1 Problems in salary management in public hospitals

1. 1 The performance appraisal index system is not comprehensive enough.

Hospital performance appraisal is mainly based on the workload, work efficiency, work quality and post task completion of medical staff. Most indicators are artificially designed and weighted, and it is difficult for the traditional performance appraisal model to significantly stimulate employees' work attitude and efficiency. There are still many practical problems in the specific implementation process:

(1) The purpose of performance appraisal is not strong;

(2) The setting of relevant assessment content and assessment cycle is not scientific enough;

(3) The standardization and institutionalization of evaluation need to be improved;

(4) Assessment is a mere formality, and the necessary incentives are neglected for management, especially the excessive qualitative assessment indicators and too few quantitative indicators, which leads to unscientific and unreasonable salary distribution and affects the work enthusiasm of hospital employees to some extent.

1.2 salary distribution assessment standard is outdated.

At present, most public hospitals still implement the hierarchical wage system, which is characterized by determining the wage level by factors such as position, education, working years and term of office. This salary system is characterized by taking qualifications and jobs as important indicators, so it can not truly reflect the role of medical ability and work performance in salary distribution, which leads to the wrong view of medical staff on salary, that is, the quantity and quality of work have nothing to do with income. This standard can't give full play to the incentive function of salary itself, which will inevitably lead to low overall work efficiency and the loss of outstanding talents, and can't make outstanding talents with clinical talents stand out.

1.3 The professional level of human resource management team needs to be strengthened.

As a part of human resource management, the quality of human resource management team also determines whether there is a professional salary management team. Very few hospital human resource managers have received systematic theoretical training in hospital human resource management, most of them are not graduates majoring in health management, lacking theoretical knowledge, relying on qualifications, experience or administrative orders to manage, lacking theories and methods needed by modern hospital human resource management such as modern management, economics, psychology and law, lacking innovation and scientificity, which is far from the professional requirements of human resource management. It is difficult for such a management team to effectively manage hospital human resources.

1.4 unreasonable salary structure design and low performance pay ratio have inhibited the innovative spirit of medical staff.

At present, the income of employees in public hospitals consists of "basic salary" and "performance salary". The biggest problem in the salary structure is that the proportion of basic salary is too large and the proportion of performance salary is too small, which leads to the unreasonable salary structure, which reflects fairness more and cannot fully reflect efficiency. The result of this situation is that the performance gap is very large, but the salary gap is very small, which can not play its due incentive role.

1.5 lack of non-economic incentives.

The salary of the hospital includes economic salary: basic salary, performance salary, subsidized salary, annual reward, insurance benefits, paid vacation, etc. Non-economic remuneration: namely, working environment and atmosphere, personal ability promotion and development, occupational safety, occupational welfare, etc. At present, the salary referred to by hospitals basically refers to economic salary, and little attention is paid to non-economic salary. Non-economic compensation can often better reflect the concept of "people-oriented management", so its incentive function is irreplaceable by economic compensation. Only when all kinds of incentive measures are used together can better incentive effects be achieved.

1.6 there is serious irrationality in taking economic income as the main performance evaluation index.

Although it has played an important role in increasing hospital income and improving doctors' treatment, the existing problems are also obvious, which are mainly reflected in the following aspects: overwork cannot be reflected, and medical staff pay too much attention to short-term interests because of paying too much attention to economic indicators, and are easy to get quick success and instant benefit.

2. Countermeasures to improve salary management in public hospitals

In order to attract and retain excellent employees, we must attract them with competitive salaries. Salary represents not only money, but also self-realization, respect, fair competition and professional value judgment. Only by constructing a scientific and reasonable salary management system can salary management serve the overall strategic goal of the hospital. Only by establishing a scientific and reasonable salary management system can a hospital have high value-added talents and high-performance employees for a long time, and can it greatly promote the realization of the overall strategic objectives of the hospital.

2. 1 Public hospitals implement performance-based salary system, increase the proportion of "floating salary" and pay according to performance.

In order to improve the incentive efficiency of salary management, we should increase the proportion of performance pay directly linked to employee performance in their total income. In the next few years, hospital salary management will pay more attention to individual ability, and the income level of employees will be linked to employees' ability, work performance, contribution and the benefits of units and departments. Whoever has strong ability, good performance and great contribution will get a high salary. Performance pay should be flexible pay, based on economic benefits and comprehensive target assessment, combined with responsibilities, risks, technical content and other factors for distribution. Performance pay is an effective means to mobilize employees' enthusiasm, improve work efficiency and break the iron rice bowl. From the assessment method based on economic income to the performance salary system based on comprehensive performance appraisal.

2.2 post appointment, according to the post salary.

We should redesign the conditions that each post should have, and set posts for employees according to their performance, achievements and other indicators. Through post analysis, post evaluation and salary content design, our hospital has completed the division of hospital staff positions, and determined the post level according to technical content, responsibilities, labor intensity and environmental advantages and disadvantages. Post performance pay is to determine the grade according to the technical content, responsibilities, labor intensity and risk degree of the post, and on this basis, divide the salary of each post into different grades, form a unified salary grade system, and then determine the specific salary range of each post in the hospital.

2.3 The salary policy of additional incentives for senior talents shall be implemented, and the salary shall be determined by the market.

Salary management in public hospitals should be classified, and higher working standards should be set for key positions and key senior talents. For the introduction of key discipline leaders and top-notch talents, the agreed salary system can be implemented according to the needs of the work. Establish an allowance system for important positions, outstanding talents or an important job independently, flexibly and flexibly. For senior talents, a relatively complicated incentive policy is adopted and an annual salary system is implemented. Annual salary consists of basic annual salary, target annual salary (performance income), incentive annual salary and flexible self-help welfare plan to increase incentives.

2.4 Improve the performance management system, incorporate performance evaluation into the daily management of hospitals, and promote the development of total performance management.

Raise the performance distribution mode to the level of performance management, speed up the top-level design of hospital performance management, promote the development of performance management from traditional performance appraisal to comprehensive performance management mode, promote the coexistence of multiple performance appraisal methods from the previous single assessment mode, and establish a complete performance management cycle of performance planning, performance counseling and communication, performance appraisal, performance result application and performance target improvement. Using the balanced scorecard, key indicators, 360-degree performance appraisal method, post-evaluation method and other management tools, in order to realize the ultimate concept of hospital total performance management, the construction of performance management system needs to refer to the management model of large-scale general hospitals at home and abroad, and combine the actual situation of the hospital to establish a performance management system that meets the strategic development goals of the hospital, so as to promote the sustainable development of the hospital.

2.5 Strengthen non-economic salary incentives

(1) Formulate various incentive policies, commend and reward employees at the end of the year, and encourage employees to work hard.

(2) Ensure the health of employees, arrange 1 employee and retired comrades for physical examination every year, give higher treatment to doctoral supervisors, second-and third-level discipline directors and senior talents, and increase physical examination items.

(3) Provide employees with a good dining environment, working environment and learning environment.

(4) Enriching the work content makes the work more attractive, such as offering special health lectures, carrying out appropriate shifts, and encouraging employees to teach part-time in colleges and universities without affecting their normal work.

(5) Provide more opportunities for further study, training and study, increase the construction of foreign bases, create opportunities for employees to study abroad, and provide employees with necessary infrastructure such as library databases.

(6) Establish medical, teaching and scientific research expert committees to provide more opportunities for employees to participate in hospital decision-making and enhance the overall cohesion of the hospital.

(7) Establish an effective position promotion system. For the medical staff whose salary has reached the highest level in this kind of position, and those who have performed well in their work, promotion is the only way to improve their salary, which can be promoted according to their actual ability and performance. Promotion is an effective means to maintain and promote their work enthusiasm, which can continuously improve their personal ability and work performance. This kind of uneconomical salary can bring a sense of honor and accomplishment to medical staff.

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