无公差目标：对医务人员的不当评估。
Targets without tolerances: improper evaluation of medical personnel.
作者信息
Butler Robert S, Johnston Douglas, Kattan Michael W
机构信息
Department of Quantitative Health Sciences, Cleveland Clinic, Cleveland, OH, USA.
Heart and Vascular Institute, Cleveland Clinic, Cleveland, OH, USA.
出版信息
Ann Transl Med. 2018 Apr;6(8):149. doi: 10.21037/atm.2018.03.35.
BACKGROUND
Mandated assessment of medical personnel by comparing individual performance averages to external targets is standard practice in many health care systems. This method of assessment uses only raw or adjusted averages without considering the associated variation. Failure to correctly incorporate variation in the assessment of medical personnel results in evaluations which are neither accurate nor fair with respect to assessing personnel performance.
METHODS
Accepted statistical methods for process evaluation and quality control, including regression, control charts, and adjusted means comparisons will be used to analyze hospital length of stay (LOS) patient data for the period between January and October 2010 for 12 physicians in the Cardiothoracic Surgery service line at the Cleveland Clinic.
RESULTS
The analysis and interpretation of physician performance data using both targets and tolerances results in physician performance ratings which differ significantly from performance ratings based only on targets.
CONCLUSIONS
Failure to include variation when assessing medical personnel performance results in a system of ranking, rewarding, and punishing based primarily on blind chance instead of one based on actual personnel performance.
背景
通过将个人绩效平均值与外部目标进行比较来对医务人员进行强制评估，这在许多医疗保健系统中都是标准做法。这种评估方法仅使用原始或调整后的平均值，而不考虑相关的变异。在评估医务人员时未能正确纳入变异，会导致在评估人员绩效方面既不准确也不公平的评价。
方法
将使用用于过程评估和质量控制的公认统计方法，包括回归分析、控制图和调整均值比较，来分析2010年1月至10月期间克利夫兰诊所心胸外科服务线12名医生的住院时间（LOS）患者数据。
结果
使用目标和公差对医生绩效数据进行分析和解释，得出的医生绩效评级与仅基于目标的绩效评级有显著差异。
结论
在评估医务人员绩效时不考虑变异，会导致一个主要基于盲目机会而非基于实际人员绩效的排名、奖励和惩罚系统。
Zotero 插件