Abstract

Objective: This study aimed to develop an understanding of the implementation of the Leading Better Value Care (LBVC) initiatives at a Local Health District (LHD). Methods: The study used a mixed method including literature reviews, survey and semi-structured interviews of the stakeholders who participated in the implementation of the state-wide LBVC program within a LHD. All information used in this study was de-identified and anonymous. Results: Twenty-two stakeholders responded to the survey reviewing the implementation process. Fifty-one percent of the participants reported that there was very good sharing of information and ideas within the LHD, where clinicians were provided with data to support better decision making (77%). The stakeholders were overall moderately to very satisfied (60%) with how the program was implemented within the LHD. A total of 10 interviews were conducted. Analysis of the transcripts identified four core themes linking different aspects of the implementation of the LBVC initiatives: 1) Engagement; 2) Understanding of implementation process; 3) Challenges; and, 4) Future strategies for implementation. This local learning will provide valuable information to develop strategies so as to improve the LBVC program and support the LHD in continuing to embed, scale and sustain the initiatives. Conclusion: This study has provided the experience of the stakeholders participating in the implementation of the LBVC program and how it was being implemented across the LHD. It has identified factors which contribute to improvement of future implementation of similar programs.

Highlights

  • Around the world, every healthcare system is struggling with rising costs and inequality (Porter & Robert, 2011)

  • This study aimed to develop an understanding of the implementation of the Leading Better Value Care (LBVC) initiatives at a Local Health District (LHD)

  • The stakeholders were overall moderately to very satisfied (60%) with how the program was implemented within the LHD

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Summary

Introduction

Every healthcare system is struggling with rising costs and inequality (Porter & Robert, 2011). Due to the complexity of health care delivery, many international health systems are struggling with unwarranted clinical variation, increases in service demand beyond population growth, an aging population, complexity of and chronic disease rising costs and uneven quality despite the hard work of well-intentioned, well-trained clinicians (Porter, 2011; Gentry & Badrinth, 2017). This highlights the need to shift the focus from volume and service outputs as emphasised by Activity Based Funding (ABF) to the patient outcomes achieved. This can facilitate improvement of implementation and acceptability of initiatives at each stage of the process (Koff & Lyons, 2020; Agency for Clinical Innovation, 2018a; Agency for Clinical Innovation, 2013)

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