Implementation of Value-based Management in Finsencentret: A Case Study

Jeanette Andresen, Jason Spiro Koutsodontis & Tilde Rehr Møller

Student thesis: Master thesis

Abstract

Trends are surfacing within global healthcare sectors, with a shift from activity- and productivitybased management systems to a patient-centered approach, referred to as value-based management (VBM) with the aim to deliver improved outcomes at a lower cost. VBM initiatives in Denmark vary vastly in set-up and show inconsistent results. The present study aims to explore how a VBM pilot project implemented in Copenhagen’s Rigshospitalet hematology department, Finsencentret, creates value across three parameters: patient experienced quality, professional quality and use of resources and further explores how the implementation process affects outcomes in each of these domains. The domains outlined above exhibit a large degree of interplay and overlap, traversing a multitude of key actors who each perceive the innovation through their unique lenses. The VBM pilot project is considered a radical innovation and this organizational shift advocates that patients requiring autologous stem cell harvest are administered through an external ambulatory unit rather than following conventional hospitalization therapy. Based on a single explorative case study design, qualitative data in the form of observational studies and interviews were conducted on site among key personnel and patients involved in the project in order to investigate how each actor interprets the implementation process and values the outcome of the VBM pilot project. Moreover, economic hospital data and documents were used to calculate utilization of resources. The study found that a shift from hospitalization to ambulatory care adds value across the entire treatment cycle, with reference to patient-centered care, efficient clinical care delivery and resource optimization. Based on the findings, the rearrangement creates value across all three parameters, yet generates unforeseen flow-on affects that negatively impact adjacent units within Rigshospitalet. We also highlight that the introduction of a hybrid manager in the implementation process positively influences the diffusion of such innovation and helps remove implementation boundaries. In order to improve the quality of healthcare delivery within a clinical setting, we need to understand the contextual and behavioral underpinnings that manifest value among and between professional groups and patients and thus design diffusion strategies that acknowledge this complexity

EducationsMSc in Business Administration and Innovation in Health Care, (Graduate Programme) Final Thesis
LanguageEnglish
Publication date2018
Number of pages201
SupervisorsKarsten Vrangbæk