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Swedish University Hospital System Defines the Outcomes That Matter

Quick wins, backed by a long-term plan, helps a hospital system embrace change.

Sahlgrenska University Hospital, based in Göteborg, Sweden, is one of the largest hospital networks in northern Europe. Sahlgrenska provides emergency and basic care for the 700,000 inhabitants of the Göteborg region and specialized care for the 1.7 million inhabitants of western Sweden. It’s also one of only two Swedish hospitals that perform pediatric heart surgery and heart, liver, and lung transplants for patients of all ages.

As is the case for many public hospitals in Europe, Sahlgrenska is facing severe pressure from the regional government (the chief payers in Sweden’s public-health system) to keep costs down. What’s more, as Sweden introduces more patient choice and elements of value-based reimbursement into its public-health system, the hospital is facing growing competition and the need to make strategic choices about the specialist areas on which to focus its resources.

BCG partnered with Sahlgrenska to assess organizational readiness for change, define the outcomes that matter, allocate costs per patient, implement quick wins, enhance service function productivity, and institutionalize the value-based approach. Developing metrics for the 200 major diseases typically covered by a major hospital will require multiple years of ongoing work, but early results have been promising. The hip replacement pilot at Sahlgrenska, for example, has now transformed into an ongoing capability for continuous improvement.

With a detailed scorecard in place, the hip replacement unit has the data that will allow it to implement a new approach to postsurgical rehabilitation, known as Fast Track. Clinical studies show that the faster a hip replacement patient can get up and about after surgery, the better the health outcomes.

With this approach, Sahlgrenska aims to improve the long-term outcome and reduce the average length of stay from the current four to seven days to just two days. This change will result in a significant improvement in patient value.

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