A decade of change towards Value-Based Health Care at a Dutch University Hospital: a complexity-informed process study

05 Aug 2024

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:

  1. Firstly, deep change through local, tailored implementation of multiple VBHC elements
  2. Then a hospital-wide program aimed at evolutionary change on a large scale, emphasizing the integration of VBHC into mainstream IT and policies
  3. 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.

Read the full report here.

Author:

Veerle van Engen, Martina Buljac-Samardzic, Rob Baatenburg de Jong, Jeffrey Braithwaite, Kees Ahaus, Monique Den Hollander-Ardon, Ingrid Peters & Igna Bonfrer