Antonio Di Carlo1, Francesca Romana Pezzella2, Alec Fraser2, Francesca Bovis2, Juan Baeza2, Chris McKevitt2, Annette Boaz2, Peter Heuschmann2, Charles D A Wolfe2, Domenico Inzitari2. 1. From the Institute of Neuroscience, Italian National Research Council, Florence, Italy (A.D.C., D.I.); Department of Emergency, San Camillo-Forlanini Hospital, Rome, Italy (F.R.P.); Department of Management, School of Social Science and Public Policy (A.F., J.B.) and Division of Health and Social Care Research (C.M.K.), King's College, London, United Kingdom; Department of Neurofarba, Neuroscience Section, University of Florence, Italy (F.B., D.I.); Faculty of Health, Social Care and Education, St. George's University of London and Kingston University, London, United Kingdom (A.B.); Institute of Clinical Epidemiology and Biometry (P.H.) and Comprehensive Heart Failure Center (P.H.), University of Würzburg, Würzburg, Germany; Clinical Trial Center Würzburg, University Hospital Würzburg, Würzburg, Germany (P.H.); and National Institute for Health Research (NIHR) Biomedical Research Centre at Guy's and St. Thomas' NHS Foundation Trust and King's College, London, United Kingdom (C.D.A.W.). dicarlo@in.cnr.it. 2. From the Institute of Neuroscience, Italian National Research Council, Florence, Italy (A.D.C., D.I.); Department of Emergency, San Camillo-Forlanini Hospital, Rome, Italy (F.R.P.); Department of Management, School of Social Science and Public Policy (A.F., J.B.) and Division of Health and Social Care Research (C.M.K.), King's College, London, United Kingdom; Department of Neurofarba, Neuroscience Section, University of Florence, Italy (F.B., D.I.); Faculty of Health, Social Care and Education, St. George's University of London and Kingston University, London, United Kingdom (A.B.); Institute of Clinical Epidemiology and Biometry (P.H.) and Comprehensive Heart Failure Center (P.H.), University of Würzburg, Würzburg, Germany; Clinical Trial Center Würzburg, University Hospital Würzburg, Würzburg, Germany (P.H.); and National Institute for Health Research (NIHR) Biomedical Research Centre at Guy's and St. Thomas' NHS Foundation Trust and King's College, London, United Kingdom (C.D.A.W.).
Abstract
BACKGROUND AND PURPOSE: Differences in stroke care and outcomes reported in Europe may reflect different degrees of implementation of evidence-based interventions. We evaluated strategies for implementing research evidence into stroke care in 10 European countries. METHODS: A questionnaire was developed and administered through face-to-face interviews with key informants. Implementation strategies were investigated considering 3 levels (macro, meso, and micro, eg, policy, organization, patients/professionals) identified by the framing analysis, and different settings (primary, hospital, and specialist) of stroke care. Similarities and differences among countries were evaluated using the categorical principal components analysis. RESULTS: Implementation methods reported by ≥7 countries included nonmandatory policies, public financial incentives, continuing professional education, distribution of educational material, educational meetings and campaigns, guidelines, opinion leaders', and stroke patients associations' activities. Audits were present in 6 countries at national level; national and regional regulations in 4 countries. Private financial incentives, reminders, and educational outreach visits were reported only in 2 countries. At national level, the first principal component of categorical principal components analysis separated England, France, Scotland, and Sweden, all with positive object scores, from the other countries. Belgium and Lithuania obtained the lowest scores. At regional level, England, France, Germany, Italy, and Sweden had positive scores in the first principal component, whereas Belgium, Lithuania, Poland, and Scotland showed negative scores. Spain was in an intermediate position. CONCLUSIONS: We developed a novel method to assess different domains of implementation in stroke care. Clear variations were observed among European countries. The new tool may be used elsewhere for future contributions.
BACKGROUND AND PURPOSE: Differences in stroke care and outcomes reported in Europe may reflect different degrees of implementation of evidence-based interventions. We evaluated strategies for implementing research evidence into stroke care in 10 European countries. METHODS: A questionnaire was developed and administered through face-to-face interviews with key informants. Implementation strategies were investigated considering 3 levels (macro, meso, and micro, eg, policy, organization, patients/professionals) identified by the framing analysis, and different settings (primary, hospital, and specialist) of stroke care. Similarities and differences among countries were evaluated using the categorical principal components analysis. RESULTS: Implementation methods reported by ≥7 countries included nonmandatory policies, public financial incentives, continuing professional education, distribution of educational material, educational meetings and campaigns, guidelines, opinion leaders', and stroke patients associations' activities. Audits were present in 6 countries at national level; national and regional regulations in 4 countries. Private financial incentives, reminders, and educational outreach visits were reported only in 2 countries. At national level, the first principal component of categorical principal components analysis separated England, France, Scotland, and Sweden, all with positive object scores, from the other countries. Belgium and Lithuania obtained the lowest scores. At regional level, England, France, Germany, Italy, and Sweden had positive scores in the first principal component, whereas Belgium, Lithuania, Poland, and Scotland showed negative scores. Spain was in an intermediate position. CONCLUSIONS: We developed a novel method to assess different domains of implementation in stroke care. Clear variations were observed among European countries. The new tool may be used elsewhere for future contributions.
Authors: Antonio Di Carlo; Maria Lamassa; Marco Franceschini; Francesca Bovis; Lorenzo Cecconi; Sanaz Pournajaf; Stefano Paravati; Annibale Biggeri; Domenico Inzitari; Salvatore Ferro Journal: PLoS One Date: 2018-03-23 Impact factor: 3.240
Authors: Sabina B Gesell; Cheryl D Bushnell; Sara B Jones; Sylvia W Coleman; Samantha M Levy; James G Xenakis; Barbara J Lutz; Janet Prvu Bettger; Janet Freburger; Jacqueline R Halladay; Anna M Johnson; Anna M Kucharska-Newton; Laurie H Mettam; Amy M Pastva; Matthew A Psioda; Meghan D Radman; Wayne D Rosamond; Mysha E Sissine; Joanne Halls; Pamela W Duncan Journal: BMC Health Serv Res Date: 2019-12-19 Impact factor: 2.655