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Article
Publication date: 8 December 2021

Petra Kokko and Harri Laihonen

The article seeks to explain whether and how value-based healthcare principles lead to hybridization. The public management literature has been increasingly interested in…

Abstract

Purpose

The article seeks to explain whether and how value-based healthcare principles lead to hybridization. The public management literature has been increasingly interested in hybrid forms of governance and hybrid performance management, but empirical studies are still rare. Further, the article studies the design of performance management and accounting systems as healthcare organizations reorganize their care processes applying value-based healthcare principles.

Design/methodology/approach

This article first connects the theoretical discussions on value-based healthcare and performance management for hybrids. The conceptual understanding of performance management in hybrid healthcare uses a case study of a Finnish healthcare organization with documentary data and transcribed interviews with healthcare professionals from both the strategic and operative levels of healthcare.

Findings

The article illustrates and analyses how new policy-level objectives and principles of value-based healthcare led to hybridity in healthcare, manifest in mixed ownership of a particular care path and new forms of social and financial control. Further, the article provides empirical evidence of how increased hybridity necessitated new organizational modes and roles, new managerial tools for performance management and created a need to develop the capability to account and measure entire integrated care processes. Important enabling factors for the integration of care and hybrid performance management were commitment created in dialogue, voluntary-based trust and technology to generate factual shared information.

Practical implications

The study is informative for stakeholders, funders and managers of healthcare organizations, namely new knowledge for the discussion of hybrid governance in healthcare, including a critical account of the applicability and impact of a hybrid service model in healthcare management. Moreover, the article illustrates what needs to be reconsidered in performance management and accounting practices when reorganizing care processes according to the principles of value-based healthcare.

Originality/value

The article extends the analysis of performance management in hybrids and sheds new light on hybridization in healthcare. It also provides much-needed empirical evidence on the processes and practices of accounting and performance management after implementing a value-based healthcare strategy.

Details

Journal of Public Budgeting, Accounting & Financial Management, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 1096-3367

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Article
Publication date: 10 August 2020

Daniel J. Rees, Victoria Bates, Roderick A. Thomas, Simon B. Brooks, Hamish Laing, Gareth H. Davies, Michael Williams, Leighton Phillips and Yogesh K. Dwivedi

The UK Government-funded National Health Service (NHS) is experiencing significant pressures because of the complexity of challenges to, and demands of, health-care…

Abstract

Purpose

The UK Government-funded National Health Service (NHS) is experiencing significant pressures because of the complexity of challenges to, and demands of, health-care provision. This situation has driven government policy level support for transformational change initiatives, such as value-based health care (VBHC), through closer alignment and collaboration across the health-care system-life science sector nexus. The purpose of this paper is to evaluate the necessary antecedents to collaboration in VBHC through a critical exploration of the existing literature, with a view to establishing the foundations for further development of policy, practice and theory in this field.

Design/methodology/approach

A literature review was conducted via searches on Scopus and Google Scholar between 2009 and 2019 for peer-reviewed articles containing keywords and phrases “Value-based healthcare industry” and “healthcare industry collaboration”. Refinement of the results led to the identification of “guiding conditions” (GCs) for collaboration in VBHC.

Findings

Five literature-derived GCs were identified as necessary for the successful implementation of initiatives such as VBHC through system-sector collaboration. These are: a multi-disciplinarity; use of appropriate technological infrastructure; capturing meaningful metrics; understanding the total cycle-of-care; and financial flexibility. This paper outlines research opportunities to empirically test the relevance of the five GCs with regard to improving system-sector collaboration on VBHC.

Originality/value

This paper has developed a practical and constructive framework that has the potential to inform both policy and further theoretical development on collaboration in VBHC.

Details

Transforming Government: People, Process and Policy, vol. 15 no. 1
Type: Research Article
ISSN: 1750-6166

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Article
Publication date: 24 July 2019

Aidan P. Walsh, Denis Harrington and Peter Hines

Hospital organisations are currently experiencing significant challenges that have encouraged a move towards a value-based approach to health care. However, such a…

Abstract

Purpose

Hospital organisations are currently experiencing significant challenges that have encouraged a move towards a value-based approach to health care. However, such a transition requires understanding the underlying competencies required to enable such a focus. This paper aims to undertake a systematic review of the available literature on managerial competencies in hospitals and considers these in a value-based health-care context.

Design/methodology/approach

A systematic literature review was conducted to identify research studies that describe the characteristics of management competence in hospital environments.

Findings

Categories and sub-categories of management competence in hospitals were identified and considered in a value-based health-care context.

Research limitations/implications

The systematic literature review identifies a need for further research regarding managerial competencies of managers of hospitals. Competencies for managing in a value-based health-care model also require deeper investigation.

Practical implications

The categories of management competence provide guidance to organisations transitioning towards value-based health care in terms of identifying and developing management competencies. Hospitals should consider the development of a competency model that includes broader categories of competencies than purely clinical or professional competencies.

Originality/value

This study builds upon and advances previous reviews of management competence in hospitals, and the competency categories presented can be used as a basis to identify management competency requirements in hospitals.

Details

International Journal of Organizational Analysis, vol. 28 no. 1
Type: Research Article
ISSN: 1934-8835

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Article
Publication date: 1 September 2017

Kerstin Nilsson, Fredrik Bååthe, Annette Erichsen Andersson and Mette Sandoff

This study explores four pilot teams’ experiences of improvements resulting from the implementation of value-based healthcare (VBHC) at a Swedish University Hospital. The…

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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.

Details

Leadership in Health Services, vol. 30 no. 4
Type: Research Article
ISSN: 1751-1879

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Article
Publication date: 24 April 2020

Lia Patrício, Daniela Sangiorgi, Dominik Mahr, Martina Čaić, Saleh Kalantari and Sue Sundar

This paper explores how service design can contribute to the evolution of health service systems, moving them toward people-centered, integrated and technology-enabled…

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1806

Abstract

Purpose

This paper explores how service design can contribute to the evolution of health service systems, moving them toward people-centered, integrated and technology-enabled care; the paper develops a research agenda to leverage service design research for healthcare transformation.

Design/methodology/approach

This conceptual study starts by analyzing healthcare challenges in terms of demographic trends and economic constraints, along with the problems of lack of people-centricity, dispersion of care and slowness in incorporating emerging technologies. Then, it examines the theoretical underpinnings of service design to develop a framework for exploring how a human-centered, transformative and service systems approach can contribute to addressing healthcare challenges, with illustrative cases of service design research in healthcare being given.

Findings

The proposed framework explores how a human-centered service design approach can leverage the potential of technology and advance healthcare systems toward people-centered care; how a transformative service design approach can go beyond explanatory research of healthcare phenomena to develop innovative solutions for healthcare change and wellbeing; and how a service systems perspective can address the complexity of healthcare systems, hence moving toward integrated care.

Originality/value

This paper systematizes and develops a framework for how service design can contribute to healthcare transformation. It identifies key healthcare application areas for future service design research and pathways for advancing service design in healthcare by using new interdisciplinary bridges, methodological developments and theoretical foundations.

Details

Journal of Service Management, vol. 31 no. 5
Type: Research Article
ISSN: 1757-5818

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Article
Publication date: 2 March 2021

Viktor Dombrádi, Klára Bíró, Guenther Jonitz, Muir Gray and Anant Jani

Decision-makers are looking for innovative approaches to improve patient experience and outcomes with the finite resources available in healthcare. The concept of…

Abstract

Purpose

Decision-makers are looking for innovative approaches to improve patient experience and outcomes with the finite resources available in healthcare. The concept of value-based healthcare has been proposed as one such approach. Since unsafe care hinders patient experience and contributes to waste, the purpose of this paper is to investigate how the value-based approach can help broaden the existing concept of patient safety culture and thus, improve patient safety and healthcare value.

Design/methodology/approach

In the arguments, the authors use the triple value model which consists of personal, technical and allocative value. These three aspects together promote healthcare in which the experience of care is improved through the involvement of patients, while also considering the optimal utilisation and allocation of finite healthcare resources.

Findings

While the idea that patient involvement should be integrated into patient safety culture has already been suggested, there is a lack of emphasis that economic considerations can play an important role as well. Patient safety should be perceived as an investment, thus, relevant questions need to be addressed such as how much resources should be invested into patient safety, how the finite resources should be allocated to maximise health benefits at a population level and how resources should be utilised to get the best cost-benefit ratio.

Originality/value

Thus far, both the importance of patient safety culture and value-based healthcare have been advocated; this paper emphasizes the need to consider these two approaches together.

Details

Journal of Health Organization and Management, vol. 35 no. 5
Type: Research Article
ISSN: 1477-7266

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Article
Publication date: 8 May 2017

Tuan Luu, Chris Rowley, Sununta Siengthai and Vo Thanh Thao

Notwithstanding the rising magnitude of system factors in patient safety improvement, “human factors” such as idiosyncratic deals (i-deals) which also contribute to the…

Abstract

Purpose

Notwithstanding the rising magnitude of system factors in patient safety improvement, “human factors” such as idiosyncratic deals (i-deals) which also contribute to the adjustment of system deficiencies should not be neglected. The purpose of this paper is to investigate the role of value-based HR practices in catalyzing i-deals, which then influence clinical error control. The research further examines the moderating role of corporate social responsibility (CSR) on the effect of value-based HR practices on i-deals.

Design/methodology/approach

The data were collected from middle-level clinicians from hospitals in the Vietnam context.

Findings

The research results confirmed the effect chain from value-based HR practices through i-deals to clinical error control with CSR as a moderator.

Originality/value

The HRM literature is expanded through enlisting i-deals and clinical error control as the outcomes of HR practices.

Details

International Journal of Health Care Quality Assurance, vol. 30 no. 4
Type: Research Article
ISSN: 0952-6862

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Article
Publication date: 2 May 2017

Patrik Nordin, Anna-Aurora Kork and Inka Koskela

The purpose of this paper is to shed light on the potential of organizational learning for developing effectiveness of care. Value-based healthcare measurement recognizes…

Abstract

Purpose

The purpose of this paper is to shed light on the potential of organizational learning for developing effectiveness of care. Value-based healthcare measurement recognizes patient value as a driver for improving health outcomes at the societal and individual levels. By using the action learning method, this paper examines the phases of organizational learning in a private healthcare organization that has developed a novel Big Data screening tool for the treatment of patients with type 2 diabetes mellitus (DM2).

Design/methodology/approach

Relying on triple-loop learning as a conceptual framework and by applying the action learning method to case study design, this paper illustrates the phases of organizational learning and efforts to utilize value-based measurement in healthcare.

Findings

The case organization was able to identify patients at risk and to improve their care balance. Although the results for the measurement of patient outcomes led to questioning of previous care processes and practices in the organization, increasing value for all stakeholders by incorporating social needs to business opportunities remains under process.

Originality/value

With the focus on organizational learning and organizational value creation processes, this paper demonstrates incorporation of measuring patient outcomes in re-structuring care processes, enhancing organizational performance and improving effectiveness as well as quality of care.

Details

Leadership in Health Services, vol. 30 no. 2
Type: Research Article
ISSN: 1751-1879

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Article
Publication date: 15 February 2021

Olga Kokshagina and Joona Keränen

This study aims to explore the institutionalization of value-based healthcare (VBHC) in the public healthcare system in the state of Victoria, Australia.

Abstract

Purpose

This study aims to explore the institutionalization of value-based healthcare (VBHC) in the public healthcare system in the state of Victoria, Australia.

Design/methodology/approach

The empirical part of this paper is based on a content analysis of 34 policy and industry-commissioned reports that have guided the development of health-care strategy in Victoria from 1988 to 2020.

Findings

This study sheds light on how VBHC in Victoria has been institutionalized over time, through three key phases (centralization, transitioning and digitalization), how the conceptualization of best value has changed in each phase and the implications each phase has presented for other actors in the health-care system.

Practical implications

This study highlights the key opportunities and challenges for organizational actors that emerge when a health-care system transitions toward VBHC, and derives implications for vendors, health-care procurement, policymakers and governmental agencies.

Originality/value

This study develops a longitudinal analysis that describes the evolution and institutionalization of a VBHC approach in a complex societal system over three decades and highlights the key implications for other organizational stakeholders.

Details

Journal of Business & Industrial Marketing, vol. ahead-of-print no. ahead-of-print
Type: Research Article
ISSN: 0885-8624

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Article
Publication date: 19 June 2017

Christian Colldén, Ida Gremyr, Andreas Hellström and Daniella Sporraeus

The concept of value is becoming increasingly fashionable in healthcare and various improvement approaches (IAs) have been introduced with the aim of increasing value. The…

Abstract

Purpose

The concept of value is becoming increasingly fashionable in healthcare and various improvement approaches (IAs) have been introduced with the aim of increasing value. The purpose of this paper is to construct a taxonomy that supports the management of parallel IAs in healthcare.

Design/methodology/approach

Based on previous research, this paper proposes a taxonomy that includes the dimensions of view on value and organizational focus; three contemporary IAs – lean, value-based healthcare, and patient-centered care – are related to the taxonomy. An illustrative qualitative case study in the context of psychiatric (psychosis) care is then presented that contains data from 23 interviews and focuses on the value concept, IAs, and the proposed taxonomy.

Findings

Respondents recognized the dimensions of the proposed taxonomy and indicated its usefulness as support for choosing and combining different IAs into a coherent management model, and for facilitating dialog about IAs. The findings also suggested that the view of value as “health outcomes” is widespread, but healthcare professionals are less likely than managers to also view value as a process.

Originality/value

The conceptual contribution of this paper is to delineate some important characteristics of IAs in relation to the emerging “value era”. It also highlights the coexistence of different IAs in healthcare management practice. A taxonomy is proposed that can help managers choose, adapt, and combine IAs in local management models.

Details

Journal of Health Organization and Management, vol. 31 no. 4
Type: Research Article
ISSN: 1477-7266

Keywords

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