With the comprehensive development and in-depth advancement of my country's medical reform work, it is imperative to continue to adjust the medical insurance payment policy, improve the distribution system of public hospitals, and promote the performance reform of public hospitals. The "Opinions on Promoting the High-quality Development of Public Hospitals" issued by the General Office of the State Council in 2021 proposes to adhere to and strengthen public welfare orientation, comprehensively carry out performance evaluation of public hospitals, continue to optimize the performance evaluation index system, and focus on the evaluation of medical quality, operating efficiency, and sustainable development. development, satisfaction evaluation, etc. Reform the internal performance appraisal method of public hospitals, based on the employment contract, focus on the completion of job responsibilities, and link the appraisal results with the salary distribution.
According to the strategic development goals of hospitals in various regions, this project takes into account the workload, service quality, medical technology content and medical insurance settlement benefits of medical staff. By building an RBRVS+DRG performance management system, it fully mobilizes the enthusiasm, initiative and creativity of employees, and establishes a correct Hospital incentive orientation and medical staff value orientation promote the healthy and healthy development of hospitals.
construction principles
1. Normative principles
The performance plan used should meet the "nine prohibitions" requirements of the National Health and Family Planning Commission, meet the policy requirements of the medical reform, and meet the latest national policy requirements and guidance requirements.
2. The principle of advancement
The performance management program adopts the internationally accepted labor value evaluation method for medical personnel, and there are successful application demonstration users in China. The software system for program verification has advanced technical level and high performance.
3. Principles of localization of technical methods
Based on the international advanced performance management theory and the successful practice of other hospitals, the project conducts localized research in this hospital in combination with the actual situation of the hospital, making it suitable for the development stage of the hospital and establishing a basic performance management framework for future development. .
4. Principle of security and confidentiality
This project involves the data of multiple internal business systems of the hospital. The system must provide comprehensive security control, and provide analysis information and usage rights of the scope of authority for users in different business fields and levels to ensure the safe operation of the entire system. .
The goal of building
1. Analyze business status and promote discipline development
Combined with the current business status of the hospital, conduct a comparative analysis with hospitals of the same specialty, level, and scale, especially benchmarking against the performance assessment indicators of national second-level public hospitals, investigate the development plans of various departments, investigate problems, and propose solutions to improve the status quo Solutions.
2. Strengthen the construction of the performance management system and improve the level of operation management
3. Based on public welfare, stimulate the enthusiasm of employees
Taking the workload as the calculation basis and the actual contribution of medical staff as the basis, create a fair and reasonable bonus distribution atmosphere, realize more pay for more work, pay for better performance, and improve the incentive effect of performance on medical staff's labor.
4. Adjust structure and control cost
Adjust the hospital's income structure, increase the proportion of service income, and reduce the proportion of drug consumption; reasonably control operating costs, enhance the awareness of cost control of personnel in various departments, improve the level of energy conservation and consumption reduction, and further reduce medical business costs.
5. Improve clinical business efficiency and quality
Project Description
This project includes three modules: RBRVS workload performance bonus system, performance bonus module under DRG environment, and performance index assessment module of secondary public general hospitals. The main contents include the following:
(1) Performance workload evaluation model. The performance plan design should apply the RBRVS evaluation system to establish a performance evaluation model for the workload value of clinicians, nursing and medical technicians, reflecting the labor value of medical staff. At the same time, the performance plan should establish a controllable cost management and control model, clarify the cost responsibility center, mobilize the enthusiasm and creativity of all staff to stop leaks and save expenses, reduce operating costs, and improve operating efficiency. Reasonably evaluate the key specialties of the hospital, comprehensively consider the characteristics of different specialties, and establish a new performance distribution plan based on the characteristics of specialties.
(2) Reasonably assess the workload of intractable diseases. The design of the performance plan should reasonably evaluate the complexity of admitted cases and the workload of treatment technical difficulties, so as to improve the enthusiasm of departments to treat difficult diseases.
(3) The whole hospital uses the same set of RBRVS point value table. When using RBRVS or workload accounting, different unit price coefficients must not be added to the calculation formula or result of each post. It is necessary to ensure that each post operates the same project and the RBRVS accounting results are consistent.
(4) Adapt to DRG payment policy. Fully consider the impact of DRG payment policies, establish an integrated performance management system of RBRVS+DRG, integrate and open up the work of workload incentive performance bonus accounting and medical insurance deduction performance management, and provide DRG payment for the performance of hospitals with large deduction issues A solution to effectively guide the frontline clinics to adapt to changes in DRG payment policies.
(5) The performance management system is seamlessly connected with the hospital's original management system, and an information module with customized content is provided based on the performance plan.
(6) The performance evaluation index provides a reference version of the main evaluation index of the hospital, and assists the hospital to establish a scientific, standardized and complete comprehensive performance evaluation index system. The evaluation index system should be compatible with the hospital performance evaluation index framework and the hospital's development plan, highlighting work quality, work efficiency, patient satisfaction, teaching and scientific research, and other aspects.