St Vincent's Health Australia Ltd, Fitzroy, Australia.
Faculty of Health Sciences, La Trobe University, Melbourne, Australia.
J Health Organ Manag. 2022 Jan 6;ahead-of-print(ahead-of-print). doi: 10.1108/JHOM-01-2021-0044.
The purpose of this study was to examine the concept of value in healthcare through a practical appraisal of the applicability of a conceptual framework, which is aimed at supporting the measurement and realisation of financial benefits from process improvement (PI) activities in a hospital setting.
DESIGN/METHODOLOGY/APPROACH: A single case study of a hospital system in Melbourne, Victoria, Australia, was used to assess the applicability of the framework. The study sought to verify the framework's intention, that PI methods could be used to address known wastes that contribute to the cost of providing healthcare. The case study examines the current approach taken by the hospital to measure and realise financial benefits from PI activities and compares these to the components of the Strategy to Balance Cost and Quality in Health Care framework to assess its applicability in practice.
The case study revealed that the steps described in the framework were fundamentally in place albeit with some variation. Importantly, the case study identified an additional step that could be added into the framework to support hospitals to better define their portfolio of initiatives to deliver value. The case study also clarified three types of contributory elements that should be in place for the application of the framework to be successful.
The Framework to Achieve Value in Healthcare is offered to hospitals as a model by which they can look to reduce expenditure through the removal of non-value adding activities. The modification to the conceptual framework has arisen from a single case study and would benefit from further testing by other hospitals in other policy settings (i.e. other countries).
ORIGINALITY/VALUE: This is the first paper to examine and enhance an existing framework to assist hospitals balance cost and quality through PI.
本研究旨在通过实际评估一个概念框架的适用性来检验医疗保健中的价值概念,该框架旨在支持衡量和实现医院环境中流程改进 (PI) 活动的财务收益。
设计/方法/途径:使用澳大利亚维多利亚州墨尔本的一家医院系统的单案例研究来评估该框架的适用性。该研究旨在验证框架的意图,即 PI 方法可用于解决导致提供医疗保健成本增加的已知浪费问题。该案例研究考察了医院目前用于衡量和实现 PI 活动财务收益的方法,并将这些方法与“平衡医疗保健成本和质量策略”框架的组成部分进行比较,以评估其在实践中的适用性。
案例研究表明,框架中描述的步骤虽然存在一些差异,但基本已经到位。重要的是,案例研究还确定了可以添加到框架中的额外步骤,以支持医院更好地定义其实现价值的计划组合。案例研究还澄清了成功应用框架所需的三种贡献要素类型。
“实现医疗保健价值框架”提供给医院作为一种模型,通过消除非增值活动来减少支出。对概念框架的修改源自单个案例研究,将受益于其他医院在其他政策环境(即其他国家)中的进一步测试。
原创性/价值:这是第一篇研究和增强现有框架以帮助医院通过 PI 平衡成本和质量的论文。