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How can skill-mix innovations support the implementation of integrated care for people with chronic conditions and multimorbidity?
- Authors:
- WINKELMANN Juliane, et al
- Publisher:
- World Health Organization
- Publication year:
- 2022
- Pagination:
- 43
- Place of publication:
- Copenhagen
This policy brief identified six skill-mix interventions as most promising to tackle current and emerging challenges in primary and ambulatory care and in improving the integration of care of patients with chronic conditions and multimorbidity. These are: (1) Shifting tasks and roles to achieve new divisions of work with advanced practitioners (nurses and pharmacists) taking on management of aspects of care and coordinating processes in close collaboration with physicians; (2) Relocation of care to other settings for example to nurse-led clinics or patients’ homes; (3) Introduction of (an explicit) care coordination role with different professionals (case managers, patient navigators) developing shared care plans and monitoring patients’ health and well-being; (4) Empowering patients and caregivers through specialist staff (educators, community health workers) who provide information and training to strengthen patients’ self-management and support behavioural change; (5) Introduction of dedicated prevention roles in primary care with nurses, pharmacists, community health workers or patient navigators fostering health literacy, offering advice and counselling, and promoting healthy lifestyles; (6) Establishment of teamwork and collaboration in multi-professional teams enabling different professions (GPs, specialists, nurses, therapists, social workers, community health workers, housing staff) to work together across sectoral boundaries to organize and coordinate joint care and link health and care services. (Edited publisher abstract)
Health and care workforce in Europe: time to act
- Author:
- WORLD HEALTH ORGANIZATION. Regional Office for Europe
- Publisher:
- World Health Organization
- Publication year:
- 2022
- Pagination:
- 205
- Place of publication:
- Copenhagen
All countries of the WHO European Region currently face severe challenges related to the health and care workforce (HCWF). This report focuses on identifying effective policy and planning responses to these HCWF challenges across the Region. The report presents an overview of the HCWF situation in the Region (focusing on medical doctors, nurses, midwives, dentists, pharmacists and physiotherapists, for whom data are available) and identifies relevant policy options, their expected benefits and potential facilitators or barriers to successful implementation. Examples of sound evidence-informed practices in countries are also provided. Despite progressive steps in many places, much more investment, innovation and partnership are needed to avert further health and care workforce shortages in the future. WHO/Europe is urging all Member States to waste no time by taking the following 10 actions to strengthen the health and care workforce: align education with population needs and health service requirements; strengthen professional development to equip the workforce with new knowledge and competencies; expand the use of digital tools that support the workforce; develop strategies that recruit and retain health workers in rural and remote areas; create working conditions that promote a healthy work-life balance; protect the health and mental well-being of the workforce; build leadership capacity for workforce governance and planning; improve health information systems for better data collection and analysis; increase public investment in workforce education, development and protection; optimize the use of funds for innovative workforce policies. (Edited publisher abstract)
Integrated care for older people (ICOPE) implementation framework: guidance for systems and services
- Author:
- WORLD HEALTH ORGANIZATION
- Publisher:
- World Health Organization
- Publication year:
- 2019
- Pagination:
- 52
- Place of publication:
- Geneva
The framework provides guidance on how to implement the Integrated care for older people (ICOPE) approach in member states. The ICOPE approach is underpinned by the principle that functional ability can be maximised when services and systems integrate health and social care for older people in a manner that responds to their unique needs - that is, in a person centred manner. The framework can be used to: identify older people in the community in need of health and social care; assess the capacity of services or systems to deliver integrated care at the community level using the ICOPE approach; and initiate an ICOPE implementation plan according to capacity. The framework includes 19 implementation actions. The macro-level system components cover: strengthening governance and accountability systems; and enabling system-level strengthening. The meso-level service components cover: engaging and empowering people and communities; supporting the coordination of services delivered by multidisciplinary providers; and directing services towards community-based care. The document includes an ICOPE implementation scorecard and is based around actions needed against individual scores for each of the 19 implementation actions. (Edited publisher abstract)
Integrated care for older people (ICOPE) implementation pilot programme: findings from the 'ready' phase
- Author:
- WORLD HEALTH ORGANIZATION
- Publisher:
- World Health Organization
- Publication year:
- 2022
- Pagination:
- 87
- Place of publication:
- Geneva
This report highlights the results and learning from the ready phase pilot to evaluate the readiness and feasibility to implement integrated care for older people ICOPE approach. Data was gathered from focused interviews on the usability of the ICOPE care pathway in clinical and community settings and by surveys examining readiness in nominated Member States. The ICOPE approach aims to support health and care workers to detect declines in older people's intrinsic capacity in community and primary care settings by conducting person-centred assessments and developing personalised care plans with older people. The evaluation covers local capacity, enablers and barriers to adopting ICOPE in clinical and community settings; staff attitudes towards implementation and outcomes of implementation. Analysis includes readiness by country income levels and regions. Key findings include: positive attitudes from health and care workers towards the principles of integrated care; proactive engagement of older people and their communities; and ICOPE is feasible to implement in different contexts. Key barriers include: human resources; digital technology; financing; coordination and collaboration. (Edited publisher abstract)
Evidence, policy, impact: WHO guide for evidence-informed decision-making
- Author:
- WORLD HEALTH ORGANIZATION
- Publisher:
- World Health Organization
- Publication year:
- 2021
- Pagination:
- 92
- Place of publication:
- Geneva
This document provides guidance for organisations that create, commission, fund, broker or apply evidence. This guidance, and associated repository of tools, provides a set of methods and tools for evidence-informed decision-making (EIDM) across the clinical (or practice), public health and health system fields. Section 1 covers what EIDM is and why the use of research evidence is important. Section 2 considers the evidence ecosystem: a comprehensive description of the evidence ecosystem framework, including its underlying principles and crosscutting approaches for turning evidence into action. Section 3 toolbox includes tools, evidence types, evidence sources and key forms of collaboration. (Edited publisher abstract)
Health and social care near the end of life: can policies reduce costs and improve outcomes?
- Authors:
- NORMAND Charles, et al
- Publisher:
- World Health Organization
- Publication year:
- 2021
- Pagination:
- 24
- Place of publication:
- Copenhagen
This brief reviews the evidence on health and social care needs and expenditures at the end of life. End of life costs are the main reason for high per person spending levels observed at older ages in many European countries. However, there is huge variation between individuals, with estimates suggesting that just 10% of people near the end of life are responsible for over 60% of total end of life health and social care expenditures. High-cost individuals tend to be frail people with multiple chronic illnesses who use considerable hospital and social care services. In most European countries, there will be large increases in annual deaths in the coming years as the ‘baby boom’ generation ages and improved survival ultimately leads to more deaths each year. This will inevitably lead to growth in end of life needs and, ultimately, spending levels. However, there are a number of strategies available to address these challenges. Hospital care is the largest component of end of life care expenditures, but not all of it is necessary or appropriate: many admissions can be prevented, while some hospital care is inappropriate for people with complex needs and multiple chronic diseases. Some end of life needs can be reduced with more active public health measures and active rehabilitation, much of which can be very cost-effective. More active assessment of care needs can also significantly improve the experiences of patients and families, reduce unnecessary tests and interventions, will not shorten survival, and can help to limit the growth in costs. (Edited publisher abstract)
Framework for countries to achieve an integrated continuum of long-term care
- Author:
- WORLD HEALTH ORGANIZATION
- Publisher:
- World Health Organization
- Publication year:
- 2021
- Pagination:
- 55
- Place of publication:
- Geneva
This document sets out a framework for countries to achieve an integrated continuum of long-term care. It identifies key aspects necessary to achieve an integrated continuum of long-term care service provision and to facilitate the integration of long-term services within existing health and social care systems. The framework is intended to guide countries in assessing system-level components to implement sustainable and equitable long-term care actions. By applying this framework, countries can begin to develop and shape their long-term care systems as part of their universal health coverage programmes and promote investment in long-term care and the health workforce, including carers. The framework depicts the following elements, which are deemed to be important to establishing a long-term care system, namely: (a) governance; (b) sustainable financing; (c) information, monitoring and evaluation systems; (d) workforce; (e) service delivery; and (f) innovation and research, and actions that can be taken to guide national planning processes and decision-making for the implementation of long-term care. (Edited publisher abstract)
Towards a dementia-inclusive society: WHO toolkit for dementia-friendly initiatives (DFIs)
- Author:
- WORLD HEALTH ORGANIZATION
- Publisher:
- World Health Organization
- Publication year:
- 2021
- Pagination:
- 101
- Place of publication:
- Geneva
Stigma and discrimination heighten the already significant psychological, social, emotional and financial impacts that dementia has on individuals, their carers, families and communities. To address this challenge, the Global action plan on the public health response to dementia 2017–2025 dedicates one action area on dementia awareness and friendliness. This toolkit for dementia-friendly initiatives supports individuals, communities and countries in raising awareness of, and empowering people living with, dementia to remain in, and be a significant part of, their community. The toolkit provides practical guidance and tools that can support efforts, including planning and implementation activities, to create dementia-inclusive societies. The toolkit is divided into two parts. Part I contains background information and a conceptual framework for creating dementia-inclusive societies. Part II includes four practical modules, each featuring a series of practical steps and exercises. The four modules focus on: starting a new dementia-friendly initiative (DFI), integrating dementia into an existing initiative, monitoring and evaluation a DFI, and scaling a DFI. The modules can be used together or separately and offer guidance that can be adapted to suit local needs and settings. (Edited publisher abstract)
Peer support mental health services: promoting person-centred and rights-based approaches
- Author:
- WORLD HEALTH ORGANIZATION
- Publisher:
- World Health Organization
- Publication year:
- 2021
- Pagination:
- 72
- Place of publication:
- Geneva
This document is part of the WHO Guidance and technical packages on community mental health services set of publications. It showcases a selection of peer support mental health services that promote hope, sharing of experiences and empowerment, and that take active steps to respect legal capacity and avoid coercive practices. This document provides specific guidance for setting up new peer support mental health services that protect and promote human rights. Peer support mental health services consist of one-to-one or group support sessions provided by people with lived experience to others who wish to benefit from their experience and support. The aim is to support people on the issues they consider important to their own lives and recovery, in a way that is free from judgment and assumptions. As experts by experience, peers are able to uniquely connect with, and relate to individuals going through a challenging time because of their first-hand knowledge and experience. As such, they serve as compassionate listeners, educators, coaches, advocates, partners and mentors. The services highlighted in this document are managed and run by people who are experts by experience. Participation in peer support is always based on choice and informed consent, and people receiving peer support are under no obligation to continue the support that was offered, allowing the person to make the choice based on their will, preference and self-identified needs. (Edited publisher abstract)
Community outreach mental health services: promoting person-centred and rights-based approaches
- Author:
- WORLD HEALTH ORGANIZATION
- Publisher:
- World Health Organization
- Publication year:
- 2021
- Pagination:
- 90
- Place of publication:
- Geneva
This document is part of the WHO Guidance and technical packages on community mental health services set of publications. It showcases a selection of versatile and dynamic community outreach mental health services that respect human rights in delivering care and support to the population in their homes or public settings, including on the streets. This document provides specific guidance for setting up new community outreach mental health services that protect and promote human rights. Community outreach services deliver care and support to the population in their homes or other settings, such as public spaces or on the streets. Community outreach services often constitute mobile teams comprising health and social workers and community members. The support options provided through community outreach are varied. As shown in this technical package, services can provide emotional support and counselling as well as support for medication, to perform daily activities and meet basic needs (supported living), or enable people to make informed decisions concerning treatment and other aspects of their lives. Community outreach services can support people to gain or regain a sense of control over their lives and recovery journeys. They also play a crucial role in connecting people to existing services in the community and provide support in navigating health and social care systems. Additionally, community outreach services often provide information about mental health, and can engage in mental health prevention and promotion initiatives. The examples of good practice provided in this technical package show how people delivering outreach services emphasise the importance of respecting individuals’ rights to legal capacity. This means that the people using the service are in control and supported to make their own decisions about where the service will take place, when, what will be included in the service and other aspects. (Edited publisher abstract)