Development of a System for Assessing Family Doctor Team Members' Performance by the Team Leader

doi:10.12114/j.issn.1007-9572.2021.00.147

Abstract

Abstract: Backgroud　Since 2014，Chengdu's Wuhou District has initiated primary care transformation，delivering person-centered active care by the family doctor team，and assessing the team performance as well as each member's performance（by the team leader）. However，there is no available easy-to-use system for assessing the team members' performance scientifically，rationally and effectively by the team leader. Objective　To develop a system for assessing the performance of each member of a family doctor team by the team leader，offering guidance on carrying out rational and scientific performance assessment within the family doctor team. Methods　We used literature review to develop the first draft of a system for assessing the performance of family doctor team members by the team leader. Based on this draft，we developed a questionnaire and used it to conduct two rounds of surveys with relevant experts using the Delphi technique between July 2019 and February 2020 for obtaining their ideas and opinions，and determined the content of the system after revising it according to the survey results. We determined the weight of each dimension，index and subindex of the system by principal component analysis. Results　The response rates of the two rounds of expert consultation were 100.0%（35/35） and 100.00%（25/25），respectively. The mean coefficients of Cs，Ca and Cr were（0.71±0.05）（0.79±0.12）（0.87±0.09） for the first round of survey，respectively，and were（0.74±0.13）（0.88±0.10）（0.81±0.10） for the second round of survey，respectively. The Kendall's W for the first and second consultations were 0.177（χ2=322.054，P<0.001） and 0.215（χ2=242.762，P<0.001），respectively. The final system consists of 3 dimensions，10 indices and 23 subindices，with corresponding weights assigned. Specifically，the dimensions include face-to-face services，non face-to-face services，face-to-face services/non face-to-face services，with weights of 0.400 0，0.100 0，0.500 0，respectively. Conclusion　This system for assessing the performance of family doctor team memebers by the team leader could be used as a tool for objectively and scientifically evaluating the performance of family doctor team memebers.

Key words: Contracted family doctor services, Family doctor team, Job performance, Delphi method, Principal components analysis, Indicator system

摘要： 背景　成都市武侯区自2014年开始“基层医疗转型”，开展以人为中心主动化健康管理服务模式（PCAC）的家庭医生签约服务，以家庭医生团队为单位进行家庭医生签约服务考核，同时团队长在团队内部进行二次考核，但是目前缺乏科学、合理、有效、易于操作的团队内部使用的考核指标体系。目的　构建一套家庭医生签约服务团队内部工作评价指标体系，为家庭医生团队合理、科学地评价团队内部工作提供指导。方法　采用文献回顾、德尔菲法等研究方法，初步建立家庭医生团队内部签约服务评估指标体系并编制专家咨询问卷。于2019年12月—2020年3月采用德尔菲专家咨询法，经两轮专家咨询，确定了家庭医生团队内部签约服务评价指标体系，通过主成分分析法确定指标权重。结果　两轮专家咨询表的回收率分别为100.0%（35/35）和100.0%（25/25）。两轮专家咨询的熟悉程度分别为（0.71±0.05）和（0.74±0.13），判断依据分别为（0.79±0.12）和（0.88±0.10），权威系数分别为（0.87±0.09）和（0.81±0.10）。两轮专家咨询的肯德尔协调系数分别为0.177（χ2=322.054，P<0.001）和0.215（χ2=242.762，P<0.001）。最终构建了一套包含3个一级指标〔面对面服务（0.400 0）、非面对面服务（0.100 0）、面对面/非面对面服务（0.500 0）〕、10个二级指标、23个三级指标及其权重的家庭医生签约服务团队内部考核指标体系。结论　本研究构建了家庭医生签约服务团队内部考核指标体系，可客观、科学地评估家庭医生签约服务团队内部服务。

关键词: 家庭医生签约服务, 家庭医生团队, 工作绩效, Delphi法, 主成分分析法, 指标体系

ZHANG Jingyu,LIU Lixia,WANG Xiaogang, et al. Development of a System for Assessing Family Doctor Team Members' Performance by the Team Leader　[J]. Chinese General Practice, 2021, 24(25): 3244-3249. DOI: 10.12114/j.issn.1007-9572.2021.00.147.
张璟瑜,刘利霞,王小刚等. 家庭医生签约服务团队内部考核指标体系构建研究[J]. 中国全科医学, 2021, 24(25): 3244-3249. DOI: 10.12114/j.issn.1007-9572.2021.00.147.

References

［1］殷东，张家睿，王真，等. 中国家庭医生签约服务开展现状及研究进展［J］. 中国全科医学，2018，21（7）：753-760. DOI：10.3969/j.issn.1007-9572.2018.07.001.
YIN D，ZHANG J R，WANG Z，et al. Delivery status of contractual services from family doctors in China and advances in the related studies［J］. Chinese General Practice，2018，21（7）：753-760. DOI：10.3969/j.issn.1007-9572.2018.07.001.
［2］欧伟麟，沈欢瑜，欧文森，等. 基于德尔菲法的广东省全科团队家庭医生式签约服务绩效考核指标体系构建研究［J］. 中国全科医学，2018，21（7）：795-799. DOI：10.3969/j.issn.1007-9572.2018.07.008.
OU W L，SHEN H Y，OU W S，et al. Development of a performance evaluation indicator system for contranctual services from a general practioner team in Guangdong Province based on the Delphi menthod ［J］. Chinese General Practice，2018，21（7）：795-799. DOI：10.3969/j.issn.1007-9572.2018.07.008.
［3］李兴春，李华. 我国家庭医生签约服务现状及存在问题研究进展［J］. 中国社区医师，2018，34（22）：11-13，15. DOI：10.3969/j.issn.1007-614x.2018.22.004.
LI X C，LI H. Research progress of present situation and existing problems of the signing service of family doctor in China［J］. Chines Community Doctors，2018，34（22）：11-13，15. DOI：10.3969/j.issn.1007-614x.2018.22.004.
［4］孙涛，曹秋茹，张淑娥，等. 城市社区全科医生职业满意度及其影响因素［J］. 中华全科医学，2017，15（2）：183-185. DOI：10.16766/j.cnki.issn.1674-4152.2017.02.001.
SUN T，CAO Q R，ZHANG S E，et al. The influence factors of career satisfaction of general practitioner in city's community health service institution［J］. Chinese Journal of General Practice，2017，15（2）：183-185. DOI：10.16766/j.cnki.issn.1674-4152.2017.02.001.
［5］刘姗姗，吴俊，李明，等. 基层全科医生的工作胜任度及满意度研究［J］. 中国全科医学，2019，22（10）：1218-1222. DOI：10.12114/j.issn.1007-9572.2019.10.017.
LIU S S，WU J，LI M，et al. Job competencies and satisfaction in grassroots general practitioners［J］. Chinese General Practice，2019，22（10）：1218-1222. DOI：10.12114/j.issn.1007-9572.2019.10.017.
［6］刘彩茵，何婷婷，王全. 基层医务人员的家庭医生签约服务政策响应度及工作满意度研究［J］. 中国全科医学，2019，22（10）：1160-1164. DOI：10.12114/j.issn.1007-9572.2019.10.006.
LIU C Y，HE T T，WANG Q. Responses to supportive policies for the implementation of contracted family doctor services and job satisfaction in primary healthcare workers［J］. Chinese General Practice，2019，22（10）：1160-1164. DOI：10.12114/j.issn.1007-9572.2019.10.006.
［7］吴军，沈安，陆旻. 全科服务团队模式下家庭医生绩效考核的方法探讨［J］. 中国全科医学，2011，14（31）：3543-3545. DOI：10.3969/j.issn.1007-9572.2011.31.003.
WU J，SHEN A，LU M. Methods for performance appraisal of family doctors in general service team model［J］. Chinese General Practice，2011，14（31）：3543-3545. DOI：10.3969/j.issn.1007-9572.2011.31.003.
［8］葛承辉，邵乐琴，朱月伟，等. 社区责任医生团队年度公共卫生工作目标量化考核方法研究［J］. 中国全科医学，2013，16（17）：1462-1465. DOI：10.3969/j.issn.1007-9572.2013.05.004.
GE C H，SHAO L Q，ZHU Y W，et al. Evaluation methods of annual public health work objectives of community responsibility doctor team［J］. Chinese General Practice，2013，16（17）：1462-1465. DOI：10.3969/j.issn.1007-9572.2013.05.004.
［9］肖俐，黄睿，陈博文. 社区卫生服务中心团队绩效考核方案实施效果研究［J］. 中国全科医学，2015，18（31）：3781-3786. DOI：10.1969/j.issn.1007-9572.2015.31.004.
XIAO L，HUANG R，CHEN B W. Effect of team performance appraisal for community health service centers［J］. Chinese General Practice，2015，18（31）：3781-3786. DOI：10.1969/j.issn.1007-9572.2015.31.004.
［10］王冬阳，陈永年，方佩英，等. 江苏省家庭医生签约服务工作现状及满意度研究［J］. 中国全科医学，2018，21（19）：2297-2302. DOI：10.3969/j.issn.1007-9572.2018.00.019.
WANG D Y，CHEN Y N，FANG P Y，et al. Current status of family doctor contracted services and its satisfaction degree in Jiangsu Province［J］. Chinese General Practice，2018，21（19）：2297-2302. DOI：10.3969/j.issn.1007-9572.2018.00.019.
［11］AHRQ. CAHPS：assessing health care quality from the patient's perspective［EB/OL］. （2011-11-16）［2020-07-03］. https://www.cahps.ahrq.gov/content/products/PROD_FacilitiesSurveys.asp.
［12］BERLOWITZ D，BRAND H，PERKINS C. Geriatric syndromes as outcome measures of hospital care：can administrative data be used?［J］. JAGS，1999，47（6）：692-696. DOI：10.1111/j.1532-5415.1999.tb01591.x.
［13］JOHANTGEN M，ELIXHAUSER A，BALI J K，et al. Quality indicators using hospital discharge data：state and national applications［J］. Jt Comm J Qual Improv，1998，24（2）：88-105. DOI：10.1016/S1070-3241(16)30364-9.
［14］王小刚，杨梓钰，代晓怡，等. 以人为中心的主动健康管理服务模式下签约服务核心团队配置研究［J］. 中国全科医学，2019，22（13）：1542-1547. DOI：10.12114/j.issn.1007-9572.2019.00.217.
WANG X G，YANG Z Y，DAI X Y，et al. The personal allocation of core family doctor team for contract service under the people-centered active care model［J］. Chinese General Practice，2019，22（13）：1542-1547. DOI：10.12114/j.issn.1007-9572.2019.00.217.
［15］周明浩，李延平，史祖民. 德尔菲法在卫生城市建设综合评价指标中的应用［J］. 中国公共卫生管理，2002，17（4）：260-263.

[1]	HAO Aihua, ZENG Weilin, LI Guanhai, XIA Yinghua, CHEN Liang. Current Situation of the Construction of Family Doctor Team: an Investigation Based on the Perspective of General Practitioners [J]. Chinese General Practice, 2023, 26(34): 4261-4268.
[2]	LIU Rui, CAO Yu, CHU Aiqun, WU Huanyun. Current Situation of Community Pharmacy Services and the Integration of Pharmacists into Family Doctor Team in Shanghai [J]. Chinese General Practice, 2023, 26(31): 3922-3929.
[3]	GUO Jia, SUN Huajun, CHEN Ying, ZHANG Jiawen, ZHANG Yaxin, MA Ying, DU Yue. Construction of On-site Evaluation Index System for Integration of Medical and Preventive Services for Chronic Diseases in Primary Health Care Institutions [J]. Chinese General Practice, 2023, 26(28): 3489-3495.
[4]	YIN Zhaoxia, KONG Chongyu, ZOU Xianhui, LI Chuang, HUANG Yin, FENG Yang, WANG Yunfei, GONG Weijie. Traditional Chinese Medicine Disease Spectrum Analysis in Outpatient Clinics of Contracted Residents by Family Doctors in Shenzhen Community Health Service Centers [J]. Chinese General Practice, 2023, 26(25): 3112-3117.
[5]	GUO Yahong, GUO Haoqian, NING Yanhua, JIANG Ting, LI Meiman, LYU Xiongxiong, KONG Weijuan, LIU Haiyan. Construction of "Internet+" Family Nursing Management Model for the Elderly Based on Contracted Family Doctor Services [J]. Chinese General Practice, 2023, 26(23): 2876-2881.
[6]	ZHAO Linlin, SHAO Shuang, LUO Qi, CHEN Xiaolei, DU Juan. Practice Strategy of Treatment-prevention Integration of Family Doctor Team in China [J]. Chinese General Practice, 2023, 26(22): 2715-2719.
[7]	XU Yifan, JING Limei, WANG Lili, WANG Zhaolin, LI Yuhan, LU Wenyuan, ZHANG Qinhua, WANG Haoran, JING Jiaheng, LI Shuijing. Development of a Comprehensive Assessment System of Hospice Care [J]. Chinese General Practice, 2023, 26(22): 2793-2799.
[8]	PAN Shasha, MA Chengcheng, CUI Lu, LI Chanjiao, NI Ziling. Development, Reliability and Validity of the Chinese Version of Primary Care Team Dynamics Scale [J]. Chinese General Practice, 2023, 26(16): 2047-2054.
[9]	XU Jiayu, YAN Hua, FANG Junbo, WANG Haiqin, GUO Pei, SHEN Fulai, WANG Xingsong. Standardized Workload-based Analysis of the Services Delivered by a Family Doctor Team in a Community Health Institution [J]. Chinese General Practice, 2023, 26(13): 1641-1647.
[10]	MENG Wenqi, LIU Songyi, JIANG Xiaoli, PENG Haibo, LI Zixin, YU Qianqian, YIN Wenqiang, SUN Kui, CHEN Zhongming, GUO Hongwei. Mechanisms Affecting the Effectiveness of Contracted Family Doctor Services: a Grounded Theory Analysis [J]. Chinese General Practice, 2023, 26(10): 1192-1197.
[11]	SUN Jingjing, ZHANG Yan, KUANG Wenbo, LUO Yimeng, HUANG Pengqun, MAIREYAMUGULI· Aihemaiti, JIN Mengyuan, GAO Zeyu, DU Hanlin, DAI Xiaojie. Willingness to Refer Patients with Common Illnesses to Lower Level Institutions and Associated Factors in County Hospital Physicians [J]. Chinese General Practice, 2023, 26(10): 1205-1211.
[12]	MA Zhiqiang, WU Xianglan. The Doctor-patient Trust in General Practice Service and Its Countermeasure Suggestions Based on Trusted Source Model [J]. Chinese General Practice, 2023, 26(10): 1172-1178.
[13]	LIU Lanping, YANG Yue, HUANG Man, MA Xiaojing, YE Yongming, LIU Xiaoxu, LIN Huize, ZHU Kexin, GUO Shengnan, FEI Yutong, YANG Tao, YU Jinna. Identification of Clinical Questions for the Development of Clinical Practice Guideline on Acupuncture and Moxibustion for Nonspecific Low Back Pain Using the Modified Delphi Method [J]. Chinese General Practice, 2023, 26(09): 1037-1043.
[14]	MA Zhiqiang, ZHANG Baoli, GUO Le. Development, Reliability and Validity of the General Practitioner Competency Rating Scale for Assessing General Practitioners' Competencies in Delivering Contracted Healthcare Services [J]. Chinese General Practice, 2023, 26(04): 477-485.
[15]	LI Xinyan, HAN Youli. Effects and Implications of Introducing Competition Mechanisms in the Delivery of Contracted Family Doctor Services [J]. Chinese General Practice, 2023, 26(04): 447-452,459.