[论文设计]l医院基于战略的绩效管理研究

2006A1A0A2A3A4EMBAA6A5A7A81L医院基于战略的绩效管理研究摘要本研究针对传统的绩效考评体系中的缺陷，在绩效考评与战略管理的理论指导下，针对L医院没有实施战略管理及医院战略与绩效脱节的实际情况，采用调查研究与统计分析相结合的方法，构建出L医院的战略导向绩效考评体系，使L医院的绩效反映战略，战略渗透到绩效。L医院的战略绩效考评体系的构建包括5个部分梳理战略使战略显式化、制定战略地图、制定关键绩效指标、制定绩效工资计算公式、绩效考核实施。L医院战略导向的绩效考核经过一年使用后得到L医院领导及员工的肯定。存在的主要问题是非财务指标的收集较为困难，还没有规范化、制度化，非财务指标还没有与医疗业务工作有机的结合起来。本研究表明即使没有实施战略管理的医院，战略导向的绩效管理也是可以在使用的，从实践意G1053G990G11487，本研究对医院G10317G2047是G3534G4630医院绩效考评G8181式的建构G1867有G11464G6521的指导意G1053。关键词战略导向绩效考核医院绩效传统的绩效考评主要是G1119后G17839G15904的G3534G1122结G7536的考评，G4581G6980是G1119中G17839G15904的G3534G1122G6523制的考评，G993论是G3534G1122结G7536还是G3534G1122G6523制得考评与G1119G2081的医院战略没有G3822G3835关系G6122关系G993G4506G2011。本研究针对传统的绩效考评体系中的缺陷，在绩效考评与战略管理的理论指导下，针对L医院没有实施战略管理及医院战略与绩效脱节的实际情况，采用调查研究与统计分析相结合的方法，构建出L医院的战略导向绩效考评体系，使L医院的绩效反映战略，战略渗透到绩效。G31、资料与方法G20G17G20G3资G7021来G9316G3本研究的资G7021来G9316G1122G47医院的G43G44G54系统、财务系统、G2520G13856G14033部G19388的G7097G5132工作G6980G6466及调查G6980G6466。G3G20G17G21G3研究方法G32006A1A0A2A3A4EMBAA6A5A7A82G20、G7003G10498分析法G726为G1114G16311G6117G3281G1237业及医院G10628G15904绩效考评G8181式以及构建相关理论与研究G1563G16786，本研究采用图G1082G20314式的G7003G10498分析法。G1866中G7003G10498主要来G9316G1122中G3281医院G11705G16794G1191G5223。G3G21、问G2379调查法G726为G1114梳理医院的战略，本研究G10628G3342调查G1114医院管理G4630有关医院战略的问题。为G1114G12591G17885关键绩效指标及G11842定指标G7447G18337，本研究G13464G13467G999G4490对相关指标的G18337要G5627G17839G15904G1114评分。为G1114G1114G16311G47医院员工对绩效管理的G11487法，本研究G10628G3342调查G1114医院管理G4630、中G4630G5190部及部分员工。为G1114G1114G16311战略导向的绩效考核实施后的效G7536，本研究G10628G3342调查G1114医院领导及员工。G3G22、G18337G9869G16787G16860法G726G15441G9994问G2379调查法可以得到G16780G3822G18337要的G1461G5699G2656G6980G6466，G1306是从结构G5627的问G2379中G6164得到的G1461G5699在G9157度G990存在一定的G19492制，为G1114G5369G15929G17837一G993G17287，G5194结合医院的G10317G9869，本研究采G2474G18337G9869G16787G16860G17839G15904G7368G2164G9157G1849的调查，G2469G6508G7368G9157G4630G8437的问题G2656G6980G6466。G3G23、统计分析法G726采用G5191G3355G1552法G12573方法G8991算相关关键绩效指标的标G1946G1552、采用G4630G8437分析法、对G1610G8616较法G8991算指标的G7447G18337。G32、结果与分析21战略的梳理战略梳理后G5430G6116战略地图。战略地图是一个战略G6203G15904的有效工G1867，图G717是G47医院的战略地图。G3G3G3G3G3G3G3G3G3G3G3G3G3财务层面A9A10A11A12A13A14A15A16A17客户及利益相关者层面A18A19A12A13A20A21A22A23A24A25A26A27A28A29A30A31A32A33A34A35A36A37A38A39A40A41A42内部层面A43A44A45A46学习与成长层面A47A48A49A44A50A51A49A44A52A53A49A44A54A55A56A57A58A59A60A61A62A63A64A57A62A65A66A46A67A68A69A70A71A72A73A74A75A76A77A39A78A79A80A81A82A83A84A85A86A87A88A89A90A91A92A93A94A87A88A95A96A97A98A99A100A101A102A103A1042006A105A106A107A108A109EMBAA110A111A112A1133图L医院战略地图22L医院的绩效考核指标221绩效工资计算方式绩效工资G32工作G18339G13G2345G1313工作G18339G708收G1849G709绩效工资G13工作G18339G708收G1849G709G7669G8503系G6980G3G708G717G709G19388G5625G16798医G10995绩效工资G3G19388G5625G16798绩效工资G32G6358G2507收G1849G13G2345G1313G6358G2507收G1849绩效工资G13G6358G2507收G1849G7669G8503系G6980G3G708G709住院部绩效工资G3住院绩效工资G32出院者占用总床G7097G6980G13G2345G1313床G7097绩效工资G13出院者占用总床G7097G6980G7669G8503系G6980G3G708G22G709G15904政后勤绩效工资G3G15904政后勤绩效工资G32医院业务G18339G13G2345G1313业务G18339绩效工资G13医院业务G18339G7669G8503系G6980。G3222工作量（收入）的统计方法G708G717G709G19388G5625G16798工作G18339的统计方法以G6358G2507收G1849代表工作G18339。G19388G5625G16798G6358G2507收G1849由G43G44G54系统提供。G3G708G709住院部工作G18339的统计方法G3住院部工作G18339采用的指标是出院者占用总床G7097G6980，由统计室统计报表提供。G3223单位工作量（收入）绩效工资的计算方式G708G717G709从医院G1461G5699系统得到G2520科室06年工作G18339G708收G1849G709的G6980G6466得到月人G3355工作G18339G708收G1849G709的G6980G6466。G3G708G709从财务科得到G2520科室06年实际绩效工资G6980G6466，计算该科室06年实际人G3355绩效工资，计算该类科室分G19388G16798、住院部的G5191G3355人G3355绩效工资，G708该科室06年实际人G3355绩效工资该类科室的G5191G3355人G3355绩效工资G709/G21为G8991算时使用的该科2006A105A106A107A108A109EMBAA110A111A112A1134室人G3355月绩效工资G6980G6466。G3G708G709G2345G1313工作G18339G708收G1849G709绩效工资G32G708该科室06年实际人G3355绩效工资该类科室的G5191G3355人G3355绩效工资G709/G21/G21006年月人G3355工作G18339G708收G1849G709224校正系数的计算方法G7669G8503系G6980由关键绩效指标而来，关键绩效指标由战略地图而来。根G6466战略地图，得到初G17885指标，采用G999G4490咨询法G17885出最后G1849G17885的指标。指标G17885择时考虑到G1866可操作G5627、客观G5627、引导G5627。G708G717G709、G19388G16798关键绩效指标。G708G709、住院关键绩效指标。225指标筛选方法采用G999G4490咨询法，G17885G2474理论G2656实践两方面的G999G4490共G210名，G1866中临床G999G4490G200人、医疗管理G999G4490G200人，G2469出打分表，G993G18337要记0分、绝对G18337要记满G2000分，G19388G16798医G10995关键绩效指标G12591G17885打分结G7536见表G20。G3G3表1各指标的平均得分A114A115A116A117A115A118A119A120A121A114A115A122A116A123A124A125A126A127A128A127A129A129A128A130A131A132A122A116A133A125A126A134A128A134A135A129A128A130A136A132A133A137A138A139A136A126A128A129A126A129A128A134A134A140A141A122A116A125A142A136A131A128A127A143A129A128A131A143A144A145A138A130A129A128A134A130A134A128A134A146A132A147A122A148A149A150A126A130A128A129A131A129A128A126A129A132A151A152A153A136A126A128A146A129A134A128A129A127A154A155A156A157A126A126A128A135A129A134A128A146A143A132A158A159A157A160A126A130A128A134A127A134A128A146A136A132A161A64A162A163A126A135A128A146A136A129A128A135A126A132A123A124A164A165A166A167A168A126A136A128A127A135A134A128A131A143A1322006A105A106A107A108A109EMBAA110A111A112A1135226参考指标标准值的测算有四类指标，第一类指标已经连续几年G17839G15904G1114G8991算；第二类指标是第一G8437使用，G1866标G1946G1552要经过几年的G8991算才可以稳定下来；第三类没有一个G1867体的G1552，排序G8616较适宜。第四类指标是用G1866它的指标G1552来代表。G3G708G20G709第一类指标的G8991算方法。G7097G3355药费就是连续G17839G15904G1114几年G8991算的指标，G1866G1552已相对稳定，G1866标G1946G1552为G990一年度的G5191G3355G1552与G990一年度的标G1946G1552的G5191G3355G1552。G3G708G21G709第二类指标的G8991算方法。以0G23年初G8437制定G19388G16798病人人G3355药费的标G1946G1552为例介绍第二类指标的G8991算方法。G3第一、将人G3355费用分G16311为药费及医疗费G708药费以外的费用G709。计算G2100G22年每G19388G16798病人G5191G3355药费作为参考指标标G1946G1552制定的G3534础G6980G6466。G3第二、目标G1552的制定G726参考区内G6523制药费效G7536较好的同级医院的G6980G6466，结合医院的总体目标，制定G2100G23年药品销售额、全院药品G8616例目标G1552，在此G3534础G990G8991算出G21007年全院G19388G16798人G3355药费的目标G1552。G3第三、调G6523G1552的制定G726全院G2100G23年统计指标的目标G1552/G2100G22年统计指标的G5191G3355G1552得到系G6980K，系G6980K乘以按科室分G13464的G2100G22年统计指标的G5191G3355G1552得到统计指标的标G1946G1552。如标G1946G1552与参考医院的G1552相差超过G210G2474调G6523G1552与参考医院G5191G3355G1552的G5191G3355G1552作为调G6523G1552。G3G708G22G709第三类指标的G8991算方法。病历迟交率G17837类指标标G1946G1552G993好制定，用排序的方法。G3G708G23G709第四类指标的G8991算方法。第四类指标主要指风险系G6980，G1866依G6466是住院病人抢救率，参考医务科的意见。G3227参考指标权重的测算指标G7447G18337的G8991算采用G4630G8437分析法及对G1610G8616较法，打分原则见表2。表2指标权重打分原则A169A170A171A172A169A170A173A169A174A175A176A177A169A174A176A177A178A179A180A181A182A183A184A185A186A187A188A189A190A191A192A193A181A194A195A196A183A184A197A198A199A200A201A202A203A204A201A202A205A206A207A208A209A210A211A212A183A184A197A198A199A200A201A202A203A204A201A202A205A206A207A213A196A208A209A214A215A216A183A184A201A202A203A204A201A202A205A206A213A208A209A217A218A219A216A220A221A222A223A224A225A187A183A184A183A184A226A227A223A2282006A229A230A231A232A233EMBAA234A235A236A2376A238A239A240A239A241A239A242A185A193A243A226A227A190A221A244A245A246A184A247A248A249A250A251按公式IWMIMIIAAA21计算初始权重系数IW按公式IWMIIIWW1计算归一化权重系数（）求因素层权重系数。图所示为结构层次模型。A252A253A254A255A5A254A7A253A254A8A9A10A11A12A13A252A253A14A15A0A15A0A17A1A17A1A124A2A3A125A4A35A6A16A18A19A20A125A21A35A6A16A18A19A20A22A23A3A125A24A25A0A25A0A17A1A17A1A73A26A27A28A29A30A131A4A36A31A32A33A34A37A38A131A21A60A35A39A40A41A131A24A42A0A42A0A43A44A43A44A132A6A36A31A2A133A4A132A6A45A2A133A21A134A46A47A48A6A49A46A132A133A24A60A50A51A52A3A133A53A60A50A54A55A3A133A56A36A31A57A58A59A61A62A63A133A64A65A66A65A66A67A68A67A68A146A69A34A70A71A72A63A150A74图2结构层次模型第一、建立该层优先判断矩阵表3第一层子目标成对比较判断优选矩阵A151A75A76A77A154A75A76A77A155A75A78A79A80A81A82A83A151A75A76A77A74A84A85A156A86A85A156A74A154A75A76A77A87A156A85A74A87A156A86A87A156A74A155A75A78A79A86A156A85A86A156A87A74A86A156A742006A88A89A90A91A92EMBAA93A94A95A967A80A81A82A83A74A156A85A74A156A87A74A156A86A741W43/533123094同理得2W0577353W259804W028867A157A97A115A159A98A99A100A101A102A103A104A1051W23094/2309405773525980028867040，同理得2W0103W0454W005（）求指标层权重系数。根据以上AHP法，同理可以对指标层的各个指标进行权重分析。第一、财务方面3个评估指标项的权重（表4）表4财务方面指标权重A106A107A108A109A110A111A110A112A110A113A162A114A116A117A111A112A118A116A117A119A118A116A116A117A111A112A118第二、服务方面3个评估指标项的权重（表5）表5服务方面指标权重A106A107A108A109A120A111A120A112A120A113A162A114A116A117A118A116A116A116A117A118A116注B2为扣分指标，权重为0第三、内部业务流程。6个评估指标项的权重（表6）表6业务流程指标权重A106A107A108A109A121A111A121A112A121A113A121A122A121A118A121A123A162A114A116A117A122A122A122A116A116A117A111A123A119A116A117A111A111A111A116A117A116A118A123A116A117A112A112A112A164A165A121A112A126A127A128A108A109A129A162A114A126A116第四、学习成长。2个评估指标项的权重（表7）表7学习成长指标权重A106A107A108A109A130A111A162A114A111A117A1162006A135A136A137A138A139EMBAA140A141A142A1438（）、求13个评价指标的组合权重系数将因素层权重系数与指标层权重系数相乘即得组合权重系数（表8）。表8各指标组合权重系数A144A145A147A148A149A152A153A158A160A167A161A163A166A161A168A161A163A160A169A170A167A161A163A161A170A171A172A173A174A175A176A158A169A167A161A163A166A161A168A161A163A177A170A161A167A161A163A178A161A171A172A173A174A175A176A179A180A153A158A178A167A161A163A166A161A168A161A163A160A169A170A167A161A163A161A170A181A182A147A148A183A184A185A186A187A188A189A160A167A161A163A160A161A168A161A163A170A161A167A161A163A161A170A190A191A192A193A194A195A196A189A169A167A161A163A160A161A168A161A163A161A161A167A161A163A161A161A197A171A198A199A200A189A178A167A161A163A160A161A168A161A163A170A161A167A161A163A161A170A201A145A202A203A204A172A190A191A152A205A160A167A161A163A166A170A168A161A163A166A166A166A167A161A163A169A161A204A172A206A152A205A169A167A161A163A166A170A168A161A167A161A163A161A161A207A208A209A210A172A211A208A204A205A178A167A161A163A166A170A168A161A163A160A212A177A167A161A163A161A177A170A197A213A214A215A153A205A166A161A163A166A170A161A163A160A160A160A167A161A163A161A170A197A213A216A217A153A205A170A167A161A163A166A170A168A161A163A161A170A212A167A161A163A161A169A170A190A191A202A203A218A219A220A221A205A212A167A161A163A166A170A168A161A163A169A169A169A167A161A163A160A161A222A223A224A225A222A223A194A224A225A226A221A227A160A167A161A163A161A170A168A160A167A161A163A161A1702006A228A229A230A231A232EMBAA140A141A142A143923考核的实施（1）、绩效方案的制定绩效考核方案由医院核算办制定，由职代会讨论通过后G4466G7057。（2）、绩效考核部G19388核算办。由核算办G6922G19610相G1863数据。（3）、绩效考核G2620G7411G8611G7388考核一次。（4）、绩效考核对G16949G19388G16798医G10995G11464G6521考核个G1166，G1315院部考核G2052G12197G4472，G12197G4472制定二G13435方案G6265核算办G3803案G1889进行二次分G18209。（5）、绩效G5049G17176G5647G20081的制定G7388绩效G5049G17176G5647G20081G7388G6922G6915结G1325G16G5415G7388G2469G4649G3534G18341。（6）、绩效G5049G17176G2469G6930G8616G1375的制定绩效G5049G17176G2469G6930G8616G1375G7388绩效G5049G17176G5647G20081/绩效G1856G5347G16757算的G5647绩效G5049G17176。（7）、G4466G19481绩效G5049G17176的G16757算G4466G19481绩效G5049G17176绩效G5049G17176G2469G6930G8616G1375G13绩效G1856G5347G16757算的绩效G5049G17176。（8）、绩效G2465G20316医院G8611G7388G1998一G7411G1461G5699G12628G6265，G18336面G7389G16826G13466的相G1863G13491G16757数据，医G11115G17148G18339数据、G11161G1166G9397G5859G5242G16855G7609数据，成G7424数据G12573。核算办G8611G7388组G13467一次绩效分析会，G5647结G13475G20576。G2465G20316的G2490一方面G7171G11015G16797，G12197G4472G2462G2604G5049个G1166G3324G8611G7388的院长G6521G5465G7097可以G11015G16797。（9）、制定绩效G6925进G16757G2022G13475过G9157G1849的绩效G2465G20316G2656G8819通，G15999考评G13785G1114G16311G2052G14270G17535的优G2195G2656G993G17287，G19036对G993G17287G1055G3800G16213制定绩效G6925进G16757G2022，同G7114G6564G1998G4466G10628绩效G6925进G16757G2022G2462G19668G16213的合理G17176G9316G2656G1866G4439G6915G6357。24实施效果、不足及改进的地方（1）、G3534G1122G6124G11065的绩效考核G4466G7057的成效。为G1114G1114G16311G4466G7057的效G7536，G7424G11752G12362对医院G12661理层G2462医G6264G1166G2604进行G1114G19394G2379G16855G7609。三个院长G3355G16760为方案的G4466G7057G1363医院的G12661理上G1114一个层次，院长G1216会G14270G16285的G1186G6124G11065的G16294G5242G5617考医院的G19394G20076。G5194G1000G3355G16760为院长G1216想做的事G4466G7057难G5242减少G1114。对全院150名医G6264G1166G2604进行的G16855G7609表明，893的医G6264G1166G2604G16760为方案G8616以前的方案好。主G16213的好G3800G7171G14270己知道怎样算G14270己的绩效G5049G17176G1114（73G15999访G13785G16760为）。（2）、存G3324的G19394G20076G2462G19668G16213G6925进的地方。第一、绩效考评G993宜由财务部G19388主G12661。传G13491的医院绩效考核G3534G7424上G7171由财务部G19388主导的，全权负责绩效考评的全过2006A228A229A230A231A232EMBAA140A141A142A14310程，G1166力G17176G9316部G19388都G993参与。如G7536由财务部G19388主导，绩效G12661理G3534G7424上给G1166的感G16285就G7171G2469奖G18341，即G1363加G1849G1114非财务指标，也还G7171G2469奖G18341。G1866G4466考评结G7536G993只G7171G2469奖G18341，还对应岗位G16855动、培训G6564升G12573G1166力G17176G9316G19394G20076。应该由G1166力G17176G9316部G19388主G12661。第二、职能部G19388G3324G6124G11065绩效G12661理模G5347下的G16294色定位。G3324G6124G11065导向的绩效考评模G5347下，考评职能逐步转移G2052职能部G19388，财务部G19388、G1166力G17176G9316部G19388的G16294色定位G1122绩效考评制G5242的组G13467制定G13785、考评制G5242G4466G7057的组G13467G13785G2656咨询G13785，以G2462考评制G5242的培训宣传G13785。G16311决这一G19394G20076的方法就G7171G16213G1363职能部G19388定位为绩效考评政策G2656制G5242的执行G13785G2656考评G13785。第三、院领导G19668G16213补G6124G11065G12661理的课。G6124G11065G12661理G7171较高G13435的G12661理，G10628G3324的医院G6124G11065G7171G8616较朴素的、G993系G13491的。第四、非财务指标G19668G16213制G5242化、规范化。由G1122职能部G19388怕得罪G1166，一些指标流G1122形G5347，这也G7171为什么大G18339采用G1114排序这种G13491G16757方法的原因。G9397G5859G5242G16855G7609宜由第三方机构来进行以保证G16855G7609结G7536的客观性，医G11115G17148G18339的考核应与G7097常的医G11115G5049作结合起来。第五、绩效考核结G7536的用途G19668G16213扩G4649。G10628G3324的绩效考核结G7536主G16213用G1122G2469G6930绩效G5049G17176，应该扩G4649G1866用途考核结G7536可以为职位的变动G6564供G1461G5699，用G1122G1219