IPCHS Practices

Learn from real-life experiences with health services reform. We distinguish three types: emerging, promising and leading practices. Share your practice by clicking "Add practice".

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Oct. 4, 2016 Europe

Strengthening governance and accountability, Coordinating services within and across sectors, Creating an enabling environment

Exploring new provider-payment models to incentivize performance improvements in Hungary

The Care Coordination Pilot was launched in 1999 to explore ways to improve the coordination and quality of health services. Under the pilot, Care Coordinator Organizations (run by health providers from general practices or polyclinics) acted as virtual fund holders for capitation-based health care budgets within their local catchment areas; carefully chosen financial incentives guided performance improvements by rewarding efficiency, incentivizing preventive care and encouraging treatment in lower-level settings; empowering professionals with new responsibilities helped to overcome provider dissatisfaction; extensive data collection supported analysis and comparison of local organizational arrangements.

Oct. 4, 2016 Europe

Strengthening governance and accountability, Reorienting the model of care, Coordinating services within and across sectors, Creating an enabling environment

Developing guidelines to reduce under-five child mortality in the Republic of Moldova

The government developed an under-five child mortality reduction initiative and established new standards and protocols for the observation of childhood illness; research conducted prior to the initiative identified the root causes of problems and provided evidence of the need to act; guidance and support from the Ministry of Health led to coordinated intersectoral action Educating and expanding providers’ competencies challenged pre-held attitudes regarding the detection and treatment of childhood illness; joint-sector delivery by health providers and social workers facilitated more comprehensive and coordinated care for patients; national ownership over the initiative was important; activities were fully integrated into national standards ...

Sept. 7, 2016 Europe

Engaging and empowering people and communities, Reorienting the model of care, Coordinating services within and across sectors

Introducing palliative care in Serbia

The Ministry of Health established the Palliative Care Task Force and adopted the National Strategy for Palliative Care to guide the development of palliative care across Serbia; partnerships with international organizations, local NGOs and supportive government actors helped secure buy-in at the national level; developing a legislative and political base was essential for creating a foundation on which to build the initiative; securing EU funding provided additional resources to support activities; incorporating a new palliative care philosophy within professional culture required extensive training, communication, advocacy and time; formalizing educational opportunities through university partnerships helped to ensure sustainability.

Sept. 7, 2016 Europe

Strengthening governance and accountability, Reorienting the model of care, Coordinating services within and across sectors, Creating an enabling environment

Integrating health and social care in San Marino

In 2004, the Government of San Marino began the process of integrating the health and social care system to improve care coordination and efficiency, and published the first social-health plan in 2006 to help guide change; health and social care reforms reinforced already widespread informal practices in service delivery and nurtured the existing spirit of mutual respect, collaboration and effective communication; familiarity and close professional relationships across health and social care sectors were integral to the development of the initiative; integration of management structures at the system level provided a strong platform from which to drive integration at the service ...

Sept. 7, 2016 Europe

Strengthening governance and accountability, Reorienting the model of care, Coordinating services within and across sectors, Creating an enabling environment

Advancing nursing roles to improve disease prevention services in Samara, Russian Federation

Polyclinic 15 led an initiative to expand health promotion and disease prevention services by advancing nursing roles. Nurses now independently care for lower-risk patients, perform screenings and deliver health education; expanding nurses’ scope of practice helped to overcome physicians’ capacity barriers. Physicians now report having more time for high-risk patients; continuous training, backed by supportive legislation and incentives, helped to institutionalize new practices; international partnerships supported the transfer of knowledge and advancement of nursing; health education helped empower patients to self-manage their conditions and adopt lifestyle changes.

Sept. 7, 2016 Europe

Engaging and empowering people and communities, Reorienting the model of care, Coordinating services within and across sectors

Integrating occupational therapy into cancer care in the Netherlands

Reade – an organization specializing in rehabilitative care – introduced a package of services specifically tailored to the needs of cancer patients and cancer survivors; support from Reade’s management in developing protocols and negotiating with national-level actors was essential for the implementation of the initiative; providers within Reade were brought together to apply their skills to treating the complex needs of cancer patients and survivors. Providers work in multidisciplinary teams to enable the delivery of more comprehensive care; initiative leaders built strong working relationships with external providers. This helped bring other providers on board with Reade’s new care concept and ...

Sept. 7, 2016 Europe

Engaging and empowering people and communities, Strengthening governance and accountability, Coordinating services within and across sectors

Establishing a Gerontology Coordination Centre to improve care for the elderly in Monaco

The Ministry of Health and Social Affairs opened the Gerontology Coordination Centre as a dedicated resource to support and provide services to elderly people aged 60 years and over; Monaco's small geographic and population size lent itself to a centralized approach. The initiative created a hub for the coordination of multiple aspects of health and social care for the elderly; services offered by the Centre are holistic, integrated, tailored to individual needs and place strong emphasis on supporting patients’ independence. Comprehensive geriatric assessments evaluating physical, mental and social needs are now available to all people aged 60 years and ...

Sept. 7, 2016 Europe

Engaging and empowering people and communities, Reorienting the model of care, Coordinating services within and across sectors, Creating an enabling environment

Strengthening diabetes service delivery at the primary care level in Iceland

Following grassroots efforts to increase the role of primary care providers in managing patients with diabetes, formal clinical guidelines to support diabetes care delivery at the primary level were published in 2009. The delivery of diabetes-related care in primary settings is increasing as a result; knowledge gained through experiences working abroad provided inspiration for the initiative and fostered local innovation; informal discussions among providers had sufficient power to initially motivate and direct change; incorporating trainings for providers into the formal education system helped to establish a new standard of care and ensured sustainability of knowledge.

Sept. 7, 2016 Europe

Engaging and empowering people and communities, Reorienting the model of care, Coordinating services within and across sectors

Community support programmes for people affected by dementia in Athens, Greece

The nonprofit organization AAADRD opened four day care centres across Athens to directly provide support services to people affected by dementia. The organization also campaigned extensively to gain attention for their cause and pushed the government to develop a national dementia action plan; highly motivated actors directly affected by dementia or working in related fields played an important role in identifying and understanding service delivery gaps; as a specialized organization, AAADRD was able to mobilize a large network of dedicated supporters. Connections established with similar organizations furthered advocacy efforts; sustainability of the initiative relies on growing government commitment, securing resources ...

Aug. 30, 2016 Europe

Engaging and empowering people and communities, Reorienting the model of care, Coordinating services within and across sectors

House of Generations Schwaz: A one-stop shop for providing health and social services in Austria

The Municipality of Schwaz reorganized local health and social services around the purpose-built House of Generations; co-location of services increased coordination and improved access for vulnerable groups; shared living spaces, group activities and cooperative initiatives within the House of Generations generated a sense of community, fostering a supportive and inclusive environment for vulnerable groups; strong leadership helped forge effective partnerships with municipal and regional politicians through clearly communicating aims and objectives, contributing to the initiative’s successful development; extensive involvement and linkages with the wider community generated a new hub for community-based health and social services.