Creating value – but for whom?
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The document discusses the application of a consumer perspective in primary health care in Australia, emphasizing the importance of patient experience and engagement in creating value. It proposes principles for consumer-centered health care, including accessible, coordinated, and comprehensive care, while highlighting the need for adaptive changes to improve the system. Promising practices and the role of consumers in governance and service design are also explored to enhance health outcomes and experiences.
Creating value – but for whom?
- 1. Creating value – but for whom? Applying a consumer lens to primary health care in Australia Leanne Wells, CEO
- 2. Overview • What is value? • Patient experience • Promising practices • A better system • Adaptive change
- 3. What is value? • Quadruple aims –Better health outcomes –Better experience of care –Better value –Better supported workforce • Patients as partners in care • Consumers as co-creators of value?
- 4. ACCESSIBLE AND AFFORDABLE CARE Timely access to care based on need Well organised, without organisational or systemic barriers Affordable for consumers Equitable access COORDINATED AND COMPREHENSIVE CARE Linked care with good referral and feedback Integrated with supported transitions across the system Availability of a range of services to multidisciplinary care Complete personally controlled health record APPROPRIATE CARE Meet the needs and preferences of individuals Evidence based with consumers engaged in research Treatment options, risks and benefits identified Safe and technically proficient with risks minimised Practitioner engages with consumers, families and carers to ensure understanding WHOLE OF PERSON CARE Take account of consumers lives and personal values Emotional Physical Cultural, spiritual and social factors Consider carers and support Address risk factors and all health problems PRINCIPLES OF CONSUMER – CENTRED HEALTH CARE TRUST AND RESPECT Provider asks about and understands concerns Transparent Accountable Timely and effective complaint resolution process Shared responsibility and decision making INFORMED DECISION MAKING Access to right information at right time Information is clear and understandable Costs are clear Personal choice and right to refuse respected Informed and timely consent Consider carers and supporters PLANNING AND GOVERNANCE Partnership with consumers to ensure sustainability Consumers involved at all levels of planning, system design and service development Consumers involved in key governance structures
- 5. • Make life easier, more convenient for ME • Let ME take ownership • Empower ME • Include and respect ME in the relationship • Keep ME informed • Enable transparent access to MY info • Give ME the best care you can • Reduce MY costs
- 7. Patient experience • Primary care organisations • Team care arrangements • Mental health reforms • Indigenous chronic care?
- 8. Multiple reviews and new ‘meso’ structures
- 9. Patient experience • A fragmented system and providers working in isolation not as a team • Uncoordinated care • Difficulty finding services • Service duplication, absent or delayed services • Low uptake of eHealth and other health technology • Access problems due to cost, transport, language, mobility and remoteness • Feelings of disempowerment
- 10. Promising practices • NSW Patient based care challenge Micro • Primary Health Networks to involve consumer experience • University offers Certificate in Health Consumer Engagement co- designed with consumers Meso • Consumers & federal reviews • Consumers & Health Training Aust • Consumers Health Forum Macro
- 11. A better system
- 12. Adaptive change “Technical changes are those with well defined problems, where a clear solution can be found and the implementation path is clear... Adaptive changes are characterised by situations where the challenge is complex and to solve it requires transforming long-standing habits ….new ways of thinking and relationships…. The development of new models of care and many challenges the local systems are being asked to plan for are in the domain of adaptive change….” Nigel Edwards, , 11 March 2016
- 13. ‘Seven Benefits’ framework • Richer insight • Potential solutions • Changing relationships • Individual benefits • Better quality decisions • Changing practice • Benefits beyond the project David Gilbert, inhealth associates, UK, Futurepatients blog, 2015
- 14. Maturity matrix 5 4 3 2 1 0 Work to create a new culture centred on patient culture Absolute focus Some focus Key principles enacted Strong narrative in place Recognition for need to act No focus Patient input into service design Systems to support shared decision making Models support self-care and help the professionals adapt Are patients assets mobilised Can patients get and use information Are patients involved in teaching and research Are the assets that communities can contribute mobilised Are there measurements systems to support this
- 15. Changing role of consumers Makers and Shapers NOT Users and Choosers (Cornwall and Gaventa 2000)