BACKGROUND: Value-based healthcare (VBHC) is increasingly implemented in healthcare worldwide. Transparent measurement of the outcomes most important and relevant to patients is essential in VBHC, which is supported by a core set of most important quality indicators and outcomes. Therefore, the aim of this study was to develop a VBHC-burns core set for adult burn patients.METHODS: A three-round modified national Delphi study, including 44 outcomes and 24 quality indicators, was conducted to reach consensus among Dutch patients, burn care professionals and researchers. Items were rated on a nine-point Likert scale and selected if ≥ 70% in each group considered an item 'important'. Subsequently, instruments quantifying selected outcomes were identified based on a literature review and were chosen in a consensus meeting using recommendations from the Dutch consensus-based standard set and the Dutch Centre of Expertise on Health Disparities. Time assessment points were chosen to reflect the burn care and patient recovery process. Finally, the initial core set was evaluated in practice, leading to the adapted VBHC-burns core set.RESULTS: Twenty-seven patients, 63 burn care professionals and 23 researchers participated. Ten outcomes and four quality indicators were selected in the Delphi study, including the outcomes pain, wound healing, physical activity, self-care, independence, return to work, depression, itching, scar flexibility and return to school. Quality indicators included shared decision-making (SDM), the number of patients receiving aftercare, determination of burn depth, and assessment of active range of motion. After evaluation of its use in clinical practice, the core set included all items except SDM, which are assessed by 9 patient-reported outcome instruments or measured in clinical care. Assessment time points included are at discharge, 2 weeks, 3 months, 12 months after discharge and annually afterwards.CONCLUSION: A VBHC-burns core set was developed, consisting of outcomes and quality indicators that are important to burn patients and burn care professionals. The VBHC-burns core set is now systemically monitored and analysed in Dutch burn care to improve care and patient relevant outcomes. As improving burn care and patient relevant outcomes is important worldwide, the developed VBHC-burns core set could be inspiring for other countries.
"De voorliggende rapportage maakt deel uit van het vervolg op het project ‘Lokaal & Integraal Werken aan Participatie’ dat onder andere in gemeente Houten in de periode 2018-2020 plaatsvond. Dit initiële project heeft kennis opgeleverd over de wijze waarop professionals integrale samenwerking effectief vorm en inhoud kunnen geven. In samenwerking met de participerende gemeenten hebben we gewerkt aan innovatieve werkwijzen om de lokale praktijk te verbeteren. In Houten is zodoende met ondersteuning van dit project geëxperimenteerd met de aanpak ‘Op Koers’. Het huidige project is bedoeld als een ‘Verspreidings- en implementatie impuls’ (VIMP) om de opgedane kennis verder te brengen. In Houten hebben we zodoende de mogelijkheid gekregen om het implementatieproces van Op Koers te ondersteunen en de opbrengsten van het project te verduurzamen."
