Rijnstate VBHC integrated organizational scale-up approach

We are proud to present how Rijnstate is accelerating the transition to a value based health care organization. Our mission is to redesign our health care organization with the purpose of achieving more value for patients. An integrated VBHC approach has been developed. The patient is involved in each step of designing the patient journeys within the IPU. Working in an IPU requires a change of mindset, this is an important element in the approach.

The key points of our initiative are:

– Patients (and their families) participate in every IPU that is formed (in various ways) (see 3.1.2.);
– The actual number of IPUS is 28;
– New IPUs are supported by an IPU coach in the first 9 months. They follow our 5 phases approach in setting up an IPU to a self-management working team.
– The capacity of the VBHC expert team is to coach 10 new IPUs a year to a self-managed working IPU team;
– IPUs work in similar ways (roles, structure, etc) if possible. Nevertheless, leaves room for individual specific complexity and customization;
– The aim is to emphasizes learning and improving along the way and creating preconditional safe culture to do so;
– There is a strong focus on data driven, integrated outcome sets with clinical-, patient reported- and patient experience outcomes. For example: mortality rates, quality of life scores, symptom scales, net promotor scores etc. We use validated questionnaires and tools that facilitate collection of outcome data;
– Also cost drivers are structural part of the IPU outcome sets, e.g. measuring length of stay, patient
consultations per patient, diagnostic tests per patient etc. We are working on management information and KPIs on organizational level;
– Leadership is key for self-managed IPUs, so IPU leadership is part of our organization wide leadership program. Thereby, nursing leadership is an important aspect (on IPU level as well as on board level)
– IPUs aim for a higher amount of staff satisfaction;
– Our Rijnstate approach is based on 6 years of learning and improving on VBHC
– The achievement of measurable results on a lot of outcome parameters, like complication rates, degree of
remission, time to recovery, undesired side effects (e.g. incontinence), long term functional status, patient satisfaction, experience of Shared Decision Making and diverse cost drivers (reduction length of stay,
reduction of amount of consultations, higher amount of digital care, etc).