社区卫生组织的绩效管理研究
|
摘要
近年来,随着我国医疗改革的进展,尤其是今年上半年最新的医改方案出台以后,我国对于基础医疗的构建提出了明确目标,即到2011年,基本医疗保障制度全面覆盖城乡居民,基本公共卫生服务得到普及,到2020年,覆盖城乡居民的基本医疗卫生制度基本建立。由此对我国社区卫生组织的发展提出了要求。鉴于此,对社区卫生组织的绩效管理研究可以有效的实现社区卫生组织的目标。社区卫生组织结构形式具有多层次、多维度和复杂性的特点,因此加大了绩效管理的研究难度。在此背景下,本文尝试对社区卫生组织的绩效管理系统进行比较深入地探讨,并分析其协同绩效,同时基于平衡记分卡建立了社区卫生组织绩效管理的体系。
本研究基于组织理论和绩效管理理论,主要对社区卫生组织绩效管理的理论、方法及管理实践进行研究,主要工作有：
第一,对绩效管理理论,平衡记分卡理论,协同理论等进行了分析。同时着重阐述了目前对社区卫生组织绩效管理的研究现状,以及本文研究社区卫生组织的绩效管理系统的背景与意义。
第二,阐述了当前社区卫生组织的战略使命,然后对社区卫生组织的组织结构进行分析,确定了社区卫生组织的结构形式,并在此基础上分析了社区卫生组织的绩效管理。
第三,分析了矩阵式组织绩效管理的协同平台,并在此基础上阐述了基于矩阵式组织的平衡记分卡的建立,分为三个层次设计了矩阵式组织的平衡记分卡,并提出了在内外联动的组织结构中平衡记分卡的建立。在上述分析的基础上建立了基于平衡记分卡的社区卫生组织绩效管理体系。
第四,依据社区卫生组织的组织结构模式,即矩阵式的内部组织结构,设计岗位说明书,并据此制定目标责任书。提出社区卫生组织绩效指标权重的确定方法,并阐述绩效指标权重的确定过程。最后,在目标责任书的基础上,论述了社区卫生组织绩效考核方法,并建立了基于模糊综合评价模型的绩效评价方法。
最后,进行了应用性研究,运用本文的研究成果对某社区卫生组织的绩效管理体系进行了范例研究,并设计其平衡记分卡。
In the recent years, with the development of medical reform in our country, especially when the newest scheme was published, the government proposed definite objectives for the construction of basic medical, which means basic medical insurance system and basic public health service can be reliable to urban and rural residents before the year 2011 and the basic medical health system can be set up before the year 2020. And then it raises demands to the development of the community health corporation. In views of that, the study on performance management of community health corporation can effectively realize the objectives in community health corporation. Community health corporation is multi-level and multi-dimension complex structure organization, which increase the research difficulty of preferment management. On this background, this paper tried to study further on performance management system of community health corporation, and analyzed its cooperative performance. Meanwhile set up the performance management system based on balanced scorecard in community health corporation.
In this study, the performance management theories, methods and practices of community health corporation were mainly discussed based on organization theory and performance management theory. The principal tasks can be shown as follows.
Firstly, it was focused on the current performance management of community Health corporation meanwhile the performance management theories and balance score card theories were analyzed in order to find the background and sense of our research.
Secondly, the strategy mission was shown that was the direction of our study. Then it was analyzed about the structure of community health corporation to determine the structure style for it, and based on this to represent the performance management of community health corporation.
Thirdly, performance management collaborative platform was analyzed for the matrix organization, and on this basis the establishment of the balanced scorecard for it was found. That is to say, the balanced scorecard of matrix organization can be designed in three levels. Moreover, it was got to establish the balanced scorecard for internal and external linkage organization. As a result the performance management system which is based on the balanced scorecard for community health corporation was found.
Fourthly, to design job description and responsibility documents according to the matrix structure of the community health corporation. At the same time the method to determine the weight of performance indicators for it was introduced. Then, the performance evaluation method was found according to responsibility documents; what's more, the performance evaluation model based on fuzzy comprehensive evaluation was established. Finally, the application study was carried out using our results, in other words, results of research was used on a concrete community health corporation and at last its balance scorecard was devised.
本研究基于组织理论和绩效管理理论,主要对社区卫生组织绩效管理的理论、方法及管理实践进行研究,主要工作有：
第一,对绩效管理理论,平衡记分卡理论,协同理论等进行了分析。同时着重阐述了目前对社区卫生组织绩效管理的研究现状,以及本文研究社区卫生组织的绩效管理系统的背景与意义。
第二,阐述了当前社区卫生组织的战略使命,然后对社区卫生组织的组织结构进行分析,确定了社区卫生组织的结构形式,并在此基础上分析了社区卫生组织的绩效管理。
第三,分析了矩阵式组织绩效管理的协同平台,并在此基础上阐述了基于矩阵式组织的平衡记分卡的建立,分为三个层次设计了矩阵式组织的平衡记分卡,并提出了在内外联动的组织结构中平衡记分卡的建立。在上述分析的基础上建立了基于平衡记分卡的社区卫生组织绩效管理体系。
第四,依据社区卫生组织的组织结构模式,即矩阵式的内部组织结构,设计岗位说明书,并据此制定目标责任书。提出社区卫生组织绩效指标权重的确定方法,并阐述绩效指标权重的确定过程。最后,在目标责任书的基础上,论述了社区卫生组织绩效考核方法,并建立了基于模糊综合评价模型的绩效评价方法。
最后,进行了应用性研究,运用本文的研究成果对某社区卫生组织的绩效管理体系进行了范例研究,并设计其平衡记分卡。
In the recent years, with the development of medical reform in our country, especially when the newest scheme was published, the government proposed definite objectives for the construction of basic medical, which means basic medical insurance system and basic public health service can be reliable to urban and rural residents before the year 2011 and the basic medical health system can be set up before the year 2020. And then it raises demands to the development of the community health corporation. In views of that, the study on performance management of community health corporation can effectively realize the objectives in community health corporation. Community health corporation is multi-level and multi-dimension complex structure organization, which increase the research difficulty of preferment management. On this background, this paper tried to study further on performance management system of community health corporation, and analyzed its cooperative performance. Meanwhile set up the performance management system based on balanced scorecard in community health corporation.
In this study, the performance management theories, methods and practices of community health corporation were mainly discussed based on organization theory and performance management theory. The principal tasks can be shown as follows.
Firstly, it was focused on the current performance management of community Health corporation meanwhile the performance management theories and balance score card theories were analyzed in order to find the background and sense of our research.
Secondly, the strategy mission was shown that was the direction of our study. Then it was analyzed about the structure of community health corporation to determine the structure style for it, and based on this to represent the performance management of community health corporation.
Thirdly, performance management collaborative platform was analyzed for the matrix organization, and on this basis the establishment of the balanced scorecard for it was found. That is to say, the balanced scorecard of matrix organization can be designed in three levels. Moreover, it was got to establish the balanced scorecard for internal and external linkage organization. As a result the performance management system which is based on the balanced scorecard for community health corporation was found.
Fourthly, to design job description and responsibility documents according to the matrix structure of the community health corporation. At the same time the method to determine the weight of performance indicators for it was introduced. Then, the performance evaluation method was found according to responsibility documents; what's more, the performance evaluation model based on fuzzy comprehensive evaluation was established. Finally, the application study was carried out using our results, in other words, results of research was used on a concrete community health corporation and at last its balance scorecard was devised.
引文
[1]常文虎,张正华,2000年世界卫生报告给我们的启示,中华医院管理杂志,2001,17(5),261-264
[2]周俊安,卢祖洵,程锦泉等,深圳市社区卫生服务绩效评价概述,中国全科医学,2005,8(5),356-358
[3]杨德华,刘军安,程锦泉等,反应性评价在社区卫生服务中的运用,中国卫生事业管理,2003,9,550-551
[4]王虹,杨兴华,梁万年,社区卫生服务模式效果效益评价指标体系信度、效度的初步研究,中国全科医学,2003,6(8),651-652
[5]杨德华,李谨邑,刘军安等,深圳市社区卫生服务反应性评价,医学与社会,2004,17(3),1-6
[6]陈瑞安,杜亚平,张淑艺,社区卫生服务中心综合评价指标体系及其应用研究,中国全科医学,2005,8(13),1112-1114
[7]裴丽昆,David Legge Judith Dwyer,基于战略导向的组织绩效测评系统,中华医院管理杂志,2005,21(8),574-576
[8]李晓惠,金新政,卢祖洵等,系统综合集成法在社区卫生服务机构绩效考核评价中的应用,中国全科医学,2006,4,1301-1303
[9]王芳,卢祖洵,社区卫生服务综合评价指标体系方法学研究,中国全科医学,2006,9(5),422-424
[10]李斌,李晓惠,社区卫生服务机构绩效考评网络系统的构建,中国初级卫生保健,2007,21(7),11-13
[11]潘志明,郑振俭,刘贤忠等,应用TOP SIS法和RSR法评价社区卫生服务中心的工作绩效,中国医院统计,2007,14(3),236-238
[12]鲍勇,社区卫生服务项目流程化管理研究(3)——绩效评价与SWOT分析,中国全科医学,2007,10(15),1232-1234
[13]黄存瑞,叶文,李国鸿,英国社区卫生服务制度及启示,国外医学卫生经济分册,2004,21(4),150-154
[14]张泽,祁素文,国外社区卫生服务现况及启示,中国全科医生,2005,4,1283-1284
[15]郝晓宁,李士雪,李湘江,美国社区卫生服务运行机制和管理模式研究,医学与哲学(人文社会医学版),2006,27(8),22-26
[16]李湘江,李士雪,郝晓宁,澳大利亚社区卫生服务运行机制和管理模式研究,中国卫生事业管理,2007,5,351-352
[17]付亚和,许玉林,绩效管理,上海：复旦大学出版社,2003,70-71
[18]葛玉辉,人力资源管理,北京：清华大学出版社,2008
[19]David Rosete, The impact of organizational values and performance management congruency on satisfaction and commitment, Asia Pacific Journal of Human Resources,2006,44(1),7-24
[20]Curtright, Jonathean W., Stolp-Smith, Steven C., Strategic performance management:Development of a performance measurement system at the Mayo Clinic, Journal of Heahthcare Management,2000,45(1),58-59
[21](美)卡普兰,(美)诺顿著,平衡记分卡：化战略为行动(刘俊勇),广州：广东经济出版社,2004.
[22]罗伯特.S.卡普兰,大卫.P.诺顿著,战略中心型组织：如何利用平衡记分卡使企业在新的商业环境中保持繁荣(周大勇),北京：人民邮电出版社,2004.
[23]Robert S. Kaplan, David P. Norton, The balanced scorecard-measures that drive performance, Harvard Business Review,1992,70 (1)
[24]Robert S. Kaplan, David P. Norton, Putting the Balanced Scorecard to Work, Harvard Business Review,1993,71 (5)
[25]刘丰收,平衡记分卡在企业绩效管理中的应用,[硕士学位论文],北京；首都经贸大学,2004
[26]H．哈肯,高等协同学(郭治安),北京：科学出版社,1989,1-20
[27]赫尔曼·哈肯,协同学——大自然构成的奥秘,上海：译文出版社,1995,8-13
[28]李灵,电子商务项目的协同管理研究,博士学位论文,天津大学,2004
[29]Kyle Bagwell, Garey Ramey, Coordination Economies Advertising and Search Behavior in Retail Markets International Journal of Value-Based management,2003, 16(1),67-73
[30]Haken H., Synergetics an introduction,3rd Springer Berlin,1983,10-52
[31]潘开灵,白列湖,管理协同机制研究,系统科学学报,2006,14(1),45-48
[32]陈剑辉,基于多智能代理决策系统的建设项目协同管理问题研究,广东电力,2005,18(4),12-12
[33]吴鹏,苏新宁,邓三鸿等,知识管理系统中的智力协同框架,研究与发展管理,2005,17(2),20-20
[34]刘明周,李军鹏,张铭鑫等,基于协同管理模式的企业员工招聘模型研究,合肥工业大学学报(自然科学版),2005,28(5),550-550
[35]杨宁,宫会丽,丁香乾,机械工业售后服务协同管理平台研究,中国制造业信息化,2004,33(1),79-79
[36]段钢,基于战略管理的绩效考评,北京：机械工业出版社,2007
[37]Janelle Heineke, Strategic Operations Management Decisions and Professional Performance in U.S. HMOs, Journal of Operations Management,13 (1995),255-271
[38]Ling X. Li, W.C. Benton, G. Keong Leong, The impact of strategic operations management decisions on community hospital performance, Journal of Operations Management,20 (2002),389-408
[39]洪波,四种现代组织结构模式的心理效应问题浅析,荆州师范学院学报,2001,4,96-99
[40]邢少国,李孝刚,矩阵式组织结构,中华工商时报,2003,3,12-14
[41]何曙光,齐二石,李莉,矩阵式组织结构中的绩效评价问题研究,工业工程,2003,6(5),13-15
[42]任长乐,张春娜,侯旭等,建立健全双向转诊制度之探讨,卫生经济研究,2008.7,42-43
[43]吴楠,张鹭鹭,仇元锋等,综合性医疗机构与社区卫生服务组织互动机制研究,第二军医大学学报,2005,26(11),1233-1235
[44](美)罗伯特.卡普兰,大卫.诺顿著,战略地图：化无形资产为有形成果(刘俊勇,孙薇),广州：广东经济出版社,2005
[45]何晓洁,李东文,基于战略的平衡记分卡分析,中国人力资源开发,2007,2,38-40
[46]陈尚斌,矩阵式项目组织结构的应用研究,江汉石油学院学报(社科版)2003,5(4),66-67
[47]王文俊,姚小刚,矩阵式组织结构及其在项目组织中的应用,安徽建筑,2001,1,91-92
[48]Zohar Laslo, Albert I. Goldberg, Matrix Structures and Performance:The Search for Optimal Adjustment to Organizational Objectives, IEEE TRANSACTIONS ON ENGINEERING MANAGEMENT,2001,48 (2),144-156
[49]汪云,熊巨洋,程勇等,区级社区卫生服务系统绩效评价指标体系研究,中国初级卫生保健,2008,22(9),13-16
[50]齐庆祝,杜纲,李伟光等,医院岗位说明书的设计与应用,中华医院管理杂志,2003,19(12),739-740
[51]杜纲,刘岩,齐庆祝等,基于绩效合同的医院绩效考核方法,中华医院管理杂志,2003,19(12),736-738
[52]申华林,基于平衡记分卡的宜宾市公立综合性医院绩效评估研究,中国现代医生,2008,46(15),4-14
[53]陆为民,韩文秀,刘萍萍,基于层次分析法与模糊评价的公务员绩效评估,天津大学学报(社会科学版),2005,7(3),192-195
[2]周俊安,卢祖洵,程锦泉等,深圳市社区卫生服务绩效评价概述,中国全科医学,2005,8(5),356-358
[3]杨德华,刘军安,程锦泉等,反应性评价在社区卫生服务中的运用,中国卫生事业管理,2003,9,550-551
[4]王虹,杨兴华,梁万年,社区卫生服务模式效果效益评价指标体系信度、效度的初步研究,中国全科医学,2003,6(8),651-652
[5]杨德华,李谨邑,刘军安等,深圳市社区卫生服务反应性评价,医学与社会,2004,17(3),1-6
[6]陈瑞安,杜亚平,张淑艺,社区卫生服务中心综合评价指标体系及其应用研究,中国全科医学,2005,8(13),1112-1114
[7]裴丽昆,David Legge Judith Dwyer,基于战略导向的组织绩效测评系统,中华医院管理杂志,2005,21(8),574-576
[8]李晓惠,金新政,卢祖洵等,系统综合集成法在社区卫生服务机构绩效考核评价中的应用,中国全科医学,2006,4,1301-1303
[9]王芳,卢祖洵,社区卫生服务综合评价指标体系方法学研究,中国全科医学,2006,9(5),422-424
[10]李斌,李晓惠,社区卫生服务机构绩效考评网络系统的构建,中国初级卫生保健,2007,21(7),11-13
[11]潘志明,郑振俭,刘贤忠等,应用TOP SIS法和RSR法评价社区卫生服务中心的工作绩效,中国医院统计,2007,14(3),236-238
[12]鲍勇,社区卫生服务项目流程化管理研究(3)——绩效评价与SWOT分析,中国全科医学,2007,10(15),1232-1234
[13]黄存瑞,叶文,李国鸿,英国社区卫生服务制度及启示,国外医学卫生经济分册,2004,21(4),150-154
[14]张泽,祁素文,国外社区卫生服务现况及启示,中国全科医生,2005,4,1283-1284
[15]郝晓宁,李士雪,李湘江,美国社区卫生服务运行机制和管理模式研究,医学与哲学(人文社会医学版),2006,27(8),22-26
[16]李湘江,李士雪,郝晓宁,澳大利亚社区卫生服务运行机制和管理模式研究,中国卫生事业管理,2007,5,351-352
[17]付亚和,许玉林,绩效管理,上海：复旦大学出版社,2003,70-71
[18]葛玉辉,人力资源管理,北京：清华大学出版社,2008
[19]David Rosete, The impact of organizational values and performance management congruency on satisfaction and commitment, Asia Pacific Journal of Human Resources,2006,44(1),7-24
[20]Curtright, Jonathean W., Stolp-Smith, Steven C., Strategic performance management:Development of a performance measurement system at the Mayo Clinic, Journal of Heahthcare Management,2000,45(1),58-59
[21](美)卡普兰,(美)诺顿著,平衡记分卡：化战略为行动(刘俊勇),广州：广东经济出版社,2004.
[22]罗伯特.S.卡普兰,大卫.P.诺顿著,战略中心型组织：如何利用平衡记分卡使企业在新的商业环境中保持繁荣(周大勇),北京：人民邮电出版社,2004.
[23]Robert S. Kaplan, David P. Norton, The balanced scorecard-measures that drive performance, Harvard Business Review,1992,70 (1)
[24]Robert S. Kaplan, David P. Norton, Putting the Balanced Scorecard to Work, Harvard Business Review,1993,71 (5)
[25]刘丰收,平衡记分卡在企业绩效管理中的应用,[硕士学位论文],北京；首都经贸大学,2004
[26]H．哈肯,高等协同学(郭治安),北京：科学出版社,1989,1-20
[27]赫尔曼·哈肯,协同学——大自然构成的奥秘,上海：译文出版社,1995,8-13
[28]李灵,电子商务项目的协同管理研究,博士学位论文,天津大学,2004
[29]Kyle Bagwell, Garey Ramey, Coordination Economies Advertising and Search Behavior in Retail Markets International Journal of Value-Based management,2003, 16(1),67-73
[30]Haken H., Synergetics an introduction,3rd Springer Berlin,1983,10-52
[31]潘开灵,白列湖,管理协同机制研究,系统科学学报,2006,14(1),45-48
[32]陈剑辉,基于多智能代理决策系统的建设项目协同管理问题研究,广东电力,2005,18(4),12-12
[33]吴鹏,苏新宁,邓三鸿等,知识管理系统中的智力协同框架,研究与发展管理,2005,17(2),20-20
[34]刘明周,李军鹏,张铭鑫等,基于协同管理模式的企业员工招聘模型研究,合肥工业大学学报(自然科学版),2005,28(5),550-550
[35]杨宁,宫会丽,丁香乾,机械工业售后服务协同管理平台研究,中国制造业信息化,2004,33(1),79-79
[36]段钢,基于战略管理的绩效考评,北京：机械工业出版社,2007
[37]Janelle Heineke, Strategic Operations Management Decisions and Professional Performance in U.S. HMOs, Journal of Operations Management,13 (1995),255-271
[38]Ling X. Li, W.C. Benton, G. Keong Leong, The impact of strategic operations management decisions on community hospital performance, Journal of Operations Management,20 (2002),389-408
[39]洪波,四种现代组织结构模式的心理效应问题浅析,荆州师范学院学报,2001,4,96-99
[40]邢少国,李孝刚,矩阵式组织结构,中华工商时报,2003,3,12-14
[41]何曙光,齐二石,李莉,矩阵式组织结构中的绩效评价问题研究,工业工程,2003,6(5),13-15
[42]任长乐,张春娜,侯旭等,建立健全双向转诊制度之探讨,卫生经济研究,2008.7,42-43
[43]吴楠,张鹭鹭,仇元锋等,综合性医疗机构与社区卫生服务组织互动机制研究,第二军医大学学报,2005,26(11),1233-1235
[44](美)罗伯特.卡普兰,大卫.诺顿著,战略地图：化无形资产为有形成果(刘俊勇,孙薇),广州：广东经济出版社,2005
[45]何晓洁,李东文,基于战略的平衡记分卡分析,中国人力资源开发,2007,2,38-40
[46]陈尚斌,矩阵式项目组织结构的应用研究,江汉石油学院学报(社科版)2003,5(4),66-67
[47]王文俊,姚小刚,矩阵式组织结构及其在项目组织中的应用,安徽建筑,2001,1,91-92
[48]Zohar Laslo, Albert I. Goldberg, Matrix Structures and Performance:The Search for Optimal Adjustment to Organizational Objectives, IEEE TRANSACTIONS ON ENGINEERING MANAGEMENT,2001,48 (2),144-156
[49]汪云,熊巨洋,程勇等,区级社区卫生服务系统绩效评价指标体系研究,中国初级卫生保健,2008,22(9),13-16
[50]齐庆祝,杜纲,李伟光等,医院岗位说明书的设计与应用,中华医院管理杂志,2003,19(12),739-740
[51]杜纲,刘岩,齐庆祝等,基于绩效合同的医院绩效考核方法,中华医院管理杂志,2003,19(12),736-738
[52]申华林,基于平衡记分卡的宜宾市公立综合性医院绩效评估研究,中国现代医生,2008,46(15),4-14
[53]陆为民,韩文秀,刘萍萍,基于层次分析法与模糊评价的公务员绩效评估,天津大学学报(社会科学版),2005,7(3),192-195