the examination of department director; 50% of the total salary at the end of the year/the economic benefit score of the director of the ward department of the whole hospital; Head nurse department sum × economic benefit score.

2. The satisfaction of head nurses at all levels is linked, accounting for 50%; Undergraduate director satisfaction 40%; The satisfaction of nursing staff was10%; The satisfaction degree of nurses in the department was 30%; Other departments are satisfied with 20%.

Sixthly, the performance pay design of nurses.

Ward nurses have multiple positions, and night shift is the hardest. Generally, there are only 1-2 night shift personnel. To undertake the treatment and observation tasks of various departments, in addition to the physical time difference, you need to have rich experience and bear heavy pressure and responsibility. Therefore, it should be the highest position when determining performance. In other positions, the nursing team leader is also an important position. Generally, experienced specialist nurses are needed to be responsible for the nursing management of a group of patients, which is also the focus of distribution consideration. Due to the lack of creativity and autonomy, nurses' work is mainly to complete doctor's orders and daily nursing tasks, which is particularly important for implementation. Therefore, their performance design is mainly based on the post coefficient, and after determining the performance quota for distribution, it is calculated according to the work coefficient.

For example, in a certain month, the total performance salary of nurses in a department is12,446 yuan, and nurse A (team leader) works 24 days in that month, and the post coefficient of team leader is 1.0, and her score is 24× 1.0 = 24 points; Nurse B works three night shifts, 3× 1.5=4.5, 4×2.5= 10, and other shifts: 7×0.7=4.9, 7×0.9=6.3, 3× 1.0=3. The total score of all nurses in this department is 335.4, and the value of each score is 12446÷335.4=35.44 yuan; Nurse A: 35.44×24=850.56 yuan; Nurse B: 35.44× 28.7 =1017.22 yuan.

The distribution of nurses in non-ward areas adopts different quantitative scoring methods according to different departments. For example, the performance appraisal scheme for nurses in the operating room:

Operation score: hand washing tour (2 points for small operation, 4 points for medium operation and 6 points for large operation); The operation time is 3 minutes/hour, and it will increase by 1 point every hour for more than 4 hours. Patients who have had two operations are scored 1 according to the type of operation height, and nurses who do not wash their hands are added 1 point. Children under 3 years old are given 1 point, patients who are rescued are given 2 points, endoscopic surgery is given 2 points, physical follow-up is given 4 points, and surgical treatment of infection is given 1 point. Night shift is 40 minutes, middle shift 10 points, day shift is 20 points (including rest shift), each person completes 154 hours, overtime will be added with 3 points, and 3 points will be deducted if it is not enough.

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