Value Based Care
Value Based Care
Value in health care is the measured improvement in a person’s health outcomes for the cost of achieving that improvement. While some descriptions conflate value-based health care and cost reduction, quality improvement, or patient satisfaction, those efforts—while important—are not the same as value, which focuses primarily on improving patient health outcomes. A decade of research into organizations that have achieved better outcomes while often lowering costs suggests a strategic framework for value-based health care implementation that starts with identifying and understanding a segment of patients whose health and related circumstances create a consistent set of needs. An interdisciplinary team of caregivers then comes together to design and deliver comprehensive solutions to address those needs.
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The team measures the health outcomes and costs of its care for each patient and uses that information to drive ongoing improvements. Care provided in this way aligns delivery with how patients experience their health and reconnects clinicians to their purpose as healers. It also asks physicians to think differently about their role within the larger care team and about the services that team provides. The authors suggest medical schools should incorporate education on the principles and implementation of value-based health care throughout the undergraduate medical curriculum to prepare their graduates to lead the transformation to value-based health care as they enter the physician workforce Value Based Care.
| DEFINED NEED | Yes | No |
| Has your organization established a need to implement value-based nursing care strategies? | ☐ | X |
| READINESS FOR CHANGE | ||
| Is now the right time for implementing value-based nursing care (e.g., it will not compete with other major changes currently being made within the organization)? | X | ☐ |
| Have employees been informed of the recommendations and been provided an opportunity to comment on the feasibility of the change? | X | ☐ |
| Have implementation plans been developed that include an action plan, training plan, and communication and change management plans? | X | ☐ |
| Does the organization have a Health Information System that has the capacity to collect, analyze and report value metrics and key performance indicators that link nursing care services to patient outcomes? | X | ☐ |
| LEADERSHIP & MANAGEMENT SUPPORT | ||
| Will the organization’s executive leaders actively support and champion implementation of value-based nursing care. | X | ☐ |
| Does the organization’s leadership reward teamwork behaviors and showcase successes throughout the organization? | X | ☐ |
| Have the strategic recommendations the interprofessional team developed been approved by organizational leaders and managers? | ☐ | X |
| TIME, RESOURCES, PERSONNEL | ||
| Has an Impact Analysis been completed to determine the influence this change will have on human and financial resources? | ☐ | X |
| Does your organization have sufficient staff with the necessary time and resources to support active project participation? | X | ☐ |
| Will your organization allow time to prepare and continue work on project deliverables? | X | ☐ |
| SUSTAINMENT OF THE CHANGE | ||
| Has the organization identified value metrics that can be used to measure the effectiveness of value-based nursing care over time? | ☐ | X |
| Will the organization be willing to use continuous improvement processes to measure and assess progress and continuously improve processes? | X | ☐ |
| Will strategies for minimizing potential project failure modes be developed prior to implementation? | X | ☐ |
| Does the organization have a culture that supports and rewards teamwork and innovation in nursing care? | X | ☐ |
Count the number of “Yes” responses and refer to the next page to determine the organization’s level of readiness for value-based nursing care.
READINESS ASSESSMENT SCORE
Number of Yes responses you have selected is 11-15 out of 15:
This is likely a good time within your organization to participate in the Value-Based Nursing Care Project. Prior to implementation, continue to monitor whether the answers to these questions change and keep a close eye on any items to which you answered “No.”
Number of Yes responses you have selected is 6-10 out of 15:
Your organization may not be ready on several of the factors. This reduces the likelihood of the success of implementing Value-based Nursing Care at this time.
Number of Yes responses you have selected is 1-5 out of 15:
Based on your responses, significant work is likely needed to raise the readiness level of your organization. Moving forward with implementing Value-Based Nursing Care could create significant risk that it will not succeed or produce the desired results.
