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

Engaging and empowering people and communities, Coordinating services within and across sectors

Introducing community-based lifestyle clinics to improve population health in Malta

Lifestyle Clinics offering healthy-living support were introduced across Malta to expand availability of health promotion and disease prevention services; a motivated, multidisciplinary group of primary care professionals led the initiative through collaborative teamwork; the initiative capitalized on recent government policies supporting chronic disease prevention and a newly-established postgraduate community nursing programme; an initial information campaign helped raise awareness and gain public acceptance for new services; patients responded well to being offered a more active role in their health; further, patients play a key advocacy role in expanding the initiative.

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. 22, 2016 Europe

Strengthening governance and accountability, Creating an enabling environment

Strengthening the response to noncommunicable disease in Turkmenistan

The government developed the National Health 2020 Action Plan 2014–2020 to guide action on noncommunicable disease; international attention on key issues helped generate national momentum and political will for health reform; a strong understanding of key challenges, supported with baseline population health data, facilitated the development of the Plan and allowed tailoring of activities to population needs; intersectoral partnerships across government ministries helped to keep the Plan on the political agenda and safeguarded health reforms against being undermined by other sectors’ policies; aligning with the existing primary care infrastructure facilitated the adoption of the Plan; a strong public communication ...

Sept. 22, 2016 Europe

Strengthening governance and accountability, Reorienting the model of care, Coordinating services within and across sectors

Establishing ambulatory care for patients with tuberculosis in Uzbekistan

Médecins Sans Frontières (MSF), in partnership with the Government of the Republic of Karakalpakstan, introduced ambulatory care from day one (ACD1) as an alternative model for TB care; a strong understanding of service delivery challenges led to a solution that met patients’ needs; a supportive political and legal framework, developed prior to implementation, helped to sustainably embed reforms within the health system; strong relationships between key actors who had a history of working together aided the initiative.

Sept. 22, 2016 Europe

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

Integrating health and social care in Highland, Scotland

A lead organization model was introduced in Highland to promote greater integration between health care and social services. This new management structure united previously fragmented professional groups, serving to streamline service delivery and improve working relationships; broad political support for integrated care created a favourable environment for change; strong support from local senior management drove the initiative forward; extensive local engagement across all care levels ensured widespread buy-in for the initiative and reduced resistance to change across stakeholder groups; design and implementation of the initiative was iterative and not every detail was worked out prior to its launch; leaders stressed ...

Sept. 7, 2016 Europe

Strengthening governance and accountability, Reorienting the model of care

Integrating delivery of TB services in primary care in Tajikistan

Following on from previous national efforts to address high TB incidence rates, the third National TB Programme 2010–2015 was approved by the government to systematically address service delivery gaps and continue to develop TB services in primary care; building on previous actions taken to reduce TB and learning from these experiences enabled a stronger approach moving forward; cross-ministry partnerships ensured united government support and greater stability for the initiative; partnerships between the government and international organizations provided an infusion of technical expertise and resources; adjusting resource allocation was used as a mechanism to drive organizational shifts in service delivery.

Sept. 7, 2016 Europe

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

Outpatient rehabilitation services for working-age patients with brain injuries in Bern, Switzerland

An outpatient rehabilitation centre specifically adapted to the needs of working-age patients recovering from brain injuries was opened in Bern; Direct clinical experience of the multi-professional leadership team helped draw awareness to service delivery gaps and aided the design of practical services to address observed needs; co-location of providers within the rehabilitation centre increased service coordination and improved access for patients, while external networking between providers helped generate referrals; gradual expansion of the initiative allowed time for sufficient resources to be collected and necessary partnerships to be established, ensuring steady and sustainable growth.

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

Pioneering integrated organizational models for improving elderly people’s care in Ängelholm, Sweden

A new integrated care organization (Hälsostaden) was established to merge primary and hospital care with elderly and social care. Hälsostaden is jointly managed by its regional and municipal government and employs 600 professionals across health and social sectors; early investments in stakeholder relationships and trust building were essential for securing the future of the initiative and developing a foundation based on teamwork; finding the uniting objective of improving care for elderly people enabled stakeholders to move forward with planning; contextualizing the initiative within emerging political priorities helped generate political support and secure the necessary legal frameworks; identifying individual ...

Sept. 7, 2016 Europe

Strengthening governance and accountability, Creating an enabling environment

Introducing evidence-based guidelines through a best practice accreditation programme to improve care quality in Spain

The Best Practice Spotlight Organization accreditation model (developed by the Registered Nurses’ Association of Ontario in Canada) was rolled out in Spain to encourage care organizations to improve adherence to best practice guidelines; while the initiative activated a well-established and structured programme model, flexibility in implementation supported the tailoring of new practices to local needs; providers were given lead roles in implementing the accreditation programme within their respective organizations, providing them with ownership over the initiative and increasing their acceptance of new practices; a focus on generating and comparing data, as well as strengthening the evaluation of care practices, motivated ...