High value care in hospitals and health services
Why the research project is important
It has been estimated that 10 to 30 percent of healthcare worldwide is wasteful, of little or no value, or harmful to patients. Using scarce resources to deliver low value care is an important health system concern as resources used for that care could be allocated to care associated with greater benefit.
What the research seeks to do
- Explore the value of care and how and why low value of care happens in major public hospitals.
- Design processes to identify and address the value of care.
- Develop a conceptual theory to guide policy, research and clinical practice.
What are the research outcomes/ impact
The project resulted in the development of a process and conceptual theory for moving towards higher value care in major public hospitals based on interviews with 40 hospital staff. This process can assist staff and researchers to identify and improve the value of care provided, prevent unnecessary hospital care, and assist timely and appropriate discharge. Clinical recommendations derived from the interviews covered ways of prompting critical thinking, using audit and feedback processes, revising patient assessment processes, rethinking training and mentoring of junior staff, and recruiting and supporting the right people in healthcare.
A toolkit has been developed to support staff in hospitals and health services to optimise the value of care provided to patients. The toolkit includes questions clinical teams can ask themselves to identify the value of care, clinical scenarios, time and cost mapping tools, and resources to support behaviour change.
The findings highlighted the need to address factors influencing implementation at multiple levels of the health system. Multi-component interventions that appropriately address the complexity of clinical environments were identified as being likely to be more effective than single component interventions (primarily addressing one main element, for example, awareness of clinical guidelines).
High Value Care Toolkit