Best Practices Around the World



Association of Ontario Health Centres (AOHC) Best Practices

Since the Best Practices Steering Committee began in 1998, the AOHC best practices initiative has conducted focus groups on health promotion practices, principles, and indicators with member Community Health Centres (CHCs), conducted a pilot study on the implementation and development of best practices in CHCs, and conducted a clinical practice guidelines survey. It has produced an Interdisciplinary Team Tool Kit For the Development of Best Practices and its companion piece Unpacking Evidence in Health Promotion, a discussion paper on the relationship between best practices indicators and guidelines, and an Integrating Best Practices and Program Development Workbook. These materials are available only to members. For more information about the AOHC Best Practices initiative, contact Loralee Gillis.

AOHC Best Practices definition
Best practices aim to adapt practice in ways that suit the particular issue and context and also to share stories, tools and understanding so that we don't keep reinventing the wheel. Best practices include the incorporation of philosophy and values, guidelines for practice based on evidence, indicators of positive intervention, and processes of staff, volunteer and community involvement (in design, implementation and evaluation).



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Canadian Best Practices Portal for Health Promotion and Chronic Disease Prevention - A Public Health Agency of Canada Initiative

A key component of our capacity to prevent chronic disease and promote healthy living conditions in Canada is our ability to gather and use relevant evidence of 'what works', commonly known as best practices. There is increasing demand in all sectors and across the research, policy, practice continuum, for evidence-based decision-making and accountability. National consultations have indicated the need for a national initiative to facilitate knowledge exchange among practitioners, policy-makers and researchers about best practices, build consensus about best practice approaches, provide a centralized access point for these best practices and coordinate activities to increase the uptake and utilization of best practice information. In collaboration with experts in best practices from the practice, policy and research communities, the Public Health Agency of Canada's (PHAC) Centre for Chronic Disease Prevention and Control (CCDPC) is currently developing, implementing and maintaining the Canadian Best Practices Initiative (CBPI) and components for the identification, recommendation and knowledge exchange of best practices for Canadian settings for health promotion and chronic disease prevention. The dissemination component of the initiative is the Canadian Best Practices Portal (CBPP) for Health Promotion and Chronic Disease Prevention. The hope is to facilitate knowledge exchange between decision-makers (practitioners and policy makers) at the local, P/T, and national levels and provide access to an evidence base for recommended effective interventions, including community programs and policies.

Currently, organizations involved in best practices work recognize that:

In order to respond and address these needs and issues, the CBPI strives to:

Project Scope:

The Canadian Best Practices Initiative supports decision making across the spectrum of health promotion and chronic disease prevention, addressing cardiovascular disease, cancer, diabetes, chronic respiratory diseases, mental health and their associated key risk factors (ex. obesity, physical inactivity, unhealthy eating, hypertension) and key underlying determinants of health (i.e., income and social status, education). The initial focus of the Initiative will be on health promotion, primary prevention and early detection (a secondary prevention strategy), although it will ultimately span the continuum from primary through tertiary prevention.

Project Goal:

To increase the proportion of decisions made by populations of interest by: engaging stakeholders; collaborating across governments; addressing, in collaboration with partners, the availability of pertinent resources.

Objectives:

The expected five-year outcomes for the CBPI are as follows:

Portal- Short-term Objectives:

Portal-Intermediate-term:

Portal-Individual and Organizational Outcomes

KEY ACTIONS FOR EACH PHASE IN THE DEVELOPMENT OF THE INITIATIVE

Phase I (Fall 2005 to Fall 2006)

Consolidate, standardize and disseminate information on currently available evidence on effective population-level and community-level interventions. This would include the following:

Phase II (Fall 2006 to Fall 2008)

Expand the evidence available on gap content areas, provide additional intervention information and increase decision maker capacity for uptake. This would include the following:

Phase III (Fall 2008 to Summer 2010)

Further expand the body of practice-based evidence in various areas (contexts, populations, etc.) relevant to the scope of the project. This would include the following:

For more information on the Canadian Best Practices Initiative or to provide comments, please contact Nina Jetha: phone (613) 952-7608, fax (613) 941-2633, e-mail nina_jetha@phac-aspc.gc.ca

This description of the Public Health Agency of Canada's Canadian Best Practices Portal for Health Promotion and Chronic Disease Prevention was submitted by: Ian Szuto, Research Analyst, Evidence and Risk Assessment Division, Centre for Chronic Disease Prevention and Control, Public Health Agency of Canada.


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European Commission - Getting Evidence into Practice

The 'Getting Evidence into Practice' project is funded by the European Commission and has the following objectives:

This collaboration ensures a coordinated joint effort in the field of public health and health promotion in Europe. By the establishment of European consensus and standards in this field, the exchange of experiences within the coalition and the development of a joint working program for Europe in the coming years will be facilitated.

This project aims to strengthen this collaboration among the key stakeholders (agencies, practitioners and researchers) in the form of a European consortium for evidence based health promotion consisting of as many as national agencies for health promotion in the European Union (including the accession-countries) as possible, supported by the International Union for Health Promotion and Education (IUHPE), EuroHealthNet (EHN) and the Research Directors Network (RDN).

The objectives of the project will be covered by a management- and communication part and three strands of work. The central coordination organization is the NIGZ (Holland); in collaboration with EuroHealthNet will cover the communication and dissemination of the results. IUHPE will be involved. The strands consist of a subcontract holder as responsible partner together with project members as representatives of national organizations who work on the deliverables and meet two times (September 2004 and February 2005) during the project and at the Stockholm Conference in June 2005.

Within the Getting Evidence into Practice project 20 European institutes are represented. The Stockholm conference on effectiveness (June 2005) will mark the end of the first stage.

For more information about the Getting Evidence into Practice project, contact Dr. Jan Bouwens: email jbouwens@nigz.nl, phone 0348-439894, fax 0348-437666, or write Postbus 500, 3440 AM Woerden. A website specifically for this project is being developed and will be available in Fall 2004.

This description of the European Commission's Getting Evidence into Practice project was submitted by: project leader Dr. Jan Bouwens, Program Coordinator, NIGZ-Centre for Knowledge and Quality Management.

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Francophone Best Practices

Members of the Francophone sub-committee, created in 1999, included representatives from academic, governmental and community sectors. Members were: Manon Lemonde, Denise Hébert, Mary Cerré, Hélène Gagné, Huguette Jacobson, and Christiane Fontaine. Its mandate was to adapt the Interactive Domain Model (IDM) to the Franco-Ontarian context. To accomplish this, in May 2000 a needs assessment was conducted to document the needs of Francophone practitioners and their capacities and interest regarding best practices in health promotion. Subsequent steps included:

Various tools, including an IDM workbook, training modules, case studies, and references, are now accessible in French through the Web.

Yet to come are the further development of case studies and supporting materials, on-going promotion of the use of the IDM, on-going support to the users of the IDM, and research for additional funding to support activities. To learn more about this project, contact Christiane Fontaine, Health Promotion Consultant: phone (416) 408-2249, ext. 229 or 1 800 263-2846; e-mail christiane@opc.on.ca.

This description of the Francophone Best Practices project is excerpted from the report "Best Practices in Health Promotion: The Franco-Ontarian Context" by Christiane Fontaine, Centre ontarien d'information en prévention/Ontario Prevention Clearinghouse, Canada.


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IDM Best Practices

The IDM and its Framework were conceived in the context of the University of Toronto's Centre for Health Promotion's Best Practices Work Group and its ongoing exploration of best practices in health promotion. This Work Group, whose members came from public health units, community health centres, hospitals, community groups, provincial and federal government, academic institutions, and the private sector, was created as the result of an International Symposium on the Effectiveness of Health Promotion organized by the Centre for Health Promotion in June, 1996.

Initially, the Work Group focused on understanding the meaning of best practices and identifying the potential benefits and risks of taking a best practices approach to health promotion. Next it developed a set of best practices principles, and conducted an Ontario scan of practitioners' needs and capacities concerning best practices. Pilot testing the IDM and its Framework became a project of a "best practices partnership" consisting of Association of Ontario Health Centres (AOHC), Ontario Public Health Benchmarking Partnership (OPHB), and Centre for Health Promotion, University of Toronto (CHP). The partnership also included the three Ontario pilot sites who generously volunteered their time and energy to participate in the pilot testing: Durham Region Health Department, East End Community Health Centre (Toronto), and The Willett Hospital (Paris). Later, the Hospital Health Promotion Network joined the partnership.

As a result of the positive results of the pilot testing, development continued of materials and processes to facilitate practitioners' use of the Framework, including the IDM Evidence Framework. More sites joined the effort, this time to take part in and contribute to the IDM "bridging the gap between research and practice" learning module; these Ontario sites included: Access Alliance Multicultural CHC (Toronto); Brant Community HealthCare System (Paris and Brantford); Peterborough County-City Health Unit; Sudbury and District Health Unit; St. Joseph's Healthcare, Women's Detox and Mary Ellis House Treatment Program (Hamilton); West Hill Community Health Centre (Toronto).

Along the way a number of other people from a variety of organizations donated time and energy to the Project in a number of different ways, from participating as key informants in interviews to reviewing material. Funding to support the Best Practices Project was provided to the Centre for Health Promotion by Health Canada Population and Public Health Branch, Ontario Region. The Project also received support from the Ontario Ministry of Health and Long Term Care. Before funding ended in March 2002, an article explaining IDM Best Practices key concepts, the IDM Manual for Best Practices in Health Promotion, and the IDM Computer Program were added to the list of IDM Best Practices resources.

Although the Best Practices Work Group no longer exists, some members are still informally in touch with each other around best practices issues; and despite lack of funding, resources such as this website continue to be developed. Sharing of IDM best practices ideas - at national and international conferences, and through consultations with wonderful groups of people from Nova Scotia, Sweden, Holland and other places - has also continued.

IDM Best Practices activity around the world includes:

For more information about IDM Best Practices, read IDM Basics and the materials in IDM Best Practices resources

IDM Best Practices definition
Best practices in health promotion are those sets of processes and activities that are consistent with health promotion values, goals and ethics, theories and beliefs, evidence, and understanding of the environment, and that are most likely to achieve health promotion goals in a given situation.

This description of the IDM Best Practices project is excerpted from: the IDM Manual for Best Practices in Health Promotion (Introduction and Basics), and updated by website editor Barbara Kahan.


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Nova Scotia Best Practices Framework

The background
The Nova Scotia Best Practices Framework began with a health promotion research project called Heart Health Nova Scotia. One phase of the initiative involved building and researching organizational capacity for health promotion and chronic disease prevention. During this project many organizations were involved in discussions about how to collectively do more health promotion work. Research was undertaken to develop individual profiles on each organization's capacity for health promotion work. For many organizations, receiving a qualitative piece of research on this aspect of their work was a new thing, which stimulated within the organizations reflection on their organizational practice. From this, Heart Health started to look at the work on "best practices" happening in other provinces. Could a shared vision of best practices be developed among health promotion organizations to further enhance health promotion work in Nova Scotia? This idea continued to develop through a process of collective thinking among representatives of many organizations. In the fall of 2000, the discussion was formalized through an application for funding through the Canadian Diabetes Strategy. A proposal which included the development of a Nova Scotia Best Practices Framework was submitted and approved.

How the Framework was developed
In the winter of 2001 the work on a Best Practices Framework for Nova Scotia began. One of the first steps was a review of the literature on Best Practices. This search revealed two main approaches. The first, a "criterion approach" was commonly used to evaluate interventions on the basis of such things as: a project's research design model, the use of evidence, practicality, and sustainability. A second approach seemed to be more focused on the "process" or looking at how people do their work.

As the Nova Scotia Framework developed, it drew on both of the above approaches. The project Steering Committee and Advisory Group helped shape the Framework into a relevant document for use in Nova Scotia. This meant ensuring that the Framework was user friendly, with content applicable to be used at the community level. The N.S. Framework was launched in March 2001 at the Doing Our Best! Symposium and also posted on The Health Promotion Clearinghouse website.

In January 2002 a
consultation workshop was held to provide an opportunity to further investigate into how people were using the N.S. Framework. The purpose was to look for direction on what revisions might need to be made to improve the Framework, what needed to happen to encourage use of the Framework and what additional tools would be useful. We invited members of the Best Practices Working Group of the University of Toronto to share their work with us so that we could learn from their experience and as well learn from the collective experience of the participants present at the Consultation.

Nova Scotia Best Practices
Materials from the Nova Scotia Best Practices initiative include A Framework for A Best Practices Approach to Health Promotion, which presents 15 core components of health promotion, sets of questions for critical reflection, case studies, exercises and activities, lists of additional resources. There is an accompanying brochure which provides an overview of the Framework.

The Heart Health program finished in Nova Scotia, however the Health Promotion Clearinghouse component was sustained by the partner organizations. It is through the Clearinghouse that the materials are still available to practitioners in Nova Scotia.

Nova Scotia Best Practices definition
Best practice is a continual process of reflecting on how to improve a systematic examination of health promotion work and uses a process of critical reflection to draw out our collective knowledge of what we know works well.

This description of the Nova Scotia Best Practices initiative was submitted by: Kari Barkhouse, original member of the Nova Scotia Best Practices Steering Committee, currently Tobacco Strategy Coordinator, South Shore Health, Public Health Services, DHA 1,2,3 (Nova Scotia, Canada).


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