Dataset Information

European value-based healthcare benchmarking: moving from theory to practice.

ABSTRACT:

Background

Value-based healthcare (VBHC) is a conceptual framework to improve the value of healthcare by health, care-process and economic outcomes. Benchmarking should provide useful information to identify best practices and therefore a good instrument to improve quality across healthcare organizations. This paper aims to provide a proof-of-concept of the feasibility of an international VBHC benchmarking in breast cancer, with the ultimate aim of being used to share best practices with a data-driven approach among healthcare organizations from different health systems.

Methods

In the VOICE community-a European healthcare centre cluster intending to address VBHC from theory to practice-information on patient-reported, clinical-related, care-process-related and economic-related outcomes were collected. Patient archetypes were identified using clustering techniques and an indicator set following a modified Delphi was defined. Benchmarking was performed using regression models controlling for patient archetypes and socio-demographic characteristics.

Results

Six hundred and ninety patients from six healthcare centres were included. A set of 50 health, care-process and economic indicators was distilled for benchmarking. Statistically significant differences across sites have been found in most health outcomes, half of the care-process indicators, and all economic indicators, allowing for identifying the best and worst performers.

Conclusions

To the best of our knowledge, this is the first international experience providing evidence to be used with VBHC benchmarking intention. Differences in indicators across healthcare centres should be used to identify best practices and improve healthcare quality following further research. Applied methods might help to move forward with VBHC benchmarking in other medical conditions.

SUBMITTER: Garcia-Lorenzo B

PROVIDER: S-EPMC10843953 | biostudies-literature | 2024 Feb

REPOSITORIES: biostudies-literature

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Publications

European value-based healthcare benchmarking: moving from theory to practice.

García-Lorenzo Borja B Gorostiza Ania A Alayo Itxaso I Castelo Zas Susana S Cobos Baena Patricia P Gallego Camiña Inés I Izaguirre Narbaiza Begoña B Mallabiabarrena Gaizka G Ustarroz-Aguirre Iker I Rigabert Alina A Balzi William W Maltoni Roberta R Massa Ilaria I Álvarez López Isabel I Arévalo Lobera Sara S Esteban Mónica M Fernández Calleja Marta M Gómez Mediavilla Jenifer J Fernández Manuela M Del Oro Hitar Manuel M Ortega Torres María Del Carmen MDC Sanz Ferrandez María Consuelo MC Manso Sánchez Luís L Serrano Balazote Pablo P Varela Rodríguez Carolina C Campone Mario M Le Lann Sophie S Vercauter Piet P Tournoy Kurt K Borges Marina M Oliveira Ana Sofía AS Soares Marta M Fullaondo Ane A

European journal of public health 20240201 1

<h4>Background</h4>Value-based healthcare (VBHC) is a conceptual framework to improve the value of healthcare by health, care-process and economic outcomes. Benchmarking should provide useful information to identify best practices and therefore a good instrument to improve quality across healthcare organizations. This paper aims to provide a proof-of-concept of the feasibility of an international VBHC benchmarking in breast cancer, with the ultimate aim of being used to share best practices with ...[more]

PMID: 37875008

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Project description:BackgroundPractice-based interprofessional education (IPE) is essential to prepare students for collaborative working. Pockets of practice-based IPE are integrated into healthcare curriculums in some regions. Yet practice-based IPE is not globally valued as a key element of healthcare curriculums. As students and clinical educators are key stakeholders, this study presents a case example of their experiences in a country where practice-based IPE is at an emergent stage. Their experiential knowledge generated important insights into how practice-based IPE is perceived. This learning can be applied, both locally and further afield, by those seeking to embed practice-based IPE in their placement curriculums.MethodsA qualitative case study was conducted at a school of allied health and partner placement sites in Ireland. Data collection comprised two participant observations, 13 interviews and 12 document analyses. Inductive thematic analysis and deductive framework analysis, underpinned by activity theory and Hofstede's cultural dimensions, informed data analysis and interpretations.ResultsParticipants are grappling to establish the value of practice-based IPE, illustrated in three themes: clarifying the concept of practice-based IPE, mapping IPE activities and diversifying interprofessionalism. First, ambiguous conceptualisation of why and how to implement practice-based IPE was identified. Highlighting how practice-based IPE improved patient care and safety created a clear rationale for implementation. It was also helpful to demonstrate how adaptations to existing practice education models, rather than entirely new models, could achieve high-quality practice-based IPE. Second, the positioning of practice-base IPE in the placement curriculum was unclear. Overt mapping of practice-based IPE activities onto learning outcomes within assessment tools enhanced its value within practice education. Third, varying levels of professional engagement were noted, perpetuating stereotypes. Creating diverse educator networks and embedding practice-based IPE in organisational strategy may incentivise engagement across a greater range of professions.ConclusionsImplementing these recommendations could enhance the value of practice-based IPE and optimise student preparation for collaborative working. Practice-based IPE remains a complex model and the trajectory of embedding in healthcare curriculums will differ globally.

Project description:A theoretical approach to assessing the barriers and levers to evidence-based practice (EBP) with subsequent tailoring of theoretically informed strategies to address these may go some way to positively influencing the delay in implementing research findings into practice. Hand hygiene is one such example of EBP, chosen for this study due to its importance in preventing death through healthcare associated infections (HCAI). The development of an instrument to assess barriers and levers to hand hygiene and to allow the subsequent tailoring of theoretically informed implementation strategies is reported here.A comprehensive list of barriers and levers to hand hygiene were categorised to the Theoretical Domains Framework (TDF) in a Delphi survey. These items formed the basis of an instrument that was tested to establish validity and reliability. The relationship between self-reported compliance with hand hygiene and barriers and levers to hand hygiene was also examined along with compliance according to where the barriers and levers fit within the domains of the TDF framework.A 33-item instrument that tested well for internal consistency (? = 0.84) and construct validity (?²/df = 1.9 [p < 0.01], RMSEA = 0.05 and CFA = 0.84) was developed. The relationship between self-reported compliance with hand hygiene moderately correlated with barriers identified by participants (total barrier score) (r = 0.41, n = 276, p <0.001). The greater the number of barriers reported, the lower the level of compliance. A one-way between groups multivariate analysis of variance was performed to investigate differences between those adopting high or low compliance with hand hygiene. Compliance was highest for this sample of participants among practitioners with high levels of motivation, strong beliefs about capabilities, when there were positive social influences, when hand hygiene was central to participants' sense of professional identity and was easier to remember to do.This study has produced encouraging findings suggesting the potential for improved hand hygiene and resulting effects on the human and financial costs of healthcare associated infection. This study identifies a further potential use for the TDF.

Dataset Information

European value-based healthcare benchmarking: moving from theory to practice.

Background

Methods

Results

Conclusions

Publications

European value-based healthcare benchmarking: moving from theory to practice.

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