The health promoting hospital (HPH): concept and development.

Health promoting hospitals (HPH) is a concept for hospital development that builds upon the health promotion concept of the WHO Ottawa Charter for health promotion, where the reorientation of health care services is considered as one of five major action areas for an overall health promotion development. The article outlines what such a re-orientation may mean for the main hospital functions. These include: the health promoting hospital setting; health promoting workplaces, the provision of health (related) services, training, education and research; the hospital as an advocate and "change agent" for health promotion in its community/environment; the "healthy" (metaphorically speaking) hospital organisation. Based on the concept, an international network of WHO, Europe has been developing since the late 1980s. The main projects of the international network so far were the first model project "health and hospital" (Vienna, 1989-1996), the European pilot hospital project of HPH (1993-1996), and the development of national/regional HPH networks (ongoing since 1995). It is argued that the further development of the HPH network will have to take into account some major changes that have occurred in the hospital landscape since the start of the network: the quality movement and, as a sub-set of this, the increasing importance of evidence based medicine.