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Implementation of a politically initiated national clinical guideline for cardiac rehabilitation in hospitals and municipalities in Denmark

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Lindström Egholm, Cecilie ; Rossau, Henriette Knold ; Nilsen, Per ; Bunkenborg, Gitte ; Rod, Morten Hulvej ; Doherty, Patrick ; Bartels, Paul ; Helmark, Lotte ; Zwisler, Ann-Dorthe. / Implementation of a politically initiated national clinical guideline for cardiac rehabilitation in hospitals and municipalities in Denmark. In: Health policy (Amsterdam, Netherlands). 2018 ; Vol. 122, No. 9. pp. 1043-1051.

Bibtex

@article{a5f73166ff3843de96285f01732f4889,
title = "Implementation of a politically initiated national clinical guideline for cardiac rehabilitation in hospitals and municipalities in Denmark",
abstract = "A politically initiated national clinical guideline was launched in Denmark in 2013 to improve quality and equality of cardiac rehabilitation (CR) services. The guideline is to be implemented in both hospital and community (municipality) settings due to shared responsibility for provision of CR services. Little is known about implementation outcomes of a guideline in these two settings. We aimed to study this by determining the extent to which Danish CR services in hospitals and municipalities adhered to national recommendations following the launch of the guideline. The study employed an observational, longitudinal design. Data were gathered by a questionnaire survey to compare CR services at baseline, measured in 2013 immediately before the guideline was launched, with CR services at a two-year follow up in 2015. All Danish hospital departments offering CR services (N = 36) and all municipalities (N = 98) were included. Data were analysed using inferential statistics. Hospitals reported improvement of both content and quality of CR services. Municipalities reported no change in content of services, and lower level of fulfilment of one quality aspect. The results suggest that the guideline had different impact in hospitals and municipalities and that the differences in content and quality of services between the two settings increased in the study period, thus contradicting the guideline´s aim of uniform, evidence-based content of CR services across settings.",
keywords = "Cardiac Rehabilitation/standards, Cities/statistics & numerical data, Community Health Services/statistics & numerical data, Denmark, Guidelines as Topic, Hospitals/statistics & numerical data, Humans, Longitudinal Studies, Quality Improvement, Surveys and Questionnaires",
author = "{Lindstr{\"o}m Egholm}, Cecilie and Rossau, {Henriette Knold} and Per Nilsen and Gitte Bunkenborg and Rod, {Morten Hulvej} and Patrick Doherty and Paul Bartels and Lotte Helmark and Ann-Dorthe Zwisler",
note = "Copyright {\circledC} 2018 Elsevier B.V. All rights reserved.",
year = "2018",
month = "9",
doi = "10.1016/j.healthpol.2018.07.015",
language = "English",
volume = "122",
pages = "1043--1051",
journal = "Health Policy",
issn = "0168-8510",
publisher = "Elsevier Ireland Ltd",
number = "9",

}

RIS

TY - JOUR

T1 - Implementation of a politically initiated national clinical guideline for cardiac rehabilitation in hospitals and municipalities in Denmark

AU - Lindström Egholm, Cecilie

AU - Rossau, Henriette Knold

AU - Nilsen, Per

AU - Bunkenborg, Gitte

AU - Rod, Morten Hulvej

AU - Doherty, Patrick

AU - Bartels, Paul

AU - Helmark, Lotte

AU - Zwisler, Ann-Dorthe

N1 - Copyright © 2018 Elsevier B.V. All rights reserved.

PY - 2018/9

Y1 - 2018/9

N2 - A politically initiated national clinical guideline was launched in Denmark in 2013 to improve quality and equality of cardiac rehabilitation (CR) services. The guideline is to be implemented in both hospital and community (municipality) settings due to shared responsibility for provision of CR services. Little is known about implementation outcomes of a guideline in these two settings. We aimed to study this by determining the extent to which Danish CR services in hospitals and municipalities adhered to national recommendations following the launch of the guideline. The study employed an observational, longitudinal design. Data were gathered by a questionnaire survey to compare CR services at baseline, measured in 2013 immediately before the guideline was launched, with CR services at a two-year follow up in 2015. All Danish hospital departments offering CR services (N = 36) and all municipalities (N = 98) were included. Data were analysed using inferential statistics. Hospitals reported improvement of both content and quality of CR services. Municipalities reported no change in content of services, and lower level of fulfilment of one quality aspect. The results suggest that the guideline had different impact in hospitals and municipalities and that the differences in content and quality of services between the two settings increased in the study period, thus contradicting the guideline´s aim of uniform, evidence-based content of CR services across settings.

AB - A politically initiated national clinical guideline was launched in Denmark in 2013 to improve quality and equality of cardiac rehabilitation (CR) services. The guideline is to be implemented in both hospital and community (municipality) settings due to shared responsibility for provision of CR services. Little is known about implementation outcomes of a guideline in these two settings. We aimed to study this by determining the extent to which Danish CR services in hospitals and municipalities adhered to national recommendations following the launch of the guideline. The study employed an observational, longitudinal design. Data were gathered by a questionnaire survey to compare CR services at baseline, measured in 2013 immediately before the guideline was launched, with CR services at a two-year follow up in 2015. All Danish hospital departments offering CR services (N = 36) and all municipalities (N = 98) were included. Data were analysed using inferential statistics. Hospitals reported improvement of both content and quality of CR services. Municipalities reported no change in content of services, and lower level of fulfilment of one quality aspect. The results suggest that the guideline had different impact in hospitals and municipalities and that the differences in content and quality of services between the two settings increased in the study period, thus contradicting the guideline´s aim of uniform, evidence-based content of CR services across settings.

KW - Cardiac Rehabilitation/standards

KW - Cities/statistics & numerical data

KW - Community Health Services/statistics & numerical data

KW - Denmark

KW - Guidelines as Topic

KW - Hospitals/statistics & numerical data

KW - Humans

KW - Longitudinal Studies

KW - Quality Improvement

KW - Surveys and Questionnaires

U2 - 10.1016/j.healthpol.2018.07.015

DO - 10.1016/j.healthpol.2018.07.015

M3 - Journal article

VL - 122

SP - 1043

EP - 1051

JO - Health Policy

JF - Health Policy

SN - 0168-8510

IS - 9

ER -

ID: 57246533