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-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.
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-centered outcomes 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.
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 care givers and patients in their treatment planning and care delivery. The mission 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’s vision is 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.
Read our FY18 Enhanced Recovery Annual Report.
ERP Poster "Experience with Applying and Improving Feasibility of an Enhanced Recovery Model for Allogenic Stem Cell Transplant Patients Aged 65 and Older" accepted and will be presented at Transplant & Cellular Therapy Meetings of ASBMT and CIBMTR on Feb. 22, 2019.
2018 Enhanced Recovery Retreat
2018 ERP Retreat Physician Panel
2018 ERP Retreat Nursing Panel
2018 ERP Retreat - Randy DeCarlo and Janna Baganz
2018 ERP Retreat - Carin Hagberg, M.D.
2018 ERP Retreat - Carol Porter
2018 ERP Retreat - Margaret Luciano
2018 ERP Retreat - Stephen Swisher, M.D.
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.
Paper of the week
- Hubner, M, Addor, Valerie, Slieker, J, et al. The impact of an enhanced recovery pathway on nursing workload: A retrospective cohort study. Int J Surgery.2015
- What is Lean Healthcare? NEJM Catalyst. 2018
- Yi, E, Jheon, S. Clinical management IT system for enhanced recovery. J Thorac Dis. 2016
- Adamina, M, Kehlet, H, Tomlinson, G, et al. Enhanced recovery pathways optimize health outcomes and resource utilization: a meta-analysis of randomized controlled trials in colorectal surgery. Surgery. 2011
- Gustafsson, UO, Scott, MJ, Hubner, M, et al. Guidelines for Perioperative Care in Elective Colorectal Surgery: Enhanced Recovery After Survery (ERAS) Society Recommendations: 2018. World Journal of Surgery. 2018
- Gustafsson, UO, Oppelstrup, H, Thorell, A, Nygren, et al. Adherenece to ERAS protocol is Associated with 5-Year Survival After Colorectal Cancer Surgery: A Retrospective Study. World Journal of Surgery. 2016
- Gustafsson, UO, Scott, MJ, Schqenk, W, et al. Guidelines for perioperative care in elective colonic surgery: Enhanced recovery after surgery (ERAS) society recommendations. Clinical Nutrition. 2012
- Thiele, RH, Rea, KM, Turrentine, FE, et al. Standardization of care: Impact of an enhanced recovery protocol on length of stay, complications, and direct costs after colorectal surgery. The American College of Surgeons. 2015
- SMART Enhanced Recovery for the Team
- Improving Surgery by Talking to Each Other
- Enhanced Recovery After Surgery: Top 10 Medical Innovations 2018
- MD Anderson Cancer Center Enhanced Recovery Program FY18 Annual Report
University of Texas Enhanced Recovery Retreat
An ERUT Retreat will be held in April 2019 at MD Anderson Cancer Center in Houston, TX, to bring all ERUT faculty and staff together to learn about enhanced recovery as a patient-centric, recovery-focused, value-based care pathway. Detailed agenda and registration information will be sent soon.
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.
Please contact Minh Mosley for additional course information or for MD Anderson employee registration discounts to the Dell Medical School courses .
- Implementing High-Value Health Care (Dell Medical School, Austin, September 19-20, 2018)
- Measuring What Matters (Dell Medical School, Austin, October 24-25, 2018)
- Strategy for Health Care Delivery (Harvard Business School, Boston, January 2019)
- Value-Based Health Care Delivery: An Intensive Seminar for Students & Practitioners (Harvard Business School, Boston, January 2019)
- PH Fleming Center for Healthcare Management Program: local option for earning aCertificate, MPH or PhD in Healthcare Management and Policy
Course materials may be available for viewing by clicking on the course links below.
- COMPLETED Value Measurement for Health Care (Harvard Business School, Boston, August 6-8, 2018)
- COMPLETED Open Value-Based Care Forum - for all MD Anderson Employees (Houston, February 20, 2018)
- COMPLETED Faculty Leadership Academy - Value Based Education Session (Houston, February 23, 2018)
- COMPLETED Education Expo - (Cancer Prevention Building, May 9, 2018)
- COMPLETED Open Value-Based Care Forum Summer Saturday Session - for all MD Anderson Employees (Houston, June 30, 2018)
ICCI Research Assistants