Abstract
Objective
To find a consensus on clinicians’ and patients’ activities that underpin an ideal value-based outpatient specialty consultation, among clinicians.
Methods
A three-round online Delphi study was conducted. A purposive sample of nineteen clinicians from a Dutch university hospital judged activities on importance. Consensus was defined at 80% agreement. Activities were thematically analyzed to derive conceptual themes.
Results
The expert panel agreed on 63 activities as being important for an ideal value-based outpatient specialty consultation and two activities as being unimportant. They failed to reach a consensus on 11 activities. Conceptual themes for activities that were considered important regard: 1) empowerment, 2) patient-reported biopsychosocial outcomes, 3) the patient as a person, 4) the patient’s kin, 5) shared power and responsibility, 6) optimization, 7) coordination, 8) therapeutic relationships, and 9) resource-consciousness.
Conclusion
A value-based outpatient specialty consultation requires contextual decision-making, is person-centered, and focusses attention on care optimization and intelligent resource allocation. No importance is attributed to healthcare’s societal burden and climate footprint. Disparities existed in various areas including the role of patient reported experience measures, “patient-like-me” data, and healthcare costs.
Practice implications
This study contributes a toolbox to guide and evaluate clinicians’ and patients’ behaviors in value-based outpatient specialty consultations and reveals opportunities to enhance facilitation.
To find a consensus on clinicians’ and patients’ activities that underpin an ideal value-based outpatient specialty consultation, among clinicians.
Methods
A three-round online Delphi study was conducted. A purposive sample of nineteen clinicians from a Dutch university hospital judged activities on importance. Consensus was defined at 80% agreement. Activities were thematically analyzed to derive conceptual themes.
Results
The expert panel agreed on 63 activities as being important for an ideal value-based outpatient specialty consultation and two activities as being unimportant. They failed to reach a consensus on 11 activities. Conceptual themes for activities that were considered important regard: 1) empowerment, 2) patient-reported biopsychosocial outcomes, 3) the patient as a person, 4) the patient’s kin, 5) shared power and responsibility, 6) optimization, 7) coordination, 8) therapeutic relationships, and 9) resource-consciousness.
Conclusion
A value-based outpatient specialty consultation requires contextual decision-making, is person-centered, and focusses attention on care optimization and intelligent resource allocation. No importance is attributed to healthcare’s societal burden and climate footprint. Disparities existed in various areas including the role of patient reported experience measures, “patient-like-me” data, and healthcare costs.
Practice implications
This study contributes a toolbox to guide and evaluate clinicians’ and patients’ behaviors in value-based outpatient specialty consultations and reveals opportunities to enhance facilitation.
| Original language | English |
|---|---|
| Article number | 107642 |
| Pages (from-to) | 1-16 |
| Journal | Patient Education and Counseling |
| Volume | 109 |
| Issue number | 107642 |
| DOIs | |
| Publication status | Published - Apr 2023 |
Bibliographical note
Funding Information:This work was funded by Erasmus School of Health Policy & Management, Erasmus University Rotterdam .
Publisher Copyright:
© 2023 The Authors
