Research and Effect Evaluation of Internal Performance Management Practice in Community Health Service Center in a District of Beijing

Abstract

Background At present, Beijing has formulated a series of performance management policies for community health service centers, most of which focus on assessment and have not yet formed a performance management system. At the same time, there are still many problems in performance management considering the actual work of the centers. On the basis of the original internal performance appraisal system, this study improved the performance management in view of the existing problems, formed a set of performance management system applicable to the district community health service center, provided a reference for the community health service centers to establish a scientific performance management system in the future, and promoted the development of community health service work. Objective To explore the effect of performance management in community health service center. Methods In 2019, this group conducted a baseline survey on the current status of performance management in terms of center position setting, assessment indicators and weights, performance feedback and improvement in 18 community health service centers in Tongzhou District, Beijing. The Delphi expert consultation method was used to determine the evaluation indicators of the implementation effect of performance management, and the Internal Performance Management Manual of Community Health Service Centers (hereinafter referred to as the Manual), which contains 6 first-level indicators (number of services, service utilization, service quality, medical staff performance evaluation, patient satisfaction, and target management) and 34 second-level indicators, was finally determined. 2021, the evaluation of the application effect of the Manual was carried out (number of services, service utilization, service quality, medical staff performance evaluation, patient satisfaction, and target management) . Results The service quantity, service utilization and service quality of key work in 2020 were improved compared with those of the previous year, except for the family doctor contract rate and the real physical examination rate of the elderly, which were slightly lower than the regional average level, other indicators were higher than the regional level; performance management evaluation: Medical staff believed that the salary and workload were relatively matched and very matched increased by 29.8%; the cognition of center development goals, department development goals and individual work priorities increased by 15.6%, 13.2% and 2.6% respectively; the assessment indicators were in line with the actual work increased by 20.6%; reasonableness of index weight value and the secondary performance distribution of departments and stations increased by 19.4% and 8.3% respectively; the incentive that is strong increased by 18.3%; the performance improvement effect increased by 18.1% significantly; the overall satisfaction with performance management increased by 11.8%. Resident satisfaction: satisfaction with chronic disease management, children's health management, medical staff's technical level, and medical treatment results improved to varying degrees. Year-end assessment of district level: except for 1 center whose ranking remained unchanged, the rest of the centers were all improved. Salary: annual per capita incomes of on-the-job workers, doctors, nurses, and preventive and public health personnel increased by 5.2%, 7.6%, 8.4%, and 10.4% respectively, which was forty seven, eighty seven, forty four and thirty nine thousand higher than that of the whole region. Conclusion After the demonstration of community health service centers with different economic development levels, the application effect of the performance management system is remarkable, which improves the quantity and quality level of key work in the community, enhances the enthusiasm and service ability of medical staff, and then improves the satisfaction of patients, and it has certain promotion value. However, the number of centers that apply performance management system is limited and the time is short, so it is necessary to expand the application scope and continue to track the application situation in the future.

Keywords

• community health services|performance management|effect evaluation|beijing