{"id":9886,"date":"2021-04-20T14:43:23","date_gmt":"2021-04-20T14:43:23","guid":{"rendered":"https:\/\/www.essenburgh.com\/the-right-care-in-the-right-place-a-step-by-step-implementation-plan\/"},"modified":"2024-12-05T09:18:15","modified_gmt":"2024-12-05T08:18:15","slug":"the-right-care-in-the-right-place-a-step-by-step-implementation-plan","status":"publish","type":"post","link":"https:\/\/www.essenburgh.com\/en\/the-right-care-in-the-right-place-a-step-by-step-implementation-plan\/","title":{"rendered":"The Right Care in the Right Place: A step-by-Step implementation plan"},"content":{"rendered":"

The Right Care in the Right Place: A step-by-Step implementation plan<\/h2>\n

\u00a0<\/span><\/p>\n

The Right Care in the Right Place is becoming the new buzzword in the healthcare sector. Understandable, because fundamentally the Right Care in the Right Place is a <\/span><\/p>\n

fantastic way to achieve the principles of <\/span>Value-based Healthcare or Triple Aim<\/a>. Yet the implementation isn\u2019t working, according to <\/span>recent<\/strong> studies. Not surprisingly, because we know that the implementation of such complex programs fails 70% of the time. The consequence is that the objectives aren\u2019t achieved, time and money is lost, and it leaves frustrated professionals and disappointed patients. What it boils down to is that the Right Care in the Right Place \u2013 the way it\u2019s being implemented now \u2013 is doomed to fail. We need a different approach. The key to success is a good implementation model and the great thing is: it exists! In this blog we will show you how you can implement the Right Care in the Right Place successfully. <\/span><\/p>\n

<\/p>\n

Why the Right Care in the Right Place?<\/strong><\/h3>\n

The composition of our population is changing, which means the demand for healthcare is too. For example, in 2030<\/a> the number of people 65 and over will have doubled to about 4.25 million in the Netherlands<\/a>. That is why we don\u2019t just need more healthcare, but different healthcare. A large percentage of elderly is dealing with multimorbidity, so their healthcare demands are complex. But multimorbidity will increase in the entire population because of an unhealthy lifestyle. In addition, there are an increasing amount of treatment options. This all leads to a giant increase in cost. The expectation is that the average healthcare costs per person will rise from over 5,000\u20ac now to 9,600\u20ac in 2040 in the Netherlands, unless we intervene on time<\/a>. And that\u2019s possible by providing the Right Care in the Right Place.<\/p>\n

<\/h2>\n

What is the Right Care in the Right Place?<\/strong><\/h3>\n

Before we explain how to successfully implement the Right Care in the Right Place, it\u2019s good to give you a definition, because a solid definition is missing. This is how the Dutch Ministry of Health defines it: \u2018The Right Care in the Right Place is a healthcare providers\u2019 initiative. This philosophy centers around the daily functioning of people. That is the starting point to look for ways to move care (closer to people\u2019s homes), prevent (more expensive) healthcare and replace healthcare by for example eHealth. This helps people live with their disease or disability more easily. The ministry of Health, Welfare and Sport supports this movement where possible and facilitates parties to learn from each other and come in contact with one another.\u2019 <\/em><\/p>\n

To sum, the Right Care in the Right Place is care that is close to the patient, where different healthcare providers cooperate and where we increasingly use digital channels. You might think: \u2018<\/a>But isn\u2019t that integrated care or care coordination<\/a>?\u2019<\/a> Yes, Right Care in the Right Place is a synonym for integrated care. Yet, it\u2019s also a synonym for care networks, Triple Aim, care pathways, outreach clinic and substitution of care. We aren\u2019t telling you this to make it even more complicated, but because you will run into all of these terms at one point or another without being able to see the overall picture \u2013 the whole elephant.<\/p>\n

Figure 1:<\/strong> The land of the blind<\/p>\n

\"Value<\/p>\n

Right Care in the Right Place: Recipe for disaster?! <\/strong><\/h3>\n

Why is the Right Care in the Right Place, the way we\u2019re approaching it in the Netherlands at the moment, doomed to fail? Aside from the fact that everyone has different definitions of and ideas for the concept of the Right Care in the Right Place, we don\u2019t meet the necessary implementation criteria. We are lacking structural, integrated financing and a cohesive, evidence-based policy agenda. We don\u2019t have an integrated approach to healthcare, but choose to initiate stand-alone projects and subsidy programs (like the Right Care in the Right Place) as a countermeasure to our fragmented financing<\/a> and policy agenda<\/span>. All purely palliative without any sort of cohesion. Because of this, the desired effects \u2013 quality improvement and cost reduction \u2013 aren\u2019t being achieved. It\u2019s not that healthcare providers aren\u2019t willing, but the current policies and financial incentives aren\u2019t really encouraging them to really integrate health and social care for people with complex needs. This means Right Care in the Right Place initiatives are having trouble taking off, let alone becoming a sustainable part of practice. The problem is higher up the ladder. Policies are fragmented at a government level and there is no evidence-based policy agenda.<\/p>\n

What needs to be done?<\/strong><\/h3>\n

We\u2019ve been muddling around in the Netherlands, while there are successful initiatives in other countries like the US, England and Germany. The reason is that they have their policies and finances in order (see Figure 2).<\/p>\n

Figure 2:<\/strong> International best practices<\/p>\n

\"Table<\/p>\n

However, a solution is within reach for the Dutch situation in the shape of a scientifically proven implementation model: the Rainbow model<\/a>.<\/p>\n

Figure 3:<\/strong> The Rainbow model<\/p>\n

\"Value<\/p>\n

Within the Rainbow Model, the needs of the patient are the starting point for different types of clinical, professional and organizational cooperation. These cooperations can take place at the: 1) micro level: between client\/patient and healthcare provider, 2) meso level: between professionals and organizations, and 3) macro level: laws and regulations that apply to all forms of cooperation.<\/p>\n

Cooperation, that\u2019s what it\u2019s all about. The Right Care in the Right Place\u2019s success is dependent on the people \u2013 patients, healthcare professionals and managers \u2013 that can and want to cooperate beyond the walls of their own organizational intrest. And that can be done in four \u2018simple\u2019 steps:<\/p>\n

Step 1: Map your patients\u2019 needs.<\/h4>\n

Do this at a regional level, share field data. Try to predict what the future needs of your patient population will be. You can do this based on clinical and cost data. This will help you figure out which interventions your patient population needs now and in the future.<\/p>\n

Step 2: Determine the outcome(s) you want to achieve.<\/h4>\n

At a clinical as well as at a patient experience and cost level. Use the Triple Aim<\/a> principles. PROMs (patient reported outcome measures) and PREMs (patient reported experience measures)<\/a> can be useful.<\/p>\n

Step 3: Determine which types of cooperation you need to reach those outcomes.<\/h4>\n

The Rainbow Model is a good guideline for this. Determine what types of cooperation<\/a> you could use at the micro, meso and macro level.<\/p>\n

Step 4: Map and organize structural and cultural conditions.<\/h4>\n

Determine what you need to make the Right Care in the Right Place a long-term success. For example, look at financing<\/a> and whether the culture within your organization means people want to implement changes.<\/p>\n

Toward evidence-based policy<\/strong><\/h3>\n

The fact that most Right Care in the Right Place projects don\u2019t make it, has nothing to do with the concept\u2019s potential, but with the way it\u2019s put in practice in the Netherlands. Instead of an integrated policy approach, we choose to finance stand-alone projects. Using grants as a quick fix, when it comes down to it. We really need to stop and ensure that we create the right conditions to make the Right Care in the Right Place the success it deserves to be. This means we agree on integrated payment models at the macro level, that we design our policies based on evidence and that we create conditions for proper sharing of patient data. Use the needs of your patient population and the desired outcomes as a starting point. And very important: cooperate! With patients, with other healthcare professionals and other care organizations. That will make the success rate of Right Care in the Right Place skyrocket.<\/p>\n<\/div><\/div><\/div><\/div><\/div>\n","protected":false},"excerpt":{"rendered":"

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Pim Valentijn","image":{"@type":"ImageObject","inLanguage":"en-US","@id":"https:\/\/www.essenburgh.com\/wp-content\/uploads\/2021\/05\/Pim-Valentijn-Essenburgh-Training-Advies-ZW_LR-96x96.jpg","url":"https:\/\/www.essenburgh.com\/wp-content\/uploads\/2021\/05\/Pim-Valentijn-Essenburgh-Training-Advies-ZW_LR-96x96.jpg","contentUrl":"https:\/\/www.essenburgh.com\/wp-content\/uploads\/2021\/05\/Pim-Valentijn-Essenburgh-Training-Advies-ZW_LR-96x96.jpg","caption":"dr. Pim Valentijn"},"description":"Ik onderzoek de toegevoegde waarde van zorginnovaties en de stappen die nodig zijn om betere gezondheid, betere zorg en lagere kosten te realiseren. Hierbij verbind ik de wetenschap met de praktijk en besteed ik aandacht aan de persoonsgerichte en de resultaatgerichte benadering in de zorg. Middels onderzoek stel ik vast hoe organisaties presteren in het realiseren van waardegedreven zorg, ook wel Value Based Healthcare of Triple Aim genoemd. Met deze kennis help ik bij het bouwen van toekomstbestendige zorgorganisaties en netwerken. Mijn motto is: Samen kan het beter en goedkoper!","sameAs":["https:\/\/www.linkedin.com\/in\/pimvalentijn\/"],"url":"https:\/\/www.essenburgh.com\/en\/author\/pim\/"}]}},"_links":{"self":[{"href":"https:\/\/www.essenburgh.com\/en\/wp-json\/wp\/v2\/posts\/9886","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/www.essenburgh.com\/en\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.essenburgh.com\/en\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.essenburgh.com\/en\/wp-json\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/www.essenburgh.com\/en\/wp-json\/wp\/v2\/comments?post=9886"}],"version-history":[{"count":2,"href":"https:\/\/www.essenburgh.com\/en\/wp-json\/wp\/v2\/posts\/9886\/revisions"}],"predecessor-version":[{"id":79579,"href":"https:\/\/www.essenburgh.com\/en\/wp-json\/wp\/v2\/posts\/9886\/revisions\/79579"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/www.essenburgh.com\/en\/wp-json\/wp\/v2\/media\/7724"}],"wp:attachment":[{"href":"https:\/\/www.essenburgh.com\/en\/wp-json\/wp\/v2\/media?parent=9886"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.essenburgh.com\/en\/wp-json\/wp\/v2\/categories?post=9886"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.essenburgh.com\/en\/wp-json\/wp\/v2\/tags?post=9886"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}