平衡记分卡在医院绩效管理中的研究进展

绩效管理作为一个将组织战略和行动有机结合的完整的管理体系,已受到国内外理论界、企业界的广泛关注.平衡计分卡具有战略管理的功能,可以促使医院根据自己的战略目标不断改进绩效,促进医院综合竞争力的提高.利用平衡计分卡将医院管理分解为客户、财务、内部流程、学习和创新四个方面,通过建立平衡计分卡绩效评价体系引导各项工作的开展和评估,并根据实施效果不断反馈和调整,从而实现医院自身发展和社会和谐发展的统一.     

基于平衡计分卡的医院职能部门绩效管理探讨

从职能部门绩效考核常见问题出发,借鉴企业和公共部门绩效管理方法,以平衡计分卡为主要框架,结合关键指标法构建医院职能部门绩效管理体系,同时探讨了具体指标的筛选原则、方法以及指标权重和目标值的确定方法。最后分析了职能部门平衡计分卡实施的注意事项。     

平衡计分卡在公立医院绩效管理中的应用与实践

通过分析医院面临的内外环境,把平衡计分卡运用到医院绩效管理中,建立了财务收益、客户、医疗服务、学习与成长多角度的绩效评价体系,经过不断完善和改进,取得了患者满意、职工积极性提高、医院可持续发展的良好效果。     

构建医院职能部门绩效评价指标体系初探

绩效评价指标体系是医院职能部门绩效评价系统的核心构成要素，针对目前某三甲医院职能部门在绩效评价方面存在的问题，结合医院管理的实践，建议运用平衡计分卡，从客户评价、业绩体现、内部管理、学习与成长4个维度初步构建绩效评价体系。     

医院战略性绩效评价模型构建及作用机理分析

依据战略管理理论与绩效管理工具,构建医院战略绩效管理模型。在战略绩效管理架构下,设计医院战略绩效评价模型,该模型包括医院战略分析系统、医院战略绩效评价循环系统、医院战略分解与传递系统,并分析其作用机理。将绩效管理纳入医院战略管理过程,并把战略目标贯穿医院绩效管理始终。构建与医院战略相匹配的绩效评价系统,有助于促进内部运行机制的规范化建设,提升医院可持续发展能力。

     

基于RBRVS的临床医师绩效分配模式指标体系构建研究

目的 构建科学的临床医师绩效分配模式,着力体现医师技术劳务价值。方法 综合运用文献研究法、专家咨询法、关键绩效指标法构建评价指标体系,利用非参数检验对专家评价数据进行统计分析。结果 构建了基于资源消耗为基础的价值评估体系医师绩效分配模式,重点突出医师技术劳务价值。结论 构建的指标体系能有效评估各诊疗项目中资源投入情况,可有效测量医师在医疗服务过程中的劳动付出,对于形成科学的绩效分配机制有重要意义。     

国家卫生系统绩效评价：经验及启示

通过对英美等发达国家卫生系统进行绩效评价分析,总结国家卫生系统绩效评价理论方法和经验。研究发现,国家卫生系统绩效评价核心过程包括参与对象确定、概念模型选择、政策背景分析、框架构建、评价实施和激励机制形成6个关键步骤。其中国家卫生系统绩效评价制定需要利益相关者全程参与,Lalonde健康影响因素模型和平衡计分卡是目前主要理论基础,国家政策背景决定了评价框架的重点和导向,成立卫生系统绩效评价管理部门是评价实施的保障,而建立激励机制是提高卫生系统绩效评价价值的重要手段。     

医院战略性绩效评价的研究概述

从战略的视角出发,以医院战略性绩效管理为研究对象,探讨在医院中设计战略绩效绩效评价体系以及其对医院战略实施的促进作用。对医院战略绩效评价进行了设计,提出了医院战略绩效管理模型,构建了战略绩效评价系统模型以及医院战略绩效评价指标体系。

     

以相对价值为基础的医师绩效薪酬分配模式研究

以资源为基础的相对比率方法,是一种合理支付医生服务酬金的新方法。利用某三级医院临床科室的数据,采用相对价值法对体现医师工作绩效的项目进行赋值,并比较赋值后医师的绩效薪酬。研究表明,该方法能够反映客观医师的工作绩效,具有合理性。     

综合性医院绩效评价的现状调查与分析

目的 了解医院绩效评价现状与存在的主要问题,为医院探索新的绩效评价方法和构建以战略为导向的绩效评价体系提供依据。方法 采用问卷调查法获得医院绩效评价的基本数据,运用统计描述法对问卷进行分析。结果 现行医院的绩效评价缺乏系统性,与外部环境相脱节,未能反映利益相关者需求,在指标设计时缺少员工参与,重视短期财务结果,在实施、反馈等方面缺乏有效沟通,绩效考评没能实现与医院战略的有效连接。结论 现行绩效评价体系同医院战略脱节,未能有效体现医院战略,评价指标侧重于医院内部评价与财务类指标,而忽视非财务类指标,绩效评价指标设置与评价结果的应用存在矛盾。     

稳定同位素质量平衡混合模型的性能评估

稳定同位素技术可以用于消费者营养溯源,以确定多种营养来源对消费者营养的贡献比重。因此,稳定同位素质量平衡混合模型已经是消费者营养溯源分析的必要方法之一。通常使用贝叶斯混合模型来估计不同营养来源的贡献;此类模型提供了每个营养来源对消费者的贡献比例的概率分布特征。然而,混合模型拟合结果的好坏,及其与实际生态学理论的匹配水平,是模型性能的重要评价内容。例如,模型在不能很好地解析营养来源贡献时,仍将返回默认先验结果,给模型解释带来困难。为直接避免同位素构建消费者营养溯源分析中的诸多技术问题,文章将综述在拟合和评估贝叶斯混合模型时遵循的最佳实践。因此,文章基于实测的同位素数据集(蒙古鲌Culter mongolicus mongolicus同位素数据集),通过识别消费者营养功能类群特征、改变营养来源先验信息特征,构建系列贝叶斯模型;通过比较模型总体性能、实测值与预测值差异,及先验信息和后验信息差异等多种模型性能评价方法,来描述模型性能评价的方法和过程。通过这些方法的综合运用,将进一步提高消费者营养溯源准确性,为更深刻地认识食物网规律提供科学支撑。     

疾病诊断相关组在医院绩效评价中的应用探讨

目前,尽管国内外关于医院绩效评价的研究较多,但普遍存在评价结果缺乏可比性的不足。其主要原因是不同医院收治的疾病类型不同、治疗难度和风险差别较大。基于DRGs的医院绩效评价方式为研究打开了思路。本文在明确当前公立医院绩效评价内容的基础上,指出了基于DRGs开展医院绩效评价的两个条件,即统一优质的数据和完善的信息系统,阐述了评价的三个维度,即医疗服务产出、效率和质量,并就上述三个维度内的相关评价指标的计算方法进行了说明。本文最后给出了基于DRGs开展医院绩效评价的五点现实意义:一是有助于优化医院内部成本结构;二是有助于规范科室临床路径工作;三是创新科室或医生的绩效考核方式;四是形成政府与医院间的长效监管机制;五是有助于探索DRGs付费模式在全国的推广。     

基于融合理念的公立医院内部绩效考核体系探索研究

目的 建立与公立医院目标任务及外部绩效评价相匹配的内部绩效考核体系。方法 监控样本公立医院内部绩效考核体系的运行状态,对现行内部绩效考核体系的运行效果及医务人员反馈意见进行分析。调研管理部门、临床科室,访谈部门科室管理人员。结果 总结了现行内部绩效考核体系待改进的问题,提出基于医疗过程和医疗结果相结合进行全面评价、改进内部绩效工资测算方法、建立完善职能部门绩效评价体系、建立绩效沟通数据平台、融合政策执行评估的改进方案。结论 内部绩效考核体系的动态改进是公立医院实现医院目标任务、执行外部绩效评价的必然要求。     

Fuzzy-logic based strategy for validation of multiplex methods: example with qualitative GMO assays

This paper illustrates the advantages that a fuzzy-based aggregation method could bring into the validation of a multiplex method for GMO detection (DualChip^® GMO kit, Eppendorf). Guidelines for validation of chemical, bio-chemical, pharmaceutical and genetic methods have been developed and ad hoc validation statistics are available and routinely used, for in-house and inter-laboratory testing, and decision-making. Fuzzy logic allows summarising the information obtained by independent validation statistics into one synthetic indicator of overall method performance. The microarray technology, introduced for simultaneous identification of multiple GMOs, poses specific validation issues (patterns of performance for a variety of GMOs at different concentrations). A fuzzy-based indicator for overall evaluation is illustrated in this paper, and applied to validation data for different genetically modified elements. Remarks were drawn on the analytical results. The fuzzy-logic based rules were shown to be applicable to improve interpretation of results and facilitate overall evaluation of the multiplex method.     

A Comprehensive Benchmark of Kernel Methods to Extract Protein–Protein Interactions from Literature

The most important way of conveying new findings in biomedical research is scientific publication. Extraction of protein–protein interactions (PPIs) reported in scientific publications is one of the core topics of text mining in the life sciences. Recently, a new class of such methods has been proposed - convolution kernels that identify PPIs using deep parses of sentences. However, comparing published results of different PPI extraction methods is impossible due to the use of different evaluation corpora, different evaluation metrics, different tuning procedures, etc. In this paper, we study whether the reported performance metrics are robust across different corpora and learning settings and whether the use of deep parsing actually leads to an increase in extraction quality. Our ultimate goal is to identify the one method that performs best in real-life scenarios, where information extraction is performed on unseen text and not on specifically prepared evaluation data. We performed a comprehensive benchmarking of nine different methods for PPI extraction that use convolution kernels on rich linguistic information. Methods were evaluated on five different public corpora using cross-validation, cross-learning, and cross-corpus evaluation. Our study confirms that kernels using dependency trees generally outperform kernels based on syntax trees. However, our study also shows that only the best kernel methods can compete with a simple rule-based approach when the evaluation prevents information leakage between training and test corpora. Our results further reveal that the F-score of many approaches drops significantly if no corpus-specific parameter optimization is applied and that methods reaching a good AUC score often perform much worse in terms of F-score. We conclude that for most kernels no sensible estimation of PPI extraction performance on new text is possible, given the current heterogeneity in evaluation data. Nevertheless, our study shows that three kernels are clearly superior to the other methods.     

基于模糊决策的临床科室主任绩效考核的研究

通过研究临床科室主任绩效考核指标,调动科室主任管理的积极性,增强科室员工质量管理意识和医疗安全意识,促进医院的发展。在分析传统临床科室绩效考核方法不足的基础上,结合模糊决策的概念,提出了一种基于模糊决策的临床科室主任综合评判方法。该方法充分利用了模糊逻辑中模糊决策的概念,对医院临床科室主任进行了模糊意见集中决策和模糊综合评判决策。最后通过具体的数值实验对该方法进行了性能分析,结果证明该方法具有良好的性能。     

基于因素评分法的医院医师岗位评价研究

通过调研,充分了解新疆某三级甲等医院人力资源管理的实际状况和人力资源管理存在的关键问题和薄弱环节。应用现代岗位评价方法对医院医师岗位进行评价,形成医院医师岗位评价体系,为优化医院人力资源配置、薪酬和绩效管理,形成医院内部良性竞争机制提供科学依据。     

The use of information technology in improving medical performance. Part II. Physician-support tools

Increasing data from a few sites demonstrate that information technologies can improve physician decision making and clinical effectiveness. For example, computer-based physician order entry systems, automated laboratory alert systems, and artificial neural networks have demonstrated significant reductions in medical errors. In addition, Internet services to disseminate new knowledge and safety alerts to physicians more rationally and effectively are rapidly developing, and telemedicine to improve rural access to specialty services is undergoing substantial growth. However, even technologies demonstrated to yield beneficial effects have not yet achieved widespread adoption, though the pace of change appears to be increasing as the Internet takes hold. Scientific evaluation of many technologies is also lacking, and the dangers of some of these technologies may be underappreciated. Research on the effects of specific technologies should be a priority. Policies should be developed to press information technology companies, such as pharmaceutical and medical device manufacturers, to recognize the importance of clinical evaluation. Research could also analyze the characteristics of effective technologies and of physicians and organizations who implement these technologies effectively.     

Imputation of missing ages in pedigree data

BACKGROUND: In human pedigree data age at disease occurrence frequently is missing and is imputed using various methods. However, little is known about the performance of these methods when applied to families. In particular, there is little information about the level of agreement between imputed and actual values of temporal data and their effects on inferences. METHODS: We performed two evaluations of five imputation methods used to generate complete data for repositories to be shared by many investigators. Two of the methods are mean substitution methods, two are regression methods and one is a multiple imputation method based on one of the regression methods. To evaluate the methods, we randomly deleted the years of disease diagnosis of some men in a sample of pedigrees ascertained as part of a prostate cancer study. In the first evaluation, we used the five methods to impute the missing diagnosis years and evaluated agreement between imputed and actual values. In the second evaluation, we compared agreement between regression coefficients estimated using imputed diagnosis years with those estimated using the actual years. RESULTS/CONCLUSIONS: For both evaluations, we found optimal or near-optimal performance from a regression method that imputes a man's diagnosis year based on the year of birth and year of last observation of all affected men with complete data. The multiple imputation analogue of this method also performed well.