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CARE4VALUE Teamwork in developing a standard set measurement of health outcomes for adults and older people Ana Querido a , Isa Santos b , Henrique Carvalho b , Ana Sargento b,c , Manuela Frederico d National Integrated Continuing Care Network (RNCCI) is a Portuguese organizational model of care, joining a set of public and private institutions that provide ongoing health care and social support in a continuous integrated way to people who are facing dependency. Long Term Care Units (LTC), are important facilities of RNCCI. Batalha is one LTC. Staff is composed by a multidisciplinary team, focused on the overall recovery of dependent patients, promoting their autonomy and functionality. CONTEXT BACKGROUND Despite the staff effort to report patient data and health indicators to the RNCCI, there was a lack of visibility of both clinical and patient reported outcomes and detailed costing of patient pathways. Outcomes of patient care and caregivers, were not being addressed. Managers and financiers report the need to manage resourses more efficiently. A team from Polytechnic of Leiria started a project to implement value-based health care (VBHC) in LTC settings called CARE 4 VALUE. The goal was to develop and implement multidisciplinary teamwork in order to identify (at a local level) a standard set measurement of health outcomes, for inpatients adults and older people in LTC. Teamwork allowed a common language among clinicians, managers, financiers and academics from health, economics and computer science. WORK DONE Following CARE 4 VALUE model, teamwork was developed to identify health outcomes indicators in LTC. For that, a literature review was conducted, experts in health measurement were consulted. We analyzed the process of care provided at the LTC and benchmarking ICHOM standard sets for health care outcomes. Teamwork was based on the core set of outcomes and its adequate instruments. Technological tools were developed to support data collection from patient /caregivers and clinical reports. COLLABORATIVE WORK IN CREATING VBHC a School of Health Sciences, Polytechnic of Leiria, Leiria, Portugal; Center for Innovative Care and Health Technology (ciTechCare), Leiria, Portugal; Centre for Research in Health Technologies and Information Systems (CINTESIS), University of Porto, Porto, Portugal; b School of Technology and Management, Polytechnic of Leiria, Leiria, Portugal; c Center of Applied Research in Management and Economics, Polytechnic of Leiria, Leiria, Portugal d Nursing School of Coimbra, Coimbra, Portugal [email protected] ; h [email protected], [email protected] ; [email protected] ; [email protected] IMPACT LESSONS POINTS The implementation of CARE 4 VALUE is still ongoing and data collection from caregivers is being introduced in admission and at the moment of patient discharge from LTC. It is expected to continue the collaborative work in collecting and analyzing data as well as introducing changes to optimize VBHC in LTC. Dedicated resources (financial and human) are vital to assure outcomes measurement core business. Multidisciplinary team involved in collaborative work is the core for change, needed to assure motivation to implement VBHC. Changes need team agreement. Regular meetings between multidisciplinary teams, act as catalysts for improvements. Information technology platforms can facilitate the process of reporting and monitoring health outcomes. CARE4VALUE challenged the LTC multidisciplinary team to work collaboratively with academic staff in implementing VBHC. Health outcome indicators identified were adapted from several ICHOM Standard Sets as followed: The Ethics Committee has approved the data collection, including a Data Processing Agreement (GDPR compliant). Approval number: CE/IPLEIRIA/03/2019. Analysis of the process of Care in LTC Experts in Health care management Literature review BENCHMARKING Standard sets for healthcare outcomes Emphasis is placed on ensuring that most indicators can be completed using data that is already routinely collected at LTC to minimize barriers. Therefore, it is expected that health outcomes would be routinely measure facilitated by the use of ICT. - Cognition - Skin integrity /PU - Social functioning - Spirituality - Comorbidities - HRQOL - Caregiver burden - Pain Population: 470 000 habitants 60 Inpatients - Spiritual scale - EQ5D - MMSE - Barthel - Braden - Charlson Index - MMNA - Zarit - VAS - SYMPTOMS, FUNCTIONING AND QOL - CLINICAL STATUS - CARERS
