Abstract
Background: While it is accepted that recognition drives performance improvement over time, less is known about implementation attitudes and behaviors following introduction of a new guideline recognition program. This analysis aims to understand guideline implementation trends within hospitals treating diabetes in patients with stroke and/or heart failure after launch of a diabetes recognition program. 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. A 26-question survey regarding implementation attitudes and behaviors related to guideline adherence for diabetes care of patients with stroke and/or heart failure was sent to a stratified random selection of 678 hospitals participating in GWTG-Stroke and 328 hospitals in GWTG-Heart Failure. A total of 311 surveys were collected. Results: Perceived value of the diabetes recognition award was higher in award-winning (34-44%) compared with non award-winning hospitals (21-24%). Both award winning and non-award winning hospitals reported "limited time due to COVID-19" as a top data entry barrier, and "reason for not prescribing an antihyperglycemic medication with proven CVD benefit" as most difficult to locate. Award-winning hospitals reported higher rates of referral for a diabetes consult as standard practice. Conclusion: This diabetes award recognition program demonstrated higher value in award-winning hospitals, with higher rates of standard practice referrals after a new diabetes diagnosis. Further barriers to achievement of standards were identified, highlighting the need for continued support of hospitals following introduction of recognition programs. Future findings may inform strategies for successful implementation of similar programs, ultimately leading to improved care of those with diabetes and CVD.
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