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The Health Dialogue Programme – A long term, systematic approach for strengthening the cooperation between health care providers in Norway

27.02.2008

Vegard Høgli, MD, MPH. Head of Cooperation Unit, Dept for Development of Services and Cooperation, Southern and Eastern Regional Health Authority, Norway.



Mr Høgli has since 2005 been responsible for the development and implementation of strategy for systematic improvement of cooperation between hospitals and Primary Health Care in the region. In 1994 he was co-founder, chief executive and Senior consultant of GRUK, Norwegian Centre for Quality Improvement in Health Care and Social Services, now part of the Norwegian Knowledge Centre for the Health Services. Mr Høgli has coached process improvement groups in health care, lectured and developed tools for Statistical Process Control and developed and implemented electronic clinical guidelines for the interaction between GPs and hospitals.

Contact info:
e-mail: vegard.hogli@helse-sorost.no
Tel: +47 90620715

The health care system in Norway

Norway (pop: 4,6 million) has a largely public funded health care delivery system. Health care costs are rising quickly, and Norway is ranking high on the OECD list of Health Care expenditure.

Hospitals are owned and run by government owned Regional Health Authorities. Last summer, the Southern and Eastern Regional Health Authorities were merged into one region, reducing the number of regional health authorities to four. The merged group, with 69 000 employees, is serving 2.5 million inhabitants and running 15 Health Enterprises (hospitals or hospital groups). Primary health care (nursing homes and home-based services) is run by politically governed municipalities. These are organized in the Norwegian Association of Local Authorities (called KS). GPs work independently under contract with the municipalities.

Developing the Programme

KS Region South and the former Southern Regional Health Authority has developed a long-term programme for systematic improvement of cooperation and interaction for provider organizations. Leaders and staff members from municipalities and hospitals have participated, so have family physicians and patient’s organizations.

Open and active dialogue between all health care providers, based on the Appreciative Inquiry (AI) method, is fundamental for the Health Dialogue Programme.

The Programme was launched in early 2005 with a total of 300 health care professionals participating in four one-day dialogue conferences. During the conferences, local interaction and integration activities with proven success were presented and discussed. Several ideas for improving cooperation in the chain of health care services where thereby identified and pursued.

The Programme is based on the values: Respect – Equity - Trust

Programme status

  • All hospitals have entered into agreements strengthening the cooperation with their local municipalities
  • Close to 70 GPs have been hired (part-time) by the hospitals to improve patient flow between hospitals and providers of primary health care
  • Financial incentives to encourage ambulatory care are established
  • All hospitals have established Patient Empowerment Centres
  • Funding for spreading good examples of best practice is provided.
The Programme is gradually implemented in the merged region. This website is established for informing about the methods, projects and results from the programme, (in Norwegian only at present). However, feel free to make further inquires.

 

Author: Vegard Høgli

 
 
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