How to pay for performance is reasonable.

How to pay for performance is reasonable.

Performance pay is divided into broad performance pay and narrow performance pay. Performance pay in a broad sense is also called performance pay increase, incentive pay or pay linked to assessment. So how can performance pay be reasonable? The following is the relevant content I have compiled, welcome to read!

Inner voice

I think so about wage income.

What is the income level of primary medical staff? Let's take a look at the salary of a community health service center in Hangzhou, Zhejiang Province.

Xiao Wang: undergraduate major in preventive medicine. 20 15 came to work in the center after graduation. He is a contract worker. I can't work alone because I haven't obtained a medical certificate. His current salary is 2000 yuan/month.

Xiaomei: Master of Traditional Chinese Medicine, graduated from July 20 10. At present, she is a full-time employee of the center. Her salary should be around 4,600 yuan/month. After deducting "four insurances and one gold", the actual income is about 6,543,800 yuan.

Lao Chen: 65438+1joined the work after graduating from technical secondary school in August 1992. It has been 24 years since he completed junior college and undergraduate education. Now we are officially recruiting staff, backbone of general practice and deputy chief physician in the center. His salary should be about 6200 yuan/month, and the actual salary after deducting "four insurances and one gold" is about 3800 yuan/month. 20 15 has a general practitioner signing fee, and the annual income is about 200,000. After deducting "four insurances and one gold", the actual income is about 654.38+0.80 million yuan.

The salaries of the above three community medical staff reflect the differences in age, professional title and post, which can be said to be representative. So, what do they think of the performance pay system?

Xiao Wang: At this stage, the salary starting point of the medical industry is low. Medical students are almost 30 years old when they finish their undergraduate, master's or even doctoral degrees, while other peers may have been struggling for several years, and their salary level may be two or three times that of us. In my opinion, the threshold of medical and health industry should be lowered appropriately, the salary of new doctors should be raised, and these valuable medical resources should be preserved as much as possible.

Xiaomei: I hope I can afford a house in the city where I work.

Lao Chen: Although I have confidence in the career of general practitioner, my current income can only be used to support my family. Starting from the general practitioner's contract service fee, I also realized that the comprehensive ability of doctors is directly related to the number and assessment of contracted residents, and the income gap between contracted doctors is getting bigger and bigger. The era of embodying the general practitioner's ability has arrived.

practice

The target annual salary system embodies fairness.

From 2065438 to June 2005, Shanghai launched a new round of comprehensive reform of community health service, which clearly placed community health service in the foundation and core position of the whole medical and health service system, and family doctors should be the "core of the core". Since July 20 15, the performance-based pay reform of community health service has been carried out (dating back to July 20 14, 10), that is, the post allowance, salary retention, going to the countryside, price, food, life, medical allowance, editorial reward, book and newspaper fees have been abolished, and the post allowance has been uniformly distributed to improve the quality of service. Besides,

In addition, our center actively promotes the performance appraisal scheme based on comprehensive budget management, takes the family doctor team as the minimum accounting unit, and implements the target annual salary system for family doctors. The index data of the comprehensive budget of the center is decomposed layer by layer, and the responsibility lies with people and the assessment lies with people. According to the total population and service situation of the neighborhood committees under their jurisdiction, each family doctor team prepares the target budget of each index and formulates the budget target (monthly, annual) and salary plan. The annual budget target and salary plan are finally approved by the center and fed back to each family doctor, and a target responsibility letter is signed to clarify the post responsibilities and work contents. Implement and set up departments and personnel specifically responsible for the management of family doctors, and regularly assess, manage and analyze the implementation of the comprehensive budget of family doctors. If the family doctor disagrees with the published data, he can apply for a review, so as to continuously improve the data verification mechanism.

Compared with the previous "big pot" distribution method, this performance distribution method can better reflect fairness and objectivity, and can also stimulate the enthusiasm and enthusiasm of family doctors to provide services to community residents. Management and assessment are carried out by special personnel to ensure the effectiveness and efficiency of family doctor services, link the assessment results with the negative performance of doctors in the current month, further guide family doctors to standardize services, effectively serve and reasonably serve, and continuously improve the feelings and satisfaction of community residents.

visual angle

It is unscientific to "resize the original cake".

Li Haidong, Yanji Community Health Service Center, Yangpu District, Shanghai: At present, family doctors are engaged in a lot of work, including outpatient service, home visits, family bed management, long prescription management for chronic diseases, home-based pension evaluation, combination of medical care and nursing, chronic disease follow-up, community health education, and street emergency support.

According to the performance pay system, every job is calculated into a certain workload unit. According to the principle of getting more for more work, the more work you do, the greater the workload and the corresponding increase in income. But at present, the fact is that the community health service center is funded by the government, and the annual funding amount is fixed, with no obvious growth. Therefore, even if a family doctor is very hard and the workload increases obviously, the amount that the community health service center can control is fixed. Only by diluting the amount of money corresponding to each workload unit can we make ends meet. In other words, no matter how much you do, you can only pay so much money Therefore, judging from the current pilot situation of performance-based wage reform, if the government does not increase the wage input to primary medical institutions, the so-called performance-based wage reform is nothing more than re-expanding the original cake and not benefiting primary medical staff.

Pay attention to satisfaction and effect.

Pan Xuefeng, Royal Service Station of Changqing Chaoming Community Health Service Center, Xiacheng District, Hangzhou City, Zhejiang Province: General practitioners should not only treat residents, but also make comprehensive evaluation from social, psychological, physiological and family aspects, so the performance pay system of general practitioners should also be considered from several aspects. In terms of workload, it should be measured not only by how much time the patient spent, but also by the patient's satisfaction or effect at that time. Work other than basic public health services should receive double compensation. For example, health education should not be included in public health work, and grassroots doctors should be compensated accordingly after completing this part of the work. The management of chronic diseases in the community should also be assessed from the aspects of satisfaction and management effect, and rewards should be given to those who pass the management.

Assessment can't just care about the "money bag"

Chen Rui, Xinhua Shaocheng Community Health Service Center, Chengdu, Sichuan: The performance appraisal should not only look at the "money bag", but also look at the sense of accomplishment brought by the performance to the primary medical staff. Performance is not a tool to calculate income, but a carrier and catalyst to better provide residents with quality health management. Therefore, performance appraisal needs to be linked with the core KPI (key performance indicator) of basic public health services and basic medical care, and needs to be linked with actual work. It cannot be emphasized that public health is more important than medical care or medical care is more important than public health, and neither of them can be neglected. Performance appraisal should not only attach importance to post-event evaluation, accounting, rewards and punishments, but also highlight the management and control of the process. It should be able to solve the problems existing in the work process and play a positive guiding role in performance management.

Let the work get a reasonable reward.

Liang Zhenyu, Center for Disease Control and Prevention, Shijiazhuang City, Hebei Province: Primary medical institutions are small in scale, and some jobs can't have full-time staff, so some people can only work part-time, but this will take up a lot of time and energy, and there is no reward, so few people are willing to do it. This kind of problem can be solved by setting up special allowance. For example, someone who writes well pays 100 yuan more every month, and he is responsible for the reporting materials of the unit; A nurse who has received vaccination training can help the preventive medicine department vaccinate her children and give her some extra subsidies. By setting up special allowance, encouraging employees to take on more temporary jobs can not only increase their income, but also reduce the labor cost for the unit.

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