The implementation of change model adds value to value-based healthcare: a qualitative study
Abstract Background Value-based healthcare (VBHC) is a concept that focuses on outcome measurement to contribute to quality improvement. However, VBHC does not offer a systematic approach for implementing improvement as implementation science does. The aim is to, firstly, investigate the implementat...
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| Format: | Article |
| Language: | English |
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BMC
2019-09-01
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| Series: | BMC Health Services Research |
| Subjects: | |
| Online Access: | http://link.springer.com/article/10.1186/s12913-019-4498-y |
| _version_ | 1818353732404903936 |
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| author | Nina Zipfel Paul B. van der Nat Benno J. W. M. Rensing Edgar J. Daeter Gert P. Westert A. Stef Groenewoud |
| author_facet | Nina Zipfel Paul B. van der Nat Benno J. W. M. Rensing Edgar J. Daeter Gert P. Westert A. Stef Groenewoud |
| author_sort | Nina Zipfel |
| collection | DOAJ |
| description | Abstract Background Value-based healthcare (VBHC) is a concept that focuses on outcome measurement to contribute to quality improvement. However, VBHC does not offer a systematic approach for implementing improvement as implementation science does. The aim is to, firstly, investigate the implementation of improvement initiatives in the context of VBHC and secondly, to explore how implementation science could be of added value for VBHC and vice versa. Methods A case study with two cases in heart care was conducted; one without the explicit use of a systematic implementation method and the other one with the use of the Implementation of Change Model (ICM). Triangulation of data from document research, semi-structured interviews and a focus group was applied to evaluate the degree of method uptake. Interviews were held with experts involved in the implementation of Case 1 (N = 4) and Case 2 (N = 7). The focus group was held with experts also involved in the interviews (N = 4). A theory-driven qualitative analysis was conducted using the ICM as a framework. Results In both cases, outcome measures were seen as an important starting point for the implementation and for monitoring change. Several themes were identified as most important: support, personal importance, involvement, leadership, climate and continuous monitoring. Success factors included intrinsic motivation for the change, speed of implementation, complexity and continuous evaluation. Conclusion Application of the ICM facilitates successful implementation of quality- improvement initiatives within VBHC. However, the practical use of the ICM shows an emphasis on processes. We recommend that monitoring of outcomes be added as an essential part of the ICM. In the discussion, we propose an implementation model that integrates ICM within VBHC. |
| first_indexed | 2024-12-13T19:14:12Z |
| format | Article |
| id | doaj.art-dcffceb926684a49a8ec653b3ab6568e |
| institution | Directory Open Access Journal |
| issn | 1472-6963 |
| language | English |
| last_indexed | 2024-12-13T19:14:12Z |
| publishDate | 2019-09-01 |
| publisher | BMC |
| record_format | Article |
| series | BMC Health Services Research |
| spelling | doaj.art-dcffceb926684a49a8ec653b3ab6568e2022-12-21T23:34:20ZengBMCBMC Health Services Research1472-69632019-09-0119111210.1186/s12913-019-4498-yThe implementation of change model adds value to value-based healthcare: a qualitative studyNina Zipfel0Paul B. van der Nat1Benno J. W. M. Rensing2Edgar J. Daeter3Gert P. Westert4A. Stef Groenewoud5Department of Value-based Healthcare, St. Antonius HospitalDepartment of Value-based Healthcare, St. Antonius HospitalDepartment of Cardiology, St. Antonius HospitalDepartment of Cardiothoracic Surgery, St. Antonius HospitalRadboud university medical center, Radboud Institute for Health Sciences, Scientific Center for Quality of Healthcare (IQ healthcare)Radboud university medical center, Radboud Institute for Health Sciences, Scientific Center for Quality of Healthcare (IQ healthcare)Abstract Background Value-based healthcare (VBHC) is a concept that focuses on outcome measurement to contribute to quality improvement. However, VBHC does not offer a systematic approach for implementing improvement as implementation science does. The aim is to, firstly, investigate the implementation of improvement initiatives in the context of VBHC and secondly, to explore how implementation science could be of added value for VBHC and vice versa. Methods A case study with two cases in heart care was conducted; one without the explicit use of a systematic implementation method and the other one with the use of the Implementation of Change Model (ICM). Triangulation of data from document research, semi-structured interviews and a focus group was applied to evaluate the degree of method uptake. Interviews were held with experts involved in the implementation of Case 1 (N = 4) and Case 2 (N = 7). The focus group was held with experts also involved in the interviews (N = 4). A theory-driven qualitative analysis was conducted using the ICM as a framework. Results In both cases, outcome measures were seen as an important starting point for the implementation and for monitoring change. Several themes were identified as most important: support, personal importance, involvement, leadership, climate and continuous monitoring. Success factors included intrinsic motivation for the change, speed of implementation, complexity and continuous evaluation. Conclusion Application of the ICM facilitates successful implementation of quality- improvement initiatives within VBHC. However, the practical use of the ICM shows an emphasis on processes. We recommend that monitoring of outcomes be added as an essential part of the ICM. In the discussion, we propose an implementation model that integrates ICM within VBHC.http://link.springer.com/article/10.1186/s12913-019-4498-yImplementation scienceImplementation of change modelValue-based healthcareOutcome improvementOutcome measurement |
| spellingShingle | Nina Zipfel Paul B. van der Nat Benno J. W. M. Rensing Edgar J. Daeter Gert P. Westert A. Stef Groenewoud The implementation of change model adds value to value-based healthcare: a qualitative study BMC Health Services Research Implementation science Implementation of change model Value-based healthcare Outcome improvement Outcome measurement |
| title | The implementation of change model adds value to value-based healthcare: a qualitative study |
| title_full | The implementation of change model adds value to value-based healthcare: a qualitative study |
| title_fullStr | The implementation of change model adds value to value-based healthcare: a qualitative study |
| title_full_unstemmed | The implementation of change model adds value to value-based healthcare: a qualitative study |
| title_short | The implementation of change model adds value to value-based healthcare: a qualitative study |
| title_sort | implementation of change model adds value to value based healthcare a qualitative study |
| topic | Implementation science Implementation of change model Value-based healthcare Outcome improvement Outcome measurement |
| url | http://link.springer.com/article/10.1186/s12913-019-4498-y |
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