Health care transformation / QBPs

How QBPs are Accelerating Health Care Transformation

March 21, 2016

They say the only constant in life is change. Somehow, health care delivery and funding models had managed to evade this principle—until now.

With the introduction and implementation of quality-based procedures (QBP) and other value-based funding (VBF) models in the Canadian and American health care systems, we’re seeing fundamental shifts in the way this sector is perceived, and how it operates.

Change requires a shift in psychology

Moving the focus from a fee-for-service to a fee-for-value model, requires a collective psychological change among health care providers. In order to optimize patient outcomes and improve care delivery under QBP standards, the onus is on hospitals and clinicians to take an objective, critical look at their current practices and find new, innovative ways to increase the value of their services At the core will be a greater focus on appropriate, coordinated, and proactive delivery of care.

Clinical redesign has been one of the greatest challenges for hospitals implementing QBPs. The QBP handbooks are are valuable resource, and outline provincial clinical standards at a macro level. Most Ontario hospitals have found it challenging to bridge the gap between these standards and front-line clinical practice; they require clear, practical guidance to transform clinical practices enterprise-wide, and tools to support practitioners in providing high quality care. The transformation requires resources and expertise to develop, implement and maintain QBP programs. Hospital-wide clinical redesign for QBPs will require contextualizing expert panel recommendations to the unique practice settings present at every site.

Improvements to clinical processes could include eliminating duplicate or unnecessary investigations, better discharge planning, and paying greater attention to preventing adverse events. These changes, alongside adoption of evidence-informed practices, will improve the overall patient experience and clinical outcomes and help create a sustainable model for health care delivery.

Data Driven at the Core

Value-based care is absolutely driven by and reliant on capturing and analyzing quality metrics.

Tracking and monitoring everything from administrative tasks, medication reconciliation, and clinician orders, progress notes, and activity is absolutely critical to ensuring that hospitals and health care facilities are meeting mandated quality targets. Additionally, this emphasis on data lends itself to detailed analysis of current processes, and informs future quality improvement initiatives that could greatly reduce administrative and operational costs for an organization, while also improving patient care.

Encourages Health System Collaboration and Coordination

With various clinicians involved in a patient’s particular episode of care, increased communication centered around that particular patient is imperative to ensuring a quality-based approach to patient care. Modern clinical tools need to zero in on the communication and connectivity issue causing breakdowns in quality and efficiency of health care provision. Breaking down the silos between health care organizations will ameliorate process inefficiencies across the system; like those that cause unnecessary duplication of services, loss of critical patient information, inaccessibility to lab results, etc. Success in a QBP world will depend on solving these existing system challenges.

QBPs serve as a powerful catalyst for the innovation and transformation required to achieve a more connected, data-driven, and clinically efficient health care system.