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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Aug. 30, 2016 Europe

Reorienting the model of care, Creating an enabling environment

Identifying high-risk chronic patients for targeted primary care intervention in Veneto, Italy

Adjusted Clinical Groups were introduced in primary care as a means to proactively target patients at high risk for chronic disease with personalized health interventions and preventive services; when designing the initiative, leaders sought out existing solutions from abroad which could be adapted for application in Veneto; gradual implementation of the initiative through a three-phase pilot project allowed time to explore, verify and refine activities before scaling up across Veneto; services were reoriented to become more proactive, nurses were awarded additional responsibilities related to patient outreach and patients’ own role in their care was increased; Veneto's existing strong data ...

Aug. 30, 2016 Europe

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

House of Generations Schwaz: A one-stop shop for providing health and social services in Austria

The Municipality of Schwaz reorganized local health and social services around the purpose-built House of Generations; co-location of services increased coordination and improved access for vulnerable groups; shared living spaces, group activities and cooperative initiatives within the House of Generations generated a sense of community, fostering a supportive and inclusive environment for vulnerable groups; strong leadership helped forge effective partnerships with municipal and regional politicians through clearly communicating aims and objectives, contributing to the initiative’s successful development; extensive involvement and linkages with the wider community generated a new hub for community-based health and social services.

Aug. 30, 2016 Europe

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

Introducing compassionate use treatment for extensively drug-resistant tuberculosis in Armenia

Compassionate use TB treatment with the experimental drug Bedaquiline was introduced by MSF in partnership with the Government of Armenia to expand treatment options available to XDR-TB patients; MSF’s prior experience of compassionate use initiatives in other contexts supported the initiative’s effective implementation and provided an immediate solution to the lack of available treatment options; donor support and a close partnership with the Ministry of Health allowed initial barriers, including the lack of a comprehensive legal framework, to be overcome; closely aligning reforms with ongoing programmes reduced the investment needed in new infrastructure and helped secure greater professional ...

Aug. 30, 2016 Europe

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

Developing multi-professional group practices in France

National and regional incentives and programmes were applied to encourage primary care providers to reorganize into multi-professional group practices (MSPs). MSPs enable providers to share resources and workloads and allow a wider range of services to be offered; sufficient autonomy for local actors spurred innovative solutions to local health system challenges, including the MSP concept; national frameworks and policies supported the widespread rollout of MSPs; financial incentives, including funding for initial start-up costs and pay-for-performance bonuses, stimulated providers to reorganize into MSPs; participation in MSPs was voluntary; this helped reduce stakeholder conflicts as change was not forced on providers.

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

Engaging and empowering people and communities, Reorienting the model of care

Peer-delivered HIV/AIDS community testing and prevention services in Lisbon, Portugal

A community centre was opened in Lisbon to provide free, anonymous and peer-delivered HIV testing and prevention services targeted to the MSM community; generating political buy-in took considerable time and was described as a “long and persuasive process” with a need to “repeat the message endless times”; strong grassroots advocacy and persistent lobbying efforts by a patient organization were essential for securing funding; incorporating the target population in the provision of services helped ensure wider community engagement and trust; absence of a formal legislative framework and financial incentives required partnerships with self-motivated health professionals to be sought out.

June 24, 2016 Europe

Engaging and empowering people and communities, Reorienting the model of care

Beyond bariatric surgery: A pilot aftercare programme for bariatric patients in Germany

A pilot aftercare programme offering a six-month nutritional counselling and weight monitoring service to qualifying bariatric patients was initiated by KKH, a major health insurer in Germany; thoughtful presentation of evidence and effective communication of observed problems by KKH staff was crucial for gaining the managerial support needed to start the initiative; capitalizing on existing infrastructure minimized the need for additional resource investments; active patient participation has been encouraged, with health education and counselling used to empower pilot participants to adopt healthy behaviours; continuation of the initiative will be determined based on a comprehensive analysis of collected data once the ...

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 ...