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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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

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 ...

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

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

Developing a national cancer plan to coordinate the fight against cancer in Luxembourg

A national cancer plan was developed by the Ministry of Health to unite current services and coordinate the fight against cancer; ten priority areas for action were identified by the initiative: governance, health promotion, prevention, screening, diagnostics, treatment, rehabilitation, resources, patients’ rights and research; strong government commitment was essential for realizing a coordinated national approach; involving a diverse range of stakeholders from the beginning helped to guide the initiative; implementation of the national cancer plan is still in the early phases and any improvements will take time to observe.

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. 6, 2016 Europe

Strengthening governance and accountability, Reorienting the model of care, Creating an enabling environment

Defining and standardizing primary care in Georgia

Government reforms aiming to establish universal health care, increase state involvement in the health system and strengthen regulation have been introduced; articulating a clear government vision ensured a strong foundation on which to build reforms; learning from previous experiences and seeking expertise from international partners helped the initiative avoid potential difficulties; inclusion of stakeholders in the design process helped build local consensus for change; following the strategy development process, detailed plans were drawn up to guide proposed reforms.

Sept. 6, 2016 Europe

Engaging and empowering people and communities, Reorienting the model of care, Creating an enabling environment

Advancing the role of nurses in Finland to improve patients’ access to care

The Ministry of Social Affairs and Health promoted the shift of responsibilities from physicians to nurses through implementing supportive policies, legislation and incentives; partnerships and international networks facilitated information exchanges and offered inspiration for activities during the initiative’s design; national legislation provided the necessary framework for aligning changes in the professional scope of practice for nurses; the development of postgraduate advanced nursing programmes in partnership with universities supported the sustainability of the initiative and ensured the continuing development of nursing skills; advancing nursing roles contributed to professional empowerment and improved workplace well-being for both nurses and physicians.

Sept. 6, 2016 Europe

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

Developing an integrated e-health system in Croatia to drive care improvements

An electronic Central Health Information System (CEZIH) was introduced by the government to connect stakeholders and provide real-time data on patients and providers; a strong government commitment and top-down leadership established the necessary conditions for the widespread adoption of e-health; data collected through the e-health system helped drive performance improvements; a new payment model for primary care providers was introduced and realigned financial incentives encouraged positive changes in clinical practice; ongoing trainings supported providers to uptake and capitalize on new technologies; a patient e-portal helped engage patients in their own care.