Abstract
BackgroundImplementing the value-based healthcare concept (VBHC) is a growing management trend in Swedish healthcare organizations. The aim of this study is to explore how representatives of four pilot project teams experienced implementing VBHC in a large Swedish University Hospital over a period of 2 years. The project teams started their work in October 2013.MethodsAn explorative and qualitative design was used, with interviews as the data collection method. All the participants in the four pilot project teams were individually interviewed three times, with interviews starting in March 2014 and ending in November 2015. All the interviews were transcribed and analyzed using qualitative analysis.ResultsValue for the patients was experienced as the fundamental drive for implementing VBHC. However, multiple understandings of what value for patients’ means existed in parallel. The teams received guidance from consultants during the first 3 months. There were pros and cons to the consultant’s guidance. This period included intensive work identifying outcome measurements based on patients’ and professionals’ perspectives, with less interest devoted to measuring costs. The implementation process, which both gave and took energy, developed over time and included interventions. In due course it provided insights to the teams about the complexity of healthcare. The necessity of coordination, cooperation and working together inter-departmentally was critical.ConclusionsHealthcare organizations implementing VBHC will benefit from emphasizing value for patients, in line with the intrinsic drive in healthcare, as well as managing the process of implementation on the basis of understanding the complexities of healthcare. Paying attention to the patients’ voice is a most important concern and is also a key towards increased engagement from physicians and care providers for improvement work.
Highlights
Implementing the value-based healthcare concept (VBHC) is a growing management trend in Swedish healthcare organizations
Value-based healthcare (VBHC), as a concept, has in recent years become established in Swedish healthcare organizations, in particular in hospitals [1]
Aim This study explores how the representatives of four pilot project teams experienced implementing VBHC over a period of 2 years in four different groups of patients at a large Swedish University Hospital
Summary
Implementing the value-based healthcare concept (VBHC) is a growing management trend in Swedish healthcare organizations. The ideas behind VBHC were introduced by Porter and Teisberg in 2006 They built their framework, concept and Nilsson et al BMC Health Services Research (2017) 17:169 of them. Porter and Lee suggested that creating value for patients and achieving success in implementing VBHC requires dedicated physicians and care providers within the organization [5]. A further component is measuring outcomes of importance to the patients and their cost and comparing these results with others inside and outside the organization They suggested moving towards a bundled payment system; creating an integrated care delivery system; creating a geographically built up and excellent specialist health service; and investing in information technology platforms [5]
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