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. 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, Reorienting the model of care, Coordinating services within and across sectors

Strengthening cancer screening in Montenegro

In 2008, the Government of Montenegro released the National Cancer Control Plan. Responding to recommendations proposed by the Plan, the Institute of Public Health developed a comprehensive cancer screening programme for colorectal cancer. Following successful piloting, the colorectal cancer screening programme is now being expanded to cover other priority cancers; partnerships with stakeholders outside of the health sector provided access to technologies and tools for engaging the public. Text messaging was the main tool used for outreach; moving from a reactive to a proactive approach was important for reaching and engaging the target population and increasing uptake of screenings; a ...

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

Strengthening governance and accountability, Coordinating services within and across sectors

Developing an integrated information system in the Former Yugoslav Republic of Macedonia

The Ministry of Health designed and implemented a web-based appointment platform to streamline information flows and reduce artificially-inflated waiting times. Additional features, such as e-referral and e-prescription applications, have since been incorporated into the information system; a comprehensive investigation at the beginning of the initiative supported the development of an informed solution to directly address key challenges; alignment with previous investments in technological infrastructure enabled rapid uptake of the new information system by providers and more economical use of existing resources; an effective communication plan, including public campaigns and efforts to gain public trust, helped ensure widespread uptake of the ...

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. 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 ...

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.