2018
DOI: 10.1136/bmjopen-2017-020739
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Do ‘physicians in the lead’ support a holistic healthcare delivery approach? A qualitative analysis of stakeholders’ perspectives

Abstract: ObjectivesValue-based healthcare implies that healthcare issues are addressed most effectively with the ‘physicians in the lead’ (PIL) strategy. This study explores whether PIL also supports a holistic care approach that patients are increasingly demanding.DesignA qualitative research design was used.SettingThis study was conducted in a general hospital in the Netherlands with an integrated PIL strategy.ParticipantsSemistructured interviews were conducted with 14 hospital stakeholders: 13 stakeholders of an Ob… Show more

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Cited by 13 publications
(16 citation statements)
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References 23 publications
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“…Open communication or speaking up remains difficult for different professional groups. The hierarchical structure of healthcare organisations and the increasingly implemented strategy of ‘physicians in the lead’ do not seem to contribute to open communication 40–44. Moreover, important dimensions might not be identified by tools if participants consider them unimportant or conceal them on purpose to prevent potential negative consequences of speaking up 10 36 37 45.…”
Section: Discussionmentioning
confidence: 99%
“…Open communication or speaking up remains difficult for different professional groups. The hierarchical structure of healthcare organisations and the increasingly implemented strategy of ‘physicians in the lead’ do not seem to contribute to open communication 40–44. Moreover, important dimensions might not be identified by tools if participants consider them unimportant or conceal them on purpose to prevent potential negative consequences of speaking up 10 36 37 45.…”
Section: Discussionmentioning
confidence: 99%
“…These elements are routinely utilised in areas of service provision in the system and can be used to compliment elements from sector stakeholders who offer innovation, new medicines and technologies (Gov UK: Office For Life Sciences (OLS), 2017; Neville, 2019; WAG, 2018) to support VBHC implementation through multidisciplinary collaboration. Malik et al, 2018 demonstrate that a multi-disciplinary approach is a preferential option as opposed to a siloed approach when attempting to deliver VBHC. The study showed that a 'Physicians in the Lead' (PIL) strategy engages physicians in system organisations' processes to make them responsible for the quality and efficiency of their departments healthcare provision.…”
Section: One: a Multidisciplinary Approachmentioning
confidence: 92%
“…Collaboration between all stakeholders; Multidisciplinary; organization from across the System, patients, patient advocates and private sector; a team-in-lead strategy; public-private partnerships; spectrum of healthcare providers; multi-sector engagement; integrated care delivery systems; collaboration with physicians, hospital systems; work together and to each-others strengths; all stakeholders to engage with medical device industry; new relationships with industry (Hara et al, 2003); (VBHC Center Europe, 2019); (Horne et al, 2019); (Malik et al, 2018); (Nishtar, 2004); ; (Beck et al, 2012); (Kaplan & Babad, 2011); (Zelmer, 2018); (Nilsson et al, 2017); (Gerecke et al, 2015); (Dafny et al, 2016); (Porter & Ishrak, 2015); (Medtronic, 2016); (Gov UK, 2016); (Martschinke & Traut, 2016); (Hu et al, 2000); (WAG, 2018); (EIU, 2016b); (Young et al, 2001); (Hurh, Ko, & Lee, 2017); (Handke et al, 2017); (Lewis (Lee, 2010) ; ; (Beck et al, 2012); (Aneurin Bevan University Health Board, 2019); (Kavanagh et al, 2012); ; (Handke et al, 2017); (Porter & Ishrak, 2015); (Neumann et al, 2011); (Wang et al, 2009); (Doyle, 2011); (Martschinke & Traut, 2016); (Miller, 2012); (Nilsson et al, 2017); (WAG, 2018); (EIU, 2016b); (Jönsson, 2009).…”
Section: Guiding Conditionmentioning
confidence: 99%
“…First, physicians’ primarily unidiscipline educational structures and mentor-apprentice approach inculcate normative traditions that govern physicians’ professional identity and behaviours in daily work and interactions 55. Early and ongoing exposure to multidisciplinary oriented education (including collective problem and solution formulation) holds potential to restructure roles and responsibilities and instil a more open-minded and collaborative approach to problem analysis and decision-making 52 56–58…”
Section: Bolstering Ml’s Potentialmentioning
confidence: 99%