A decade of change towards Value-Based Health Care at a Dutch University Hospital:a complexity-informed process study

Background: While healthcare organizations in several countries are embracing Value-Based Health Care (VBHC), there are limited insights into how to achieve this paradigm shift. This study examines the decade-long (2012–2023) change towards VBHC in a pioneering Dutch university hospital. Method: Through retrospective, complexity-informed process research, we study how a Dutch university hospital’s strategy to implement VBHC evolved, how implementation outcomes unfolded, and the underlying logic behind these developments. Data include the hospital’s internal documents (n = 10,536), implementati... Mehr ...

Verfasser: van Engen, Veerle
Buljac-Samardzic, Martina
Baatenburg de Jong, Rob
Braithwaite, Jeffrey
Ahaus, Kees
Den Hollander-Ardon, Monique
Peters, Ingrid
Bonfrer, Igna
Dokumenttyp: Artikel
Erscheinungsdatum: 2024
Reihe/Periodikum: van Engen , V , Buljac-Samardzic , M , Baatenburg de Jong , R , Braithwaite , J , Ahaus , K , Den Hollander-Ardon , M , Peters , I & Bonfrer , I 2024 , ' A decade of change towards Value-Based Health Care at a Dutch University Hospital : a complexity-informed process study ' , Health Research Policy and Systems , vol. 22 , no. 1 , 94 , pp. 1-19 . https://doi.org/10.1186/s12961-024-01181-z
Schlagwörter: Change / Complexity / Hospital / Implementation / Institutionalization / Patient reported outcome measures / Process / Qualitative / Strategy / Value-Based Health Care
Sprache: Englisch
Permalink: https://search.fid-benelux.de/Record/base-28996122
Datenquelle: BASE; Originalkatalog
Powered By: BASE
Link(s) : https://researchers.mq.edu.au/en/publications/47149aa3-94ac-4d4d-b6df-4f19e377f690

Background: While healthcare organizations in several countries are embracing Value-Based Health Care (VBHC), there are limited insights into how to achieve this paradigm shift. This study examines the decade-long (2012–2023) change towards VBHC in a pioneering Dutch university hospital. Method: Through retrospective, complexity-informed process research, we study how a Dutch university hospital’s strategy to implement VBHC evolved, how implementation outcomes unfolded, and the underlying logic behind these developments. Data include the hospital’s internal documents (n = 10,536), implementation outcome indicators (n = 4), a survey among clinicians (n = 47), and interviews with individuals contributing to VBHC at the hospital level (n = 20). Results: The change towards VBHC is characterized by three sequential strategies. Initially, the focus was on deep change through local, tailored implementation of multiple VBHC elements. The strategy then transitioned to a hospital-wide program aimed at evolutionary change on a large scale, emphasizing the integration of VBHC into mainstream IT and policies. Recognizing the advantages and limitations of both strategies, the hospital currently adopts a “hybrid” strategy. This strategy delicately combines deep and broad change efforts. The strategy evolved based on accumulated insights, contextual developments and shifts in decision-makers. The complexity of change was downplayed in plans and stakeholder communication. By the end of 2023, 68 (sub)departments engaged in VBHC, enabled to discuss patients’ responses to Patient Reported Outcomes Measures (PROMs) during outpatient care. However, clinicians’ use of PROMs data showed limitations. While pioneers delved deeper into VBHC, laggards have yet to initiate it. Conclusions: VBHC does not lend itself to linear planning and is not easily scalable. While there appears to be no golden standard for implementation, blending local and larger-scale actions appears advantageous. Local, deep yet harmonized and system-integrated ...