社区卫生服务绩效考核中标准工时的应用研究

The Application of Standard Working Hours in Performance Assessment of Community Health Service

目的了解社区卫生服务常规项目标准工时的测算方法,探讨标准工时在社区卫生服务绩效考核中的应用效果。方法于2013年4月,随机抽取117名参加黑龙江省社区卫生服务管理干部培训班的社区卫生服务中心主任,对其进行问卷调查。问卷内容包括社区卫生服务工作人员开展各项常规项目所需工作时间、重要性及难易程度情况。将社区卫生服务项目分为基本卫生服务和公共卫生服务项目两大类,根据各项目平均工作时间、难易程度评分及重要性评分,得出社区卫生服务项目标准工时表。随机抽取哈尔滨市5家社区卫生服务中心的69名医务人员进行现场调研,验证标准工时指标体系。结果基本卫生服务和公共卫生服务的整体重要性评分分别为4.3、4.5分,难易度评分分别为3.2、3.8分;门诊接诊、预防接种、重症精神病健康管理、老年人健康管理、慢性病患者健康管理及健康档案管理的标准工时分别为12、10、38、26、25、20 min。标准工时可以考核不同岗位员工的工作量;平衡不同社区卫生服务项目绩效权重,衡量员工工作量比例。结论标准工时体系平衡了不同任务、不同工作岗位人员间的工作绩效,符合社区卫生服务工作复杂的特点,具有较好适用性和拓展性,给社区卫生服务机构绩效考核提供了新思路和新方法。

Objective To study on the calculating methods of standard working hours in the conventional projects of community health service and explore the application effect of standard working hours in performance assessment. Methods In May, 2013, 117 directors of community health service centers were randomly chosen from those who took part in the cadre training in Heilongjiang province. They were investigated about the standard working hours of different conventional service projects, the importance and the degree of difficulty or easiness. Researchers divided the service projects into basic service projects and public service projects and obtained the standard working hour table according to the evaluation scores of averaged working hours, degree of difficulties or easiness and importance, and then verified the working hour index system by field survey of 69 medical workers randomly chosen from 5 community health service centers in Heilongjiang province. Results The overall importance scores of public health service and basic health service were 4. 3 and 4. 5 ; the scores of difficult or easy degree were 3.2 and 3.8. The standard hours for clinic reception, immunization, health management for severe mental illness, health management for edueare, health management＇for chronic disease, and health librarianship were 12, 10, 38, 26, 25 and 20 min. The standard working hour table could check the workload of the medical workers, balance the performance evaluation weight of different projects and calculate the workload proportion of the staff. Conclusion The system of standard working hours balances the performance among staffs with different missions, accords with the complex characteristics of community health service, has good suitability and extensiveness and provides new thoughts and methods for the performance assessment.