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, 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

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

Developing an integrated primary care model in Slovakia

Networks of primary-level integrated health care centres (IHCC) that co-locate providers and promote interdisciplinary team working are being developed and piloted; piloting of reforms will enable gradual introduction and testing of planned changes; a national-level framework provided the initiative with a strong starting base from which to develop, set clear goals for change and supported the alignment of activities; regional authorities will lead implementation of reforms to allow adaptations based on local needs; the creation of a new agency to provide analysis and implementation support increased the government’s capacity to lead change.

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, 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 ...