基于绩效合同的医院绩效考核方法

绩效考核是绩效管理的重要环节 ,也是绩效薪酬分配的主要依据[1] 。医院所具有的岗位构成复杂性、绩效的群体性和行为指标的难以量化等特性决定了医院绩效考核的难度 ,而如何设立全院统一的科学规范的考核依据和方法 ,已成为建立科学有效的医院绩效管理体系的关键问题。在济南市妇幼保健院 2 0 0 3年岗位、绩效与薪酬管理改革的课题研究中 ,课题组设计了一种基于岗位绩效合同的医院绩效考核方法 ,适用于对医院的医、护、技、职能、后勤等各类所有岗位进行统一形式的考核。本方法的核心是绩效合同的内容设计。绩效合同及其内容设计绩效合同是…     

医院岗位评价方法设计

岗位评价是一个系统客观评估岗位相对价值的过程 ,是实行岗薪制的基础和关键依据[1] 。医院岗位评价的难点在于如何以全院统一的评价标准和统一的等级制对全院所有岗位进行统一的评价。在济南市妇幼保健院 2 0 0 3年岗位、绩效与薪酬管理改革的课题研究中 ,课题组对此问题进行了比较深入的研究 ,设计了一种医院岗位评价方法 ,适用于对医院的医、护、技、职能、后勤等各类所有岗位进行统一评价。本方法的核心是评价指标体系和评分表的设计。一、岗位评价的指标体系与权重岗位评价的指标体系是评价岗位所依据的要素(准则 )及其子要素组成的一…     

基于信息化平台的医院绩效工资分配改革的探索

绩效工资是医院根据岗位技术含量、责任大小、劳动强度和所承担的风险程度确定等级．以医院运行发展的合理预期总量控制、结构调整,以员工劳动成果（业绩）为依据核算劳动报酬．是人力资源管理与绩效管理相结合的薪酬体系。我院积极探索公立医院绩效工资分配改革,依托现代化的信息化技术平台,推出“要素考核．系统支撑,适时控制”为主要特点的绩效工资考核分配方案．较好地调动了全院工作人员的积极性．促进了医疗业务工作的有效开展。     

公立医院绩效工资分配改革的探索与思考

绩效工资是医院根据岗位技术含量、责任大小、劳动强度和所承担风险程度确定等级．以医院运济发展的合理预期总量控制、结构调整,以员工劳动成果（业绩）为依据核算劳动报酬．是人力资源管理与绩效管理相结合的薪酬体系。     

基于岗位价值的公立医院绩效薪酬管理体系的设计与应用

科学的绩效薪酬体系对医院实施内部有效管理, 提高医务人员积极性, 推进公立医院高质量发展有重要意义。某三级甲等综合医院基于国家薪酬制度改革的要求, 自2016年开始进行绩效薪酬体系的设计与应用实践。该院构建了岗位评价指标体系对医院各岗位序列进行分层, 并确定了不同序列和层级的岗位价值系数;构建了包含岗位绩效薪酬、专项绩效薪酬和创新绩效薪酬的绩效薪酬项目体系;建立了涵盖薪酬标准制定, 绩效薪酬核算与分配, 以及绩效薪酬管理体系的动态调整的绩效薪酬管理体系。该绩效薪酬管理体系的应用实现了员工价值、岗位层级与医疗服务的匹配, 2016年至2020年员工对绩效薪酬的整体满意度均超过85%, 同时提高了医院的运行效率和质量, 驱动了技术发展与科研创新, 对医院高质量发展发挥了正向激励作用。     

公立医院行政管理人员绩效考核改革探索与实践

对行政管理人员的绩效考核是公立医院绩效改革的难点, 构建合理的行政管理人员绩效考核方案有利于推动医院的高质高效发展。H医院自2019年开始探索实施行政管理人员绩效考核改革, 首先明确了全院各行政管理岗位职责, 并采用海氏职位评估法进行岗位价值评估;其次, 在此基础上构建了涵盖共性指标、个性指标、隐性能力指标的绩效考核指标体系并明确绩效奖金核算及分配方法, 其中共性指标的制定以医院"十四五"规划作为出发点, 个性指标为各部门根据医院年度重点工作分解及"十四五"规划制定的本部门绩效考核重点, 隐性能力指标为根据胜任力模型构建的引导促进职工个人发展的指标;最后, 建立反馈和监察机制, 以确保绩效考核方案的稳步运行。通过以岗位价值评估为基础的行政管理人员绩效改革, H医院消除了行政管理人员绩效分配的"平均主义"现象, 发挥了绩效考核对职工的导向和激励作用, 使得医院的战略目标得到较好落实, 可为其他医疗机构的行政管理人员绩效改革提供参考。     

新医改下公立医院绩效薪酬设计与实践

阐述了医院薪酬的原理和合理性、薪酬体系设计的原则,以及原有薪酬模式的不足,结合医院的实践,提出了设计由国家档案工资、技术岗位工资、劳务质量工资、社保福利补贴等组成的固定薪酬和以科室收支结余为主,结合工作岗位性质、工作技术难度、工作风险程度、工作数量与质量等工作业绩,根据不同科室的业务内容、技术水平、风险程度、劳动强度等制定不同的考核内容和分配系数组成的绩效薪酬的薪酬体系。强调了医院薪酬体系设计既要符合当前国家关于公立医院运行机制改革和管理年的要求,同时,形成激励机制,保证医院可持续健康发展。     

制订合理岗位绩效方案 深化医院分配制度改革

医院岗位绩效工资分配办法改革,是医院深化改革的需要。本文针对医院岗位绩效工资方案需要注意的相关问题提出建议：加强领导,统一思想,提高认识;做好工作分析与岗位价值评估;坚持“公开、公平、公正”的原则,制订合理方案;注意岗位设置阶段过渡,做好分配制度改革的基础管理工作。     

医院护理岗位绩效考核与分配探索

为适应深化医药卫生体制改革的要求,有效落实卫生部加强医院临床护理工作优质护理示范工程的精神．规范临床护理工作．夯实基础护理,改善护理服务．护理岗位绩效考核及绩效分配问题尤为重要。结合护理工作特点建立按岗取酬、按工作量取酬、按服务质量和工作绩效取酬的体现工效挂钩的考核及分配体系．才能有效调动临床一线护士的工作积极性,稳定护士队伍．规范护理岗位绩效考核与分配,实现与国家绩效工资政策的对接,促进医院可持续发展。     

Calcium intake in the elderly: validation of a dietary questionnaire

Epidemiological studies of calcium and osteoporosis have been hampered by the lack of a suitable tool for assessing calcium intake. This report describes a new frequency and amount questionnaire for measuring present and past calcium intake in the elderly. The validity of the questionnaire was tested against two commonly used standards of dietary assessment, five-day duplicate diets and seven-day weighed dietary inventories. The resulting correlation coefficients were, respectively, r = 0.76 and r = 0.69, while that for repeatability was r = 0.84. Furthermore, the questionnaire categorized subjects into thirds of the distribution of intake with almost no gross misclassification. It is suggested that the present findings may be extended to the majority of normal, healthy elderly subjects, implying wide application for the questionnaire in the assessment of calcium intake in the elderly.     

The occurrence of antimicrobial substances in toilet,sink and shower drainpipes of clinical units: A neglected source of antibiotic residues

Antibiotics represent one of the most important drug groups used in the management of bacterial infections in humans and animals. Due to the increasing problem of antibiotic resistance, assurance of the antibacterial effectiveness of these substances has moved into the focus of public health. The reduction in antibiotic residues in wastewater and the environment may play a decisive role in the development of increasing rates of antibiotic resistance. The present study examines the wastewater of 31 patient rooms of various German clinics for possible residues of antibiotics, as well as the wastewater of five private households as a reference.To the best of our knowledge, this study shows for the first time that in hospitals with high antibiotic consumption rates, residues of these drugs can be regularly detected in toilets, sink siphons and shower drains at concentrations ranging from 0.02?μg·L^?1 to a maximum of 79?mg·L^?1. After complete flushing of the wastewater siphons, antibiotics are no longer detectable, but after temporal stagnation, the concentration of the active substances in the water phases of respective siphons increases again, suggesting that antibiotics persist through the washing process in biofilms. This study demonstrates that clinical wastewater systems offer further possibilities for the optimization of antibiotic resistance surveillance.     

Self-reported health problems among Swedish miners one year after unemployment

Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).     

Excès de cas humains et animaux de tularémie en France au cours de l’hiver 2007–2008 : émergence ou phénomène isolé ?

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.     

Occupational health hazards in mining: an overview

This review article outlines the physical, chemical, biological, ergonomic and psychosocial occupational health hazards of mining and associated metallurgical processes. Mining remains an important industrial sector in many parts of the world and although substantial progress has been made in the control of occupational health hazards, there remains room for further risk reduction. This applies particularly to traumatic injury hazards, ergonomic hazards and noise. Vigilance is also required to ensure exposures to coal dust and crystalline silica remain effectively controlled.     

Manufacture and use of nanomaterials: current status in the UK and global trends

This paper provides an overview of the production and use of nanomaterials (NMs), particularly in the UK. Currently, relatively few companies in the UK are identifiable as NM manufacturers, the main emphasis being the bulk markets in metals and metal oxides, and some niche markets such as carbon nanotubes and quantum dots. NM manufacturing in the UK does not reflect the global emphasis on fullerenes, nanotubes and fibres. Some assumptions have been made about the types of NM that are likely to be imported into the UK, which currently include fullerenes, modified fullerenes and other carbon-based NMs including nanotubes. Many university departments, spin-offs and private companies have developed processes for the manufacture of NMs but may only be producing small quantities for research and development (R&D) purposes. However, some have the potential to scale up to produce large quantities. The nanotechnology industry in the UK has strong R&D backup from universities and related institutions. This review has covered R&D trends at such institutions, and appropriate information has been added to a searchable database. While several companies are including NMs in their products, only a few (e.g. manufacturers of paints, coatings, cosmetics, catalysts, polymer composites) are using nanoparticles (NPs) in any significant quantities. However, this situation is likely to change rapidly. There is a need to collect more information about exposure to NPs in both manufacturing and user scenarios. As the market grows, and as manufacturers switch from the micro- to the nanoscale, the potential for exposure will increase. More research is required to quantify any risks to workers and consumers.     

深圳公立医院管理体制改革制度设计

深圳公立医院管理体制改革实行政事分开、管办分开,在理事会架构下按法定机构模式组建市医管中心,落实公立医院运营管理自主权.作者从当前公立医院管理体制的弊端入手,介绍了深圳市进行公立医院管理体制改革的基本思路及改革方案设计的主要举措,深入剖析了的改革方案的特点,并对改革效果进行了预测.     

Effects of nitrogen dioxide on red blood cells of rats: Changes in components of red cell membranes during in vivo exposure to NO2

Red cell membranes, prepared from red blood cells of rats exposed to 4, 10, or 20 ppm nitrogen dioxide (NO₂) for 1 to 10 days, were examined for evidence of changes in membrane components. Appreciable changes were not found in contents of phospholipid and cholesterol during exposure to 10 ppm NO₂. By contrast, protein content altered with the time of exposure. Moreover, changes in protein composition were observed by employing sodium dodecyl sulfate — polyacrylamide gel electrophoresis. Twenty-four-hour exposure to NO₂ at the concentration above 10 ppm resulted in a marked increase in the percentage of lysophosphatidylethanolamine (LysoPE) to the total phospholipids. The prolonged exposure to 10 ppm NO₂ gave rise to a further increase in LysoPE, whereas the percentage of phosphatidylethanolamine (PE) showed a gradual decrease. A 1-day exposure to 4.0 ppm NO₂ also caused an increase in sialic acid content and decreases in those of PE and hexose. In addition to contents of these components the percentage of LysoPE increased 5 days after exposure and the elevated values were maintained up to the end of exposure period. These results demonstrate that red blood cells in circulation exhibit different membrane properties in terms of lipid and carbohydrate composition during 10 days of exposure to 4.0 ppm NO₂.     

Investigating clusters in the workplace and beyond

Clusters of disease are common and occur in the workplace and in the general community. They often arouse considerable concern among the population. Investigations have sometimes lead to exciting new knowledge, but in general the investigation of clusters is difficult and often unrewarding, especially for community clusters. In the workplace, investigations are more likely to find associations and even new causes, but still many clusters remain enigmatic. Despite this, there are many reasons for investigating clusters, including allaying community concern and identifying uncontrolled exposures. A structure for investigating clusters in the workplace is suggested.