Performance appraisal scheme for secondary hospitals

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performance appraisal scheme for secondary hospitals 1

in order to accelerate the comprehensive reform of county-level public hospitals, promote the healthy and sustainable development of county-level public hospitals, and solve the problem of people seeking medical treatment in counties, this document is formulated according to the spirit of the Notice of General Office of the State Council on Printing and Distributing the Pilot Opinions on Comprehensive Reform of County-level Public Hospitals (Guo Ban Fa No.2x33) and Opinions of Anhui Provincial People's Government on Comprehensive Reform of County-level Public Hospitals (Wan Zheng No.2x98).

1. Guiding ideology

Guided by Scientific Outlook on Development, with the goal of establishing a medical and health service system that is suitable for the economic and social development of the county, we should implement the medical reform idea of "ensuring the basics, strengthening the grass-roots units and building mechanisms", with the direction of adhering to the public welfare nature of public hospitals, fully mobilizing the enthusiasm of medical staff and meeting the basic medical needs of the people as the core. Focusing on the separation of management from office, separation of government affairs, separation of medicine and the reform of personnel and distribution system, we will reform the compensation mechanism and operation mechanism of public hospitals, improve the medical service system and improve the supervision mechanism, strive to improve the technical level and service capacity of county-level medical institutions, and strive to solve the problem of "difficult and expensive medical treatment" for the broad masses of the people.

II. Work Objectives

With the goal of building a county-level medical service system with clear objectives, reasonable layout, appropriate scale, optimized structure, perfect functions and high efficiency, we will establish a management system and operation mechanism of public hospitals with local characteristics, and a scientific and standardized compensation mechanism and supervision mechanism of public hospitals. Through the comprehensive reform of county-level public hospitals, the operating efficiency, internal management level and service capacity of hospitals have been significantly improved, providing safe, effective, convenient and cheap medical and health services for the broad masses of the people. Strive to improve the rate of medical treatment within the county to about 9% by 2XX, and basically realize that serious illness will not leave the county.

III. Main tasks

(1) Separate management from office, and establish a new management system for public hospitals

1. The county government has established a county-level hospital management committee (hereinafter referred to as the "Medical Management Committee"), with the main person in charge of the government as the director, and the members are the main persons in charge of the organization, establishment, development and reform, health, finance, people's society, price, drug supervision and other departments and county-level hospitals. Under the Medical Management Committee, there is a county-level hospital management office (hereinafter referred to as the "Medical Management Office"), which is located in the county health bureau. The main person in charge of the health bureau concurrently serves as the director of the office, and the responsible comrades in charge of health and finance concurrently serve as the deputy director of the office. The specific work is undertaken by the Medical Management Office, fulfilling the responsibilities of the government as the investor of public hospitals, and being responsible for the asset management, financial supervision and performance appraisal of public hospitals. The components of the hospital management committee shall, in accordance with their duties, formulate and implement policies and measures such as the development and construction of public hospitals, staffing, government investment, medical prices, income distribution, etc., and establish a unified, efficient and consistent government medical system to provide guarantee conditions for the performance of public service functions.

2. The administrative department of public health shall make unified planning for the scale layout and functional types of medical institutions, implement unified access for personnel and technical equipment, and conduct unified supervision over medical services, quality and safety. The person in charge of the administrative department of health shall not concurrently hold the leadership position of a public hospital.

(2) separating government from business, establishing and improving the corporate governance mechanism of county-level hospitals

3. standardizing the generation, appointment and management of public hospital presidents. Formulate the management system for the qualifications and term assessment of the presidents of county-level public hospitals, and promote the professionalization and specialization of the presidents. Implement the dean's management autonomy. The vice presidents, functional departments and heads of internal institutions shall be nominated by the president within the approved post limits, reported to the Medical Management Committee for review, and submitted for approval according to the cadre management authority. Major hospital decisions, appointment and dismissal of important cadres, major project investments, and the use of large amounts of funds are discussed collectively by the hospital leadership. The dean assumes management responsibilities, accepts the supervision of the Medical Management Committee and the workers' congress, and reports and fulfills the approval procedures according to the management authority and regulations. Implement the status of public hospitals as independent legal persons and strengthen specific management functions and responsibilities.

4. establish the performance appraisal management system of county-level public hospitals with public welfare as the core and the incentive and restraint mechanism of hospital presidents. The Medical Management Committee signed a performance management contract with county-level hospital directors, taking medical quality and service efficiency, medical cost control, social satisfaction and asset operation effect as the main quantitative assessment indicators. County-level financial departments to assess the effect of county-level hospital assets operation. The Medical Management Office is responsible for organizing the assessment of the quality and efficiency of medical services, the control of medical expenses and social satisfaction in county-level hospitals. The assessment results are linked to the financial subsidy, dean's income, rewards and punishments and the overall salary level of the hospital.

5. Improve the hospital financial accounting management system. Strict budget management and revenue and expenditure management, strengthen cost accounting and control. Actively promote the reform of hospital financial system and accounting system, strictly centralize and unify financial management, strengthen asset management, establish and improve internal control system, and implement internal and external audit system. Explore the implementation of the chief accountant system.

(3) deepen the reform of personnel and distribution system, implement performance management mechanism

and strive to cover all county-level hospitals by 2XX. The medical insurance fund can effectively improve the basic medical security level by purchasing services, commercial serious illness insurance or establishing supplementary insurance. Gradually increase the actual reimbursement ratio, and strive to reach about 7% in 2XX.

13. Establish a restraint mechanism that medical insurance pays equal attention to incentives and punishments for medical institutions. The use rate of drugs and the control rate of drugs at one's own expense, the proportion of drugs, the proportion of consumables, the average cost per time, the hospitalization rate and the average length of stay in the Catalogue of Essential Drugs were used for assessment, and real-time monitoring was strengthened. The assessment results were linked to the payment of medical insurance funds.

(6) Strengthen service capacity building and improve the level of basic medical services within the county

14. Rationally allocate medical resources. In view of the main health problems of the people in the county, according to the factors such as population quantity and distribution, geographical transportation, etc., the county health planning and medical institution setting planning are formulated, and the number, layout, function, scale and standard of hospitals in the county are reasonably determined. Focus on running 2 county-level hospitals (including Chinese medicine hospitals). Improve the county emergency service system with county hospitals as the center, and establish the county pre-hospital emergency system.

focus on strengthening the construction of specialized clinical departments of intensive care, hemodialysis, newborn, pathology, infection, first aid, occupational disease prevention, mental health and traditional Chinese medicine, as well as the top four diseases (tumor, cardiovascular disease, cerebrovascular disease and thyroid occupation) with referral rate outside the county in recent three years, so as to improve the technical service level.

15. Strengthen the construction of talent team. We will further increase preferential policies, encourage and guide academic leaders, senior and intermediate technical talents and medical college graduates to work in county-level hospitals through effective measures such as policy support and promotion of professional titles, and optimize the ranks of primary medical staff. Set up special posts in county hospitals to introduce urgently needed high-level talents. We will improve the system of continuing education and implement the system of doctors from county-level hospitals going to big city hospitals for further study. Strengthen the training of business backbones in county-level hospitals, improve the training system focusing on standardized training of residents, and formulate talent training plans. Every year, a certain number of backbone forces are selected to study in tertiary hospitals in cities, and the professional quality and clinical diagnosis and treatment ability of medical staff are continuously improved. Strive to establish a system of rotating doctors and managers from urban tertiary hospitals to county hospitals. Strengthen the construction of nursing team, improve the admission system for nurses, and strive to achieve a ratio of 1: 2 in county hospitals by 2XX.

strengthen technical assistance and guidance and personnel training for primary medical and health institutions in county hospitals, gradually establish a new mechanism for integrated management of medical institutions at the county, township and village (community) levels, and accelerate the formation of a medical service model of primary diagnosis, graded medical care and two-way referral.

16. Strengthen information construction. In accordance with the principle of unified standards and interconnection, accelerate the establishment of county-level public hospital information management system focusing on hospital management and electronic medical records, make full use of existing resources and gradually establish interconnection mechanisms between hospitals, superior hospitals and primary medical and health service institutions, hospitals and public health institutions and medical insurance agencies, and build a convenient and efficient hospital information platform. By means of information technology, we will strengthen the supervision of medical quality control, rational use of drugs and control of medical expenses in county-level hospitals, and promote county-level hospitals to strengthen management, improve services and improve their level.

IV. Steps

1. Preparation stage: carefully study the policy documents, make clear the general idea of medical and health system reform, make a thorough investigation and accurate calculation, learn from the successful experience of other pilot cities and counties, explore the ideas and models of medical and health system reform in our county, and carry out the publicity and mobilization work of the reform pilot.

2. Pilot start-up stage: a county-level public hospital reform leading group was established, with organization, organization, development and reform, finance, people's society, drug administration, price and health as member units, and an office under the leading group was located in the county health bureau. Establish a medical management Committee and a medical management office according to relevant regulations. The leading group of medical reform fully investigated, demonstrated in many ways, solicited opinions extensively, formulated the implementation plan, held a pilot work start-up meeting, and comprehensively deployed and arranged the reform pilot work.

3. organization and implementation stage: from November 1st, 2XX, zero difference rate of drugs will be implemented, and public hospital reform will be carried out in an all-round way.

4. adjustment and summary stage: hold regular seminars on the reform of county-level public hospitals, discuss and analyze the existing problems in the reform, adjust relevant policies, formulate relevant evaluation plans to comprehensively evaluate the reform, sum up successful experiences, analyze existing problems, and further improve the reform policies.

V. Safeguards

(1) Strengthen organizational leadership. The task of comprehensive reform of county-level public hospitals is heavy and difficult. We should fully understand its complexity and arduousness, adhere to the principle of easy first and difficult later, highlight key points and steadily advance, and do all the work well. The leading group for comprehensive reform of county-level public hospitals guides the reform of county-level public hospitals. County-level public hospitals comprehensive reform pilot work leading group office, responsible for the coordination and handling of specific affairs. On the basis of the determined direction and principle of medical reform, the county health bureau should refine the measures, highlight the key points, actively and steadily innovate the system and mechanism, and make bold attempts to make breakthroughs and achieve practical results.

(2) strengthen departmental cooperation. All departments should, according to their respective functions and responsibilities, strengthen communication and close cooperation, formulate and issue supporting documents for comprehensive reform of county-level public hospitals in a timely manner, and refine relevant policies and measures. Regularly monitor and evaluate the progress and effect of the pilot reform, establish the corresponding assessment mechanism, conduct regular assessment, timely report, and summarize the promotion experience. Study and solve the difficulties and problems encountered in the work, form a joint force, and ensure the comprehensive reform of county-level public hospitals. The responsibilities of relevant departments are as follows:

County staffing department: responsible for the staffing of relevant institutions involved in the reform of county-level public hospitals.

county development and reform department: responsible for the formulation of standardized standards and the examination and approval of plans for county-level hospitals, and for the examination and approval of investment plans for capital construction and large-scale equipment.

county finance department: increase the government's health investment, and be responsible for the development of key clinical specialties in the county, other expenses in line with national regulations and policy loss subsidies according to the requirements of government's health investment; Improve the financial accounting system of county hospitals, standardize budget management and revenue and expenditure management, strengthen asset and fund management, and establish and improve the internal control system; Improve the financial analysis and reporting system and strengthen the financial audit and supervision of county hospitals. County human resources and social security department: according to the overall deployment of the county government's medical reform work, it is responsible for guiding the reform of the personnel system, income distribution system and medical insurance system, formulating relevant supporting policies with relevant departments, and reviewing the implementation plan of the reform. We will steadily push forward the reform of medical insurance payment methods in county-level hospitals and promote the smooth progress of comprehensive reform in county-level hospitals.

county price department: responsible for organizing the implementation of national, provincial and municipal policies to deepen the price of drugs and medical services, and promoting the reform of the price formation mechanism of drugs as a whole; Formulate the county-wide drug and medical service price management policies; Responsible for the examination and approval and supervision of the county's medical security drugs, basic drug prices and medical service prices of non-profit medical institutions.

county food and drug supervision department: responsible for drug quality and safety supervision.

county health department: responsible for coordinating the pilot reform of county hospitals and closely tracking the progress of the pilot reform. Responsible for setting county health planning and setting up county medical institutions, strengthening industry supervision, clinical specialty construction, hospital information construction and medical quality management; Establish a division of labor and cooperation mechanism between county-level hospitals and primary medical and health institutions, and explore the integrated management of counties and villages; Explore the establishment of county hospitals equipped with the use of basic drugs system; Introduce management measures to strengthen the supervision and control of medical expenses; Supervise the implementation of backbone talents to tertiary hospitals for further study, and supervise the development of quality nursing services, clinical pathway pilots, and convenience outpatient services.

(3) strengthen financial security. The county government will increase investment in health and implement the investment policy of county hospitals; Strengthen the management of the use of financial funds and improve the efficiency of the use of funds; Strengthen investigation and study, and formulate and improve relevant supporting policies.

(4) Actively publicize and guide. Strengthen the publicity of public hospital reform policies, and county hospitals should adopt various forms to publicize the objectives, significance and tasks of public hospital reform. Educate and guide the majority of medical staff to support reform, actively participate in reform, and play the role of the main force of reform. County TV stations should set up a column on the reform of county-level public hospitals, widely publicize the policies, measures and achievements of the pilot reform of county-level public hospitals, strengthen policy interpretation, make the whole society understand, support and cooperate with the reform, and create a good environment for the pilot reform of county-level public hospitals. Second-level hospital performance appraisal scheme 2

1. Assessment objectives:

In order to inspire the enthusiasm of medical staff, we should follow the purpose of taking patients as the center and taking hospital interests as the goal, embody the principle of fair distribution and more pay for more work, and promote the harmonious development of doctor-patient relationship.

II. Assessment organization and division of responsibilities:

(1) Assessment team:

Team leader:

Deputy team leader:

Office:

Members: hospital office, medical education department, nursing department, operation department, human resources department, finance department, medical insurance office, customer service department, logistics department and directors of clinical medical technology departments.

(2) Duties:

Administrative execution: led by the president, supervised and assessed with the vice president, assistant to the president, office and other departments, and organized by the office;

medical quality: mainly supervised and assessed by the business dean in conjunction with the medical education department, nursing department and business department, and organized by the medical education department;

financial indicators: the business dean will supervise and assess with the operation department, medical education department, nursing department, finance department and medical insurance office, and the finance department will organize the assessment;

department management: it is mainly supervised and assessed by business dean, medical education department, nursing department, human resources department and business department, and organized by nursing department;

customer relationship: