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Implementation of national palliative care guidelines in Swedish acute care hospitals : A qualitative content analysis of stakeholders’ perceptions

Lind, Susanne; Wallin, L. LU ; Brytting, T.; Fürst, C. J. LU and Sandberg, J. (2017) In Health Policy 121(11). p.1194-1201
Abstract

In high-income countries a large proportion of all deaths occur in hospitals. A common way to translate knowledge into clinical practice is developing guidelines for different levels of health care organisations. During 2012, national clinical guidelines for palliative care were published in Sweden. Later, guidance for palliative care was issued by the National Board of Health and Welfare. The aim of this study was two-fold: to investigate perceptions regarding these guidelines and identify obstacles and opportunities for implementation of them in acute care hospitals. Interviews were conducted with local politicians, chief medical officers and health professionals at acute care hospitals. The Consolidated Framework for Implementation... (More)

In high-income countries a large proportion of all deaths occur in hospitals. A common way to translate knowledge into clinical practice is developing guidelines for different levels of health care organisations. During 2012, national clinical guidelines for palliative care were published in Sweden. Later, guidance for palliative care was issued by the National Board of Health and Welfare. The aim of this study was two-fold: to investigate perceptions regarding these guidelines and identify obstacles and opportunities for implementation of them in acute care hospitals. Interviews were conducted with local politicians, chief medical officers and health professionals at acute care hospitals. The Consolidated Framework for Implementation Research was used in a directed content analysis approach. The results showed little knowledge of the two documents at all levels of the health care organisation. Palliative care was primarily described as end of life care and only few of the participants talked about the opportunity to integrate palliative care early in a disease trajectory. The environment and culture at hospitals, characterised by quick decisions and actions, were perceived as obstacles to implementation. Health professionals' expressed need for palliative care training is an opportunity for implementation of clinical guidelines. There is a need for further implementation of palliative care in hospitals. One option for further research is to evaluate implementation strategies tailored to acute care.

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author
organization
publishing date
type
Contribution to journal
publication status
published
subject
keywords
Acute care hospital, Consolidated framework for implementation research, Guidelines, Implementation, Palliative care
in
Health Policy
volume
121
issue
11
pages
8 pages
publisher
Elsevier
external identifiers
  • scopus:85030319378
ISSN
0168-8510
DOI
10.1016/j.healthpol.2017.09.011
language
English
LU publication?
yes
id
2c79d230-a989-4143-b8c3-806ab879a8d9
date added to LUP
2017-11-07 15:20:26
date last changed
2018-01-16 13:31:40
@article{2c79d230-a989-4143-b8c3-806ab879a8d9,
  abstract     = {<p>In high-income countries a large proportion of all deaths occur in hospitals. A common way to translate knowledge into clinical practice is developing guidelines for different levels of health care organisations. During 2012, national clinical guidelines for palliative care were published in Sweden. Later, guidance for palliative care was issued by the National Board of Health and Welfare. The aim of this study was two-fold: to investigate perceptions regarding these guidelines and identify obstacles and opportunities for implementation of them in acute care hospitals. Interviews were conducted with local politicians, chief medical officers and health professionals at acute care hospitals. The Consolidated Framework for Implementation Research was used in a directed content analysis approach. The results showed little knowledge of the two documents at all levels of the health care organisation. Palliative care was primarily described as end of life care and only few of the participants talked about the opportunity to integrate palliative care early in a disease trajectory. The environment and culture at hospitals, characterised by quick decisions and actions, were perceived as obstacles to implementation. Health professionals' expressed need for palliative care training is an opportunity for implementation of clinical guidelines. There is a need for further implementation of palliative care in hospitals. One option for further research is to evaluate implementation strategies tailored to acute care.</p>},
  author       = {Lind, Susanne and Wallin, L. and Brytting, T. and Fürst, C. J. and Sandberg, J.},
  issn         = {0168-8510},
  keyword      = {Acute care hospital,Consolidated framework for implementation research,Guidelines,Implementation,Palliative care},
  language     = {eng},
  month        = {11},
  number       = {11},
  pages        = {1194--1201},
  publisher    = {Elsevier},
  series       = {Health Policy},
  title        = {Implementation of national palliative care guidelines in Swedish acute care hospitals : A qualitative content analysis of stakeholders’ perceptions},
  url          = {http://dx.doi.org/10.1016/j.healthpol.2017.09.011},
  volume       = {121},
  year         = {2017},
}