The implementation of multiprofessional guidelines for cardiac rehabilitation: a pilot study

This study is concerned with the implementation of nationally developed multiprofessional guidelines for cardiac rehabilitation in the United Kingdom. The objectives of the study were: (1) to compare cardiac rehabilitation in settings: (a) actively receiving guidelines and additional facilitation; (b) actively receiving guidelines; and (c) not actively receiving guidelines; (2) to determine whether there are any differences in the three settings between those centres identified as either low or high providers of cardiac rehabilitation; (3) to identify particular problems associated with the implementation of guidelines in a multiprofessional setting; and (4) to gain feedback from health care workers about the credibility and feasibility of guidelines developed for cardiac rehabilitation. Six centres were randomized into the three groups, and a variety of tools were used, including questionnaires, facilitation, audit and semi-structured interviews. Results show that the national guidelines did not appear to have been utilized, other than in brief discussions. Recommendations include the need for education and training for cardiac rehabilitation staff, the development of a more comprehensive audit tool to help centres examine their performance in relation to the national guidelines, and further exploration of facilitation as a technique for the implementation of guidelines.