Khan Naghma S, Simon Harold K
Departments of Pediatrics and Emergency Medicine, Hughes Spalding Children's Hospital, Grady Health System, Emory University School of Medicine, 1405 Clifton Road NE, Atlanta, GA 30028.
Acad Emerg Med. 2003 Aug;10(8):904-7. doi: 10.1111/j.1553-2712.2003.tb00639.x.
Relative value units exist for measuring clinical productivity. Limited objective measures exist, however, for nonclinical activities, specifically teaching.
To develop an objective measure of teaching productivity linked to a performance-based incentive plan.
Teaching goals and objectives were identified before the 1998-1999 academic year. Teaching value units (TVUs), objective measures for quantifying teaching activities, were developed and assigned based on an estimation of time needed to complete each activity and weighted for importance to the teaching mission. Each physician was allocated teaching time based on past performance and future goals. Targeted TVUs necessary to meet expectations were proportionate to allocated teaching time. Teaching productivity was defined as a percentage of targeted TVUs achieved. Incentive dollars for teaching were distributed based on percentage of targeted TVUs achieved, weighted individually for teaching load.
Teaching productivity was evaluated over a three-year period. In year 1, mean TVUs allocated/physician were 181 units (range 25 to 449). Four of 18 physicians (22%) met expectations. The mean individual TVUs achieved were 54% of expected (range 0% to 114%). By year 3, mean TVUs allocated/physician were 179 (range 45 to 629). Twelve of 22 physicians (55%) met expectations. The mean individual TVUs achieved were 82% of expected (range 11% to 146%). Between year 1 and year 3, group productivity increased from 73% to 88%, and mean individual productivity increased from 54% to 82% (p = 0.01).
The development of a TVU-based system enabled objective quantification and monitoring of a broad range of teaching activities. The TVU-based system linked to an incentive plan helped to increase individual and group teaching productivity.
存在用于衡量临床工作效率的相对价值单位。然而，对于非临床活动，特别是教学，客观的衡量方法有限。
制定一种与基于绩效的激励计划相关的教学工作效率客观衡量方法。
在1998 - 1999学年之前确定教学目标。开发了教学价值单位（TVU），这是用于量化教学活动的客观衡量指标，并根据完成每项活动所需时间的估计进行分配，并对教学任务的重要性进行加权。根据每位医生过去的表现和未来目标分配教学时间。达到预期所需的目标TVU与分配的教学时间成比例。教学工作效率定义为实现的目标TVU的百分比。基于实现的目标TVU的百分比分配教学激励资金，并根据教学负荷进行个体加权。
在三年期间对教学工作效率进行了评估。在第1年，每位医生分配的平均TVU为181个单位（范围为25至449）。18位医生中有4位（22%）达到预期。实现的平均个体TVU为预期的54%（范围为0%至114%）。到第3年，每位医生分配的平均TVU为179（范围为45至629）。22位医生中有12位（55%）达到预期。实现的平均个体TVU为预期的82%（范围为11%至146%）。在第1年和第3年之间，团队工作效率从73%提高到88%，平均个体工作效率从54%提高到82%（p = 0.01）。
基于TVU的系统的开发实现了对广泛教学活动的客观量化和监测。与激励计划相关的基于TVU的系统有助于提高个体和团队的教学工作效率。
