Common use of Leading Better Value Care Clause in Contracts

Leading Better Value Care. The Leading Better Value Care (LBVC) Program identifies and scales evidence-based initiatives for specific diseases or conditions and supports their implementation in all local health districts across the state. The LBVC Program has a strong focus on measurement and evaluation to show the impact of care across the four domains of value. The main roles and responsibilities in the LBVC Program are:  The Ministry of Health will continue as system manager and will articulate the priorities for NSW Health. Performance against delivery of the priorities will be monitored in line with the NSW Health Performance Framework.  Districts and Networks will continue to provide services established through LBVC in 2017-18 and 2018-19 and determine local approaches to deliver new LBVC initiatives in 2019-20.  The Pillars will continue to support Districts and Networks in a flexible manner that can be customised to meet statewide and local needs and will support measurement activities as required.  Districts and Networks will participate with Ministry of Health and Pillars in evaluation, monitoring and regular reporting on the progress of the LBVC initiatives as specified in the Monitoring and Evaluation Plans. In 2019-20, districts and networks will:  Continue to provide and expand the reach of clinical services in the most appropriate care setting for patients in LBVC Tranche 1 initiatives of Osteoporotic Refracture Prevention (ORP), Osteoarthritis Chronic Care Program (OACCP), Renal Supportive Care (RSC) and High Risk Foot Services (HRFS) through non-admitted services, including designated HERO clinics.  Continue to implement, expand and embed LBVC approaches, including but not limited to a focus on activities outlined in Clinical Improvement Activity Briefs for Chronic Heart Failure (CHF), Chronic Obstructive Pulmonary Disease (COPD) and Inpatient Management of Diabetes.  Continue to sustain improvement work and spread when interventions are reliably practiced to reduce falls and harm from falls in hospital. Districts should have a Sustainability Action Plan (including actions on how to progress implementation endorsed by the district Executive) to identify opportunities and risks to sustaining and spreading the Falls in Hospital Collaborative improvements.  Participate in and provide data to inform monitoring, evaluation and other studies of LBVC initiatives.  Utilise their PRMs Project Officer to support the implementation, collection and use of identified Patient Reported Measures and work with other district resources to support the broader work program to embed value-based healthcare approaches in the district.  Be expected to demonstrate improved health outcomes (clinical and patient reported), experiences and activity benefits from all Tranche 1 initiatives as outlined in the monitoring and evaluation plans.  Work with the Ministry of Health and Pillar agencies to implement LBVC Tranche 2 initiatives for: o Bronchiolitis: Implement and embed LBVC approaches as outlined in the Clinical Improvement Activity Brief for the Bronchiolitis initiative including: - Appropriate investigations for Bronchiolitis, including Paediatrician medical review - Implement guidelines for the appropriate use of oxygen and antibiotics - Develop consistent advice on safe home management for families o Hip Fracture: Implement and embed LBVC approaches to meet the Australian Commission on Safety and Quality in Health Care Hip Fracture Care Clinical Standards, with a particular focus on activities outlined in the Clinical Improvement Activity Brief for the Hip Fracture Care initiative including: - Pain management assessments upon presentation - Reduce time to surgery to less than 48 hours - Early mobilisation and weight bearing - Implementation of an orthogeriatric model of care o Direct Access Colonoscopy for Positive Faecal Occult Blood Test (+FOBT) - By December 2019 develop a plan for the implementation of direct access colonoscopy for +FOBT across the district by June 2021 - Beginning in January 2020, implement Clinical Categorisation Guidelines for the booking of colonoscopy waiting lists - By December 2019, commence quarterly reporting on the number of colonoscopies performed as a result of +FOBT. - By June 2020, establish direct access for +FOBT referrals in at least one new public colonoscopy facility in the district, including collaboration with the PHN to update health pathways. - By June 2020 be ready to commence quarterly reporting of wait times for colonoscopy in public facilities by triage category and referral type and have a plan for ongoing quality assurance of waitlists. o Hypofractionated Radiotherapy for Early Stage Breast Cancer - Regularly collect, provide, and report on key data items in alignment with the initiative’s Monitoring and Evaluation Plan; providing quarterly and annual updates. - By September 2019 perform a self-assessment of current hypofractionated radiotherapy utilisation for the treatment of early stage breast cancer; identifying gaps in utilisation - Participate in the co-design of a solution toolkit and implement local solutions and change management plans to achieve optimal utilisation of hypofractionated radiotherapy. o Wound Management - Develop localised models of care, utilising statewide data and local diagnostics, to guide the provision and delivery of services for wound management across the healthcare system in line with the LBVC Standards for Wound Management.

Leading Better Value Care. The Leading Better Value Care (LBVC) Program identifies and scales evidence-based initiatives for specific diseases or conditions and supports their implementation in all local health districts creates shared priorities across the state. The LBVC Program has a strong focus on measurement and evaluation NSW health system to show improve health outcomes, improve the impact experience of care across the four domains of valuefor patients, carers and clinicians and provide efficient and effective care. The main roles and responsibilities in components of this approach include the LBVC Program arefollowing:  The Ministry of Health will continue as system administrator, purchaser and manager and will articulate the priorities for NSW Health. Performance against delivery of the priorities will be monitored in line with the NSW Health Performance Framework.  Districts and Networks will continue to provide services established through LBVC in 2017-18 and 2018-19 and determine local approaches to deliver new LBVC initiatives in 20192018-2019.  The Pillars Pillars, as required, will continue to support Districts and Networks in a flexible manner that can be customised to meet statewide and local needs and will support measurement activities as required.  Districts and Networks will participate with Ministry of Health and Pillars in evaluation, monitoring and regular reporting on the progress of the LBVC initiatives as specified in the Monitoring and Evaluation Plans. In 2019-202018/19, districts Districts and networks Networks will:  Continue to provide and expand the reach of clinical services in the most appropriate care setting for patients in LBVC Tranche 1 One (T1) initiatives of Osteoporotic Refracture Prevention (ORP), Osteoarthritis Chronic Care Program (OACCP), Renal Supportive Care (RSC) and High Risk Foot Services (HRFS) through non-admitted services, including designated HERO clinics.  Continue to implement, expand and embed Implement the LBVC approaches, including but not limited to a focus on activities outlined in Clinical Improvement Activity Briefs solutions for Chronic Heart Failure (CHF), Chronic Obstructive Pulmonary Disease (COPD) and Inpatient Management of Diabetes.  Continue to sustain improvement work undertake and spread when interventions are reliably practiced report on the agreed solutions to reduce falls and harm from falls in hospital. Districts should have a Sustainability Action Plan (including actions on how to progress implementation endorsed by the district Executive) to identify opportunities and risks to sustaining and spreading the Falls in Hospital Collaborative improvements.  Participate in and provide data to inform monitoring, evaluation and other studies (e.g. costing) of LBVC initiativesinitiatives Formative evaluations will occur throughout 2018-19 in consultation with the Districts and other stakeholders.  Utilise their PRMs Project Officer to support the implementation, collection and use Undertake regular reviews of identified Patient Reported Measures and work activity associated with other district resources to support the broader work program to embed value-based healthcare approaches in the district.  Be expected to demonstrate improved health outcomes (clinical and patient reported), experiences and activity benefits from all Tranche 1 initiatives as outlined in the monitoring and evaluation plansT1 initiatives.  Work with the Ministry of Health and lead Pillar agencies to implement participate in data gathering and other activities to support the development and implementation of LBVC Tranche 2 (T2) initiatives for: o Bronchiolitis: Implement and embed LBVC approaches as outlined in the Clinical Improvement Activity Brief for the Bronchiolitis initiative including: - Appropriate investigations for Bronchiolitis, including Paediatrician medical review - Implement guidelines for the appropriate use of oxygen and antibiotics - Develop consistent advice on safe home management for families . o Hip Fracture: Implement and embed LBVC approaches to meet the Australian Commission on Safety and Quality in Health Care Hip Fracture Care Clinical Standards, with a particular focus on activities outlined in the Clinical Improvement Activity Brief for the Hip Fracture Care initiative including: - Pain management assessments upon presentation - Reduce time to surgery to less than 48 hours - Early mobilisation and weight bearing - Implementation of an orthogeriatric model of care o Direct Access Colonoscopy for Positive Faecal Occult Blood Test (+FOBT) - By December 2019 develop a plan for the implementation of direct access colonoscopy for +FOBT across the district by June 2021 - Beginning in January 2020, implement Clinical Categorisation Guidelines for the booking of colonoscopy waiting lists - By December 2019, commence quarterly reporting on the number of colonoscopies performed as a result of +FOBT. - By June 2020, establish direct access for +FOBT referrals in at least one new public colonoscopy facility in the district, including collaboration with the PHN to update health pathways. - By June 2020 be ready to commence quarterly reporting of wait times for colonoscopy in public facilities by triage category and referral type and have a plan for ongoing quality assurance of waitlists. o Hypofractionated Radiotherapy Cancer care (optimal care pathways for Early Stage Breast Cancer - Regularly collect, provide, and report on key data items in alignment with the initiative’s Monitoring and Evaluation Plan; providing quarterly and annual updates. - By September 2019 perform a self-assessment of current hypofractionated radiotherapy utilisation for the treatment of early stage breast colorectal cancer; identifying gaps in utilisation - Participate in the co-design of a solution toolkit and implement local solutions and change management plans to achieve optimal utilisation of hypofractionated radiotherapy. o Wound Management - Develop localised models of care, utilising statewide data and local diagnostics, to guide the provision and delivery of services for wound management across the healthcare system in line with the LBVC Standards for Wound Managementhypofractionation).

Leading Better Value Care. The Leading Better Value Care (LBVC) Program identifies and scales evidence-based initiatives for specific diseases or conditions and supports their implementation in all local health districts across the state. The LBVC Program has a strong focus on measurement and evaluation to show the impact of care across the four domains of value. The main roles and responsibilities in the LBVC Program are:  • The Ministry of Health will continue as system manager and will articulate the priorities for NSW Health. Performance against delivery of the priorities will be monitored in line with the NSW Health Performance Framework.  • Districts and Networks will continue to provide services established through LBVC in 2017-18 and 2018-19 and determine local approaches to deliver new LBVC initiatives in 2019-20.  • The Pillars will continue to support Districts and Networks in a flexible manner that can be customised to meet statewide and local needs and will support measurement activities as required.  • Districts and Networks will participate with Ministry of Health and Pillars in evaluation, monitoring and regular reporting on the progress of the LBVC initiatives as specified in the Monitoring and Evaluation Plans. In 2019-20, districts and networks will:  • Continue to provide and expand the reach of clinical services in the most appropriate care setting for patients in LBVC Tranche 1 initiatives of Osteoporotic Refracture Prevention (ORP), Osteoarthritis Chronic Care Program (OACCP), Renal Supportive Care (RSC) and High Risk Foot Services (HRFS) through non-admitted services, including designated HERO clinics.  • Continue to implement, expand and embed LBVC approaches, including but not limited to a focus on activities outlined in Clinical Improvement Activity Briefs for Chronic Heart Failure (CHF), Chronic Obstructive Pulmonary Disease (COPD) and Inpatient Management of Diabetes.  • Continue to sustain improvement work and spread when interventions are reliably practiced to reduce falls and harm from falls in hospital. Districts should have a Sustainability Action Plan (including actions on how to progress implementation endorsed by the district Executive) to identify opportunities and risks to sustaining and spreading the Falls in Hospital Collaborative improvements.  • Participate in and provide data to inform monitoring, evaluation and other studies of LBVC initiatives.  • Utilise their PRMs Project Officer to support the implementation, collection and use of identified Patient Reported Measures and work with other district resources to support the broader work program to embed value-based healthcare approaches in the district.  • Be expected to demonstrate improved health outcomes (clinical and patient reported), experiences and activity benefits from all Tranche 1 initiatives as outlined in the monitoring and evaluation plans.  • Work with the Ministry of Health and Pillar agencies to implement LBVC Tranche 2 initiatives for: o Bronchiolitis: Implement and embed LBVC approaches as outlined in the Clinical Improvement Activity Brief for the Bronchiolitis initiative including: - Appropriate investigations for Bronchiolitis, including Paediatrician medical review - Implement guidelines for the appropriate use of oxygen and antibiotics - Develop consistent advice on safe home management for families o Hip Fracture: Implement and embed LBVC approaches to meet the Australian Commission on Safety and Quality in Health Care Hip Fracture Care Clinical Standards, with a particular focus on activities outlined in the Clinical Improvement Activity Brief for the Hip Fracture Care initiative including: - Pain management assessments upon presentation - Reduce time to surgery to less than 48 hours - Early mobilisation and weight bearing - Implementation of an orthogeriatric model of care o Direct Access Colonoscopy for Positive Faecal Occult Blood Test (+FOBT) - By December 2019 develop a plan for the implementation of direct access colonoscopy for +FOBT across the district by June 2021 - Beginning in January 2020, implement Clinical Categorisation Guidelines for the booking of colonoscopy waiting lists - By December 2019, commence quarterly reporting on the number of colonoscopies performed as a result of +FOBT. - By June 2020, establish direct access for +FOBT referrals in at least one new public colonoscopy facility in the district, including collaboration with the PHN to update health pathways. - By June 2020 be ready to commence quarterly reporting of wait times for colonoscopy in public facilities by triage category and referral type and have a plan for ongoing quality assurance of waitlists. o Hypofractionated Radiotherapy for Early Stage Breast Cancer - Regularly collect, provide, and report on key data items in alignment with the initiative’s Monitoring and Evaluation Plan; providing quarterly and annual updates. - By September 2019 perform a self-assessment of current hypofractionated radiotherapy utilisation for the treatment of early stage breast cancer; identifying gaps in utilisation - Participate in the co-design of a solution toolkit and implement local solutions and change management plans to achieve optimal utilisation of hypofractionated radiotherapy. o Wound Management - Develop localised models of care, utilising statewide data and local diagnostics, to guide the provision and delivery of services for wound management across the healthcare system in line with the LBVC Standards for Wound Management.