Mary Muir, national clinical consulting manager at Arjo, looks at how a value-based approach to healthcare in the care sector should be defined, and how it can be achieved
Care homes play a crucial role in supporting the most vulnerable members of our society, and their importance will continue to grow with our ageing population. In recent years, the healthcare sector has witnessed a paradigm shift in how value is perceived and measured. In this new paradigm, value-based healthcare is defined as the equitable, sustainable, and transparent use of the available resources to achieve better outcomes and experiences for every person.1 Value-based healthcare prioritises outcomes and cost-effectiveness, ensuring that residents receive high-quality care. This aligns with the CQC Single Assessment Framework that focuses on care that is safe, effective, caring, responsive to people’s needs, and well-led,2 using the Health and Social Care Act 2008 (Regulated Activities) as part of their inspection process.3
The challenge: quality care versus cost efficiency
Long-term care facilities must deliver high-quality care alongside managing costs, meeting CQC standards, and minimising litigation liability. Challenges include a changing resident population, staffing resources, staff knowledge and care skills, equipment provision, and care delivery methods. In many facilities, care roles have potentially become task-oriented rather than person-centred, prioritising completing tasks over improving the health and wellbeing of the resident.4
Value-based healthcare includes improving resident outcomes while minimising costs, emphasising wellness, and preventing unnecessary hospitalisations. In the context of elderly care, an important aspect is to minimise immobility and deconditioning in residents, achieved through personalised care plans, regular physical activity, and social engagement.
Immobility, deconditioning, and associated risks
Residents of all ages are at risk of consequences of immobility. This is particularly true as people get older,5 which can also lead to deconditioning.6 Recognising these consequences has led to an increased focus on appropriately mobilising residents throughout their care, providing an opportunity to prevent functional decline and its implications.
Deconditioning refers to the decline in both physical and mental function that can occur due to prolonged inactivity or bed rest following an injury or illness.7 It is associated with various physiological effects, including pneumonia, pressure ulcers, constipation, incontinence, depression, and an increased risk of falls. Rehabilitation and physical therapy are essential in addressing deconditioning, focusing on improving joint flexibility, muscle strength, and overall endurance.8 There is increased recognition of the importance of identifying effective approaches to behaviour change, sharing best practice and the need for mobility strategies to prevent deconditioning, at scale and speed.9 Identifying residents at elevated risk for deconditioning is essential, and there are various screening tools10 available to assist in this process. Preventative measures and interventions are vital in managing deconditioning in care home residents. Restorative nursing care, which includes function-focused care, can significantly impact the wellbeing of residents.11
Philosophy of mobility
Mobility plays a fundamental role in a resident’s quality of life. Arjo’s Positive 812 and the Mobility Gallery13 support care facilities in delivering high-quality care to the residents, while reducing the risk of physical overload for caregivers. The Positive 8 philosophy is built on three main tenets – care skills, equipment, and environment. Working with the Positive 8 principles can help to improve clinical benefits for the resident, enhance workflow efficiencies for caregivers, and achieve f inancial optimisation for the facility.
The Mobility Gallery is a communication tool designed to assess a resident’s functional mobility level, ranging from independent to dependent. It outlines the support required for each individual, evaluates the risk of physical overload to caregivers, and recommends appropriate equipment provision to minimise the risk of harm.14
Educating caregivers on best practices in elderly care is crucial for ensuring the wellbeing, dignity, and comfort of residents. Prioritising education can lead to better outcomes for residents while optimising the cost-effectiveness of their care. This includes investing in comprehensive risk management processes, incorporating thorough assessments, implementation of effective control measures, root cause analysis. It also includes the continuous professional development of care staff to enhance their knowledge and skills.
By focusing on these areas, care facilities can create a safer and more supportive environment for both residents and caregivers.
Risk management and root cause analysis
Risk management involves identifying, evaluating, and prioritising risks, while root cause analysis identifies the underlying causes of problems or incidents. Integrating these approaches enhances risk management, allowing for targeted and effective risk mitigation strategies.15
Arjo Insight assessments16 provide evidence-based risk assessments aligned with recognised working standards,14, 17 supporting care facilities with detailed evaluations of population characteristics, clinical outcomes, educational needs, and compliance with clinical and regulatory guidelines. By using these assessments, care facilities can work to improve clinical outcomes, promote mobility, reduce healthcare-acquired pressure ulcers, and minimise the risk of caregiver physical strain and injury. Additionally, they can identify deficit and surplus equipment needs and facilitate efficient workflow and resource management as part of a risk mitigation strategy.
Evidence-based education
To support the implementation of a risk mitigation strategy, Arjo offers tailored educational programs aimed at improving clinical outcomes, workflow efficiencies, regulatory compliance, and optimised resource utilisation. These evidence-based clinical programs focus on individualised mobility to improve care process efficiency, reduce physical strain and injury to care staff, and prevent pressure ulcers.
Arjo MOVE™ programs provide care facilities with knowledge, skills, and tools to drive improvements towards strategic clinical and operational goals, supported by clinical evidence and the facility’s own data, ultimately delivering value-based healthcare, measurable outcomes, and sustainable cultural change. Moreover, Arjo provides evidence-based, CPD-accredited educational content, including the aforementioned programs, study days, and events. We also offer interactive webinars and specialised training focused on the effective use of equipment.
In summary
The delivery of education programs on people handling and pressure ulcer prevention, supported by workplace coaching, can embed a cultural change in clinical practice. This approach can support high-quality care improvement initiatives in long-term care facilities.
Aligning the Arjo MOVETM educational programs with the CQC Single Assessment Framework can help meet regulatory requirements, improve outcomes, and enhance the quality of care provided, ensuring that facilities deliver safe, effective, and compassionate care that meets the needs of their residents by integrating these value-based healthcare principles.
As the healthcare landscape continues to evolve, care facilities need to be able to adapt by embracing value-based principles to provide the best possible care to their residents. This commitment to ongoing education and adherence to regulatory standards ensures that residential and nursing care homes remain at the forefront of delivering high-quality, personalised care
References available on request
Overview
Arjo’s philosophy, centred around value based healthcare and empowering movement, aligns seamlessly with the CQC Single Assessment Framework. This synergy fosters a unified approach to enhance care quality, improve resident mobility, and deliver measurable health outcomes.
As a value-based healthcare provider, our goal is to collaborate with you to become your trusted mobility outcome partner. We strive to create the perfect synergy between the work environment, the equipment, and the dedicated professionals providing care to residents.
Using the facility’s own data, Arjo’s Insight assessments and MOVE education programs can be tailored to meet specific needs. Together, we can enhance the quality of care, improve risk mitigation, and achieve better outcomes for those we serve
To find out more visit http://www.arjo.co.uk
Mary Muir
With over 30 years in healthcare, Mary joined Arjo in 2004. She has held various roles and is currently the national clinical consultancy manager for the Mobility Outcome Team. This team supports facilities with Insight assessments , consultation and MOVE educational programs.
