IPCHS. Integrated People-Centred Health Services

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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Oct. 4, 2016 Europe

Designing a national diabetes plan for Slovenia

Problem: Rising prevalence of type 2 diabetes and associated health care costs; limited availability of diabetes-related health promotion and disease prevention services.

Solution highlights: The Ministry of Health convened a working group to develop a national diabetes strategy. After several years of deliberation among working-group members, the finalized National Diabetes Strategy was approved by the government in 2010; an active patient association supported patient engagement and involvement throughout the initiative’s planning and implementation process; meaningful stakeholder engagement across professions and institutions helped develop a common vision for the initiative; building trust between stakeholders took time, but was necessary to ...

Oct. 4, 2016 Europe

Exploring new provider-payment models to incentivize performance improvements in Hungary

Problem: National life expectancy five years below the WHO European Regional average; high prevalence of chronic disease, particularly circulatory diseases and cancer; service delivery concentrated in higher-level settings; coordination across care levels fragmented; weakened provider motivation, partially due to harsh cost-containment policies.

Solution highlights: The Care Coordination Pilot was launched in 1999 to explore ways to improve the coordination and quality of health services. Under the pilot, Care Coordinator Organizations (run by health providers from general practices or polyclinics) acted as virtual fund holders for capitation-based health care budgets within their local catchment areas; carefully chosen financial incentives guided performance ...

Oct. 4, 2016 Europe

Introducing community-based lifestyle clinics to improve population health in Malta

Problem: Growing burden of chronic disease, partly attributable to lifestyle-related risk factors; limited availability of services focusing on health promotion and disease prevention; limited time for general practitioners to spend with patients on health promotion and disease prevention; lack of communication between professionals offering health promotion and disease prevention services.

Solution highlights: Lifestyle Clinics offering healthy-living support were introduced across Malta to expand availability of health promotion and disease prevention services; a motivated, multidisciplinary group of primary care professionals led the initiative through collaborative teamwork; the initiative capitalized on recent government policies supporting chronic disease prevention and a newly-established postgraduate ...

Oct. 4, 2016 Europe

Developing guidelines to reduce under-five child mortality in the Republic of Moldova

Problem: Elevated rates of child mortality in home settings, particularly for vulnerable groups; out-of-date practices for detecting and treating childhood illness, with an overemphasis on clinical assessment; limited education for providers and parents regarding childhood illness.

Solution highlights: 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 ...

Sept. 22, 2016 Europe

Strengthening the response to noncommunicable disease in Turkmenistan

Problem: High levels of chronic disease in an ageing population; health system oriented towards acute, reactive care rather than proactive, chronic care.

Solution highlights: The government developed the National Health 2020 Action Plan 2014–2020 to guide action on noncommunicable disease; international attention on key issues helped generate national momentum and political will for health reform; a strong understanding of key challenges, supported with baseline population health data, facilitated the development of the Plan and allowed tailoring of activities to population needs; intersectoral partnerships across government ministries helped to keep the Plan on the political agenda and safeguarded health reforms ...

Sept. 22, 2016 Europe

Establishing ambulatory care for patients with tuberculosis in Uzbekistan

Problem: High prevalence of TB and increasing burden of MDR-TB; admission to hospital required for all patients with TB; increased waiting times for TB care due to the longer treatment period required for MDR-TB and the continued use of a consilium model; risk of TB transmission between patients waiting for treatment and the population; potential for cross-contamination of TB strains between hospitalized patients.

Solution highlights: Médecins Sans Frontières (MSF), in partnership with the Government of the Republic of Karakalpakstan, introduced ambulatory care from day one (ACD1) as an alternative model for TB care; a strong understanding of service ...

Sept. 22, 2016 Europe

Integrating health and social care in Highland, Scotland

Problem: Ageing population with complex care needs; suboptimal service delivery due to fragmented health and social sectors.

Solution highlights: A lead organization model was introduced in Highland to promote greater integration between health care and social services. This new management structure united previously fragmented professional groups, serving to streamline service delivery and improve working relationships; broad political support for integrated care created a favourable environment for change; strong support from local senior management drove the initiative forward; extensive local engagement across all care levels ensured widespread buy-in for the initiative and reduced resistance to change across stakeholder groups; design and ...

Sept. 7, 2016 Europe

Integrating delivery of TB services in primary care in Tajikistan

Problem: Tajikistan ranked among the highest TB and MDR-TB burdened countries in the WHO European Region; suboptimal TB outcomes were linked to the concentration of TB treatment in hospital settings and poor coordination with primary care, as well as inadequate monitoring systems.

Solution highlights: Following on from previous national efforts to address high TB incidence rates, the third National TB Programme 2010–2015 was approved by the government to systematically address service delivery gaps and continue to develop TB services in primary care; building on previous actions taken to reduce TB and learning from these experiences enabled a stronger approach ...

Sept. 7, 2016 Europe

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

Problem: Rehabilitation services for brain injuries were largely organized around the needs of geriatric patients and thus failed to meet specific rehabilitation needs of younger patients; physical separation and a lack of communication between providers resulted in fragmented care delivery and hindered effective rehabilitation of patients with brain injuries.

Solution highlights: 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 ...

Sept. 7, 2016 Europe

Pioneering integrated organizational models for improving elderly people’s care in Ängelholm, Sweden

Problem: Ageing population with rising chronicity; fragmented services delivery resulting from split management of health and social services; provider dissatisfaction over the standard of care for elderly patients.

Solution highlights: A new integrated care organization (Hälsostaden) was established to merge primary and hospital care with elderly and social care. Hälsostaden is jointly managed by its regional and municipal government and employs 600 professionals across health and social sectors; early investments in stakeholder relationships and trust building were essential for securing the future of the initiative and developing a foundation based on teamwork; finding the uniting objective of improving ...