Spurrell Mark, Potts Lorraine, Shaw Amy
Alliance Manchester Business School, University of Manchester and Niche Consulting, UK.
Your Care Strategy Ltd., UK.
Int J Integr Care. 2023 Jan 9;23(1):1. doi: 10.5334/ijic.5975. eCollection 2023 Jan-Mar.
There is a gap between aspiring to co-produce and co-create value in integrated healthcare and realising that in practice, particularly with complex needs and multiple stakeholders. Key principles from literature on value-based healthcare offer a conceptual framework for building suitable care platforms to support practice. This paper outlines the Complex Care and Recovery Management Framework (CCaRM) as an example of co-platforming value-based healthcare within case level practice.
The CCaRM was co-produced with clinicians and service users in a learning disability service. Highlighted are 6 value-making themes for building collaborative value over time, alongside case management. "Experience-in-use" was that it made sense to participants, and activated service-users and clinicians. Further empirical evaluation is needed.
There was encouragement that the CCaRM approach was implementable. Alongside further evaluative work, key issues would be: collaborating with local participants; supporting training; reconciling case-level perspectives with wider systems. Progressing integrated value-based healthcare involves: refreshing focus on the case-based view; ways of operationalising complexity; value-based case management; customisation of care styles and "democratic outcomes" within co-platforming systems.
In principle, the CCaRM contributes to operationalising collaborative value-based healthcare for complex cases. It surfaces further research themes to refocus value and integrated care thinking. Further empirical work is needed.
在综合医疗保健中追求共同创造价值与在实践中实现这一目标之间存在差距,尤其是在面对复杂需求和众多利益相关者时。基于价值的医疗保健文献中的关键原则为构建合适的护理平台以支持实践提供了概念框架。本文概述了复杂护理与康复管理框架(CCaRM),作为在个案层面实践中基于价值的医疗保健共同平台的一个示例。
CCaRM是与学习障碍服务机构的临床医生和服务使用者共同创建的。文中强调了随着时间推移与病例管理一起构建协作价值的6个价值创造主题。“使用体验”是指它对参与者有意义,并能激发服务使用者和临床医生的积极性。还需要进一步的实证评估。
有人鼓励采用CCaRM方法,认为其具有可实施性。除了进一步的评估工作外,关键问题还包括:与当地参与者合作;提供培训支持;使个案层面的观点与更广泛的系统相协调。推进基于价值的综合医疗保健涉及:重新关注基于病例的视角;应对复杂性的操作方法;基于价值的病例管理;护理方式的定制以及共同平台系统内的“民主成果”。
原则上,CCaRM有助于将基于协作价值的医疗保健应用于复杂病例。它提出了进一步的研究主题,以重新聚焦价值和综合护理思维。还需要进一步的实证研究。