“European Civic Prize on Chronic Pain - Collecting Good Practices”
CONTACT PERSON
Name:
Surname:
Organisation:
Position:
Country:
Country Region:
Email:
Phone number:
Short description of the person submitting this project
(specify if he/she is the project leader):
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DESCRIPTION
Title of the good practice:
Write a short title
Category – tick one or more:
Empowerment
Innovation
Clinical practices
Professional education
Who are the stakeholders involved in the Good Practice? (Fill in as many as apply )
Civic Organization(s):
Write the name of the civic organization(s) involved
Helthcare Organisation(s) :
Write the name of the public institution(s) involved
Health Professionals:
Write the name and the type of health professionals involved
University:
Write the name(s)
Other:
Give details of the other stakeholders involved
Location:
Insert the city(cities) and region(s) and the country where the initiative/project took place.
Insert the start and ending dates in the most complete and precise way possible (month and year).
Start Date:
End Date:
Ongoing:
Yes
No
Objectives:
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Outcomes
Impact on participants :
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Resources:
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ANALYSIS
Development of the good practice
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Obstacles
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Means used to overcome or remove the obstacles detailed above
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Factors enabling the process
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EVALUATION
Please explain how
your
good practice
meet the criteria below:
Reproducibility:
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Innovativeness:
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Added value:
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Appropriateness:
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NEXT STEPS
Lessons Learned
:
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Key Take Aways:
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Next Steps:
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OTHER INFORMATIONS
Notes:
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Links to additional information are welcome.
Privacy Authorization: According to the Italian legislation (Data Protection Code 196/2003), I allow Cittadinanzattiva-Active Citizenship Network to use this personal information to update me on its activities.