随着人们生活水平的提高，医疗以及健康理念的深入，对医疗服务的要求也越来 越高，越来越多的社会办医也加入到社会医疗事业中，中国公立医院面临着机遇与挑 战并存的复杂环境。随着医改对公立医院要求的提高，公立医院必须学习先进的管理 经验，引进先进的管理工具，优化内部资源配置和管理流程，从根本上提升医院的管 理能力，从而增强竞争实力。绩效管理在医院管理中发挥着核心的作用已成为不争的 事实，自医改以来，国家对公立医院绩效管理改革的要求也做了明确指示，并指出公 立医院在绩效指标设计、绩效管理落实、绩效结果应用等多个环节都还欠缺科学性。 本文所选择的 YF 公立医院绩效管理实施情况，反映了当下大部分公立医院的绩效管 理现状，所以本文的研究内容和研究方法以及研究思路为中国公立医院的绩效管理体 系优化设计提供了可借鉴的参考价值。 本文以福建 YF 公立医院为研究对象，采用了历史分析法、文献分析法、问卷调 查法、访谈法、实际工作经验法等多种分析方法，对 YF 公立医院现行的绩效管理方 案中存在的问题做深入剖析，总结其问题出现的原因。然后，本文以科学系统的绩效 管理的流程和方法为核心，基于 YF 公立医院的基本情况，重新梳理 YF 公立医院的 战略目标，完善 YF 公立医院以绩效管理为核心的组织架构、以平衡计分卡为工具绩 效指标体系，最后在绩效执行阶段提出建立监督辅导机制和申述反馈机制的思路，在 绩效结果应用环节指出绩效结果本质是绩效改进的依据，由此为 YF 公立医院设计出 一套适合于 YF 公立医院的绩效管理体系优化设计的思路。 最后本文也指出，在绩效管理实际管理过程中，绩效管理的流程并不是一成不变 的，而是根据环境、根据实施中出现的问题及时作出调整。绩效管理体系的设计执行 也不是一个人完成的，应该是一个医院的全体员工系统性、科学性的参与到其中。 关键词：公立医院，绩效管理，医院管理，平衡计分卡III Abstract With the improvement of people's life standards, the deepening of medical and health concepts, the requirements for medical services are getting higher and higher, and more and more social medical doctors are also joining the social medical cause. Chinese public hospitals face opportunities and challenges. Coexisting complex environment. With the improvement of the requirements of public hospitals for public hospitals, public hospitals must learn advanced management experience, introduce advanced management tools, optimize internal resource allocation and management processes, and fundamentally improve the hospital's management capabilities, thereby enhancing competitiveness. Performance management has played a central role in hospital management. It has become an indisputable fact. Since the medical reform, the state has made clear instructions on the performance management reform of public hospitals, and pointed out that public hospitals in performance indicator design, performance management implementation, performance As a result, the application and other aspects are still lacking in science. The implementation of performance management of YF public hospitals selected in this paper reflects the current status of performance management of most public hospitals. Therefore, the research content, research methods and research ideas of this paper provide reference for the optimization design of performance management systems in public hospitals in China. Reference value. This paper takes Fujian YF public hospital as the research object, and adopts various analysis methods such as historical analysis method, literature analysis method, questionnaire survey method, interview method and actual work experience method to solve the problems in the current performance management plan of YF public hospital. Do an in-depth analysis to summarize the reasons for its problems. Then, based on the process and method of performance management of scientific system, this paper reorganizes the strategic goals of YF public hospitals based on the basic situation of YF public hospitals, and improves the organizational structure of YF public hospitals with performanceIV management as the core, and balances scorecards. For the tool performance indicator system, and finally put forward the idea of establishing supervision and guidance mechanism and representation feedback mechanism in the performance execution stage, it is pointed out that the essence of performance results is the basis of performance improvement in the application of performance results, thus designing a suitable set for YF public hospitals. The idea of optimizing the performance management system of YF public hospitals. Finally, the paper also points out that in the actual management process of performance management, the process of performance management is not static, but is adjusted according to the environment and according to the problems in the implementation. The design of the performance management system is not completed by one person. It should be the systematic and scientific participation of all the staff of a hospital. Key Words：Public Hospital, Performance Management, Hospital Management, Balanced Score Card(BSC)V 目 录 第一章 绪论...............................................................................................................................1 1.1 研究背景与意义..............................................................................................................1 1.2 国内外相关研究现状......................................................................................................2 1.2.1 国外研究及应用现状...............................................................................................2 1.2.2 国内研究及应用现状...............................................................................................3 1.2.3 研究现状述评...........................................................................................................5 1.3 研究思路..........................................................................................................................7 1.4 研究方法..........................................................................................................................7 第二章 相关理论基础...............................................................................................................9 2.1 绩效管理..........................................................................................................................9 2.1.1 绩效定义及特征.......................................................................................................9 2.1.2 绩效管理的定义及内涵...........................................................................................9 2.2 医院绩效管理................................................................................................................11 2.2.1 医院绩效.................................................................................................................11 2.2.2 医院绩效管理定义.................................................................................................12 2.2.3 医院绩效管理的目的.............................................................................................12 2.3 绩效管理的工具和方法................................................................................................13 第三章 福建 YF 公立医院绩效管理现状及问题分析......................................................... 16 3.1 福建 YF 公立医院简介................................................................................................ 16 3.1.1 医院发展使命和愿景.............................................................................................16 3.1.2 医院组织架构.........................................................................................................17 3.2 福建 YF 公立医院绩效管理现状................................................................................ 19 3.2.1 YF 医院现行绩效管理制度概况............................................................................19 3.2.2 绩效管理实施情况问卷调查及访谈.....................................................................23 3.3 绩效管理体系问题及成因分析....................................................................................29 第四章 YF 公立医院绩效管理体系优化设计.......................................................................34 4.1 务实绩效计划基础........................................................................................................35 4.1.1 明确 YF 公立医院发展战略................................................................................. 35VI 4.1.2 成立绩效管理办公室.............................................................................................38 4.1.3 平衡医院、科室、个人目标间利益关系.............................................................41 4.2 绩效评价指标体系优化................................................................................................42 4.2.1 确定医院层次绩效指标体系.................................................................................43 4.2.2 科室层级绩效考核指标设计.................................................................................48 4.2.3 个人岗位层次绩效指标.........................................................................................56 4.3 优化绩效执行 建立监管辅导机制..............................................................................58 4.4 建立科学有效的绩效评价体系....................................................................................60 4.4.1 评价主体的选择.....................................................................................................60 4.4.2 绩效评价周期的选择.............................................................................................62 4.5 绩效反馈与申诉流程....................................................................................................62 4.5.1 绩效反馈.................................................................................................................62 4.5.2 绩效申诉.................................................................................................................64 4.6 绩效结果的应用措施....................................................................................................65 4.7 绩效计划的更新与重新签订........................................................................................66 第五章 结论与展望.................................................................................................................67 5.1 研究结论........................................................................................................................67 5.2 研究展望........................................................................................................................68