IPCHS. Integrated People-Centred Health Services

Contents

Contents tagged: multidisciplinary teams

Jan. 21, 2020 Americas Publication

Primary Health Care That Works: The Costa Rican Experience

Long considered a paragon among low- and middle-income countries in its provision of primary health care, Costa Rica reformed its primary health care system in 1994 using a model that, despite its success, has been generally understudied: basic integrated health care teams. This case study provides a detailed description of Costa Rica’s innovative implementation of four critical service delivery reforms and explains how those reforms supported the provision of the four essential functions of primary health care: first-contact access, coordination, continuity, and comprehensiveness. As countries around the world pursue high-quality universal health coverage to attain the Sustainable Development Goals, Costa Rica’s experiences provide valuable lessons about both the types of primary health care reforms needed and potential mechanisms through which these reforms can be successfully implemented.

Jan. 21, 2020 Americas Publication

Building a Thriving Primary Health Care System: The story of Costa Rica

Situated in Central America, Costa Rica’s 4.9 million citizens have access to one of the most effective primary health care systems in the world. The country’s unique, team-based model of primary care service delivery successfully combines preventive and curative care to provide comprehensive primary health care to nearly all Costa Rican citizens. This case study examines the process by which Costa Rica developed its laudable primary health care system, fully describes the functioning of the system through both clinical and patient perspectives, and elucidates key lessons about primary health care delivery that can be learned from the Costa Rican experience.

Jan. 21, 2020 Americas Multimedia

High Quality Primary Health Care in Action: The Story of Costa Rica

Costa Rica’s primary health care system is supported by robust integrated care teams that provide comprehensive, coordinated, continuous, and person-centered care to empaneled populations. As a result, health outcomes in Costa Rica are consistently strong and improving.

Jan. 17, 2020 Americas Practice

Comprehensive Primary Health Care Reform in Costa Rica

In the past, Costa Rica was characterized by a duplicative and fragmented public primary healthcare system. In 1994, the country initiated a sweeping reform of the health system, including primary health care. Bureaucratic reorganization of the Ministry of Health (MOH) and the Social Security Agency (CCSS) led to the integration of all healthcare delivery under the CCSS, from public health activities to tertiary care. Comprehensive multidisciplinary primary healthcare teams (EBAIS)—comprised of a doctor, nurse assistant, community health worker, and data specialist—were created to care for approximately 5,000 patients each. A system of geographic empanelment was implemented to assign every Costa Rican to one of the newly-formed EBAIS teams. Finally, quality assurance mechanisms were initiated and promoted data collection and feedback central as a central function of the EBAIS teams. The first EBAIS team was established in 1995 and by 2002, there were 818 active teams throughout the ...

Oct. 11, 2016 Europe Practice

Strengthening community-based mental health services in Cyprus

New political commitments to mental health reform led the government to pass the Mental Health Act in 1997 to promote community-based mental health care; a wide variety of community-based mental health services have been made available, with emphasis on services for prevention, early treatment, rehabilitation and home care; advocacy from the health workforce motivated reforms and helped define the vision for care transformations; strategic timing was an important contributing factor in achieving political support for mental health reform; partnerships with NGOs and volunteer organizations helped expand the continuum of mental health care.

Oct. 4, 2016 Europe Practice

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 and supported with legislation.

Sept. 7, 2016 Europe Practice

Outpatient rehabilitation services for working-age patients with brain injuries in Bern, Switzerland

An outpatient rehabilitation centre specifically adapted to the needs of working-age patients recovering from brain injuries was opened in Bern; Direct clinical experience of the multi-professional leadership team helped draw awareness to service delivery gaps and aided the design of practical services to address observed needs; co-location of providers within the rehabilitation centre increased service coordination and improved access for patients, while external networking between providers helped generate referrals; gradual expansion of the initiative allowed time for sufficient resources to be collected and necessary partnerships to be established, ensuring steady and sustainable growth. 

Sept. 7, 2016 Europe Practice

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 Practice

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 generate referrals; a national occupational therapy network supported knowledge sharing and enabled the wider dissemination of lessons learned by the initiative.

Aug. 30, 2016 Europe Practice

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.