Promoting value-based care in EDs (PROV-ED)

Initiative Type
Redesign
Research
Service Improvement
Status
Plan
Added
01 March 2019
Last updated
18 July 2019

Summary

The PROV-ED Project supports widespread implementation of established clinical redesign initiatives to improve value-based care of patients presenting to emergency departments (EDs) across Queensland Health (QH). An EOI calling for applications, followed by a selection process culminating in the “PROV-ED Pitchfest” resulted in the following six initiatives being selected for statewide rollout.

By facilitating the adoption of these successful piloted initiatives, PROV-ED will promote dissemination of innovation beyond hospital and HHS boundaries.

It will also enable capacity building for health service redesign and quality improvement through multidisciplinary clinician engagement, workforce skills development and by creating a model for widespread implementation of initiatives.

Keywords: proved

Key dates
Feb 2019
Jun 2020
Partnerships
Queensland Emergency Department Strategic Advisory Panel (QEDSAP) Metro North HHS (Clinical Operation Strategy Implementation – COSI)

Aim

The PROV-ED Project aims to support widespread implementation of established clinical redesign initiatives to improve value-based care of patients presenting to Emergency Departments (EDs) across Queensland Health.

Benefits

  • To provide a suite of successful low-value care reduction initiatives suitable to widespread implementation.
  • To provide networking opportunities and dissemination of ideas and innovation at events such as “PROV-ED Pitchfest”.
  • Assist with dissemination of the initiatives to EDs across Queensland Health.
  • To provide guidance and assistance to hospitals in the implementation of value-based care.
  • Evaluation of the impact of improved care for the value-based care initiatives.
  • Demonstrate measurable reductions in low-value care in Queensland Health EDs.
  • Demonstrate measurable improvements in high-value care in Queensland Health EDs.
  • To provide data and feedback to hospitals to encourage continual improvement and engagement.
  • To build capacity for ongoing implementation of quality improvement initiatives to improve patient care and experience as well as health system efficiency.
  • To support innovation for service improvement by decreasing the time between the emergence of clinical evidence and integration into practice.

Background

Value-based care is increasingly important within Health Services, including in the ED environment. Overuse of low-value care and underuse of high-value care is widespread and contributes to unnecessary costs and poor health outcomes The concept of value-based care broadly encompasses balancing the benefits of treatments provided to patients with the financial costs of the treatment. To provide efficient and safe healthcare, clinicians must consider the benefits and risks of investigations and treatments in an environment of increasing healthcare costs, and be aware of options and methods to changing care (1).

Value-based healthcare is not only about costs. The quality of care provided to patients can be enhanced with new developments in clinical care. Improving healthcare provision also reduces overcrowding and improves staff efficiency (reduced stress and cognitive load, improved morale and satisfaction), patient satisfaction, and importantly patient safety (2).

Various activities have been developed within HHSs aimed at improving efficiency and reducing use of low-value care. However, to date, limited action has occurred on a state-based level. Many initiatives are most likely scalable, however there are no clear pathways to enable dissemination. A broad strategy to affect change in clinical practice that targets frequent use, high cost and/or inappropriately used interventions in EDs is required. This same platform can also promote high quality initiatives identified at improving patient experience in our health care system. The PROV-ED Project addresses this need by utilising clinical redesign methodology to roll out already proven strategies to improve efficiency across the health system.

References

  1. Brownlee S, Chalkidou K, Doust J, et al. Evidence for overuse of medical services around the world. The Lancet. 2017.
  2. Porter ME. A Strategy for Health Care Reform — Toward a Value-Based System. New England Journal of Medicine. 2009;361(2):109-12.

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Key contact

Prof Louise Cullen / Dr Andrew Hobbins-King
PROV-ED Project (Professional Lead)
PROV-ED Project – Healthcare Improvement Unit (HIU) – Clinical Excellence Queensland (CEQ)
(07) 3646 5005
PROVED.Project@health.qld.gov.au