Transforming adult cochlear implant services: A holistic value-based care model to improve quality and patient outcomes

This thesis proposes a person-centred and value-based care model to improve cochlear implant (CI) service delivery by focusing on outcomes that reflect the needs, priorities and experiences of potential and existing recipients. Drawing on a comprehensive literature review and mixed-methods research, it highlights the need to measure outcomes across the full CI care pathway, recognising the multidimensional and interconnected nature of CI outcomes. The proposed evaluation framework centres on capability, calm, and comfort— capturing clinical (surgical, audiological), functional, and experience of care to improve care quality, enhance patient experience, and benchmark system-level performance improvement. The collective outcomes define CI success.