Differences in implementation strategies of the European Resuscitation Council Guidelines 2015 in Danish hospitals – a nationwide study

Abstract

IntroductionGuideline implementation is essential to improve survival following cardiac arrest. This study aimed to investigate awareness, expected time frame, and strategy for implementation of the European Resuscitation Council (ERC) Guidelines 2015 in Danish hospitals.MethodsAll public, somatic hospitals with a cardiac arrest team in Denmark were included. A questionnaire was sent to hospital resuscitation committees one week after guideline publication. The questionnaire included questions on awareness of ERC Guidelines 2015 and time frame and strategy for implementation.ResultsIn total, 41 hospitals replied (response rate: 87%) between October 22 and December 22, 2015. Overall, 37% hospital resuscitation committees (n=15) were unaware of the guideline content. Most hospitals (80%, n=33) expected completion of guideline implementation within 6 months and 93% hospitals (n=38) expected the staff to act according to the ERC Guidelines 2015 within 6 months. In contrast, 78% hospitals (n=32) expected it would take between 6 months to 3 years for all staff to have completed a resuscitation course based on ERC Guidelines 2015. Overall, 29% hospitals (n=12) planned to have a strategy for implementation later than a month after guideline publication and 10% (n=4) hospitals did not plan to make a strategy.ConclusionThere are major differences in guideline implementation strategies among Danish hospitals. Many hospital resuscitation committees were unaware of guideline content. Most hospitals expected hospital staff to follow ERC Guidelines 2015 within six months after the publication even though they did not offer information or skill training to all staff members within that time frame.

Hospital‐level variation in outcomes after in‐hospital cardiac arrest in Denmark

“…4,14 In Denmark, previous studies reported on differences in resuscitation teams and guideline implementation strategies across hospitals. [16][17][18] Resuscitation teams at hospitals with high IHCA survival have been shown to differ in features (e.g., team design, communication, and training)…”

“…3,7,10,14,15 However, it remains unclear to what extent patient characteristics may explain potential variations in outcomes. Additionally, while hospital-level variation in resuscitation care strategies has been identified in Denmark, [16][17][18] variation in outcomes remain to be explored.…”