IPCHS. Integrated People-Centred Health Services


Sept. 7, 2016 Leading practice Europe

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.

Description of practice
City: Samara Country: Russian Federation
The problem

In the 1990s, health care in the Russian Federation was highly specialized and reactive in orientation. Health promotion and disease prevention services were lacking and prevalent risky health behaviours, such as tobacco use or alcohol consumption, were not adequately addressed by the health system. Physicians in polyclinics were overburdened and had little time to dedicate to proactive care delivery; this situation was exacerbated by a hierarchical professional model which limited nurses’ scope of practice.

The solution

Polyclinic 15 – responsible for providing care to 73 000 residents in Samara – led an initiative to expand health promotion and disease prevention services by advancing nursing roles. Under the initiative, nurses at Polyclinic 15 participated in training courses at local institutions to enable them to expand their scope of practice; complementary on-the-job trainings for nurses were also provided by physicians at Polyclinic 15. To further support changes in nursing roles, several infrastructural improvements were also carried out at Polyclinic 15, including the introduction of electronic medical records and a new scheduling system. As a result of the initiative, nurses now play a greater role in care delivery and split their time between independently receiving patients and assisting physicians. Examples of services now performed by nurses include home care visits, cancer screenings and blood glucose testing. Additionally, all patients at Polyclinic 15 now receive comprehensive health screenings and risk-assessment questionnaires and, those with identified health risks (such as high blood pressure or tobacco use), are referred to health education classes taught by nurses. These screenings have contributed to Polyclinic 15 observing earlier detection of health problems. Administrators at Polyclinic 15 routinely collect and monitor health data to identify emerging needs and areas for improvement. A composite score (reflecting both individual and group performance) determines part of health providers’ salaries to help incentivize teamwork and drive improvements in efficiency and quality; administrators alter indices to reflect emerging priorities. Increasing nurses’ understanding of performance indices and continuing to support advanced nursing are ongoing priorities for the administration of Polyclinic 15.

Implementation of practice
What stage is the practice currently in?


Who was/is responsible for the implementation of the practice?

Strong leadership by the administration of Polyclinic 15 carried the initiative forward. Providers across departments at Polyclinic 15, including both nurses and physicians, provided input on the initiative and worked together to implement changes. Development of new guidelines and training programmes for nurses was supported by partners including the Association of Nurses, Samara Medical University and the Centre for Professional Qualification Education. Additional resources and technical support came through an international partnership with the American International Health Alliance. Later, active promotion of the initiative succeeded in gaining funding and support from the Samara Ministry of Health. Today, providers at Polyclinic 15 work closely together in their adapted roles to care for patients.


Polyclinic 15 has been recognized throughout the Russian Federation as an innovative best-practice model. Improvements in screening rates, health education delivery and access to providers have been observed. For example, health risk assessments delivered by nurses almost tripled from 2267 in 2007 to 6675 in 2012, participation in health education schools increased from approximately 1000 patients in 2006 to 11 000 in 2014, and physicians reported having more time for high-risk patients.            

Additional information

This case was prepared as part of a larger effort by the WHO Regional Office for Europe and published (2016) in the document, "Lessons from transforming health services delivery: Compendium of initiatives in the WHO European Region".

© Copyright World Health Organization (WHO), 2016

The methodology used for the development of this case is slightly different from the templates used on the IntegratedCare4People web platform, in particular in the analysis of enabling factors and barriers to change.


Please click on the link below for more information about this practice. 

Contact information
Larisa Yuldashevna Pudovinnikuva
Polyclinic 15, Samara

Andrew Naomi 17/04/2022 02:17

I was infected with Herpes (HSV) two years ago and I was devastated. I visited different hospitals but they only gave me drugs to treat the symptoms. One day I was browsing through Dr. SEBI then I found a lady who introduced me to an Herbal Doctor called Dr. OJAMO. She explained to me how Dr. OJAMO cured her from herpes with natural herbs and root products, she gave me the doctor Email:: dr.ojamoherbalhome@gmail. com I contacted him and asked him questions about his product. He explained to me how the product works and also showed me those he has cured with his product. He told me he would prepare the product and shipped it to me, the product got delivered after 5 days of delivery. I took the product as instructed by Dr. OJAMO and after 21 days I was having diarrhea and constantly urinating. I went for a test and I was tested for Herpes Negative. The product worked exactly the way Dr. OJAMO instructed and now I am free from HSV. I am very happy, I will recommend this great testimony to save a lot of people suffering from Herpes. Contact: Dr. OJAMO Whats-app:: https://wa.me/2349077406037 also Email dr.ojamoherbalhome@gmail.com His website https://drojamoherbalhome.wixsite.com/welcometodrojamoherb

Monica Raymond 18/04/2022 09:44

One day I was reading an article online we’re I found about Dr. Ojamo and how people have been cured using his herbs and roots so I message Dr. Ojamo on WhatsApp  https://wa.me/2349077406037   and I got a reply. He told me with God everything is possible. Dr. Ojamo told me about plants/herbs and it’s purpose that when he told me no matter the situation you found yourself in there is always a solution. I decided to try Dr. Ojamo Healing Herbs. He made a fresh herb and told me the plant and root because his product is 100% plants and root cooked and packaged inside a container and he shipped it through UPS. I received it and finished the product exactly 21 days ago and before then I was having diabetes and difficulties in breathing, I went to the hospital and my doctor was surprised how I got cured from all these diseases then I said praise to God .  Share Dr. Ojamo email: dr.ojamoherbalhome@gmail.com or you can call and WhAtsapp him on  https://wa.me/2349077406037   if you are infected with HERPES virus or having any health problems contact Dr. Ojamo and he will help you. Share his email so that everyone will know there are herbs and roots that cures every diseases because there can never be a smoke without a fire; dr.ojamoherbalhome@gmail.com   Check his Website https://drojamoherbalhome.wixsite.com/welcometodrojamoherb

Add your comment

Sign in to add your comment.