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Strategy 4: Coordinating services within and across sectors

 

Services should be coordinated around the needs and demands of people, and respect their preferences. This result requires integration of health care providers within and across health care settings, development of referral systems and networks among levels of care, and the creation of linkages between health and other sectors. It encompasses intersectoral action at the community level in order to address the social determinants of health and optimize use of scarce resources, including, at times, through partnerships with the private sector. Coordination does not necessarily require the merging of the different structures, services or workflows, but rather focuses on improving the delivery of care through the alignment and harmonizing of the processes and information among the different services.

 

Strategic approach Policy options and interventions

4.1 Coordinating care for individuals. Coordination of care is not a single activity, but rather a range of strategies that can help to achieve better continuity of care and enhance the patient's experience with services, particularly during care transitions. The focus for improvement is on the delivery of care to the individual, with services coordinated around their needs and those of their families. This approach also covers improved information flows and maintenance of trustworthy relationships with providers over time.

  • Care pathways

  • Referral and counter-referral systems

  • Health navigators

  • Case management

4.2 Coordinating health programmes and providers. This approach includes bridging the administrative, informational and funding gaps between levels of care and providers. This involves sector components such as pharmaceutical and product safety regulators, information technology teams working with disease surveillance systems, allied health teams delivering treatment plans in collaboration with each other, disease-specific laboratory services linked to broader services improvement, and provider networks focused on closer relationships in patient care.

  • Regional or district-based health service delivery networks

  • Purchasing integrated services

  • Integrating vertical programmes Into national health systems

  • Incentives for care coordination

4.3 Coordinating across sectors. Successful coordination in health matters involves multiple actors, both within and beyond the health sector. It encompasses sectors such as social services, finance, education, labour, housing, the private sector and law enforcement, among others. It necessitates strong leadership from the health ministry to coordinate intersectoral action, including coordination for early detection and rapid response to health crises.

  • Health in all policies

  • Intersectoral partnerships

  • Merging of health sector with social services

  • Working with education sector to align professional curriculum towards new skills needed

  • Integrating traditional and complementary medicine with modern health systems

  • Coordinating preparedness and response to health crises

Extract from: WHO. Framework on integrated people-centred health services: report EB138/37. Geneva: World Health Organization; 2015, available online at: http://apps.who.int/gb/ebwha/pdf_files/EB138/B138_37-en.pdf, accessed 12 January 2016