A 10-Year Journey Toward an Accountable and Sustainable Patient-Centered Care Model

Purpose:  The provision of an accountable and sustainable healthcare system is a major challenge worldwide. The delivery of a patient-centred care model that is accessible, safe, reliable and affordable remains elusive for many organisations. Over the past decade, St Vincent’s Private Hospital Sydney has implemented three frameworks – the Balanced Scorecard, the Magnet Recognition Program® and a revenue cycle management program – to address this challenge and strive towards the delivery of an accountable and sustainable patient-centred care model.The aim of this research was to analyse the financial, clinical and cultural impact of the three frameworks implemented at St Vincent’s Private Hospital to improve its overall performance and sustainability.

Methods:  The research design adopted was a modified sequential, explanatory mixed-method organisational single-case study design. The quantitative component of the study consisted of a cost-benefit analysis of the past 10 years of the implementation of the Balanced Scorecard, the Magnet Recognition Program® and a prospective analysis of the implementation of a revenue cycle management program. The qualitative component of the research study comprised semi-structured interviews and focus groups to analyse the impact of these frameworks on the participants’ roles and functions and linking their feedback with the findings of the quantitative component of the study.

Results:  The overall findings suggest that the combined impact of these three frameworks may have assisted St Vincent’s Private Hospital in its journey towards an accountable and sustainable patient-centred care model. The quantitative component of the study established that improved quality and safety outcomes, patient and staff experience, and greater efficiencies and savings may have been realised through the individual as well as the combined implementation of these frameworks. The qualitative component of the study explained the varying degrees of understanding of these frameworks by the nursing staff, and how the frameworks may have assisted them in achieving improved performance. In terms of the level of support for the three programs from the nursing staff, the study indicated that the Magnet Recognition Program® received the highest level, which was quite significant. The Balanced Scorecard was second in the level of support received and the revenue cycle management program was third.

Conclusion:

Analysis of the individual and cumulative impact of the Balanced Scorecard, the Magnet Recognition Program® and the revenue cycle management program, indicates that using these frameworks in combination may have assisted St Vincent’s Private Hospital in improving its overall performance. In addition, the findings of this research advocate and support the incorporation of these three frameworks into a single, integrated patient-centred care model. However, further research is required to test this proposition empirically.