Project Highlights
What is Value?
"Achieving high value for patients must become the overarching goal of healthcare delivery, with value defined as the health outcomes achieved per dollar spent. This goal is what matters for patients and unites the interests of all actors in the system."
- Porter, 2010.
Value and Clinical Integration
Value-based healthcare delivery is being discussed in a variety of healthcare forums. This concept is of great importance in the reform of the U.S. healthcare delivery system. Defining and applying the principles of value-based competition in healthcare delivery models will permit future evaluations of various delivery applications. However, there are relatively few examples of how to apply these principles to an existing care delivery system. We strive to assess the value created when treating cancer patients in a multidisciplinary care setting within a comprehensive cancer center.
Value of Care Analyses
Understanding and managing the cost of cancer care delivery continues to be a priority for the Institute. ICCI has partnered with The Division of Finance to provide clinicians and administrators with appropriate cost related data for clinical decision making. ICCI continues to advocate and support accurate cost measurement in healthcare.
Patient and Provider Outcome Measurement
Patient reported outcomes (PROs) are a foundation of value-based healthcare and a priority for ICCI since 2008. Our approach aims to incorporate the patient’s ‘voice’ through routine use of validated patient-reported outcome questionnaires and strives to prioritize measures that are most relevant to patients, providers and insurers. Recently, we have dedicated efforts to prioritize the clinical workflow integration and systematic reporting of outcomes into MD Anderson’s new electronic health record.
All surveys for PROs built in OneConnect must be submitted through the Patient Survey Governance Committee (PSGC) for review and approval. To submit a PRO survey in OneConnect build request, fill out this form.
Enhanced Recovery Program
MD Anderson’s institution-wide Enhanced Recovery Program (ERP) is a collaborative patient-centric, recovery focused, care transformation initiative led by our multidisciplinary team members actively engaging caregivers and patients in their treatment planning and care delivery. The goal for our ERP teams is “implementation of proven and emerging innovations in cancer therapies to deliver safe, effective, and value-based cancer care programs for an increasing number of patients.” The program aims to minimize treatment related complications by rapid rescue interventions, reduce patient’s symptom burden, and enhance patient experience and functional recovery, thereby facilitating timely return to adjuvant oncologic therapies when indicated and improving cancer outcomes.
Resources:
Read our FY20 Enhanced Recovery Annual Report.
Szewczyk,NA, Ngo-Huang,A, Soones,TN, et al. Feasibility and Implementation of a Multimodal Supportive Care Program to Improve Outcomes in Older Patients Undergoing Allogeneic Stem Cell Transplantation, Science Direct, (https://www.sciencedirect.com/science/article/pii/S2666636721012240); https://doi.org/10.1016/j.jtct.2021.09.002.
Wang, XS, Shi, Q, Williams, LA, et al. Development of a patient-reported outcome tool for assessing symptom burden during perioperative care in liver surgery: The MDASI-PeriOp-Hep, European Journal of Oncology Nursing: Vol. 52, June 2021, 101959; https://doi.org/10.1016/j.ejon.2021.101959
Kruse, B, Recinos, I, Eska, J, et al. Scaling an Enhanced Recovery Program to an Institution-Wide Initiative: It Takes a Village, Quality Management in Health Care: July/September 2021; Vol. 30; Issue 3; pgs. 200-206; doi: 10.1097/QMH.0000000000000306
Blumenthaler, A.N., Robinson, K.A., Kruse, B.C., et al. Implementation of a perioperative-enhanced recovery protocol in patients undergoing open gastrectomy for gastric cancer, J Surg Oncol. 2021; 1-11; Wileyonlinelibrary.com/journal/jso; http:/doi.org/10.1002/jso.26591
Zorilla-Vaca, A, Mena, G.E., Ramirez, P.T., et al. Effectiveness of Perioperative Opioid Educational Initiatives: A Systematic Review and Meta-Analysis, Anesth Analg. 2021 June 11. doi: 10.1213/ANE.0000000000005634
Enhanced Recovery at the University of Texas (ERUT)
The Enhanced Recovery at the University of Texas (ERUT) quality improvement project is an initiative to develop strategic partnerships to implement and sustain Enhanced Recovery Programs among University of Texas health-related institutions. The goals of this project are:
- To provide structure, support and implementation expertise to UT System institutions for implementation of Enhanced Recovery Programs.
- To provide general change management education and training that augments UT System institution expertise in implementation and sustainability of quality improvement programs.
- To learn more about factors that influence successful change implementation and quality improvement sustainability in multi-disciplinary patient care environments.
For more information email the ICCI ERUT Team.
Resources
Paper of the week
- Alokozai, A, Jayakumar, P, Bozic, KJ. Value-based Healthcare: Improving Outcomes through Patient Activation and Risk Factor Modification, Clinical Orthopaedics & Related Research: Nov. 2019, Vol 477, Issue 11, Pgs. 2418-2420; DOI 10.1097/CORR.0000000000000985
- Balvardi, S, Pecorelli, N, Castelino, T, et al. Construct Validity and Responsiveness of the Abdominal Surgery Impact Scale in the Context of Recovery After Colorectal Surgery, Diseases of the Colon & Rectum: March 2019, Vol 62, Issue 3, Pgs. 309-317, doi: 10.1097/DCR.0000000000001288
- Hughes, C, Boncyk, C, Culley, D, et al. American Society for Enhanced Recovery and Perioperative Quality Initiative Joint Consensus Statement on Postoperative Delirium Prevention, Anesthesia & Analgesia: Jan. 31, 2020, doi: 10.1213/ANE.0000000000004641
- Hu QL, Liu JY, Hobson DB, Cohen ME, Hall BL, Wick EC, Ko CY. Best Practices in Data Use for Achieving Successful Implementation of Enhanced Recovery Pathway, Journal of the American College of Surgeons, Vol 229, Issue 6, Dec. 2019, Pgs. 626-632.el, doi: https://doi.org/10.1016/j.jamcollsurg.2019.08.1448.
- Aloia, TA, Keller, DS, Kowalski, RB, Luciano, M. et al. Enhanced Recovery Program Implementation: An Evidence-Based Review of the Art and the Science, Surgical Endoscopy (2019) 33:3833-3841; https://doi.org/10.1007/s00464-019-07065-6
Videos
Webinars
- *Status Updates & Feedback Session (June 2019)
- *Baseline Data and Dashboards (July 2019)
- Developing Nursing Partnerships (September 2019)
- Building Nutrition into Your Enhanced Recovery Program (October 2019)
- The Role of the Advanced Practice Provider (November 2019)
- Enhanced Recovery and Patient Reported Outcomes (January 2020)
Slides
- *Status Updates & Feedback Session (June 2019)
- *Baseline Data and Dashboards (July 2019)
- Teamwork Perceptions in the UT System: Where are we and why does it matter? (August 2019)
- A Nursing Perspective Gathering Support Amongst a Nursing Team (September 2019)
- Building Nutrition into Your Enhanced Recovery Program (October 2019)
- The Role of the Advanced Practice Provider (November 2019)
- Enhanced Recovery and Patient Reported Outcomes (January 2020)
- Our ERUT Journey: The University of Texas Health Science Center at Tyler (February 2020)
* The webinar and slides for June and July 2019 are not currently available. If you would like additional information regarding these topics, please contact the ERUT Team.
Other
- The impact of an enhanced recovery pathway on nursing workload: A retrospective cohort study
- A systematic review of the intervention components, adherence and outcomes of enhanced recovery programmes in older patients undergoing elective colorectal surgery
- Barriers and benefits to using mobile health technology after operation: A qualitative study
Value-Based Care Education
MD Anderson recognizes the need to support and educate our staff about value-based care delivery strategies. ICCI has partnered with Harvard’s Institute for Strategy & Competitiveness, UT Dell Medical School and various healthcare education leaders to provide value-based care development courses for MD Anderson executives, clinical leaders, providers, and employees.
Upcoming Courses
Please contact Minh Mosley for additional course information or for MD Anderson employee registration discounts to the Dell Medical School courses.
PH Fleming Center for Healthcare Management Program: local option for earning a Certificate, MPH or PhD in Healthcare Management and Policy
Internships
ICCI Research Assistants
Team work
Future leaders
Brainstorming
Professional confidence