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".

Sept. 6, 2016 Europe

Shifting towards community-oriented mental health care in Belgium

Changes to legislation, policy and care guidelines at the national level guided mental health reform and government funding was made available to promote the implementation of local community mental health projects aligned with the new national vision for mental health; top-down support for bottom-up ideas ensured both the necessary resources and local ownership needed to optimize mental health reform; a supportive legislative framework helped solidify a common vision for mental health reform, providing a unified focus for local efforts to align with; space for experimentation in the delivery of mental health care was allowed for, motivating locally-adapted projects and sparking ...

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Sept. 6, 2016 Europe

Piloting integrated health networks to improve type 2 diabetes care in Andorra

Primary care nurse-physician teams were introduced to lead new diabetes health networks, with the aim of connecting providers across sectors and strengthening primary care gatekeeping; collaboration with stakeholders in the early design stages of the initiative encouraged multistakeholder buy-in from the outset; updated evidence-based care pathways published in a guidebook helped streamline and standardize care; extensive patient education and coaching on self-management skills enabled patients to engage in their own care; pragmatic intermediary solutions were found to address pressing challenges; for example, implementing paper medical records carried by the patient to counter poor communication between providers in the absence of ...

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Aug. 30, 2016 Europe

House of Generations Schwaz: A one-stop shop for providing health and social services in Austria

The Municipality of Schwaz reorganized local health and social services around the purpose-built House of Generations; co-location of services increased coordination and improved access for vulnerable groups; shared living spaces, group activities and cooperative initiatives within the House of Generations generated a sense of community, fostering a supportive and inclusive environment for vulnerable groups; strong leadership helped forge effective partnerships with municipal and regional politicians through clearly communicating aims and objectives, contributing to the initiative’s successful development; extensive involvement and linkages with the wider community generated a new hub for community-based health and social services.

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Aug. 17, 2016 Africa

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 5th 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 ...

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June 24, 2016 Europe

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 ...

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June 24, 2016 Europe

Peer-delivered HIV/AIDS community testing and prevention services in Lisbon, Portugal

A community centre was opened in Lisbon to provide free, anonymous and peer-delivered HIV testing and prevention services targeted to the MSM community; generating political buy-in took considerable time and was described as a “long and persuasive process” with a need to “repeat the message endless times”; strong grassroots advocacy and persistent lobbying efforts by a patient organization were essential for securing funding; incorporating the target population in the provision of services helped ensure wider community engagement and trust; absence of a formal legislative framework and financial incentives required partnerships with self-motivated health professionals to be sought out.

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June 24, 2016 Europe

Beyond bariatric surgery: A pilot aftercare programme for bariatric patients in Germany

A pilot aftercare programme offering a six-month nutritional counselling and weight monitoring service to qualifying bariatric patients was initiated by KKH, a major health insurer in Germany; thoughtful presentation of evidence and effective communication of observed problems by KKH staff was crucial for gaining the managerial support needed to start the initiative; capitalizing on existing infrastructure minimized the need for additional resource investments; active patient participation has been encouraged, with health education and counselling used to empower pilot participants to adopt healthy behaviours; continuation of the initiative will be determined based on a comprehensive analysis of collected data once the ...

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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.

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May 23, 2016 Europe

Disparity reduction strategy in Israel’s Clalit Health Services

Creation of a composite disparity score allowed health disparities in Clalit Health Services to be identified, assessed and then targeted for intervention; top-down leadership from senior management within Clalit Health Services was essential for creating the conditions needed for change; locally-designed initiatives provided tailored solutions for achieving targets set by senior management; capitalizing on preexisting strengths and resources minimized the need for costly investments; data-driven performance measures were the backbone of the initiative and provided evidence of the need for intervention, helped incentivize performance improvements and allowed monitoring and evaluation of progress; regular feedback and monitoring fostered a culture of ...

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May 20, 2016 Europe

Strengthening local capacity to implement integrated community health services in rural Romania

Through strengthening leadership capacity of local leaders, the initiative hopes to improve health and social services delivery within local communities; a longstanding international partnership built from experience collaborating on other projects was important for establishing the initiative; training was necessary to strengthen the management skills of local leaders to enable them to assess, coordinate and manage delivery of health and social services orientated to community needs; integration of health, social and community services at the local level was encouraged to support a comprehensive response to community needs, particularly for underserved groups.

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