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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Sept. 6, 2016 Europe

Strengthening governance and accountability, Coordinating services within and across sectors, Creating an enabling environment

Developing an integrated e-health system in Croatia to drive care improvements

An electronic Central Health Information System (CEZIH) was introduced by the government to connect stakeholders and provide real-time data on patients and providers; a strong government commitment and top-down leadership established the necessary conditions for the widespread adoption of e-health; data collected through the e-health system helped drive performance improvements; a new payment model for primary care providers was introduced and realigned financial incentives encouraged positive changes in clinical practice; ongoing trainings supported providers to uptake and capitalize on new technologies; a patient e-portal helped engage patients in their own care.

Aug. 17, 2016 Africa

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

Creating a sustainable model of spine care in underserved communities in Botswana

As identified in the Global Burden of Disease report (2012), spine disorders present an enormous burden on individuals, their families, communities and societies and are the leading cause of disability worldwide. In Botswana, the burden of low back pain has been estimated to be the 5^th leading cause of disability adjusted life years (DALYS) in 2013 and neck and back pain combined is ranked as the number 1 cause of years lived with disability (YLDs), increasing from the third position in 1990 to the first position in 2013. In the developing world the burden of spine disorders is expected ...

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

Strengthening governance and accountability, Creating an enabling environment

Implementing clinical audits to improve care standards in Turkey

Clinical audits were implemented to improve adherence to national guidelines through increasing transparency and accountability for service delivery across health care institutions; lengthy discussions with stakeholders and clear communication of the initiative’s aims were essential for establishing sufficient buy-in to begin implementation; establishing data collection and analysis systems was a critical step for improving and optimizing care. Strong data collection, followed up with monitoring and evaluation, was paramount to the initiative’s success; while the initiative was led by the Ministry of Health, regional health authorities played an increasingly important role in supporting auditing processes and providing local oversight ...

May 26, 2016 Americas

Enhancing primary healthcare delivery in the inner-city community in Toronto, Canada

A very participatory evaluation process with broad involvement of all stakeholders, including patient and community members, led to consensus on priorities and gaps in services; prioritization of an innovative, patient-centred, model of health and social care led to development of an integrative Family Health team working from a social determinants of health lens; multiple partnerships support long-term sustainability and educational collaboration; supportive leadership and internal champions created momentum for change and mitigated internal and external barriers to change; active and ongoing engagement of patients, community and health team members in program design and implementation.

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 ...