Structuring an IPU: moving from continuous to aligned

VBHC diagnosis and integrated scorecard (outcomes – costs – processes): steps 1 and 2 of the five-step IPU implementation process.

The starting point: a clinic ahead of the curve, ready to structure things differently

Clinique Pasteur did not wait for VBHC to commit to quality. For years, the clinic has cultivated high standards: medical excellence, team culture, patient experience and continuous improvement.

But a conviction took hold among the executive and medical team: all these efforts would benefit from being aligned within a logic of a managed, measured, cross-functional patient journey.

What Pasteur is seeking to do is not to “do VBHC” in the marketing sense of the term. It is to structure its model around an integrated practice unit (IPU):

• a clear, smooth, managed patient journey
• a team that sees itself as collectively responsible for outcomes
• a data system that serves decision-making

Choosing breast cancer as the lever

Breast cancer was identified as the priority scope for launching this approach. Why? Because the volume is sufficient to build a structure, variations are observable, and above all because the team is already highly committed — both medically and on a human level.

The motivation: to take one more step towards a model in which care and experience are no longer separated, in which performance is considered from the patient’s point of view, and in which management tools serve a clear purpose.

What we contributed: method, objective assessment, alignment

We worked alongside LSD Consulting to support the first two phases of structuring the IPU.

A rigorous diagnosis of the real patient journey

• Immersion in the field with professionals, patients and support functions
• Qualitative analysis (interviews, direct observation) and quantitative analysis (stay and procedure data over 3 years)
• Identification of critical sequences: operating theatre organisation, combined procedures, post-surgery follow-up…

An objective assessment of the resources used

• Estimating the costs of the patient journey, not for the purpose of “control”, but to put data to work for clinical efficiency
• Initial work on the value chain: where is the workload concentrated? Where are the redundancies? What creates or destroys value?

Alignment on a shared scorecard

This is the project’s central deliverable: an integrated scorecard, designed with the teams, that can be used to manage the entire patient journey.

• Patient results (outcomes): complications, waiting times, perceived experience, return to normal life…
• Resources used (costs): medical time, procedures, stays, operating theatre…
• Key processes: waiting times, coordination, rate of combined vs. separate procedures, typical journeys

Far from top-down dashboards, this scorecard becomes a tool for dialogue between teams, a basis for prioritising actions and steering the next steps.