AbstractRationale, aims and objectives: This study provides insight into how Dutch hospitalsensure that guidelines are used in practice and identifies what key messages other hospitals canlearn from existing practices. We examine current practices in handling compliance and, there-fore, focus on hospitals that reported that they do not experience problems in the implementa-tion of guidelines.Method: A survey of Dutch hospital boards and 9 semistructured interviews were conductedwith a purposive sample of 3 hospitals. Interviews were held with 3 representatives of eachhospital, specifically, with a member of the board of directors, a member of the executive medicalstaff, and the manager of the quality and safety department.Results: Hospitals find guidelines necessary and useful. Hospitals have the power to improveimplementation if boards of directors and medical staff are committed, intrinsically motivated,cooperate with each other, and use guidelines pragmatically. Even then, they prioritize guidelines,as resources are scarce. Despite their good work, all hospitals in this study appeared to struggle toadhere to guidelines.Conclusions: If hospitals experience problems with guideline implementation, they tend tofocus more on external expectations, leading to defensive behaviour. Hospitals that do notexperience implementation problems focus more on integrating guidelines into their own policies

Additional Metadata
Keywords Compliance, External demands, Guidelines, Hospitals, Implementation, Regulations, Requirements, Standardization
Persistent URL dx.doi.org/10.1111/jep.12775, hdl.handle.net/1765/100799
Journal Journal of Evaluation in Clinical Practice (Print)
Blume, L.H.K. (Louise H. K.), van Weert, N.J.H.W. (Nico J. H. W.), Busari, J.O.O, Stoopendaal, A.M.V, & Delnoij, D.M.J. (2017). What hospitals need to know about guidelines-A mixed-method analysis of guideline implementation in Dutch hospitals. Journal of Evaluation in Clinical Practice (Print). doi:10.1111/jep.12775