基于病种临床路径的门急诊绩效考核机制探索

为改变以工作量为导向的传统门急诊绩效分配模式，通过建立并试行门急诊优势病种电子化临床路径，结合“多劳多得、优绩优酬”的考核新思维，建立了以临床专业能力评价、医师工作量贡献、医师劳务贡献及分配方式改变等为核心的多维度门急诊绩效考核新机制。实践以来，30个优势病种的门急诊量与同期相比增加8.9%，临床路径入组率达89.2%，完成率达91.5%，患者满意度从92.1%提升至97.2%，90%以上的医务人员收入明显增加。绩效引导下的门急诊病种临床路径管理方法可充分调动医务人员工作积极性，有效提高医师工作效率和临床服务能力，进而改善患者就医体验，提升门急诊服务质量与水平

Exploration of Performance Evaluation Mechanism of Outpatient and Emergency Department Based on Clinical Pathway of Diseases

In order to change the workload-oriented traditional outpatient and emergency department performance allocation model, the outpatient and emergency electronic clinical pathway for superior diseases was established and preliminary applied. Combined with the new conception of "more pay for more work and more pay for better work", a new multi-dimensional outpatient and emergency department performance evaluation mechanism was established based on professional competence evaluation, physician workload contribution, physician labor contribution, and changes in distribution methods. Since the practice, the workload of outpatient and emergency predominant diseases increased by 8.9% compared with the same period, the enrollment rate of clinical pathways had reached 89.2%, the completion rate had reached 91.5%, and the patient satisfaction rate had reached 97.2% from 92.1%; Furthermore, more than 90% of medical staff's income increased significantly. Performance guided clinical pathway management had improved the enthusiasm of medical staff, effectively improved physicians' efficiency and clinical service ability, and improved the patients' medical experience, enhanced the medical service ability of outpatient and emergency department