LEFO - Legeforskningsinstituttet

Institute for Studies of the Medical Profession


Value-based healthcare as a trigger for improvement initiatives

- Regardless of strategi, managers and clinical leaders need to develop increased competence in change management, is the conclusion of a study from LEFO's guest researcher Fredrik Bååthe in Leadership & Organization Development Journal (LODJ).
4. oktober 2017

This peer reviewed research article, Value-based healthcare as a trigger for improvement initiatives. Nilsson K, Bååthe F, Erichsen Andersson A, Sandorff M, was published online 1 September: Leadersh Health Serv (Bradf Engl) 2017; 30: 364-77 (doi: 10.1108/LHS-09-2016-0045).

The study showes that to implement and sustain improvements managers and clinical leaders need to increase their understanding of change-management principles. It is important to motivate changes not just amongst those directly involved in a change projects, but also engage all other staff providing care.

Abstract in PubMed:
Purpose: This study explores four pilot teams' experiences of improvements resulting from the implementation of value-based healthcare (VBHC) at a Swedish University Hospital. The aim of this study is to gain a deeper understanding of VBHC when used as a management strategy to improve patients' health outcomes.
Design/methodology/approach: An exploratory design was used and qualitative interviews were undertaken with 20 team members three times each, during a period of two years. The content of the interviews was qualitatively analysed.
Findings: VBHC worked as a trigger for initiating improvements related to processes, measurements and patients' health outcomes. An example of improvements related to patients' health outcomes was solving the problem of patients' nausea. Improvement related to processes was developing care planning and increasing the number of contact nurses. Improvement related to measurements was increasing coverage ratio in the National Quality Registers used, and the development of a new coding system for measurements. VBHC contributed a structure for measurement and for identification of the need for improvements, but this structure on its own was not enough. To implement and sustain improvements, it is important to establish awareness of the need for improvements and to motivate changes not just among managers and clinical leaders directly involved in VBHC projects but also engage all other staff providing care.
Originality/value: This study shows that although the VBHC management strategy may serve as an initiator for improvements, it is not enough for the sustainable implementation of improvement initiatives. Regardless of strategy, managers and clinical leaders need to develop increased competence in change management.

Until 31.12.2018 you can have free access to  a full text version by following this link (Emerald Publishing).

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Read more (in Norwegian and Swedish): - Artikkel om verdibasert helsetjeneste høster anerkjennelse