Good Practices Overview | Basque Country | Czech Republic | Norrbotten | Puglia | Scotland

Thirty-four Good Practices in integrated care were collected from five European regions participating in the SCIROCCO project – Basque Country, Norrbotten County Council, Olomouc region in Czech Republic, Puglia region in Italy and Scotland. The Good Practices were initially assessed in terms of their viability for scaling up. As a result, 15 Good Practices were prioritised for the application of the B3-Maturity Model to assess the maturity requirements necessary for their adoption and replication in Europe. The potential of a Good Practice to be transferable within or outsides the region / organisation depends on its viability but also on the maturity required for the system in which the Good Practice is implemented. In fact, the transferability potential would increase, the higher the viability score and the lower the system maturity levels needed is for a particular Good Practice.

Good Practices – Scotland

NameFocusScopeOrganisationMaturity Assessment
Building Healthier & Happier Communities (BHHC)
Strategic investment in the third sector to manage demand for services LocalScottish Council of Voluntary OrganisationsYes
Home & Mobile Health MonitoringNational service model for HMHMRegionalScottish GovernmentNo
Collaborative Commissioning of Care at Home ServicesStrategic commissioning approach to the development & delivery of the servicesLocalNHS HighlandNo
Technology Enabled Care Programme Self-management serviceRegional / localNHS 24 / SCTTYes
Reshaping Care for Older People - RCOPAnticipatory & Coordinated CareRegionalScottish GovernmentNo
cCBT in Scotland Computerised evidence based treatment for individuals suffering from depressionNationalNHS 24 / SCTTYes
Living it UpSelf-management serviceRegional / localNHS 24 / SCTTNo

Good Practices Overview | Basque Country | Czech Republic | Norrbotten | Puglia | Scotland

Good Practices – Basque Country

NameFocusScopeOrganisationMaturity Assessment
Malnutrition in the Elderly and Hospital StayNutritional assessment at hospital admissionLocalSanta Marina HospitalYes
Transversal Approach of the Pain from a Pain UnitFunctional plan for pain treatmentRegionalIntegrated Care Organisation ArabaYes
Advance Care Planning in an Integrated OrganisationAdvanced care planningLocalIntegrated Care Organisation ArabaYes
Telemonitoring COPD Patients with frequent hospitalisationTelemonitoring serviceRegionalIntegrated Care Organisation Barrualde-GaldakaoNo
Design & Implementation of Interventions aimed at Improving the safety of prescriptionManagement of polypharmacy in multimorbid elderly /fragile peopleLocalIntegrated Care OrganisationNo
Care Plan for the ElderlyPreventative interventions & health promotion activitiesRegionalRegional Public AuthorityNo
Integrated Care Process for Children with Special NeedsIntegrated care model for childrenLocalOSI Bilbao-BasurtoNo

Good Practices Overview | Basque Country | Czech Republic | Norrbotten | Puglia | Scotland

Good Practices – Czech Republic

NameFocusScopeOrganisationMaturity Assessment
Integrated health and social care/services in the Pardubice region (AZASS)
Holistic approach to service delivery / integrated governanceRegionalAssociation of MunicipalitiesNo
Improved Management of Visits in Home CareMedical care at patients’ homeLocalSt Borromeo Hospital in PragueYes
Telehealth service for patients with advanced heart failureTelehealth serviceRegionalUniversity Hospital OlomoucYes
Telemonitoring of patients with AMII & in Anticoagulation RegimeTelemonitoring serviceRegionalUniversity Hospital OlomoucYes

Good Practices Overview | Basque Country | Czech Republic | Norrbotten | Puglia | Scotland

Good Practices – Norrbotten

NameFocusScopeOrganisationMaturity Assessment
My PlanPatient empowermentRegionalNorrbotten County CouncilNo
Care Process PsychosisEarly intervention & professional treatmentLocalNorrbotten County CouncilYes
Distance Spanning HealthcareHealthcare at distance – acute & planned assessmentRegionalNorrbotten County CouncilYes
The Patient Journey through Emergency Medical Care (IVAK)Accessibility for patients to local hospitalsLocalNorrbotten County CouncilNo
An Effective Palliative Care ProcessCoordination of palliative careLocalNorrbotten County CouncilNo
Shoulder rehabilitation via distance technologyCare at distanceRegionalSunderby HospitalYes

Good Practices Overview | Basque Country | Czech Republic | Norrbotten | Puglia | Scotland

Good Practices – Puglia

NameFocusScopeOrganisationMaturity Assessment
MARIOInnovative interventions delivered via robotsEuropeanIRCSS Casa Sollievo della SofferenzaNo
CKD Integrated Care“Digital” healthcare modelRegionalBari PolyclinicYes
DIAMONDSTelemedicine-based intervention RegionalAzienda Ospedaliero-Universitaria Policlinico
Consorziale di Bari
No
SMARTAGING MindbrainPrevention & Early Diagnosis of cognitive declineRegionalUniversity of BariNo
Remote Monitoring in Heart Failure OutpatientRemote management of chronic diseasesRegionalBari PolyclinicYes
TeleHomeCare ProjectTelemonitoring/ teleconsultations to patients with HF, COPD & DiabetesNationalASL BrindisiYes
TelescopicoTelemonitoring/ teleconsultations to patients with HF, COPD & DiabetesLocalASL BariNo
RITARadiofrequency-induced thermal ablation of liver tumorsRegionalIRCCSNo

Good Practices Overview | Basque Country | Czech Republic | Norrbotten | Puglia | Scotland

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