Abstract
BackgroundThe Netherlands can be regarded as unique in the use of the Netherlands Diabetes Federation (NDF) Care Standard (CS) for diabetes. The need to understand the barriers obstructing optimal health care, the dissemination and implementation of health care innovations into daily practice and the extent to which health care professionals actually adhere to guidelines has been emphasized repeatedly. Therefore, the aim of the present study was to suggest ways to optimize the implementation of the CS by examining the perceptions of Dutch health care professionals regarding the CS and the barriers to using it.MethodsA cross-sectional questionnaire survey was conducted among health care professionals (N = 1547) in 2010.ResultsA total of 39.6% (N = 1323) of the participating health care professionals possessed the CS. Only 15.5% of the professionals who were to some extent familiar with the CS (N = 1100) described themselves as working in complete accordance with the CS. The majority (83.9%) thought the CS contributed greatly to ensuring the quality of care; the judgment on the feasibility of working in accordance with the CS was positive (mean = 3.9 on a 5-point Likert scale). However, professionals tended to perceive the guidelines issued by the own professional association as the norm for high quality diabetes care, rather than the CS. The main barrier to using the CS was the lack of effective lifestyle interventions (or access to them) to provide care for people with diabetes or those at increased risk for the disorder.ConclusionsA limited percentage of health care professionals were found to posses the CS. It is questionable whether possession of the CS is a prerequisite for delivering high quality care. Overall, professionals were largely positive about the CS, although only a minority indicated they were working in complete accordance with it. Professionals and professional organizations should be further educated about the content of the CS and especially its added value with respect to the guidelines for their own professional group, in terms of the multidisciplinary approach to diabetes care. Furthermore, attention should be given to the most important perceived barriers, to facilitate adherence to the CS.
Highlights
The Netherlands can be regarded as unique in the use of the Netherlands Diabetes Federation (NDF) Care Standard (CS) for diabetes
In Dutch diabetes care, the Chronic Care Model (CCM) is reflected in the National Diabetes Action Program (NAD), which is funded by the Ministry of Health, Welfare and Sport [9]
Familiarity with and adherence to the Care Standard Of the health care professionals who answered the question on familiarity with the CS for diabetes (N = 1323), 39.6% possessed the standard, while 19.7% had seen the CS, but did not possess it; 23.8% had heard about it, but did not possess it and 16.9% were unfamiliar with it
Summary
The Netherlands can be regarded as unique in the use of the Netherlands Diabetes Federation (NDF) Care Standard (CS) for diabetes. In the Netherlands, attention to continuity of care has increased as a result of the initiative of the Dutch Ministry of Health, Welfare and Sport to start an integrated, programmatic approach of chronic diseases [6]. The concept of continuity of care is reflected in the Chronic Care Model (CCM), a framework that can be used to optimize the provision of care to patients with chronic conditions [7], and that advocates integrated care and disease management and the use of evidence-based care standards and guidelines [8]. The main objective of the action program is the systematic implementation of the Netherlands Diabetes Federation (NDF) Care Standard (CS) for the content, organization, quality and funding of diabetes prevention and care [9]. The Care Group assumes financial and clinical accountability and in turn subcontracts individual care providers (like the GP, dietician, internal specialist, etc.) or delivers parts of the services itself
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