Integration of health promotion in clinical hospital departments: standards fulfilment, documentation of needs and service delivery

Abstract

Background Integrating health promotion (HP) in clinical settings has tremendous effects on treatment outcomes, patient safety and expenses on short and long-term. WHO-HPH standards and models are used globally - but publications on compliance and provision of HP remain rare. Objective To evaluate WHO-HPH Standards compliance, identification of HP needs and related HP deliveries at hospitals, as well as to identify important factors for high level of service deliveries to patients in need of HP.

Methods 21 clinical departments, each with 50 patient records, were included in Taiwan. Standards compliance was recorded. The 1050 medical records were audited for documentation of patients’ HP need (HPH DATA model) and HP service deliveries (HPH Doc Act model) regarding malnutrition, overweight, physical inactivity, smoking and excessive drinking.

Results The Standards compliance was high; 93% (88-98%). Identification rate was 46% (32-72%) and delivery rate to those with identified HP needs was 33% (22-40%). Of the total deliveries, 17% (5-24%) were given to patients documented as not having HP needs, and 46% (41-59%) to patients without information on HP needs. Modifiable factors of significance for high level of HP service delivery were Standards compliance and HP needs identification; OR 1.89-3.75 and 1.74-12.66. Conclusion The compliance was high at organisation level, but lower at patient level. Most deliveries were given to patients without identified needs. Future research should include implementation strategies reaching out to the patients.