How to Integrate Value for Money Thinking into Your Healthcare Organization’s Culture

Value for money (VfM) thinking is an important “new” imperative that healthcare organizations must build into their organizational skill set. However, before launching into this post, let’s be clear that I am not suggesting that, in response to this new requirement, you should create an exclusively VfM-oriented culture in your healthcare organization. Safety and patient care quality, for example, are also important in a successful healthcare institution. So is knowledge translation and a culture of inter-professional learning and care.

It really turns out that integrating VfM thinking into your healthcare organization’s culture is the next strategic requirement you are facing as a healthcare leader.

Whether it’s safety, quality, or VfM, every organization essentially has two options when it comes to producing the desired results – they can take a program approach (i.e. a core group of experts designs and implements top down initiatives relating to the topic or discipline at hand) OR they can work to build the desired element into the way their organization and people work every day.

While every organization will achieve a certain degree of success by taking the program approach, the data shows that more sustainable results are achieved when the people who are doing the work internalize the objective/topic/discipline and apply it in their thinking and through their actions and decisions on the job every day.

I’ve seen this effect myself when it comes to hand hygiene efforts in hospitals. While Infection Control groups can design a sophisticated program of information, alerts and reminders, and compliance results reports that is launched simultaneously across multiple hospital floors, better results/compliance and outcomes are achieved when healthcare professionals, staff, and infection control experts collaborate to attack the issue and develop a home grown program that is their own and that they can implement together – and, perhaps most importantly, share enthusiastically with their peers.

So we know which approach works better – why then don’t we implement it more often?

In my experience, it’s usually because it’s perceived as being too hard and time consuming. And, to be honest, people simply don’t know where to start.

So, with this in mind, let’s explore a proven model that will support a sustainable VfM-focused culture (or any kind of strategically important culture) within your organization.


Here’s the model (click on the image to get a closer look):

Creating a VfM Culture

Let’s begin with the center elements in this picture.

Successfully building a culture of anything that’s important in your organization is essentially about building shared ownership.  In the case of VfM, your goal is to build a climate of shared ownership where the intent and necessary supporting values and beliefs are embraced by all, and the actions embodied by VfM thinking are demonstrated in the work and business decisions employees and executives complete every day.  

Under a model of shared ownership, employees and business leaders fully understand, internalize, and commit to the spirit of and intent behind the element under consideration. When people are connected to, and feel very deeply about, something (such as ensuring patient safety or maximizing value delivery, for example) they take their roles and responsibilities very personally  – so much so that they choose their words and actions carefully with the purpose being to bring those imperatives to life every day in their work.

This deep commitment is visible to all through the things people choose to work on, the utility and creativity of the solutions they create, and the value realized through the business decisions they make. Employees and business leaders do what they do not because it’s expected or required of them but because they care passionately about what they are doing, the contribution they wish to make, and the results and outcomes they want to contribute to producing by living and acting a certain way.

This is what shared ownership looks like in action. And, ultimately, the foundation of a strong culture in any organization is a state of shared ownership.   

However, before going any further, let’s stop and talk about who should be included when we define the “group” that is sharing ownership within our model. Your first response might be that, since we are talking about your organization’s culture, the “group” would naturally include your employees and executives/business leaders. While I agree that these are the core participants in any organizational group, forward thinking organizations are realizing that their boundaries are increasingly becoming blurred.  Stakeholders are having a greater say in shaping the organizations that serve them (witness the greater involvement of patients in hospital management processes and decisions) and partners are becoming a critical part of the service delivery chain.

As a result, stakeholders and partners should be included in your model of shared ownership.

It’s important to realize that shared ownership is both an outcome of and a mechanism for integrating VfM thinking into your organization’s culture.

As a mechanism, shared ownership means that all the relevant players are actively involved in developing a clear vision for the elements of value being considered in any VfM assessment as well as your organization’s overall objectives for applying VfM thinking to its work and business decisions. Shared ownership as a mechanism also means that everyone participates appropriately and pro-actively in defining and applying your VfM approach and framework in working situations.

The act of working together in this collaborative way to bring VfM thinking into practice produces greater feelings of shared ownership across your organization. In this way, shared ownership is also an outcome of your organization’s culture.


While shared ownership is the key requirement for integrating VfM thinking into your organization’s culture, there are four critical enablers that must be in place if your organization’s cultural transformation is going to be successfully achieved. These include:

Collaboration, Dialogue, and Knowledge Sharing

First and foremost, you must give your employees, business leaders, partners, and interested stakeholders a seat at the VfM “table” and make them true partners in defining, applying, and refining your VfM approach, processes, and framework across your entire organization. Without taking this step of establishing a level playing field and creating the opportunity for everyone to engage, you will be unable to lay the foundation for shared ownership.

Active and Committed Leadership

Many people would say that this is the most important enabler as you strive to integrate VfM thinking into your organization’s culture. To achieve success, executives and business leaders must be as committed to VfM efforts as they want everyone else in the organization to be.  Active leadership needs to include walking the talk. Do this by actively participating in your organization’s VfM efforts and making the shared ownership mindset transparent and obvious through your interactions with people across the organization.

Training, Learning, and Continuous Improvement

To achieve the successful integration of VfM thinking into your organization’s culture you must ensure that everyone has the training and learning experiences they need to make their fullest possible contribution every day to your VfM efforts. It’s also important to enable your employees, business leaders, partners, and interested stakeholders to use this knowledge to help make your organization’s VfM approach and results even better.

Tools, Technologies, and Infrastructure

Instilling a VfM culture, including the levels of shared ownership you wish to create, won’t happen on its own. You’ve got to invest in and implement the infrastructure, tools, and technologies employees, business leaders, partners, and interested stakeholders need to connect and play their role in your VfM efforts. Putting these resources in place ensures that all of these players can get to the VfM table and make an optimal contribution to your VfM processes, activities, and efforts – no matter where they are inside (or outside) your organization.


Intuitively, it’s easy to understand that taking a collaborative, shared ownership approach to integrating VfM thinking into your organization’s culture is best for sustainable success. Practically, implementing this model does require some upfront and sustained investment, however, you and the members of your organization will be rewarded with high levels of efficiency, greater levels of meaningful engagement, and better results and outcomes from your VfM efforts.

The model outlined here provides you with an excellent implementation roadmap that will guide your organization to where you ultimately need to go. And, while it’s important to implement all elements of this roadmap over the long run to achieve the organizational transformation you require, simply getting started OR taking your current efforts to the next level doesn’t have to be that difficult.

Just commit to implementing one or two parts of the model and see where that takes your organization on its VfM journey. I think that you’ll be surprised with the transformation you’ll see.