Value-based Healthcare: Person-centered Measurement: Focusing on the Three C's

Liu, Tiffany C.; Bozic, Kevin J.; Teisberg, Elizabeth

doi:10.1007/s11999-016-5205-5

Cited by 27 publications

(24 citation statements)

References 3 publications

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“…Additionally, while the importance of outcome measurements for VBHC is generally well established, the range of its utility remains debated. Whereas some argue that outcome measurements seem less valuable regarding chronic diseases [ 9 ], others argue that such measurements are actually particularly applicable to chronic conditions [ 10 ]. Similar dissonance can be observed regarding the idea of value-based payment: while some scholars include pay-for-performance and capitation as value-based methods [ 11 ], these payment models are explicitly declared invalid by others [ 4 ].…”

Section: Introductionmentioning

confidence: 99%

Redefining value: a discourse analysis on value-based health care

Steinmann

Bovenkamp

Bont

et al. 2020

BMC Health Serv Res

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Background Today’s remarkable popularity of value-based health care (VBHC) is accompanied by considerable ambiguity concerning the very meaning of the concept. This is evident within academic publications, and mirrored in fragmented and diversified implementation efforts, both within and across countries. Method This article builds on discourse analysis in order to map the ambiguity surrounding VBHC. We conducted a document analysis of publicly accessible, official publications (n = 22) by actors and organizations that monitor and influence the quality of care in the Netherlands. Additionally, between March and July 2019, we conducted a series of semi-structured interviews (n = 23) with national stakeholders. Results Our research revealed four discourses, each with their own perception regarding the main purpose of VBHC. Firstly, we identified a Patient Empowerment discourse in which VBHC is a framework for strengthening the position of patients regarding their medical decisions. Secondly, in the Governance discourse, VBHC is a toolkit to incentivize providers. Thirdly, within the Professionalism discourse, VBHC is a methodology for healthcare delivery. Fourthly, in the Critique discourse, VBHC is rebuked as a dogma of manufacturability. We also show, however, that these diverging lines of reasoning find common ground: they perceive shared decision-making to be a key component of VBHC. Strikingly, this common perception contrasts with the pioneering literature on VBHC. Conclusions The four discourses will profoundly shape the diverse manners in which VBHC moves from an abstract concept to the practical provision and administration of health care. Moreover, our study reveals that VBHC’s conceptual ambiguity largely arises from differing and often deeply rooted presuppositions, which underlie these discourses, and which frame different perceptions on value in health care. The meaning of VBHC – including its perceived implications for action – thus depends greatly on the frame of reference an actor or organization brings to bear as they aim for more value for patients. Recognizing this is a vital concern when studying, implementing and evaluating VBHC.

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Section: Introductionmentioning

confidence: 99%

Redefining value: a discourse analysis on value-based health care

Steinmann

Bovenkamp

Bont

et al. 2020

BMC Health Serv Res

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“…Future work should be done to better the understanding of the dynamic between patients and providers and services and to assess whether optimizing facets of care-provider behavior and hospital services early after injury can decrease future limitations and vice versa. Better health care depends on improvements not only in technical elements and treatments to alleviate physical limitations but also in the delivery of a comfortable experience that allows patients to better engage and navigate health-care systems in pursuing better health 35 . This is reflected by the expansion of quality improvement initiatives within current health-care organizations in areas such as communication (e.g., telephone contact/messaging systems) and care coordination (e.g., streamlining pathways and discharge) to enhance patient experience 36 .…”

Section: Discussionmentioning

confidence: 99%

Relationship Between Magnitude of Limitations and Patient Experience During Recovery from Upper-Extremity Fracture

Jayakumar

Teunis

Vranceanu

et al. 2019

JBJS OA

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Background:The relationship between the magnitude of limitations (measured by patient-reported outcome measures, or PROMs) and satisfaction with care providers and hospital services (measured by patient-reported experience measures, or PREMs) over the course of recovery after injury is unclear. The purpose of this study was to assess the relationship between a range of PROMs and 2 PREMs at 3 time points (initial office visit within a week, 2 to 4 weeks, and 6 to 9 months) after shoulder, elbow, and wrist fractures.Methods:We enrolled 744 adult patients with an isolated shoulder, elbow, or wrist fracture and invited them to complete PROMs (the Patient-Reported Outcomes Measurement Information System Upper Extremity Physical Function computer adaptive test [PROMIS UE], PROMIS Physical Function (PROMIS PF) scale, Quick Disabilities of the Arm, Shoulder and Hand [QuickDASH] questionnaire, EuroQol 5-Dimensions 3-Level Index [EQ-5D-3L], and Oxford Shoulder Score [OSS], Oxford Elbow Score [OES], or Patient-Rated Wrist Evaluation [PRWE]) and PREMs (Numerical Rating Scale [NRS] for satisfaction with care providers [NRS-C] and for satisfaction with hospital services [NRS-S]) at their initial visit at the outpatient surgical practice (maximum, 1 week after the fracture), between 2 and 4 weeks after the injury, and between 6 and 9 months after the injury. Correlational analysis was performed at each time point.Results:There was moderate correlation between the PROMIS UE and the NRS-C (r = 0.56) and NRS-S (r = 0.59) at 6 to 9 months after injury, which was stronger than the correlation at the 2 to 4-week mark (NRS-C, r = 0.34; NRS-S, r = 0.36) and at the evaluation that took place within a week after the injury (NRS-C, r = 0.18; NRS-S, r = 0.16). These correlational trends were observed with all forms of PROMs. Patients reporting greater limitations after injury were also less satisfied with their care and services.Conclusions:The increasing alignment of PROMs and PREMs over the course of recovery after an upper-extremity fracture suggests that restored physical function may improve perceptions of satisfaction with care providers and hospital services over time. Future studies should assess factors that could be addressed to improve patient satisfaction and their limitations during recovery after fracture in order to maximize patient outcomes.Level of Evidence:Therapeutic Level IV. See Instructions for Authors for a complete description of levels of evidence.

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“…Increased knowledge on patient outcomes gives the potential to obtain a higher quality of care using patient‐reported measurement tools for evaluation of their condition and experiences of treatments (Liu, Bozic, & Teisberg, ). However, for the continuity of care, follow‐ups performed by perioperative nurses for evaluating given care give a more precise perception of how the patients experience their physical and psychological condition after surgery.…”

Section: Discussionmentioning

confidence: 99%

Patient‐reported extremity symptoms after robot‐assisted laparoscopic cystectomy

Johansson

Vogelsang

2019

Journal of Clinical Nursing

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Aims and objectives To describe patient‐reported extremity symptoms after robot‐assisted laparoscopic cystectomy in patients with bladder cancer. Background Preventive activities for remaining patient safety due to correct positioning play an important part in perioperative nursing care.Extremity injuries are well‐known after prolonged surgery, especially in robot‐assisted urologic surgery in the steep Trendelenburg position. The risk of injury increases due to patient‐related and operative risk factors. Methods A quantitative prospective observational study was conducted. Patients were followed up with the QuickDASH (Disabilities in the Arm, Shoulder and Hand), Lower Extremity Functional Scale (LEFS) and a study‐specific questionnaire 7–10 days and monthly, up to six months after surgery in patients with extremity symptoms. The study adheres to STROBE (strengthening the reporting of observational studies in epidemiology) guidelines, see Supporting information File S1. Results Out of the 94 included participants, 46.8% (n = 44) experienced extremity symptoms 7–10 days after surgery. Pain, numbness and weakness were the most frequent symptoms. There was a discrepancy between the patients reported symptoms and the documentation in the patient records. Only 13.6% (n = 3) of the reported pain was documented, respectively 27.5% (n = 11) of other symptoms. Conclusion A large proportion of the patients report postoperative extremity symptoms after robot‐assisted laparoscopic cystectomy. Prevention of complications in the perioperative setting, are together with follow‐ups, important nursing activities for maintaining patient safety and may both prevent and detect postoperative extremity symptoms and injuries. Relevance to clinical practice This study reveals the need of accurate documentation regarding extremity symptoms in digital patient records, as well as continuous follow‐ups during the hospital stay and after hospital discharge to enable detection of treatable extremity injuries. The result of this study also indicates the importance of nursing activities such as evidence‐based positioning guidelines in the operating theatre for optimal positioning.

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Value-based Healthcare: Person-centered Measurement: Focusing on the Three C's

Cited by 27 publications

References 3 publications

Redefining value: a discourse analysis on value-based health care

Redefining value: a discourse analysis on value-based health care

Relationship Between Magnitude of Limitations and Patient Experience During Recovery from Upper-Extremity Fracture

Patient‐reported extremity symptoms after robot‐assisted laparoscopic cystectomy

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