摘要
目的期望建立一个客观、公允的护理劳动强度和风险评价模型,作为护理定岗定编和绩效管理的依据。方法利用量表抽样统计和业务数据量化评价相结合的方法,确定不同护理单元的风险等级。参考以资源为基础的相对价值系数,从精神压力、生理负荷、风险程度、技术难度4个维度设计量表。引入量表的信度和效度分析方法,依据效度对量表进行校正。在信度可信的前提下,再使用聚类方法对各护理单元的业务数据进行量化分析,依据结果对抽样统计数据进行校正,计算各等级的对应系数或权重。结果该评价模型取得的结果与医院管理者和一线护理人员的预期较为一致;将研究结果用于10余家不同类型医院的护理岗位定岗定编和绩效管理,取得了较好的效果。结论通过量表抽样统计建立护理风险评价模型具有可行性,关键在于抽样方法科学,量表信度分析结果可靠。由于医院收费数据受到数据采集时点、医院业务特点等因素限制,不能以客观业务数据作为护理单元风险等级的主要依据。如果使用全部临床业务数据,可能会更准确,或者可以考虑替代量表调查的方式建立新的评价模型。
Objective The paper aims to build an objective and fair evaluation model for nursing labor intensity and risk as the basis for the definition of work posts and personnel quota and the performance management of nursing. Method Scale sampling statistics and business data quantification and evaluation are combined to determine the risk ranks of different nursing units. The scale is designed based on four dimensions, namely, mental stress, physiological load, risk degree, and technical difficulty, by reference to the resource-based relative value scale(RBRVS). Reliability and validity analysis is introduced into the scale to correct it on the basis of validity. On the premise of reliability, clustering method is used to quantitatively analyze the business data of nursing units. The statistical data of sampling are corrected based on the analysis result to calculate the coefficient or weight corresponding to each rank. Result The result obtained by the evaluation model is basically consistent with the expectation of hospital managers and frontline nursing personnel. Relatively good effect is achieved when the study result is applied in the definition of nursing work posts and personnel quota and the performance management of over 10 hospitals of different types. Conclusion The nursing risk evaluation model built through scale statistics and sampling is feasible, and the key lies in the scientific sampling method and the reliable analysis result of scale reliability. Because the data of hospital charges are restricted by factors like data acquisition time, hospital business characteristics, and so on, it is not advisable to take objective business data as the main basis for risk rank of nursing unit. If all clinical business data are adopted, the result may be more accurate; or we can consider building a new evaluation model by replacing scale survey.
出处
《中国医疗管理科学》
2016年第1期23-29,共7页
Chinese Journal Of Medical Management Sciences
关键词
绩效管理
护理单元
劳动强度
风险评价
定岗定编
Performance Management
Nursing unit
Labor intensity
Risk evaluation
Definition of work posts and personnel quota
