Recently, our unit is adjusting the performance distribution plan, but after the adjustment, we found that most people have less money!
Whether it is between departments, between clinical and medical technology, or between superiors and subordinates, there are quite a few criticisms of the new plan. Some colleagues couldn't help but joke, how did this performance adjustment plan make everyone dissatisfied?
The adjusted per capita performance of the medical technicians in the laboratory department is 1,000 yuan less than before, and the adjusted overall performance of the medical and technical department is 8,000 yuan less than that of the clinical department!
A leader in the laboratory department is also a senior deputy high, and he has never cared much about performance distribution. And after the new performance came out in the first month, he was nearly 2,000 yuan less than his laboratory doctor! According to the old plan, his performance was 2,000 yuan more than that of the laboratory doctor. The deputy director was indignant and finally offered to resign.
So, how is the performance pay deducted step by step? Why is there such a big difference before and after the adjustment? Next, the author will calculate the account in detail.
One, two, three generations
Increasingly complex accounting models
1. Accounting model based on the balance of income and expenditure
This is the 1.0 version of the prize distribution. The hospital distributes performance bonuses to the monthly balance of income and expenditure, but the difference between the departments is not large, the income cannot be separated, and the busy departments such as the laboratory department and the nursing department, which are "less people, more things, and low status", do not get more money.
2. Performance-based accounting model
This model began to introduce the concept of performance in the distribution of bonuses, and the income of different departments was different. However, if the difference in the number of patients at a certain time is too large, it is easy to cause "drought death and waterlogging death" between departments, causing dissatisfaction among some departments.
For example, some time ago, the respiratory department was full of patients, and the per capita performance of respiratory doctors in some hospitals was 10,000 more than that of obstetrics and gynecology. However, with the non-stop busyness, the amount of testing and workload have increased significantly, but the performance has not seen a significant difference.
3. A mixed accounting model for income and expenditure balances and performance
Versions 1.0 and 2.0 were not perfect, so version 3.0 was born, which appropriately introduced "leverage allocation" - using the balance of income and expenditure indicators to measure bonuses, and set up multiple metrics to balance the workload and quality of work allocation performance.
The new performance plan of our unit is also the 3.0 version adopted, and our initial performance depends on various indicators such as the output value of the department's business, the number of patients tested, and the TAT turnover rate.
However, this initial amount is not the final amount received, and the money received still needs to be based on the initial amount, plus special performance rewards and minus special performance deductions. In other words, the total performance of the month is composed of three parts, 25% of the job performance, 70% of the workload performance, and 5% of the work quality performance.
In addition, the performance distribution should also refer to the number of attendance days, post coefficient, workload points, work quality scores, etc. of each person in the current month in order to finally calculate the performance bonus of the inspector in the current month.
The performance gap is really widened
It turned out to be this one!
It's a bit boring to look at the scheme alone, so let's give an example!
There are a total of 4 laboratory physicians in the laboratory department (including 1 department director, 1 deputy chief physician and 2 laboratory physicians). According to the calculation of the financial department, the initial performance of employees in the month was 12,000 yuan, and the section director did not participate in the secondary distribution, and the performance of the month was 4,800 yuan. The remaining three laboratory physicians assign the remaining performance.
If the special performance reward of the month is 200 yuan, and the special performance deduction is 800 yuan, the total performance of the month is 12000 + 200-800 = 11400 yuan. In other words, the remaining 3 laboratory physicians in the department jointly distributed the 11,400 yuan.
Among the 11,400 yuan, according to the proportion of job performance, workload performance, and work quality performance, it can be obtained: the total post performance is 2,850 yuan, the total workload performance is 7,980 yuan, and the total work quality performance is 570 yuan.
The post coefficient of the deputy chief physician is 1.32/day, and the post coefficient of the laboratory physician is 1.22/day, and the actual number of working days in the month is 25 days according to the single and double days off each month. Therefore, the post coefficient of the deputy chief physician is 33 yuan, and the post performance is 1000 yuan, and the post coefficient of the laboratory physician is 30.5, and the post performance is 925 yuan.
None of the three physicians were complained or praised by patients that month, and the quality performance was the same, 190 yuan.
It can be seen from this that the real place to open the gap between each person's performance is in the workload performance!
As we all know, the workload of the laboratory department is basically different, if you are particularly busy this month, then your workload points will be high, and the proportion of the total workload in the department will definitely be high.
Therefore, the department continued to distribute, and the workload score of the deputy chief physician was 8800 points, and the performance was 2712 yuan; the laboratory physician A was very busy in the month, the workload score was 11999 points, and the performance was 3698 yuan; the workload score of the laboratory physician B was 5096 points, and the performance was 1570 yuan.
Based on all the above performances, we can conclude that the performance of the deputy chief physician in the month was 3902 yuan, the laboratory physician A received 4813 yuan, and the laboratory physician B received 2685 yuan. In this way, the performance of the deputy high school will indeed be inferior to that of ordinary laboratory physicians with a large workload.
No matter how you divide the performance
will feel unfair!
In fact, the new plan is to use performance to motivate business growth, and the starting point is certainly not a problem. However, when it comes to the issue of performance distribution, it is actually unfair how to allocate medical staff. The author has seen too many incidents of medical staff complaining about the unfair distribution of performance, which mainly includes four aspects: unfair distribution of medical care, unfair distribution between doctors, unfair distribution between clinical and medical technology, and unfair distribution between clinical and logistics.
The "unfair distribution between clinical and logistical" is particularly vehement. Every time it comes to the performance sharing, almost all the major online platforms have medical staff complaining "Why does the logistics not generate income but still share such a high performance?" Although the question is raised every time, it is always difficult to solve.
A medical staff once wrote: "People in the logistics department can get average performance without clinical contact, night shifts, and off-duty shifts." Through unremitting efforts, the clinical department does not leave after the night shift, and the performance is barely on par with the logistics department.
Judging from these complaints, the clinical front-line medical staff mainly think that the logistics staff are "idle", less risky, and have higher salaries than the clinical front-line...... This, of course, leads to an imbalance in the minds of frontline medical staff. But it is undeniable that no matter which department it is, there must be people who really work hard, and the work of these people is often very irreplaceable.
However, while there are many points for logistics performance, many regions have issued documents to limit the performance of logistics staff to no more than clinical medical personnel. For example, on January 15, 2024, the Baotou Municipal Health Commission, the Municipal Finance Bureau and the Baotou Municipal Human Resources and Social Security Bureau of Inner Mongolia jointly issued and implemented the "Work Plan for Deepening the Reform of the Performance Pay System of Public Hospitals in Baotou City (Trial)", which introduced ten measures for the reform of the performance pay system of medical staff, which once again sparked heated discussions in the industry.
Among them, the most interesting is the internal distribution of performance-based pay in public hospitals. The plan points out that it fully reflects the value of knowledge, technology, management and other elements, reflects the differences in medical, nursing, technology, medicine, management and other positions, reasonably widens the income gap, and avoids egalitarianism. Among them, the average performance pay of medical and technical department personnel, nursing staff, administrative and logistics personnel shall not be higher than 80%, 70% and 50% of the average performance salary of clinicians.
To be honest, there will be arguments about how performance is divided, as a medical worker in Shanghai said: "If you don't suffer from a small number, you will suffer from unevenness, and whoever gives more or less will have complaints......
At present, many hospitals are exploring and piloting performance reforms, but "how to change" and "how to improve" are still unknown. When we evaluate whether a performance plan is appropriate, we must start from the feelings of the medical staff and listen to their voices, so as to avoid this situation that most people are not satisfied.
Source: Lilac Talent