IMPLEMENTING VALUE-BASED CARE, Study Guides, Projects, Research of Nursing

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IMPLEMENTING

VALUE-BASED

CARE

A S T R AT E G I C AC T I O NP L AN

JENNIFER HOGAN

RN, BSN

What is Value- Based Care (VBC)?

A delivery model

where providers

are paid based on

the VALUE of care

they provider not

the number of

patients they see

Benefits Include:

improved patient

outcomes,

reduced number

of re-

hospitalizations

and patients

living healthier

Value-Based Healthcare Framework UNDERSTANDI UNDERSTANDI NG NG SHAREDSHARED HEALTH HEALTH NEEDSNEEDS OFOF^ PATIENTSPATIENTS

DESIGNDESIGN

SOLUTIONSOLUTION

TO TO

IMPROVE IMPROVE

HEALTH HEALTH

OUTCOMES OUTCOMES

INTEGRATE INTEGRATE

LEARNINLEARNIN

G G TEAMSTEAMS

• MEASUR

E

HEALTH

OUTCOME

S AND

COSTS

• EXPAND

PARTNERSHI

PS

• REPEAT

(Teisburg et al., 2020)

RATIONALE FOR IMPLEMENTING VBC ❑ Patient Advocacy

By providing more efficient and

improved care for our

patients is the greatest

avocation for our

patients.

Patient Safety

Patient’s safety is one of the

main purposes of VBC by

providing

routine safe care for our

population.

Reduction in Healthcare Costs

By making care more

efficient is is also more

affordable for

both

patients and providers

What is an Advanced Practice Nurse Role in Implementing VBC? “Nurse’s must act as Scientist, Detective and a Manager of The Healing Environment” ❖ (^) As provider with the most patient contact, we are best apt to determine what the patient’s most valued care is. ❖ (^) APRN’s collaborate to coordinate care and make is efficient. ❖ (^) Educate both patients, caregivers and peers on patient’s goals, protocols and policies. ❖ (^) Role to manage care and addressing all aspects of care including social and cultural responsibilities. (Western Governors University, 2016)

EVIDENCE REVIEW # Value-Based Care and Patient-Centered Care: Divergent or Complementary? ● This article discusses the two care models value- based care (VBC) and patient-centered care (PCC) and if they can effectively be used together or if one is more efficient that the other (^) in reference to cancer care settings. ● VBC is defined in this article as value of healthcare that is determined by health outcomes modified by cost. (^) While the quality of PCC is solely determined by patients’ and families decisions and opinions of quality. ● The only way both can co-exist well is if the patients’ preferences and opinions are worked into the VBC metrics.

EVIDENCE REVIEW

Four Steps Within Your Stride: Surprising Insights from Implementing Value-based

Care Delivery

● This article discusses the possibility of organizations to implement VBC protocols and the process for them to achieve (^) it. Organizations with vary in how long implementation takes but it is agreed upon that there is a desperate need to focus on the patient, improve quality and reduce costs. The authors determined there are four steps for organizations to start moving towards VBC. ◆ Step^ 1: Measure Results ◆ Step^ 2: Document Care Paths ◆ Step^ 3: Create Teams ◆ Step^ 4: Engage in Human Centered Design

(Teisburg & Wallace, 2017)

(National Advisory Council on Nurse Education and Practice (NACNEP), 2019)

EVIDENCE REVIEW

Defining and Implementing Value-Based Healthcare: A Strategic

Framework

● This article discusses what VBC is and how it is best implemented. A valid and most often overlooked point made by the authors that patient satisfaction and value are two very different subjects. Techniques and subjects included: ◆ Difference of Patient Satisfaction that ask “How were we” versus Value that asks “How are you”. ◆ Understanding^ shared health needs of patient ◆ Design^ a comprehensive solution that improves health outcomes ◆ Integrate^ learning teams ◆ Measure^ health outcomes and costs ◆ Expand^ Partnerships ◆ Including^ VBC in education of medical providers.

EVIDENCE REVIEW # Value-Based Healthcare: Fad or Fabulous? ● This article discusses how the United States can implement the VBC system that has been implemented in many other countries such as Canada and Australia. (^) The guidelines for this is based off of research done by the authors of Value- Based Care, Porter and Teisburg in 2016:

1. Focus of the value to patients, not just lowering costs

2. Competition should be based on results

3. Competition should focus on medical conditions over the full cycle of care

4. High-quality care should be less expensive

5. Value must be driven by provider experience, scale and learning at the

medical condition level

6. Competition should be regional and national, not just local

7. Results information related to competition must be widely available

8. Innovations that increase value must be strongly rewarded

(Duckett, 2019)

TWO STRATEGIES TO IMPLEMENT VBC Staff Participation and Input ❖ Encourage staff frequent input and utilize peer committees for improvements ❖ Be transparent about changes and have common goals