Dealing with institutions, organising care, coping with routine and with isolation, all of these factors tend to put a lid on professional practices. This is particularly true in healthcare where there is a tendency to settle for things as they are.

The explanation may be that it’s more convenient, or that it is difficult to do otherwise, due to administrative or organisational obstacles. But also because of a lack of communication, or simply lack of time. It is easier to give in, even knowing there are flaws in the system, or to convince oneself that no matter how bad things are, they could be worse. And this is how very imperfect systems survive without being reformed, and inexorably go downhill.

But lifting the lid opens the way to new opportunities. The world of healthcare abounds in new initiatives, in experiments, in the search for alternative types of organisation. Many people are aware of their healthcare system's shortcomings, and are trying to change the system. Their aim is to improve healthcare practices and to meet the needs of patients, at various levels of the healthcare system: in the primary care setting, at the local level, in the national health insurance system, in the initial or continuing education of healthcare professionals, etc.

Often those who promote these initiatives are concerned with contributing to the common good, and therefore attempt to evaluate the results they obtain.

The "Rencontres Prescrire" workshop, held 30 May-1 June 2008 in Rennes, France, was dedicated to multidisciplinarity in healthcare teams. The event provided an opportunity to share examples of vital and productive initiatives. The Prescrire team aims (among other goals) to highlight these initiatives and to spread the word about the many projects, concrete actions and various types of organisation undertaken in the name of providing better service to patients. This is the case, for example, with Switzerland's physician-pharmacist "quality circles".

Imagination and action are needed to open up new paths in healthcare.

Let's lift the lid. Let's get closer to these initiatives and analyse them. Experiences and results should be shared, in order to motivate others to adapt them in other places. And, whenever justified, let us try to draw whatever relevant information we can from these initiatives, in order to improve healthcare professionals’ practices and continuing education, to better serve patients.

Let's hear it for initiatives!

©Prescrire 2008

Source: "Initiatives", Rev Prescrire 2008; 28(297): 481.