Value-Based Healthcare Project Implementation in a Hierarchical Tertiary Hospital: Lessons Learned

An important innovation in healthcare is the value-based healthcare (VBHC) framework, a way to solve health services' sustainability problems and ensure continuous improvement of healthcare quality. The Quality and Safety Unit at the Hospital Universitario 12 de Octubre has been since May 2018...

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Main Authors: Carolina Varela-Rodríguez, Albert García-Casanovas, Blanca Baselga-Penalva, Pedro M. Ruiz-López
Format: Article
Language:English
Published: Frontiers Media S.A. 2022-02-01
Series:Frontiers in Public Health
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fpubh.2021.755166/full
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author Carolina Varela-Rodríguez
Carolina Varela-Rodríguez
Albert García-Casanovas
Blanca Baselga-Penalva
Pedro M. Ruiz-López
author_facet Carolina Varela-Rodríguez
Carolina Varela-Rodríguez
Albert García-Casanovas
Blanca Baselga-Penalva
Pedro M. Ruiz-López
author_sort Carolina Varela-Rodríguez
collection DOAJ
description An important innovation in healthcare is the value-based healthcare (VBHC) framework, a way to solve health services' sustainability problems and ensure continuous improvement of healthcare quality. The Quality and Safety Unit at the Hospital Universitario 12 de Octubre has been since May 2018 coordinating the implementation of several healthcare innovation projects within the paradigm of VBHC. Implementing innovations in a complex institution, such as a tertiary hospital, is a challenge; we present here the lessons learned in the last 4 years of work. We detail exclusively the aspects related to continuous improvement and value addition to the process. In summary, for any VBHC project implementation, we found that there are five main issues: (1) adequate data quality; (2) development of data recording and visualization tools; (3) minimizing healthcare professional's effort to record data; (4) centralize governance, coordination, and transparency policies; (5) managerial's implication and follow-up. We described six steps key to ensure a successful implementation which are the following: testing the feasibility and complexities of the entry process; establishing leadership and coordination of the project; developing patient-reported outcomes and experience measurements; developing and adapting the data recording and data analysis tools; piloting in one or more medical conditions and evaluating the results and project management. The implementation duration can vary depending on the complexity of the Medical Condition Clinical Process and Patient Pathways. However, we estimate that the implementing phase will last a minimum of 18 and a maximum of 24 months. During this period, the institution should be capable of designing and implementing the proposed innovations. The implementation costs vary as well depending on the complexity, ranging from 90,000 euros to 250,000 euros. Implementation problems included the resistance to change of institutions and professionals. To date, there are few successful, published implementations of value-based healthcare. Our quality of care and patient safety methodological approach to the implementation has provided a particular advantage.
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spelling doaj.art-6a52cfd0c7594263ace3f4ee284fa16a2022-12-21T23:49:17ZengFrontiers Media S.A.Frontiers in Public Health2296-25652022-02-01910.3389/fpubh.2021.755166755166Value-Based Healthcare Project Implementation in a Hierarchical Tertiary Hospital: Lessons LearnedCarolina Varela-Rodríguez0Carolina Varela-Rodríguez1Albert García-Casanovas2Blanca Baselga-Penalva3Pedro M. Ruiz-López4Quality of Care Unit, Hospital Universitario 12 de Octubre, Madrid, SpainInstituto de Investigación Biomédica del Hospital Universitario 12 de Octubre I+12, Madrid, SpainIMIM (Hospital del Mar Medical Research Institute), Barcelona, SpainQuality of Care Unit, Hospital Universitario 12 de Octubre, Madrid, SpainInstituto de Investigación Biomédica del Hospital Universitario 12 de Octubre I+12, Madrid, SpainAn important innovation in healthcare is the value-based healthcare (VBHC) framework, a way to solve health services' sustainability problems and ensure continuous improvement of healthcare quality. The Quality and Safety Unit at the Hospital Universitario 12 de Octubre has been since May 2018 coordinating the implementation of several healthcare innovation projects within the paradigm of VBHC. Implementing innovations in a complex institution, such as a tertiary hospital, is a challenge; we present here the lessons learned in the last 4 years of work. We detail exclusively the aspects related to continuous improvement and value addition to the process. In summary, for any VBHC project implementation, we found that there are five main issues: (1) adequate data quality; (2) development of data recording and visualization tools; (3) minimizing healthcare professional's effort to record data; (4) centralize governance, coordination, and transparency policies; (5) managerial's implication and follow-up. We described six steps key to ensure a successful implementation which are the following: testing the feasibility and complexities of the entry process; establishing leadership and coordination of the project; developing patient-reported outcomes and experience measurements; developing and adapting the data recording and data analysis tools; piloting in one or more medical conditions and evaluating the results and project management. The implementation duration can vary depending on the complexity of the Medical Condition Clinical Process and Patient Pathways. However, we estimate that the implementing phase will last a minimum of 18 and a maximum of 24 months. During this period, the institution should be capable of designing and implementing the proposed innovations. The implementation costs vary as well depending on the complexity, ranging from 90,000 euros to 250,000 euros. Implementation problems included the resistance to change of institutions and professionals. To date, there are few successful, published implementations of value-based healthcare. Our quality of care and patient safety methodological approach to the implementation has provided a particular advantage.https://www.frontiersin.org/articles/10.3389/fpubh.2021.755166/fullvalue-based healthcareoperative implementationquality of careresources estimationpatient- reported outcomes (PRO)patient-reported experience (PRE)
spellingShingle Carolina Varela-Rodríguez
Carolina Varela-Rodríguez
Albert García-Casanovas
Blanca Baselga-Penalva
Pedro M. Ruiz-López
Value-Based Healthcare Project Implementation in a Hierarchical Tertiary Hospital: Lessons Learned
Frontiers in Public Health
value-based healthcare
operative implementation
quality of care
resources estimation
patient- reported outcomes (PRO)
patient-reported experience (PRE)
title Value-Based Healthcare Project Implementation in a Hierarchical Tertiary Hospital: Lessons Learned
title_full Value-Based Healthcare Project Implementation in a Hierarchical Tertiary Hospital: Lessons Learned
title_fullStr Value-Based Healthcare Project Implementation in a Hierarchical Tertiary Hospital: Lessons Learned
title_full_unstemmed Value-Based Healthcare Project Implementation in a Hierarchical Tertiary Hospital: Lessons Learned
title_short Value-Based Healthcare Project Implementation in a Hierarchical Tertiary Hospital: Lessons Learned
title_sort value based healthcare project implementation in a hierarchical tertiary hospital lessons learned
topic value-based healthcare
operative implementation
quality of care
resources estimation
patient- reported outcomes (PRO)
patient-reported experience (PRE)
url https://www.frontiersin.org/articles/10.3389/fpubh.2021.755166/full
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