Abstract
Background: Guideline recognition programs are known to drive hospital performance improvement, yet rapid translation of guidelines into practice continues to be a challenge. This analysis identifies guideline implementation challenges and strategies following the introduction of a new guideline recognition program for diabetes care of patients with heart failure and/or stroke. Methods: Hospitals participating in American Heart Association’s (AHA) Get With The Guidelines (GWTG)-Stroke and/or GWTG-Heart Failure modules are asked to document adherence to guidelines for diabetes care. Representatives from 21 GWTG-Stroke and GWTG-Heart Failure hospitals were invited to take part in virtual focus groups. Four focus groups with 21 participants were conducted in March 2021. Participants shared their attitudes, strategies, and challenges related to the diabetes recognition program. Transcripts were coded and analyzed for common themes with NVivo 12. Results: Participants consistently reported positive attitudes towards national recognition and guideline recognition programs. Improved team-based care, care coordination, and antihyperglycemic medication education were consistently reported as diabetes-guideline implementation opportunities. Standard protocols following diabetes diagnosis varied, as did hospital practices for ensuring adherence to treatment guidelines and complete data documentation. Conclusion: These findings demonstrated consistency in both positive attitudes towards recognition and opportunities for improved guideline-implementation. Variability in established diabetes-treatment protocols and strategies for ensuring guideline adherence suggests the need for increased best practice sharing and guideline-implementation support. These results may be used to inform successful implementation of future guideline-based award programs to improve the care of those with diabetes and CVD.
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