Transition to outcome-driven healthcare requires more than enthusiastic pilot teams

Why do VBHC projects often stay stuck in the pilot phase? What is needed to secure and accelerate improvement initiatives? In this blog post, I outline my views on this and illustrate them with a practical example.

As we saw again recently at the conference on Value-Based Healthcare in practice with prof. Robert S. Kaplan, there is increasing momentum for multidisciplinary improvement initiatives aimed at providing the right care in the right place to ensure better outcomes for patients. Most of these Value-Based Healthcare (VBHC) initiatives that we see in hospitals arise as a result of professionals who are driven to improve healthcare for a specific group of patients. This is naturally a great starting point. However, we also often see that initiatives remain isolated and form a very limited part of a broader change programme. With a few exceptions, we note that there is little exposure for a concrete VBHC vision and targeted, hospital-wide support for initiatives.

Most initiatives arrive at a certain point where funding, labour, ICT and other facilities, and organisational support are needed in order to accelerate their progress. If these are lacking, then there’s a good chance that the project will get bogged down in delays and frustration, with the result that it does not progress to being scaled up and rolled out on a broader basis.

In order to actually make the transition and involve the whole organisation in the ambitions towards care cycle collaboration and focusing on patient outcomes, it is essential to establish a concrete VBHC vision and strategy. This is not as simple as it sounds. Naming the ambition and strategy is one thing, but establishing the enablers for the implementation, as well as disseminating it broadly and actively facilitating it is just as important.

But how do you formulate a concrete vision, and ensure that you also truly secure it within the organisation?

Ask yourself the right strategic questions that mirror the hospital’s long-term ambitions
Such as:

  • How do we ensure that we connect properly with patients so that they receive the best care?
  • What is our own profile, and how can we collaborate successfully with the parties around us?
  • How can we optimally arrange our organisation, locations and processes?
  • What sort of culture and leadership are best suited to this?

Organise hospital-wide support with clear priorities aligned with the vision

Then formulate concrete objectives that need to be achieved in order to create the enablers for VBHC. For example, this might include clear starting points for regional collaboration and focusing on outcomes, the necessary ICT and other infrastructure, stimulating a culture for the improvement of outcomes, and facilitating the change yourself with people and/or money. This enables the hospital to provide clear starting points for VBHC pilots and a strong foundation for launching pilot projects quickly, as well as making roll-out possible.

Because this step is often neglected, we provide practical tools for tackling this in this white paper (in Dutch).

A dynamic strategy with broad support

The essence of success for every strategy – and certainly around a theme like VBHC, in which the view on healthcare changes – is that the strategy should be created for and by all employees. You can achieve this by involving the various stakeholders (patients, general practitioners, directors of other hospitals, insurers, and of course employees) in the development of the new strategy, and by listening carefully to their desires and interests.

A good example of this approach is a leading clinical hospital that chose a clear path: delivering ‘optimal care for patients for every euro’.

This hospital employed co-creation to translate its clear vision into concrete ambitions. The hospital organised plenary meetings at which it asked its internal and external stakeholders to help refine the ambitions for the future. This provided enriching insights for the new strategy. They received answers to questions such as: ‘In which areas should we really distinguish ourselves?’ and: ‘How can we collaborate even better in order to provide optimal healthcare for the patient?’ This led to long-term ambitions for strategic questions, with the VBHC principles of integrated care cycle collaboration, the patient as priority, and focusing on outcomes occupying a central position.

Using these ambitions as a springboard, the hospital sets concrete objectives to enable acceleration. This involved the realisation of strategic, hospital-wide partnerships, facilitating shifts to primary care, financing innovation, and a uniform approach to measuring and focusing on patient outcomes. Training courses have also been organised for project leaders and teams in order to build up a growing group of ambassadors, and to further spread the necessary VBHC mindset. Thanks in part to this approach, the chosen strategy now exists both within and outside of the organisation, and provides fertile ground for the VBHC pilots that have been started up.

In short, if hospitals want to safeguard and accelerate the implementation of the VBHC strategy, then this approach provides a good foundation.

Vintura is keen to use its VBHC expertise and broad experience with organisational transition in healthcare to support you in realising the switch to value-driven healthcare in your organisation. This could include arriving at a dynamic VBHC strategy and setting up the necessary enablers to accelerate the transition (see our white paper), as well as outcome-oriented care cycle development, care cycle collaboration, training and contracting. We always start out with an open discussion so that we can clearly understand the goals you have in mind. If you would like to know more, feel free to make an appointment with Koen Jansen.