Creating a framework for change: transitioning to value-based healthcare in Queensland
Belinda Gavaghan A * , Jennifer Finch A and Katelyn Clarke AA
Abstract
Value-based healthcare has been described as the sustainable, equitable and transparent use of healthcare resources to achieve improved experiences and outcomes for people and communities. It is supported by all levels of government in Australia, with recent initiatives championing a shift away from traditional, clinician-centric care delivery to a more contemporary, value-based approach. To date, however, efforts in Queensland have focused on smaller scale siloed models of care and have not extended to the transformational change required to create equitable and sustainable healthcare delivery. The Queensland Health Allied Health Framework for Value-Based Health Care (the Framework) builds on contemporary frameworks with reference to the local context in Queensland and provides a structure and starting point for clinicians and managers to work together with consumers to transform services to focus on preventative health and wellbeing, shifting the focus of care to the community and sustainably improving the quality of care delivered. The Framework outlines key considerations for the design and implementation of new services, including understanding the care pathway, supporting an outcome driven workplace culture, measuring what matters and designing for outcomes. Several key lessons were learnt during the development of the Framework, including the importance of early and sustained consumer partnerships, of establishing a shared definition of value-based healthcare that enables integration across the care pathway and the need for leadership at all levels to actively support the change management process. While developed for Queensland public allied health services, the Framework is intended to be a system-wide tool relevant to all health professionals and services.
Keywords: allied health services, consumer engagement, health service innovation, value‐based healthcare.
References
1 Australian Institute of Health and Welfare. Australia’s health 2022: In brief, catalogue number AUS 241. Australia’s health series number 18. Canberra: Australian Government; 2022. Available at https://www.aihw.gov.au/reports/australias-health/australias-health-2022-in-brief/summary [verified 19 February 2024].
2 Amalberti R, Nicklin W, Braithwaite J. Preparing national health systems to cope with the impending tsunami of ageing and its associated complexities: Towards more sustainable health care. Int J Qual Health Care 2016; 28(3): 412-4.
| Crossref | Google Scholar | PubMed |
3 Armstrong BK, Gillespie JA, Leeder SR, Rubin GL, Russell LM. Challenges in health and health care for Australia. Med J Aust 2007; 187(9): 485-9.
| Crossref | Google Scholar | PubMed |
4 Organisation for Economic Co-Operation and Development (OECD). OECD Health at a Glance 2023 Country Note: Australia. Paris: OECD; 2023. Available at https://www.oecd.org/australia/health-at-a-glance-Australia-EN.pdf [verified 10 February 2024].
5 Tudor Hart J. The inverse care law. Lancet 1971; 297(7696): 405-12.
| Crossref | Google Scholar |
6 Harris E, Harris MF. An exploration of the inverse care law and market forces in Australian primary health care. Aust J Prim Health 2023; 29(2): 137-41.
| Crossref | Google Scholar | PubMed |
7 Lewis S. Value-based healthcare: is it the way forward? Future Healthc J 2022; 9(3): 211-5.
| Crossref | Google Scholar | PubMed |
10 Ramos P, Savage C, Thor J, Atun R, Carlsson KS, Makdisse M, et al. It takes two to dance the VBHC tango: A multiple case study of the adoption of value-based strategies in Sweden and Brazil. Soc Sci Med 2021; 282: 114145.
| Crossref | Google Scholar | PubMed |
11 Noël F. Accelerating the pace of value-based transformation for more resilient and sustainable healthcare. Future Healthc J 2022; 9(3): 226-9.
| Crossref | Google Scholar | PubMed |
13 Reform Planning Group. Unleashing the potential: an open and equitable health system. Healthcare for Queenslanders in a pandemic ready world. Brisbane: The State of Queensland (Queensland Health); 2020. Available at https://www.health.qld.gov.au/system-governance/strategic-direction/plans/unleashing-the-potential-an-open-and-equitable-health-system [verified 10 February 2024].
14 Philip K. Allied health: untapped potential in the Australian health system. Aust Health Rev 2015; 39(3): 244-7.
| Crossref | Google Scholar | PubMed |
15 Lizarondo L, Turnbull C, Kroon T, Grimmer K, Bell A, Kumar S, et al. Allied health: integral to transforming health. Aust Health Rev 2016; 40(2): 194-204.
| Crossref | Google Scholar | PubMed |
16 Scott I. Ten clinician-driven strategies for maximising value of Australian health care. Aust Health Rev 2014; 38(2): 125-33.
| Crossref | Google Scholar | PubMed |
17 Tan CC, Lam CSP, Matchar DB, Zee YK, Wong JEL. Singapore’s health-care system: key features, challenges, and shifts. Lancet 2021; 398(10305): 1091-104.
| Crossref | Google Scholar | PubMed |
18 Teisberg E, Wallace S, O’Hara S. Defining and Implementing Value-Based Health Care: A Strategic Framework. Acad Med 2020; 95(5): 682-5.
| Crossref | Google Scholar | PubMed |
19 Nilsen P. Making sense of implementation theories, models and frameworks. Implement Sci 2015; 10(1): 53.
| Crossref | Google Scholar | PubMed |
20 Greenhalgh T, Robert G, Macfarlane F, Bate P, Kyriakidou O. Diffusion of innovations in service organizations: systematic review and recommendations. Milbank Q 2004; 82(4): 581-629.
| Crossref | Google Scholar | PubMed |
21 Queensland Health. Allied Health Framework for Value-Based Health Care. Brisbane: Queensland Government; 2022. Available at https://www.health.qld.gov.au/ahwac/html/VBHC [verified 28 November 2023].
22 Carlini J, Muir R, McLaren-Kennedy A, Grealish L. Researcher Perceptions of Involving Consumers in Health Research in Australia: A Qualitative Study. Int J Environ Res Public Health 2023; 20(10): 2725.
| Crossref | Google Scholar | PubMed |
23 Colldén C, Hellström A. Value-based healthcare translated: a complementary view of implementation. BMC Health Serv Res 2018; 18(1): 681.
| Crossref | Google Scholar | PubMed |
24 Carlini J, Muir R, McLaren-Kennedy A, Grealish L. Transforming health-care service through consumer co-creation: directions for service design. J Serv Mark 2024; 38: 326-43.
| Crossref | Google Scholar |
25 Boyce MB, Browne JP, Greenhalgh J. The experiences of professionals with using information from patient-reported outcome measures to improve the quality of healthcare: a systematic review of qualitative research. BMJ Qual Saf 2014; 23(6): 508-18.
| Crossref | Google Scholar | PubMed |
26 Damschroder LJ, Aron DC, Keith RE, Kirsh SR, Alexander JA, Lowery JC. Fostering implementation of health services research findings into practice: a consolidated framework for advancing implementation science. Implement Sci 2009; 4(1): 50.
| Crossref | Google Scholar | PubMed |
27 McHugh M, Joshi M. Improving evaluations of value-based purchasing programs. Health Serv Res 2010; 45: 1559-69.
| Crossref | Google Scholar | PubMed |
28 Zipfel N, van der Nat PB, Rensing BJWM, Daeter EJ, Westert GP, Groenewoud AS. The implementation of change model adds value to value-based healthcare: a qualitative study. BMC Health Serv Res 2019; 19(1): 643.
| Crossref | Google Scholar | PubMed |
