July 2023 edition
Sarah Buckley, Clinical Nurse Consultant, Respiratory at the Hastings Macleay Clinical Network, talks about what value based healthcare means to her. Looking back at the last few years she reflects on how it helps to describe what clinicians have always sought to achieve.
To me, value based healthcare means providing patient‑centred care that is grounded in evidence‑based best practice.
I think one of the biggest challenges we have is translating the term value based healthcare into language that is meaningful to bedside clinicians. Language that communicates that the focus is on value in patient outcomes and experiences rather than simply value for money. And that there are many different dimensions and perspectives that we need, to achieve value as a health system.
The past few years have been exceptionally challenging for our healthcare system and the workforce within it, and the resulting change fatigue is very real.
In response to the pandemic, healthcare needed to be organised differently using a targeted approach with a clear focus on improving measurable outcomes and experiences. Value based healthcare helps us to align toward these common goals and to use the resources we have available in the most effective way.
Ultimately what clinicians continue to strive for is innovative, evidence-based practice that improves the quality of life and health outcomes for consumers. The value based healthcare model aligns with and supports this ethos. It’s not something completely new, it is a new way to describe what clinicians have always sought to achieve.
What excites me about value based healthcare is that the approach enables us to review and redesign services, with clear benchmarks and targets that recognise the unique needs of our consumers and what’s important to them.
There is a strong focus on strategies, such as pulmonary rehabilitation, that support and empower patients to maintain a healthy lifestyle while promoting health literacy and self-management.
One example of this is the relocation of our Pulmonary Rehabilitation Program in Mid North Coast Local Health District.
An eight-week education and exercise program for patients with a chronic respiratory impairment, it aims to improve their breathing, fitness, mobility and self-management using a multidisciplinary team approach.
Consumers provided feedback that a hospital outpatient program was geographically difficult to access and they felt afraid to attend the hospital setting in the new post-COVID era.
As a result, the Port Macquarie rehabilitation program was relocated to a local community hall. Decentralising this outpatient service away from the hospital and into the community has improved access and placed a stronger emphasis on well patients staying well in their community.
In line with the principles of value based healthcare, patients have reported increased satisfaction and better, more sustained health outcomes.
It’s a good example of where an evidence-based approach puts the patient at the centre of service design and care, adapting best practice to improve outcomes and experiences.
