Value-based healthcare measurement as a context for organizational learning

Nordin, Patrik; Kork, Anna‐Aurora; Koskela, Inka

doi:10.1108/lhs-10-2016-0053

Cited by 8 publications

(8 citation statements)

References 42 publications

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“…This supports the previous observation by researchers that “learning by doing” is a strong facilitator (e.g. [ 21 , 22 , 25 – 28 , 63 ]). Ways to assist change in support functions should be described as a continuum, starting from a discrete task-focused activity (i.e., doing for others) and leading to a process of enabling individuals, teams, and the organization [ 64 ].…”

Section: Discussionsupporting

confidence: 91%

“…New approaches are needed to address vital challenges in health and social care related to size, complexity, and context; working with loosely coupled systems and actors [ 7 , 8 ]; and simultaneously pursuing quality, safety, and cost controls [ 1 , 2 ]. Our study also contributes to the knowledge base surrounding how to support organizations in changing deep-rooted behaviors through action-learning and cultivation of double and triple-loop learning [ 21 , 22 ]. The study’s pilot project led to important lessons, further described under the first four headings below, including specific aspects of change that need additional consideration by change agents seeking to build COIL capability in health and social care.…”

Section: Discussionmentioning

confidence: 89%

“…To fundamentally change organizational behaviors, basic underlying mental models must be addressed. Action-learning has been proposed as a way to address quality and safety challenges in healthcare and to foster double and triple-loop learning [ 21 , 22 ]. Double-loop learning reframes or alters basic assumptions and values, leading to deeper and more sustainable change.…”

Section: Introductionmentioning

confidence: 99%

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Exploring the potential of a multi-level approach to improve capability for continuous organizational improvement and learning in a Swedish healthcare region

Nyström

Höög

Garvare

et al. 2018

BMC Health Serv Res

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BackgroundEldercare and care of people with functional impairments is organized by the municipalities in Sweden. Improving care in these areas is complex, with multiple stakeholders and organizations. Appropriate strategies to develop capability for continuing organizational improvement and learning (COIL) are needed. The purpose of our study was to develop and pilot-test a flexible, multilevel approach for COIL capability building and to identify what it takes to achieve changes in key actors’ approaches to COIL. The approach, named “Sustainable Improvement and Development through Strategic and Systematic Approaches” (SIDSSA), was applied through an action-research and action-learning intervention.MethodsThe SIDSSA approach was tested in a regional research and development (R&D) unit, and in two municipalities handling care of the elderly and people with functional impairments. Our approach included a multilevel strategy, development loops of five flexible phases, and an action-learning loop. The approach was designed to support systems understanding, strategic focus, methodological practices, and change process knowledge - all of which required double-loop learning. Multiple qualitative methods, i.e., repeated interviews, process diaries, and documents, provided data for conventional content analyses.ResultsThe new approach was successfully tested on all cases and adopted and sustained by the R&D unit. Participants reported new insights and skills. The development loop facilitated a sense of coherence and control during uncertainty, improved planning and problem analysis, enhanced mapping of context and conditions, and supported problem-solving at both the individual and unit levels. The systems-level view and structured approach helped participants to explain, motivate, and implement change initiatives, especially after working more systematically with mapping, analyses, and goal setting.ConclusionsAn easily understood and generalizable model internalized by key organizational actors is an important step before more complex development models can be implemented. SIDSSA facilitated individual and group learning through action-learning and supported systems-level views and structured approaches across multiple organizational levels. Active involvement of diverse organizational functions and levels in the learning process was facilitated. However, the time frame was too short to fully test all aspects of the approach, specifically in reaching beyond the involved managers to front-line staff and patients.Electronic supplementary materialThe online version of this article (10.1186/s12913-018-3129-3) contains supplementary material, which is available to authorized users.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 89%

Section: Introductionmentioning

confidence: 99%

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Exploring the potential of a multi-level approach to improve capability for continuous organizational improvement and learning in a Swedish healthcare region

Nyström

Höög

Garvare

et al. 2018

BMC Health Serv Res

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“…Successful implementation of VBHC requires an assessment of actual healthcare costs using methods that evaluate how each patient consumes resources in the healthcare system [11]. Hospitals' ability to compare health outcomes and costs is expected to improve through value-based competition [12]. Less attention has been dedicated to developing a cost calculation method [13].…”

Section: Introductionmentioning

confidence: 99%

Elective caesarean section cost efficiency with time-driven activity-based costing

Haq

Pribadi²,

Akrom³

2023

IJPHS

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Hospitals compete to increase the value of services, one of which is cost-efficiency. The complexity of the service process and many resources in health services make calculating costs difficult. Time-driven activity based costing (TDABC) can identify specific cost drivers so that it has the potential to help identify inefficient processes. This study analyzes the cost efficiency of caesarean section with the TDABC. This study uses a qualitative research design with a case study method at one of the hospitals in Bantul, Yogyakarta, Indonesia. Primary data was taken from direct observation and interviewing hospital staff. Secondary data were obtained from hospital annual report 2019, hospital financial reports 2019, and patient medical records. The cost of a caesarean section was calculated and analyzed using the seven-step TDABC model with one-year hospital 2019 data. The cost of an elective caesarean section with the TDABC method is IDR 4,576,182.72. Hospitals can reduce postoperative costs by 25% by reducing the use of medicine and antibiotics. Based on the research results, TDABC can properly analyze costs based on services and identify inefficient processes.

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“…Modern healthcare leadership theories (e.g., Triple Aim [1], 4P [2] and Value-Based Healthcare [3]) emphasize the data significance within the decision making. Continuous measurement supports enterprise strategy utilization and is based on a selected set of indicators [4], which are describing the health care service system performance, resource consumption and the outcome.…”

Section: Introductionmentioning

confidence: 99%

Voices behind indicators for welfare and healthcare in Finland

Mussalo

Hotti²,

Mussalo³

2019

FinJeHeW

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The voices of different kinds (i.e., stated or unstated expectations of the entities) affect the functioning of the systems. Voices of authorities (VoA), processes (VoP) and shareholders (VoS) are seen in controls interacting with an environment. Therefore, control-related indicators are prescriptive, and they provide expectations for the functioning of the systems. In the study, the entity-related approach of the voices (VoA, VoP, and VoS) adapted to formalize rules for the evaluation metadata of the KUVA and SOTKANET indicators the meaning of which is to control welfare and health in Finland. The KUVA indicators are meant to control especially cost-effectiveness. The region classifications of the KUVA and SOTKANET indicators used to figure out whether responsible information providers (VoP) and information consumers (VoA and VoS) can be established. When 15 region classifications mapped within the voices by the nine rules the result of which was that nine region classifications mapped within VoA, three within VoS, and two within VoP. The main information providers are municipalities and hospital districts and municipalities. Despite our metadata-based KUVA and SOTKANET content research, without the deployment instructions of the indicators, the municipalities and other service providers do not get a complete picture of how the authorities and shareholders see them and what is expected of them, i.e., control-related cost-effectiveness will not be transparent.

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Value-based healthcare measurement as a context for organizational learning

Cited by 8 publications

References 42 publications

Exploring the potential of a multi-level approach to improve capability for continuous organizational improvement and learning in a Swedish healthcare region

Exploring the potential of a multi-level approach to improve capability for continuous organizational improvement and learning in a Swedish healthcare region

Elective caesarean section cost efficiency with time-driven activity-based costing

Voices behind indicators for welfare and healthcare in Finland

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