For 30 years, health promoting hospitals have been helping to re-orient health services towards health promotion and prevention. Their vision is of comprehensive and ambitious organisation-wide reforms. Guidance has been developed to make this reality. But what does it mean to be a health-promoting service during the pandemic and beyond?
Written by Dr. Rainer Christ and Birgit Metzler, Gesundheit Österreich GmbH
In February public health authorities in Europe started to display SARS Cov 2 epidemiological data on dashboards. While the pandemic demands enormous attention, there is a risk that other relevant health issues become marginalised. There is evidence that health care of other serious conditions has been disrupted or halted in many cases. The pandemic reveals again the pressures health services are under to treat illness and the difficulties they face in meeting expectations.
Reorienting health services towards health promotion
Reorienting health services in a health promotion direction is the one of five action areas of the Ottawa Charter (WHO 1986) that provided the impetus for the health promoting hospitals movement. Initiated in 1990 by the World Health Organization, the International Network of Health Promoting Hospitals and Health Services (HPH) supports hospitals and other types of health services in their development towards health-promoting settings. 30 years later, the network comprises around 600 member organizations in more than 20 countries worldwide. Annual international conferences provide them a platform to meet, discuss and share knowledge. Thus the network is an important think tank and advocate for shifting the focus on health and health determinants.
There are different strategies to mobilise resources for health in health services. They range from rather narrow concepts, in which health promotion projects are implemented on an ad hoc basis, to more ambitious, comprehensive approaches aimed at developing health services into health promoting settings. HPH is programmatically committed to the latter, which requires the health services’ commitment to organisational change to improve the health of patients, staff and the community. If taken seriously and strategically the implementation of the HPH vision is an asset for every health service. Several HPH task forces and working groups have developed guidelines and standards that help to make this vision a reality.
Organisational commitment to health promotion is essential
An essential cornerstone is the organisational commitment to health promotion as part of the overall strategy. This means defining of leadership, capacity building, systematic monitoring, implementation and evaluation. A human resource management system that considers the principles of health promotion – focusing on empowerment and participation – is a precondition for people-centred care that goes beyond the treatment of a condition. Furthermore, a health promoting hospital bridges the gap between the inpatient services provided during hospital stay and a person’s everyday living conditions. Networking and cooperation – not only with health care specialists, but also with the social sector, communities, caregivers and families – is therefore a core strategy of health promoting hospitals and health services.
Following these principles, the self-assessment tools and guidelines address further issues like:
- How does the organisation ensure accessibility of services? How does the organisation contribute to health equity?
- How does the organisation comply with the rights of children and adolescents? How does the organisation regard specific needs of older patients or ageing staff?
- How does the organisation ensure that persons from different cultures, with different languages, and various levels of education and health literacy get appropriate health information and find their way through the health system?
- Is the hospital a safe and healthy setting for all? Are all persons well protected from smoke and noise? How healthy is the food offered in the premises? Is there space to relax and a place for privacy?
- And what is the ecological footprint of the hospital or the organization? How can it perform environmentally friendly?
Health promotion strategies will make organisations more resilient
All these ambitions, which are supported by the HPH vision, are under serious pressure during the COVID-19 pandemic. Eventually, those organisations which invest in health promotion strategies will be more resilient to cope with the challenges that will accompany us this winter and beyond. This will also benefit the needs of patients and their families, staff, and the community.