以某公立医院为例谈医院人才流失的影响因素及控制机制

人才流失已成为困扰医院的一大难题,如何能够吸引人才、凝聚人才、留住人才是医院增强竞争力的一个重要手段。本文以某公立医院为例,对人才流失的影响因素及控制机制进行分析和解读。     

公立医院人才流失的影响因素和建议

医疗市场竞争的日趋激烈,使公立医人才流失的现状日益明显。究其原因,既有医院外部大环境的客观因素,也有医院内部自身管理以及个人心理、观念、意识等方面的主观因素。探讨人才流失原因,采取切实可行的方法留住人才去赢得医院竞争的新优势,是当前公立医院生存与发展的关键所在。     

徐州市中医院构建心理契约的家文化

医院的健康持续发展离不开"以人为本"的管理理念,离不开医院职工和患者"以院为家"的情感归宿,医院文化建设中"心理契约"的培育对医院的发展和医患关系的和谐构建具有十分重要的作用。心理契约是维系医院、员工和患者关系的心理纽带,是维持和发展员工和患者与医院关系的内在力量。充分发挥心理契约的作用,重视心理契约的构建,对于创建充满活力的医院具有重要的意义。     

医护人员心理契约满足及其测量

目的探讨医护人员心理契约满足的内容结构,了解医护人员心理契约满足的维度,加强对医护人员心理契约的管理。方法对294名临床科室的医护人员进行心理契约问卷调查,并进行统计分析。结果医护人员心理契约满足为三维结构:发展责任,对总变异的贡献率为46.010%;规范责任,对总变异的贡献率为8.797%;人际责任,对总变异的贡献率为6.888%。表明该量表可靠性良好,也充分表明了心理契约量表的维度具有文化特性。结论量表可靠性良好,充分表明了心理契约量表的维度具有文化特性,对医院人力资源管理具有指导性意义,有助于提升医院管理水平。     

基于心理契约的医院志愿者管理研究

目的 :通过对医院志愿者心理契约现状的分析,探讨基于心理契约的医院志愿者管理的有效方法和途径。方法 :设计调查问卷,采用随机抽样方法,对5所公立医院的志愿者进行调查。结果 :医院志愿者心理契约管理还存在一些不足,需要进一步完善。结论 :营造融洽医院文化,完善志愿者组织架构,打造信息化服务平台,引入平衡记分卡理论,进一步加强医院志愿者心理契约管理。     

浅议医院如何留住人才

人才是医院发展的根本，人才流失是医院不可忽视的问题，医院应树立“以人为本”的理念，想方设法留住人才。     

医院员工心理契约与离职倾向关系的实证研究

目的了解医院员工心理契约与离职倾向的现状,比较不同个体特征的员工在心理契约与离职倾向上的差异,探讨员工心理契约与离职倾向的关系。方法以广州市某三甲医院在职员工为研究对象,进行心理契约与离职倾向问卷调查。结果医院员工的个体特征在心理契约与离职倾向上有显著差异,心理契约与离职倾向存在显著负相关,心理契约对离职倾向具有显著的预测力。结论医院管理者要通过公平报酬、增进员工间情感联系、发挥员工所长、增强员工成就感等途径来提升员工与医院的心理契约,降低离职倾向。     

浅谈医院如何留住人才

医院录用人才，可以说仅完成了招聘工作，从人才的招聘、使用、留住来说仅完成了三分之一的工作，如何使用员工．发挥其才能是又一三分之一工作，如何留住他为医院长期效力、创造效益，是最后的三分之一工作，也是最重要的、最难操作的工作。从服务的竞争到技术的竞争，归根结底是人才的竞争。如何有效地应对人才流失的严峻挑战，招聘和留住人才，增强核心竞争力，降低人才流失呢？     

从心理契约角度谈医院人力资源管理

本文概述了心理契约的概念、内容和特点,分析了心理契约在医院人力资源管理中的作用和意义,指出在医院人力资源管理中心理契约构建的障碍、基础、原则和措施。     

新形势下我国公立医院人才管理的思考

人才是医院的核心竞争力，是医院可持续发展的重要资源，本文试从新形势下公立医院人才管理存在的问题入手，分析公立医院人才流失特征和原因，提出了现阶段公立医院留住人才的建议。     

Trust‐based or performance‐based management—a study of employment contracting in hospitals

Hospitals are frequently changing managerial practices due to numerous public sector reforms taking place. In general, these reforms include the making and monitoring of contracts that regulate relations between the hospitals and their professional staffs. The aim of this paper is to discuss some main characteristics of the contracts that regulate the perceived relations between physicians as employees and the public hospital as employer. The theoretical framework is based on a contract theory approach. The empirical data is based on survey data from full‐time employed physicians in the medical and surgical divisions in one of the largest university hospitals in Norway. This study shows that perceived obligations and psychological contracts indicate high degree of relational contracts between the hospital and the physicians. These socio‐cultural elements should be recognized as important mechanisms of coordination and communication when policy makers and hospital managers are designing hospital management control systems. Copyright © 2009 John Wiley & Sons, Ltd.     

The effects of hospitals' governance on optimal contracts: bargaining vs. contracting

We propose a two-stage model to study the impact of different hospitals’ governance frameworks on the optimal contracts designed by third-party payers when patients’ disease severity is the private information of the hospital. In the second stage, doctors and managers interact within either a bargaining or a contracting scenario. In the contracting scenario, managers offer a contract that determines the payment to doctors, and doctors decide how many patients to treat. In the bargaining scenario, doctors and managers strategically negotiate on both the payment to doctors and the number of patients to treat. We derive the equilibrium doctors’ payments and number of treated patients under both scenarios. We then derive the optimal contract offered by the government to the hospital in the first stage. Results show that when the cost of capital is sufficiently low, the informational rent is lower, and the social welfare is higher, in the contracting scenario.     

基于心理契约的医院人力资源管理

论述了将心理契约理论应用于医院人力资源管理,不但有助于管理者全面认识员工的需要,而且体现了“以人为本”的管理理念,提出心理契约理论在医院人力资源管理中的应用措施,以期提升医院人力资源管理水平。     

心理契约理论在医院人力资源管理中的应用

心理契约作为员工和组织之间对于彼此责任与义务的相互期望与理解,具有主观性、互惠性、动态性和效能性的特点,有益于组织的健康发展。将心理契约理论应用于医院人力资源管理,不但有助于管理者全面认识员工的需要,而且体现了“以人为本”的管理理念。本文论述了心理契约理论在医院人力资源管理中的应用措施,以期提升医院人力资源管理冰平。     

心理契约对护士流失影响因素分析及管理对策

目的调查内蒙古医学院附属医院的240名护士的心理契约,以了解护士的需要,提出护士的管理及预防流失的期望与义务,让护理人员能更好的为患者服务。方法通过对240名个专业护士心理契约问卷,采用Likert分级量表,根据各条目在护理人员心中的重要程度可选择＂非常重要,比较重要,重要,一般重要,不重要＂五级,同时还设定开放式问题,做进一步补充。结果医院的护士无论是否选择离职,她们最看重的是医院的领导阶层能否充分看重自己,所在医院是否能为自己提供一个知识信息交流的平台,提供一个健康向上的医院环境。结论心理契约是影响护士流失的一个重要因素,良好心理契约的构建和维护可减少护理人员的流失,稳定护理队伍。医院可通过人力资源管理策略,通过作用于影响护士心理契约的因素,减少护理人员的流失。     

公立医院对知识型员工实施心理契约管理的策略研究

文章从分析心理契约理论入手,在对公立医院知识型员工的特点深入分析的基础上,阐述了在公立医院对知识型员工实施心理契约管理的重要作用,从客观订立心理契约、动态调整心理契约、文化引导心理契约等方面提出心理契约在人力资源管理中的应用策略,并从全面管理心理契约角度提出了预防心理契约破裂的具体思路,以期对提高公立医院人力资源管理水平有所帮助。     

Payment contracts in a preventive health care system: a perspective from operations management

We consider a health care system consisting of two noncooperative parties: a health purchaser (payer) and a health provider, where the interaction between the two parties is governed by a payment contract. We determine the contracts that coordinate the health purchaser–health provider relationship; i.e. the contracts that maximize the population's welfare while allowing each entity to optimize its own objective function. We show that under certain conditions (1) when the number of customers for a preventive medical intervention is verifiable, there exists a gate-keeping contract and a set of concave piecewise linear contracts that coordinate the system, and (2) when the number of customers is not verifiable, there exists a contract of bounded linear form and a set of incentive-feasible concave piecewise linear contracts that coordinate the system.     

The changing psychological contract at work and employee burnout

Today we stand in a vortex of technological, economic, and cultural changes that altered dramatically the world of labor and with it the psychological contract between employers and employees. While the effects of the changed contract at work are usually addressed from an organizational, social or economic perspective, the current article addresses it from a psychological perspective from which one noteworthy cost of the changed psychological contract is employee burnout. The article describes burnout, differentiates it from stress, and proposes an existential perspective to explain its underlying dynamic, using the results of a cross-cultural study of Israeli and American managers as an example. Recent studies on gender differences in management are used to point in the recommended for preventing employee burnout, despite the new psychological contract, namely--a democratic, egalitarian management style.     

Classical versus relational approaches to understanding controls on a contract with independent GPs in South Africa

Contracts have played a central role in public sector reforms in developed countries over the last decade, and research increasingly highlights their varied nature. In low and middle income countries the use of contracts is encouraged but little attention has been paid to features of the setting that may influence their operation. A qualitative case study was used to examine different dimensions of a contract with private GPs in South Africa. Features of the contract are compared with the notions of classical and relational contracts. Formal aspects of the contract such as design, monitoring and resort to sanctions were found to offer little control over its outcome. The relational rather than classical model of contracting offered a more meaningful framework of analysis, with social and institutional factors found to play an important role. In particular, the individual nature of GP practices highlighted the role played by individual motivation where a contract exercised little formal control. Due to the similarity of factors likely to be present, results are argued to be relevant in many other LMIC settings, and policy-makers considering contracts for clinical services are advised to consider the possibility of experiencing a similar outcome.     

Risk factors for injury among construction workers at Denver International Airport

Background The Denver International Airport construction project provided a rare opportunity to identify risk factors for injury on a large construction project for which 769 contractors were hired to complete 2,843 construction contracts. Workers' compensation claims and payroll data for individual contracts were recorded in an administrative database developed by the project's Owner-Controlled Insurance Program. Methods From claims and payroll data linked with employee demographic information, we calculated injury rates per 200,000 person-hours by contract and over contract characteristics of interest. We used Poisson regression models to examine contract-specific risk factors in relation to total injuries, lost-work-time (LWT), and non-LWT injuries. We included contract-specific expected loss rates (ELRs) in the model to control for prevailing risk of work and used logistic regression methods to determine the association between LWT and non-LWT injuries on contracts. Results Injury rates were highest during the first year of construction, at the beginning of contracts, and among older workers. Risk for total and non-LWT injuries was elevated for building construction contracts, contracts for special trades companies (SIC 17), contracts with payrolls over $1 million, and those with overtime payrolls greater than 20%. Risk for LWT injuries only was increased for site development contracts and contracts starting in the first year of construction. Contracts experiencing one or more minor injuries were four times as likely to have at least one major injury (OR &equals: 4.0, 95% CI (2.9, 5.5)). Conclusions Enhancement of DIA's safety infrastructure during the second year of construction appears to have been effective in reducing serious (LWT) injuries. The absence of correlation between injury rates among contracts belonging to the same company suggests that targeting of safety resources at the level of the contract may be an effective approach to injury prevention. Interventions focused on high-risk contracts, including those with considerable overtime work, contracts held by special trades contractors (SIC 17), and contracts belonging to small and mid-sized companies, and on high-risk workers, such as those new to a construction site or new to a contract may reduce injury burden on large construction sites. The joint occurrence of minor and major injuries on a contract level suggests that surveillance of minor injuries may be useful in identifying opportunities for prevention of major injuries. Am. J. Ind. Med. 34:113–120, 1998. © 1998 Wiley-Liss, Inc.