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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June 24, 2016 Europe

Strengthening governance and accountability, Creating an enabling environment

Developing an integrated e-health system in Estonia

A system-wide electronic health information system was introduced by the government and a national e-health foundation was established to guide change; development of e-health aligned with a broader government information strategy, enabling change and motivating necessary political support; early introduction of legislation provided a clear framework for activities and the Estonian Health Information System Development Plan 2005–2008 mapped out the change process; legislation coupled with aligned incentives encouraged widespread uptake of e-health by providers; partnerships with the private sector, universities and research organizations helped drive innovation; features of the electronic system (including electronic medical records, digital imaging, e-prescriptions and ...

June 24, 2016 Europe

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

National rollout of Healthy Life Centres in Norway

Municipally-managed Healthy Life Centres staffed by multidisciplinary public health teams were established across Norway to advance local health promotion; government commitment to addressing chronic disease through strengthening health promotion provided a platform for change and fostered widespread scale-up of activities; the Healthy Life Centre concept was invented locally and continues to depend on locally-driven efforts, with municipalities given significant autonomy over activities; a structured approach to the rollout of Healthy Life Centres from the outset (including research, piloting and creation of national guidelines) ensured accountability and systematic evaluation; collaborative partnerships between primary care providers, Centre staff and patients proved integral ...

June 24, 2016 Europe

Strengthening governance and accountability, Creating an enabling environment

Implementing clinical audits to improve care standards in Turkey

Clinical audits were implemented to improve adherence to national guidelines through increasing transparency and accountability for service delivery across health care institutions; lengthy discussions with stakeholders and clear communication of the initiative’s aims were essential for establishing sufficient buy-in to begin implementation; establishing data collection and analysis systems was a critical step for improving and optimizing care. Strong data collection, followed up with monitoring and evaluation, was paramount to the initiative’s success; while the initiative was led by the Ministry of Health, regional health authorities played an increasingly important role in supporting auditing processes and providing local oversight ...

May 26, 2016 Americas

Enhancing primary healthcare delivery in the inner-city community in Toronto, Canada

A very participatory evaluation process with broad involvement of all stakeholders, including patient and community members, led to consensus on priorities and gaps in services; prioritization of an innovative, patient-centred, model of health and social care led to development of an integrative Family Health team working from a social determinants of health lens; multiple partnerships support long-term sustainability and educational collaboration; supportive leadership and internal champions created momentum for change and mitigated internal and external barriers to change; active and ongoing engagement of patients, community and health team members in program design and implementation.

May 23, 2016 Europe

Engaging and empowering people and communities, Strengthening governance and accountability, Creating an enabling environment

Disparity reduction strategy in Israel’s Clalit Health Services

Creation of a composite disparity score allowed health disparities in Clalit Health Services to be identified, assessed and then targeted for intervention; top-down leadership from senior management within Clalit Health Services was essential for creating the conditions needed for change; locally-designed initiatives provided tailored solutions for achieving targets set by senior management; capitalizing on preexisting strengths and resources minimized the need for costly investments; data-driven performance measures were the backbone of the initiative and provided evidence of the need for intervention, helped incentivize performance improvements and allowed monitoring and evaluation of progress; regular feedback and monitoring fostered a culture of ...

May 20, 2016 Europe

Engaging and empowering people and communities, Coordinating services within and across sectors, Creating an enabling environment

Strengthening local capacity to implement integrated community health services in rural Romania

Through strengthening leadership capacity of local leaders, the initiative hopes to improve health and social services delivery within local communities; a longstanding international partnership built from experience collaborating on other projects was important for establishing the initiative; training was necessary to strengthen the management skills of local leaders to enable them to assess, coordinate and manage delivery of health and social services orientated to community needs; integration of health, social and community services at the local level was encouraged to support a comprehensive response to community needs, particularly for underserved groups.

May 20, 2016 Europe

Engaging and empowering people and communities, Creating an enabling environment

Campaigning to improve obstetric care in Poland

The Childbirth with Dignity Foundation was established to advocate for improved obstetric care through uniting the voices of thousands of women and bringing evidence to light on key issues. Advocacy efforts ultimately led the Ministry of Health to establish obstetric care standards; systematically collecting and documenting patient experiences served as an important advocacy tool and engaging with the target population helped build public support; leveraging a highly-visible public media platform lent sufficient credibility to information conveyed and gained needed attention for action; all stakeholders were engaged to effect change from both the bottom-up and top-down.

May 19, 2016 Europe

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

Implementing an integrated cardiology programme in Eastern Lithuania to improve cardiovascular health

The initiative strengthened cardiovascular care in primary and secondary settings, providing new training and equipment to providers to establish infrastructure for improved cardiology care outside of specialist settings; a detailed situational analysis informed the initiative’s design and provided evidence supporting the intervention; strong leadership by senior management at Vilnius University Hospital provided technical expertise and generated stakeholder support, while backing from the Ministry of Health added legitimacy to activities; extensive engagement of providers from the beginning was necessary for overcoming an individualistic culture and building collaborative relationships; distribution of a standardized cardiology equipment package to participating locations established basic ...

May 16, 2016 Europe

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

Shifting acute care delivery from hospitals to homes in Ireland

Community-based acute care services delivered by mobile nursing teams were introduced by Caredoc, a private nonprofit organization contracted by the Irish Health Services Executive; first-hand insights of providers enabled identification of services delivery challenges and supported development of relevant solutions; supportive senior management generated momentum for change and helped secure necessary approval for activities from authorities; stakeholder engagement was described as time consuming, but crucial to success; electronic medical records and new technologies facilitated the creation of a simple, connected and user-friendly service; training for nursing staff was important for establishing the necessary clinical competencies to deliver acute care services ...