Guidelines are an important instrument for quality enhancement, but their observance is in practice everything except self-evident. About half the members of the Netherlands Society of Occupational Medicine (NVAB) indicate that in daily practice they are not able to implement the guidelines. On these grounds, focus group interviews were conducted with a group of 74 occupational physicians, representative for the membership of the NVAB, in order to investigate the reason why they can or cannot implement the guidelines. The arguments mentioned in the interviews were placed in the following core categories: | Familiarity with the guidelines and incentives for their use. In practice this appears often not to be the case. | Significance. Guidelines offer a touchstone for good professional actions. Often the added value is not appreciated as the guidelines are found to be far removed from daily practice. | Practicability in current daily practice. This is often difficult due to the wide variety of work contexts and to organisational and financial limitations such as exist in companies which have organised the occupational health and safety care according to the selfmanagement model. | The notion of the strictness with which the guidelines should be applied. This determines the occupational physicians' opinions on the applicability of the guidelines. With a view to the diversity of the practical execution and the interweaving with the non-medical organisational environment, a less strict interpretation of the guidelines is advisable and feasible.

Bedrijfsgezondheidszorg, Implementatie, Kwaliteit zorg, Richtlijnen, Visitatie,
Tijdschrift voor Bedrijfs- en Verzekeringsgeneeskunde
Erasmus MC: University Medical Center Rotterdam

Plomp, N, El Markhous, S, & Hermsen, M. (2012). Why the guidelines of the Netherlands Society of Occupational Medicine are not implemented. Qualitative research into the opinions of occupational physicians. Tijdschrift voor Bedrijfs- en Verzekeringsgeneeskunde (Vol. 20, pp. 306–317). doi:10.1007/s12498-012-0147-7