医院绩效评估实践的发展

通过总结相关文献对部分国外医院绩效评估项目进行了描述，对这一领域的发展进行了简要总结。分析表明评估的基本框架已经得到广泛认可，评估项目需要结合特定的对象得以实施，注重反馈和改进措施。同国外的实践相比，国内的医院绩效评估实践需要深化细节，并同公立医院的内部绩效管理相融合。     

公立医院内部绩效工资分配三阶段测算方法研究

目的 建立适应公立医院改革背景的医院内部绩效工资分配测算方法。方法 监控样本医院内部绩效工资分配的运行情况,梳理绩效工资分配测算方法的短板。进行文献研究、医务人员访谈,分析医务人员反馈意见。对绩效工资分配模拟测算结果进行对比分析。结果 建立了包含基础奖、完成率奖、超额奖的三阶段测算方法,依据科室在各阶段的贡献程度测算绩效工资。三阶段测算方法能有效实现医院控制内部绩效工资分配的效率与公平的平衡,方法运行稳健。结论 三阶段测算方法促进医院改进内部绩效工资分配工作的质量和效率。     

哈尔滨市综合医院手术室护理人员绩效考评现状研究

目的:通过对哈尔滨市10家综合医院手术室护理人员绩效考评现状研究,发现存在的问题,为医院手术室护理人员绩效考评体系的改进提供有价值的参考.方法:采用现场问卷调查和专家访谈法了解手术室护理人员绩效考评现状.结果:通过对目标手术室182人的调查显示:在二、三级医院中开展护理人员绩效考评的医院所占的比例分别为71.43%和82.73%,其中有67.98%的医院护理人员绩效考评工作与其他科室的考评指标相同,缺乏专门性.被调查者中有60.34%的护理人员认为科室的绩效考评指标不合理、有61.24%的护理人员认为科室护理人员绩效考评工作留于形式,并有大部分护理人员对科室的绩效考评指标不满意,占总人数的62.29%0结论:哈尔滨市10家综合医院手术室护理人员绩效考评现状调查数据显示:手术室洗手护士与巡回护士通用一套考评指标,指标没有体现出不同护理岗位的特点,其内容不能够全面、合理的覆盖两个不同岗位的关键工作目标、职责与内容;绩效考评缺乏科学、规范的管理;绩效考评与其他人力资源管理工作相脱节;绩效考评结果应用单一;绩效反馈不够.     

医院绩效管理体系的构建与实施

绩效管理已逐渐成为医院管理进步的重要标志。但目前我国还尚未形成较为科学的医院绩效评估体系,医院绩效管理在从理论研究阶段向深层应用推进的过程中受到了较大的阻力。文章通过总结我院绩效管理中的问题,设计和探索新的绩效管理体系与实施策略,为绩效管理的落实提供思路和借鉴。     

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.     

医院绩效管理的二次转型

医药卫生体制改革对医院管理提出新的、更高的要求,需要构建有效的绩效管理体系,实现医院绩效管理的二次转型。绩效管理是将医院整体发展战略落实为医护人员个人具体工作和效果的有效手段,传统的绩效管理关注部门和科室整体绩效水平,二次转型的重要内容是医护人员个人效能的提高,特别是提升医院中效能较低人员的绩效。从严预算、流程优化、提升科室经济管理能力等有助于实现绩效管理的二次转型,提升医院深层次核心竞争力。     

武警部队医院绩效考评体系的构建与实践

介绍了武警部队医院绩效考评体系的构建,介绍了医院绩效考评体系的设计思路和具体实施过程,分析了绩效考评工作实践和成效情况,并结合医院自身特点和运行机制改革,对照军队医院等级评审有关要求,对进一步完善综合绩效考评工作提出了建议,以期为军地医院绩效管理工作提供一定的参考和借鉴。     

试论转型时期公立医院的绩效激励机制与可持续发展

在经济转型时期保持医院可持续发展的动力,绩效激励机制是医院管理者采用的方法。分析了经济转型时期公立医院的经济运行特点,并分析了各种绩效激励方法促进医院可持续发展的效果。医院通过合理运用绩效激励理论,有效地推动了医院和员工目标的共同发展,使医院在经济转型时期的激烈市场竞争环境中立于不败之地,对医院的可持续发展起到关键性作用。     

对医院绩效工资分配导向性制度的思考

通过对医院绩效工资分配中具有代表性的几个导向制度的分析,阐述了医院绩效分配工资分配制度一定要为医院发展服务的观点,并强调了医院在不同的发展阶段要采用不同的绩效工资分配制度的思想。     

我院实施绩效管理的做法与思考

通过构建综合绩效考核体系和改革绩效薪酬分配制度,医院在实施绩效管理中取得较好的效果。同时,思考医院绩效管理实施过程中存在的问题,对其实践价值进行探究分析,为完善医院绩效管理体系提供参考。

     

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。     

公立医院绩效评价PATH优化模型指标体系的构建

目的 构建适用于三级公立医院的绩效评价体系,为医院开展绩效考核与管理工作提供决策参考。方法 应用文献法、个人访谈法和头脑风暴法构建评价模型和初始指标库,运用德尔菲法和层次分析法确定指标权重。结果 运用医院质量改进的绩效评价工具（The Performance Assessment Tool for Quality Improvement in Hospitals,PATH）理念构建了以病人为中心、以员工为导向、临床效率效果、运营表现、响应治理、卓越提升6个核心维度的三级公立医院绩效评价体系。结论 指标体系的可信程度较高、权威性高、具有较好的适用性。

     

The effect of feedback-assisted reduction in heart rate reactivity on videogame performance

In 67 male volunteers, we examined the reduction of cardiovascular responsivity to a psychomotor challenge (videogame) achieved by use of heart rate (HR) feedback and effects of these procedures on concomitant behavioral performance. Each subject participated in a pretraining assessment of his cardiovascular responses to the videogame, a training condition, and a posttraining assessment identical to the initial evaluation. During training, subjects were assigned to one of four conditions: (a) a habituation control group receiving no instructions to alter HR (HC); (b) an instructions-only control group receiving instructions to maintain a low or unchanged HR during videogame presentations (IC); (c) a feedback group receiving instructions to reduce HR using ongoing HR feedback (FB–); or (d) a feedback group receiving instructions to lower HR and given HR feedback plus a score contingency in which total game score was jointly determined by subjects' game performance and success at HR control (FB+). Subjects receiving feedback (FB+, FB–) exhibited greater reductions in HR response to the videogame in the posttraining assessment than control (HC, IC) subjects; FB+ subjects showed greater HR reductions than subjects in any other group. FB+ and FB– subjects showed a lower SBP at posttraining relative to the two control groups, but no reduction in task-induced blood pressure reactivity. There were no group differences in videogame performance, either before or following training.The authors wish to thank Fred Claus, who served as a research assistant for this study.     

Performance limitations from delay in human and mechanical motor control

We discuss natural limitations on motor performance caused by the time delay required for feedback signals to propagate within the human body or mechanical control systems. By considering a very simple delayed linear servomechanism model, we show there exists a best possible speed-accuracy trade-off similar to Fitts' law that cannot be exceeded when delay is present. This is strictly a delay effect and does not occur for the ideal case of instantaneous feedback. We then examine the performance of the vector integration to endpoint (VITE) circuit as a model of human movement and show that when this circuit is generalized to include delayed feedback the performance may not exceed that of the servomechanism with an equal delay. We suggest the existence of such a limitation may be a ubiquitous consequence of delay in motor control with the implication that the index of performance in Fitts' law cannot arbitrarily large.     

PATH模型对我国医院绩效评价体系构建的启示

绩效评价工具的选择对发挥医院绩效管理体系的作用和反映医院运营情况有着重要作用。本文简要介绍了医院质量改进的绩效评价工具（The Performance Assessment Tool For Quality Improvement In Hospitals,PATH）及其优势,提出我国医院绩效评价改革可以借鉴PATH模型,建立科学统一的指标评价体系,同时加快医疗领域信息化建设以及发挥第三方评价机构在医院绩效评价中的作用。     

公立医院战略绩效管理体系概念框架研究

探讨了开展公立医院战略绩效管理的必要性,剖析了当前公立医院绩效管理的弊端及实质,结合对战略绩效管理理论和医院战略绩效内涵特征的分析,提出了集本质特征、功能定位和未来发展于一体的,包含了2个层面、4个模块和7个循环子系统的公立医院战略绩效管理体系概念框架。     

An Evaluation of Some Beowulf Clusters

We report the results of an evaluation project on three Beowulf type clusters. The purpose of this study was to assess both the performance of the clusters and the availability and quality of the software for cluster management and management of the available resources. This last goal could hardly be achieved because at the time this project was undertaken much of the management software was either very immature or not yet available. However, it was possible to assess the cluster performance both from the point of view of single program execution as well as with respect to throughput by loading the systems according to a predefined schedule via the available batch systems. To this end a set of application programs, ranging from astronomy to quantum chemistry, together with a synthetic benchmark were employed. From the results we wanted to derive answers about the viability of using cluster systems routinely in a multi-user environment with comparable maintenance cost and effort to that of an integrated parallel machine.     

High-Altitude Adaptation: Mechanistic Insights from Integrated Genomics and Physiology

Population genomic analyses of high-altitude humans and other vertebrates have identified numerous candidate genes for hypoxia adaptation, and the physiological pathways implicated by such analyses suggest testable hypotheses about underlying mechanisms. Studies of highland natives that integrate genomic data with experimental measures of physiological performance capacities and subordinate traits are revealing associations between genotypes (e.g., hypoxia-inducible factor gene variants) and hypoxia-responsive phenotypes. The subsequent search for causal mechanisms is complicated by the fact that observed genotypic associations with hypoxia-induced phenotypes may reflect second-order consequences of selection-mediated changes in other (unmeasured) traits that are coupled with the focal trait via feedback regulation. Manipulative experiments to decipher circuits of feedback control and patterns of phenotypic integration can help identify causal relationships that underlie observed genotype–phenotype associations. Such experiments are critical for correct inferences about phenotypic targets of selection and mechanisms of adaptation.