Past Program

Session Overview

People across the world are living longer but sicker lives, as chronic illnesses soar and health inequities persist. It's time for hospitals to move beyond simply treating people after they get sick, and play a more active role in preventing illness and promoting health for individuals, families and communities.

This session reviewed progress approaches and possibilities towards such realignment. Among the considerations:

Cross-Sector Collaboration: To improve overall health, hospitals will need to collaborate with the many systems that impact health-including housing, food, public safety, employment, and education. New strategies will need to be put in place to enhance interaction within and between hospitals, social services, public health and community organizations, and to boost information-sharing across institutions and sectors.

Institutional Changes: As hospitals shift focus, they will require a realignment of mission, adjustments in organizational and professional culture, expanded staff roles and leadership competencies, new institutional networks, and changes in infrastructure, including new payment systems, financial incentives and technologies to spur collaboration.

Community Engagement: As hospitals look beyond their walls, and begin collaborating with local agencies and organizations to address the social determinants of health, it will be important to engage patients and other citizens in decisions about how best to improve community health and deliver community-centered care.

New Metrics: Evaluation and measurement of hospitals will also need to transform, going beyond the purely bio-medical. While hospitals have increasingly embraced patient-reported measures to assess the health of individuals, a new focus will need to be placed on developing metrics that relate to the health of the community.

Participant Profile

Salzburg Global Seminar’s Health and Health Care Innovation sessions seek to bring together cross-sector and cross-generational change-makers to tackle complex challenges.

For this session, teams of three or four Fellows were selected from diverse countries. Each team was drawn from across sectors representing hospitals, social service institutions, public health and community organizations, and policymakers from specific communities.

Session Format

The five-day session brought together 60 participants from across the globe for a highly-interactive program at Schloss Leopoldskron, home of Salzburg Global Seminar.

The session focused on building new insights and aggregating perspectives and experiences from relevant sectors, areas of expertise and regions. Working groups, each with a thematic and/or country focus, prepared recommendations for action.

Key Questions

Over the course of the five-day program, participants addressed the following questions:

  • How can other sectors more effectively and pro-actively collaborate with hospitals in support of better health?
  • How can hospitals best realign their mission, practices and institutional networks to address the social determinants of health?
  • How should financial incentives and payment systems best be adapted to achieve this realignment, especially in the light of system complexities, such as multiple payers and misaligned incentives?
  • How can this transformation be assisted by the smart utilization of new technologies or the application of older technologies in novel ways? And by a more open, connected and collaborative institutional culture of hospitals and staff roles?
  • How could emerging citizen- and patient-centered and contextual metrics for the whole continuum of health creation, health support, and different forms of care, help drive this transformation?
  • In what ways can mutual understanding of health issues and information-sharing across cultural, institutional and sectoral barriers best be enhanced?

Outcomes and Impact

  • Seed new and innovative approaches through international and cross-border exchange and the transmission of best practice.
  • Initiate networking and collaborations among participants and the institutions they represent.
  • Co-create action plans designed and agreed by participants for them to take forward as appropriate at local and regional levels, and to leverage the global scope of the project to influence public opinion and democratic debate and policy making, through agenda-setting articles published as part of a media partnership with the British Medical Journal.


Session Photos

View full set on Flickr

Graphic Facilitation by Wolfgang Irber

Online Library

Asset-based places: A model for development. SCIE, July 2017.

Byrne, D. “Evaluating complex social interventions in a complex world.” Evaluation19(3):217-228, 2013.

Danielle Varda and Lisa VanRaemdonck, “Hospital Investment and Interaction in Public Health Systems,” (webinar) for PHSSR Research in Progress webinar series, May 4, 2016.

Social determinants of health: How are hospitals and health systems investing in and addressing social needs? Deloitte, 2017.

Dementia Friendly America. Elements of Dementia Friendly Communities.

Diamond, Dan. "A Nation of Mchospitals?Politico. 2017. 

Exploring the Process, Models, and Outcomes of Hospital-Public Health Partnerships. Dr. Paul Halverson interviews Dr. Danielle Varda, RE-ACT (Research-to-Action in Public Health Delivery) podcast, August 2015.

Fisher, M, Milos, D, Baum, F, & Friel, S. “Social determinants in an Australian urban region: a ‘complexity’ lens.” Health Promotion International. 31(1):163-173, 2014. 

Freeman, T, Baum, F, Lawless, A, Jolley, G, Labonte, R, Bentley, M, & Boffa, J. “Reaching those with the greatest need: how Australian primary health care service managers, practitioners and funders understand and respond to health inequity.” Australian Journal of Primary Health. 17(4):355, 2011. 

Freeman, T, Baum, F, Lawless, A, Labonte, R, Sanders, D, & Boffa, J. et al. “Case Study of an Aboriginal Community-Controlled Health Service in Australia: Universal, Rights-Based, Publicly Funded Comprehensive Primary Health Care in Action.” Health and Human Rights Journal. 18(2):93-108, 2016.

HRET. Social Determinants of Health. 

Innovation Models in Health and Housing. Mercy Housing and The Low Low Income Investment Fund for The California Endowment and the Kresge Foundation.

Introduction to Hospital Investment and Interaction Project in Public Health Systems Project. Denver, CO: University of Colorado Denver, 2015

Matheson, A, & Ellison-Loschmann, L. “Addressing the complex challenge of unmet need: a moral and equity imperative?” NZMJ. 130(1452):6-8, 2017.

Matheson, A, Walton, M, Gray, R, Lindberg, K, Shanthakumar, M, & Fyfe, C. et al. “Evaluating a community-based public health intervention using a complex systems approach.” Journal of Public Health. 1-8, 2017.

Megan Sandel, Matthew Desmond. Investing in Housing for Health Improves Both Mission and MarginJAMA. Published online October 31, 2017.

Paul Gregg and Graeme Cooke. Liberation Welfare. Demos, 2010.

Public Health Wales NHS Trust, Adverse Childhood Experiences and their impact on health-harming behaviours in the Welsh adult population. 2015.

Public Health Wales NHS Trust, Adverse Childhood Experiences (ACEs) in Wales (Infographic). 2015.

Public Health Wales NHS Trust, Adverse Childhood Experiences and their association with Mental Well-being in the Welsh adult population. 2016.

Public Health Wales NHS Trust, Adverse Childhood Experiences and Adult Mental Well-Being in Wales (infographic). 2016.

Public Health Wales NHS Trust, Adverse Childhood Experiences and their association with chronic disease and health service use in the Welsh adult population. 2016.

Public Health Wales NHS Trust, Adverse Childhood Experiences, chronic disease and health service use in Wales (infographic). 2016.

Public Health Wales NHS Trust, Making a Difference: Investing in Sustainable Health and Well-being for the People of Wales: Executive Summary. 2016.

Public Health Wales NHS Trust, Making a Difference: Investing in Sustainable Health and Well-being for the People of Wales: Supporting Evidence. 2016.

Public Health Wales NHS Trust, Addressing Alcohol Misuse in Wales (infographic). 2016.

Public Health Wales NHS Trust, Eight infographics focusing on key health challenges for Wales and suggested evidence-based solutions. 2016.

Public Health Wales NHS Trust, Adverse Childhood Experiences (ACEs) (Wales) (Animation). 2016.

Rachel Hogg, “A framework and analysis of hospital investment and interaction in public health systems.” (presentation), American Public Health Association Annual Meeting and Expo, November 1, 2016.

Ralph Broad. People, Places, Possibilities: Progress on Local Area Coordination in England and Wales. The Centre for Welfare Reform, 2015.

Realising the Value: Ten actions to put people and communities at the heart of health and wellbeing. Nesta, 2016.

Robson, B, & Ellison-Loschmann, L. “Māori and cancer care in Aotearoa/New Zealand - responses to disparities.” European Journal of Cancer Care. 25(2):214-218, 2016. 

Schiller, B. From Cardiff To Cuba: A Global Search For The Best “Cultures Of Health.”Fast Company, October 8, 2017.

Six Innovations in Social Care. Shared Lives Plus, 2017.

Slater, T, Matheson, A, Davies, C, Goodyer, C, Holdaway, M, & Ellison-Loschmann, L. “The role and potential of community-based cancer care for Māori in Aotearoa/ New Zealand.” NZMJ. 129(1430):29-38, 2016.

Slater, T, Matheson, A, Davies, C, Tavite, H, Ruhe, T, Holdaway, M, & Ellison-Loschmann, L. “‘It’s whanaungatanga and all that kind of stuff’: Maori cancer patients’ experiences of health services.” Journal of Primary Health Care. 5(4):308-314, 2013.

Social value of local area coordination: learning outcomes from Thurrock Council and Derby City Council SROI analyses. Kingfishers (Project Management) Ltd, 2016.

Total transformation of care and support. SCIE, March 2017.

Varda DM, VanRaemdonck L, Tung G, Hogg RA, Atherly A. “A conceptual framework for the study of hospital interaction and investment in public health systems.” Frontiers in Public Health Services and Systems Research. 5(5):44–9, 2016.

Young, Emma. How Iceland got Teens to say Not to Drugs. The Atlantic, 19 January, 2017.

Multi-Year Series


Salzburg Global Seminar has long been a leading forum for the exchange of ideas on issues in health and health care affecting countries throughout the world. At these meetings agendas have been re-set affecting policy and practice in crucial areas, such as patient safety and the engagement of patients in medical decision making. In 2010, Salzburg Global Seminar launched a multi-year series – Health and Health Care Innovation in the 21st Century – to crystallize new approaches to global health and health care in the face of emerging challenges affecting us now and set to continue on through the coming generation.

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