Driving High Value Care

No Queenslander wants to undertake, nor be the recipient of, care that could be considered low value or low benefit.

Low value care (LVC) is defined as any investigation or treatment that provides no additional benefit to patients or, in some instances, could be considered to ‘do more harm than good’. Despite LVC being undesired by patients, clinicians, and the healthcare system at large, it continues to occur.

The issue is that low value care appears to occur quite commonly, with some reports indicating approximately 30% of care could fall into the low value category.

We were engaged by Queensland Health to apply a behavioural science approach to address the following questions –

• What is low value care

• What can be done to reduce it?

The focus of our activities was on undertaking a behavioural systems analysis—Evidn’s user-centred methodology that determines why patterns of behaviour occur in complex settings and what can be done to modify behaviour in such settings.

If we conceptualise low value care as a behaviour, we can treat it as a behavioural problem. The focus of our approach was on developing an explanatory behavioural model of LVC and a behaviour change framework of strategies to help reduce instances of LVC in Queensland’s healthcare system.

In undertaking the behavioural analysis, we engaged over 100 stakeholders across public hospitals in the Brisbane Metro area, including hospital staff and consumers, as well as conducting extensive reviews of the literature and consulting with departmental staff and other external organisations who have experience in value-based healthcare settings.

Core to this methodology, is identifying the modifiable factors influencing LVC that have the greatest potential for impact. Our analysis extracted a total of 30 psychological and behavioural forces that predict the occurrence of LVC in Queensland’s healthcare system.

Through our field work, we have built strong relationships with key departmental staff, clinicians and consumers. This network of stakeholders and influencers will be central  for championing change on-the-ground. To date, a behaviour change framework has been developed comprising several strategies co-designed with clinical staff for testing and implementation across several specialities and facilities in the Brisbane Metro area.