A decade of change towards Value-Based Health Care at a Dutch University Hospital: a complexity-informed process study
A study which investigates the decade-long change towards VBHC in a pioneering Dutch university hospital, between 2012-2023
While healthcare organizations in several countries are embracing Value-Based Health Care (VBHC), there are limited insights into how to achieve this paradigm shift in practice. This paper aims to shine a light onto implementation of VBHC at the Erasmus University Medical Center.
The change towards VBHC in this hospital has been characterized by three sequential strategies:
- Firstly, deep change through local, tailored implementation of multiple VBHC elements
- Then a hospital-wide program aimed at evolutionary change on a large scale, emphasizing the integration of VBHC into mainstream IT and policies
- Recognizing the advantages and limitations of both strategies, the hospital currently adopts a “hybrid” strategy
Overall, VBHC does not lend itself to linear planning and is not easily scalable. While there appears to be no golden standard for implementation, blending local and larger-scale actions appears advantageous. Local, deep yet harmonized and system-integrated changes culminate in large scale transformation. Embracing complexity and focusing on the ultimate aims of (re)institutionalization and (re)professionalization are crucial.
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