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

Engaging and empowering people and communities, Reorienting the model of care, Creating an enabling environment

Advancing the role of nurses in Finland to improve patients’ access to care

The Ministry of Social Affairs and Health promoted the shift of responsibilities from physicians to nurses through implementing supportive policies, legislation and incentives; partnerships and international networks facilitated information exchanges and offered inspiration for activities during the initiative’s design; national legislation provided the necessary framework for aligning changes in the professional scope of practice for nurses; the development of postgraduate advanced nursing programmes in partnership with universities supported the sustainability of the initiative and ensured the continuing development of nursing skills; advancing nursing roles contributed to professional empowerment and improved workplace well-being for both nurses and physicians.

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.

Sept. 6, 2016 Europe

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

Introducing home care services in Bulgaria

The introduction of home care services was proposed as a patient-oriented solution for ensuring appropriate service provision closer to home; a pilot approach allowed the gradual rollout and testing of an existing home care model being implemented abroad, which was adapted to meet the Bulgarian context; efforts to introduce home care included creating new roles and responsibilities for the health workforce and developing information and communication resources; establishing the necessary health system conditions, including the development of a supportive legal framework, is an important area of focus for advancing the sustainability and scale of the current transformations.

Sept. 6, 2016 Europe

Engaging and empowering people and communities, Strengthening governance and accountability, Reorienting the model of care, Creating an enabling environment

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 ...

Sept. 6, 2016 Europe

Strengthening governance and accountability, Reorienting the model of care, Creating an enabling environment

Strengthening prenatal and obstetric care in Belarus

Improving maternal and child health was established as a key government priority. Strong top-down support for change reinforced by legislation provided a guiding framework for transformations; Investigation into key challenges leading to a strong understanding of root causes ensured health reforms responded to needs; prenatal screening recommendations were developed and changes to resource distribution, provider training and incentives were implemented to promote uptake and adherence to new guidelines; financial incentives for patients helped encourage desired participation in prenatal care by women; service delivery reforms took time and adoption of a long-term vision was needed.

Sept. 6, 2016 Europe

Strengthening governance and accountability, Reorienting the model of care, Creating an enabling environment

Comprehensive health system reform to improve health in Azerbaijan

A health sector reform project was launched by the Government of Azerbaijan with the financial and technical support of the World Bank, leading to the adoption of a comprehensive National Master Plan for health in 2008; a strong understanding of the political context and environment proved important in determining an acceptable pace for proposed reforms; top-down leadership from the Ministry of Health ensured national ownership over internationally-supported reforms; strengthening the stewardship capacity of the Ministry was important; investment in human resources, including formalizing medical training and developing new medical specializations, was critical to driving sustainable change.

Aug. 30, 2016 Europe

Strengthening governance and accountability, Reorienting the model of care, Creating an enabling environment

Establishing a unified emergency medical service in Latvia

Latvia’s 39 separate emergency service organizations were merged to form the single, centralized State Emergency Medical Service; implementing a unified structure for the provision of prehospital emergency medical services reduced fragmentation, standardized care and improved the coordination of services; formalizing provider training and education embedded new practices as the professional norm and helped ensure high-quality care delivery according to the guidelines in place; strong national leadership, along with a clear narrative and communication plan, helped gain stakeholder support for the initiative; widespread population support was secured by making services available free of charge.

Aug. 30, 2016 Europe

Reorienting the model of care, Creating an enabling environment

Identifying high-risk chronic patients for targeted primary care intervention in Veneto, Italy

Adjusted Clinical Groups were introduced in primary care as a means to proactively target patients at high risk for chronic disease with personalized health interventions and preventive services; when designing the initiative, leaders sought out existing solutions from abroad which could be adapted for application in Veneto; gradual implementation of the initiative through a three-phase pilot project allowed time to explore, verify and refine activities before scaling up across Veneto; services were reoriented to become more proactive, nurses were awarded additional responsibilities related to patient outreach and patients’ own role in their care was increased; Veneto's existing strong data ...

Aug. 30, 2016 Europe

Strengthening governance and accountability, Reorienting the model of care, Creating an enabling environment

Introducing compassionate use treatment for extensively drug-resistant tuberculosis in Armenia

Compassionate use TB treatment with the experimental drug Bedaquiline was introduced by MSF in partnership with the Government of Armenia to expand treatment options available to XDR-TB patients; MSF’s prior experience of compassionate use initiatives in other contexts supported the initiative’s effective implementation and provided an immediate solution to the lack of available treatment options; donor support and a close partnership with the Ministry of Health allowed initial barriers, including the lack of a comprehensive legal framework, to be overcome; closely aligning reforms with ongoing programmes reduced the investment needed in new infrastructure and helped secure greater professional ...

Aug. 30, 2016 Europe

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

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.