基于DRGs和RBRVS的护士绩效薪酬改革方案的探索

目的将DRGs与RBRVS结合起来用于护士的绩效改革方案,更好地评估护士的工作量,提高护士的工作积极性。方法采用文献评阅及回顾性分析方法,利用DRGs和RBRVS两种评价方法,在新疆某三甲医院针对不同类型的科室建立两种护理绩效评价模型,并回顾性分析了2018年9月、10月、11月的病例数据,将两种方案与现有方案进行对比,以寻求最适合科室的护理绩效管理方案。结果建立的两种护理绩效评价模型与现有方案相比,不同科室的工作量绩效均有不同程度的增长或下降。结论新建立的两种模型可以分别应用到重症监护体系和普通病区,重症监护体系采用方案一,CMI值正好可以反映重症科室的特点;在普通科室采用方案二,通过DRG的护理操作权重及数量可以体现护士工作量实现绩效管理的精细化、科学化。

Nurse Performance Salary Reform Scheme Based on DRGs and RBRVS

ObjectiveThe combination of DRGs and RBRVS was used in the performance reform scheme of nurses to better evaluate the workload of nurses and improve their work enthusiasm.MethodsThe literature review and retrospective analysis was used with two evaluation methods of DRGs and RBRVS,two nursing performance evaluation models were established for different types of departments in a tertiary hospital in Xinjian. The patient's data of September, October and November of 2018 were retrospectively analyzed, and the two schemes were compared with the existing scheme to find the most suitable nursing performance management scheme for the department.ResultsCompared with the existing scheme, the two nursing performance evaluation models increased or decreased the workload performance of different departments to different degrees.Conclusion The two newly established models can be applied to the critical care system and the general ward respectively. The CMI value can exactly reflect the characteristics of the critical care department with using the scheme one in the critical care system. The scheme two could be adopted in general departments, which the weight and quantity of nursing operation of DRG could reflect the workload of nurses and realize the refined and scientific performance management.