1. Jaime Acevedo Vera, M.D. An original idea by Jaime Acevedo Vera, M.D. Executive Coordinator of UNAMOS Programs Centre for Extension in Health, Faculty of Medical Sciences of the University of Santiago of Chile (USACH) Yuri Salinas Valenzuela Presented by Yuri Salinas Valenzuela Chilean Medical Student at the Faculty of Medicine of Peoples’ Friendship University of Russia Proposal for Expanding the HPH Initiative from WHO/Europe to three Chilean Public Hospitals Latin-America in the 12 th International Conference on Health Promoting Hospitals Moscow, May 28 th of 2004

3. USACHUSACH The University of Santiago of Chile (USACH) is a statal and public chilean university. The Faculty of Medical Sciences was founded 10 years ago by Professor José Luis Cárdenas. Our future Health Professionals are expected to be ‘Permanent Educators of the Patient, the Family and the Community’. THE UNIVERSITY

4. UNAMOSUNAMOS The ‘UNAMOS’ Initiative was founded on 2000 Solidarity’s Day, by 3 Medical Students, sponsored by the Dean and supported by senior Professors of our Faculty of Medical Sciences. Its mission was to design, to implement, to equip and to open an ‘Organized and Solidary Medical Help Unit’ (translated to spanish, its acronym is ‘UNAMOS’) for improving the social capital in our students. THE INITIATIVE

5. Extension Assistance After four years of exploratory study with voluntary students, professors, public officials and ad honorem outer professionals, the ‘UNAMOS’ Initiative developed a new Model of ‘Learning & Service’ for our voluntary students. ‘Extension in Health Assistance’ takes the voluntary work traditionally made by students in developing countries and incorporate it into each Faculty/Department trough transversal Programs of Health Promotion and Medical/Social Research. THE MODEL

6. ‘UNAMOS’ Programs Since June 2004, 6 original Programs of Health Promotion and Medical/Social Research will be started by 10 Pilot–Projects. Each Department will open its own ‘Extension in Health Assistance’ team, whose students will participate in different Pilot–Projects (academic networks). The Centre for Extension in Health will coordinate sponsoring, technnical assistance and finnancement networks for supporting the Pilot-Projects (colaboration networks). THE STRUCTURE

7. Students as Educators The Pilot–Project designed for oppening our “Patients & Hospitals” Program, is “Hospitalized Patients and their Families Accompaniment and Education Network & Health Promoting Hospitals Initiative”. We want to run this Pilot–Project in three ‘Teaching & Assistance’ Hospitals at Santiago of Chile: ‘Barros Luco - Trudeau Hospital’, ‘San Jose Hospital’ and ‘El Pino Hospital’. THE HPH PILOT-PROJECT

8. HPHHPH Looking for the state of the art in relation with health promotion and illness prevention, patients accompaniment and education, humanization of medicine and quality of health care, we found the ‘HPH’ Initiative of WHO/Europe, wich started in 1992 as a pilot-project and has disseminated around Europe and Asia, but still hasn’t arrived at Latin-America. The international effort in this matter would allow us to start our program in a safe mode. THE INTERNATIONAL NETWORK

9. Students in HPH We need to open our ‘Teaching and Assistance’ Hospitals to projects designed, directed and executed by health students as educators of their own patients while they are learning pathologycal and clinical aspects of diseases. At the same time, professors and clinical instructors have the opportunity for improving the quality of their helath care, running a new research line, and doing extension in health, mediated by their students. THE VISSION

10. HPH in Chile Health Centres are classified in 3 levels. Hospitals are the third level centres, where the medical specialists can offer a better diagnosis & therapy process to those patients whose clinical condition need more knowledge, vigilance or technology for being disgnosed or treated. Quality improving is generally understood as efficiency in an economical sense, focused on the management process of resources or on organizational aspects, in a normative sense. THE BACKGROUND

11. HPH in Chile However, in every Hospitals there are pioneer teams, that have incorporated to their clinical management the promotion & prevention process, implementing and evaluating new interventions, always based on the intuition of a leader and on the learning of a theoretical model of demostrated value in a foreign place. These teams are seen as the better ones in their Hospitals (‘russians will take them far away’), so in a clinical sense as also in a human sense. However they aren’t majority at Hospital. THE SITUATION

12. HPH in Chile ‘HPH’, as an international Initiative, will serve as a political and technnical ‘Umbrella’, for incorporating health promotion, patient education, medical/social research and extension in Health, mediated by students, in all the clinical services of our three ‘Teaching and Assistance ‘ Hospitals. For starting our pilot-project in our 3 Hospitals, we will ask the pioneer teams for being technnical assesors of their coleagues of other clinical services without their experience. THE STRATEGY

13. HPH in Latin-America Technnological transference of our model of ‘Extension in health assistance mediated por students’, to regional Networks of HPH, for applying and evaluating it. Oppening the Latin-American Network of HPH with the technnical assistance of Boltzmann Institute for Sociology of Medicine and Healt Care, with our Centre for Extension in Health as Coordinating Centre and with PAHO/WHO as official sponsor. THE PROPOSAL

14. HPH in Latin-America New research line that vinculates Health Promotion in Students as special group at Hospital, with Generation of Social Capital in voluntary students of developing countries. Maybe it could be sponsored by InterAmerican Development Bank Initiative. HPH Model can be incorporated to management process of the modern public hospital and related to the reform of the health system in Chile. In fact, the Health Ministry is interested in this strategic alliance. THE EXPECTED PRODUCTS