To read the full version of this content please select one of the options below:

Value-based healthcare as a trigger for improvement initiatives

Kerstin Nilsson (Institute of Health and Care Sciences, Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden)
Fredrik Bååthe (Sahlgrenska University Hospital, Gothenburg, Sweden, and Institute of Health and Care Sciences, Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden)
Annette Erichsen Andersson (Institute of Health and Care Sciences, Sahlgrenska Academy at Gothenburg University, Gothenburg, Sweden, and Department of Orthopaedic Surgery, Sahlgrenska University Hospital, Gothenburg, Sweden)
Mette Sandoff (Department of Business Administration, University of Gothenburg, Gothenburg, Sweden)

Leadership in Health Services

ISSN: 1751-1879

Article publication date: 1 September 2017

Issue publication date: 19 October 2017

Downloads
1586

Abstract

Purpose

This study explores four pilot teams’ experiences of improvements resulting from the implementation of value-based healthcare (VBHC) at a Swedish University Hospital. The aim of this study is to gain a deeper understanding of VBHC when used as a management strategy to improve patients’ health outcomes.

Design/methodology/approach

An exploratory design was used and qualitative interviews were undertaken with 20 team members three times each, during a period of two years. The content of the interviews was qualitatively analysed.

Findings

VBHC worked as a trigger for initiating improvements related to processes, measurements and patients’ health outcomes. An example of improvements related to patients’ health outcomes was solving the problem of patients’ nausea. Improvement related to processes was developing care planning and increasing the number of contact nurses. Improvement related to measurements was increasing coverage ratio in the National Quality Registers used, and the development of a new coding system for measurements. VBHC contributed a structure for measurement and for identification of the need for improvements, but this structure on its own was not enough. To implement and sustain improvements, it is important to establish awareness of the need for improvements and to motivate changes not just among managers and clinical leaders directly involved in VBHC projects but also engage all other staff providing care.

Originality/value

This study shows that although the VBHC management strategy may serve as an initiator for improvements, it is not enough for the sustainable implementation of improvement initiatives. Regardless of strategy, managers and clinical leaders need to develop increased competence in change management.

Keywords

Acknowledgements

Authors’ contributions: K.N.: study design, data collection and analysis, interpreting the analysis and responsible for drafting the manuscript. F.B.: interpreting the analysis and involved in drafting the manuscript. A.E.A.: interpreting the analysis and involved in drafting the manuscript. M.S.: interpreting the analysis and involved in drafting the manuscript.

Citation

Nilsson, K., Bååthe, F., Erichsen Andersson, A. and Sandoff, M. (2017), "Value-based healthcare as a trigger for improvement initiatives", Leadership in Health Services, Vol. 30 No. 4, pp. 364-377. https://doi.org/10.1108/LHS-09-2016-0045

Publisher

:

Emerald Publishing Limited

Copyright © 2017, Emerald Publishing Limited