1. Unfair distribution of medical and nursing care is mostly based on departmental accounting. The hospital calculates the performance salary and informs the department, and the department proposes a method for the distribution of medical and nursing care. Since the hospital does not have a specific secondary distribution method for medical and nursing care, it is just The introduction of secondary allocation guidance has led to department directors and head nurses to have different approaches to allocation. Some medical and nursing staff are allocated based on capitation, which reflects a bias towards nursing. The reason for nursing is that doctors have other gray income. ; Some medical and nursing care are allocated according to a certain ratio, but whether it is 4:6 or 5:5, it is still difficult to coordinate the distribution of medical care. Because there is no reasonable value assessment in the allocation of medical care, no benchmark performance has been established, and it is not known how much the allocation must be to be fair. The main reason is the mixed accounting of medical and nursing staff, which increases the distribution conflicts between department directors and head nurses. 2. Unfair distribution among doctors No matter what method is used to distribute the total performance salary of doctors, there is a share of the total performance salary of doctors. In some departments, doctors are also distributed based on head count, and in some departments, they are distributed based on the position distribution coefficient. Equal distribution of heads cannot reflect more work, more rewards, and better rewards for good performance. It sacrifices the interests of efficient employees. It will affect the enthusiasm of outstanding personnel in the long run and reflect an unobvious workload. There are many job allocation methods, which mainly set different distribution coefficients according to positions, which embodies egalitarianism under unfairness and seniority. 3. Unfair distribution among nurses. Nurses are assigned performance, and during the redistribution, some are based on distribution coefficients, and some are based on night shift distribution patterns. Most of the allocations are based on coefficients and are based on seniority, which cannot reflect the number of nursing hours. For example, night shifts are not reflected enough, and there is a large difference in the allocation between staff and non-staff, etc. 4. Unfair distribution between the department head nurse and the staff. The department head nurse assumes greater management responsibilities, and the difference in performance distribution cannot be reflected. Instead, the employees think that the department head nurse is eating them. share, leading to disharmonious secondary allocation relationships among departments and affecting team collaboration. 5. Scientific and reasonable method for secondary allocation of departments. The performance salary distribution of departments should fully consider multiple dimensions and take into account various factors, such as qualifications, contributions, job value, working hours, etc. 1. Implement separate accounting for medical and nursing care. Due to the contradiction in the distribution relationship between medical and nursing care, from the top-level design of the hospital, separate accounting for medical and nursing care can also be implemented. When conditions are not mature, separate accounting and management for medical and nursing care can be implemented without separation of families to resolve the issue of medical and nursing care. contradictions in distribution. 2. The head nurse of the department implements the secondary distribution of the performance salary of the department head nurse and the department director. The hospital separately calculates the management performance of the department director and head nurse and pays them separately. They are paid according to the management effect assessment to avoid the participation of the department director and head nurse in the performance of the department. Distribution Dilemma. The roles of department secondary allocation management should be divided into two, one is the designer and the other is the supervisor. The designers of department secondary allocation mechanisms are generally department directors and head nurses. They have a clearer understanding of the department's business characteristics and specific conditions, so they are fully qualified for this role. The supervisor of the department's secondary allocation mechanism is usually the director of the performance office or the chief of the human resources department. They review the department's secondary allocation plan proposed by the department director and head nurse from the perspective of professional functions. Department employees sign and approve it. Department secondary allocation plans that are in line with the spirit of the national medical reform and do not conform to the hospital's performance allocation strategy will not be approved; in the process of department performance salary payment, supervision functions must also be performed to prevent the department's secondary allocation plan from being strictly implemented and prevent allocation. unfairness occurs. 3. The workload is tilted towards the individual to reflect the priority of efficiency, and the effectiveness is tilted towards the team while taking into account the fairness of the secondary distribution of department performance wages. It should be clear that the workload is tilted towards the individual, such as the number of outpatient visits, discharges, surgeries, nursing visits, working hours, etc., to reflect efficiency. Priority is given to merit-based pay; performance includes efficiency, effectiveness, quality, etc. Performance-based pay is extracted based on cost control, with reference to multi-dimensional comprehensive assessment, tilting towards the team and taking into account fairness.