Evaluation of current care effectiveness: a survey of hypertension guideline implementation in Finnish health centres.
OBJECTIVE
To assess the extent and style of implementation of the Hypertension Guideline (HT Guideline) in Finnish primary health centres, and to identify a scale of contrasting implementation styles in the health centres (with the two ends of the scale being referred to as information implementers or disseminators respectively).


METHODS
A cross-sectional study. Development of a questionnaire and criteria for assessing the extent and style of implementation of the HT Guideline.


METHODS
Primary healthcare.


METHODS
All head physicians and senior nursing officers in Finnish health centres (n =290).


METHODS
The extent of adoption of the HT Guideline in health centres and the characteristics associated with the implementation style.


RESULTS
Responses were received from 410 senior medical staff (246 senior nursing officers and 164 head physicians) representing altogether 264 health centres (91%) in Finland. The HT Guideline had been introduced into clinical practice in most health centres (89%). The style of implementation varied widely between health centres: at opposite ends of the implementation scale were 21 implementer health centres, which used multiple implementation channels, and 23 disseminator health centres, which used few or no implementation channels. The implementers had typically larger population bases and had organized services around the family doctor system, while the disseminators were smaller and had organized services according to a traditional model (appointments could be with any doctor in the surgery).


CONCLUSIONS
The Finnish HT Guideline has become well known in most health centres since being introduced into clinical practice. However, the style of implementation varies markedly between health centres.
Alanen
Seija I
SI
Tampere University Hospital, Finland. seija.alanen@pshp.fi
Johannala-Kemppainen
Riitta
R
Ijäs
Jarja J
JJ
Kaila
Minna
M
Klockars
Matti
M
Mäkelä
Marjukka
M
Välimäki
Maritta A
MA
D000959:Antihypertensive Agents / Q000627:therapeutic use; D002983:Clinical Competence; D003151:Community Health Centers; D019091:Critical Pathways; D003430:Cross-Sectional Studies; D019317:Evidence-Based Medicine; D005194:Family Practice; D005260:Female; D005387:Finland; D019983:Guideline Adherence; D006801:Humans; D006973:Hypertension / Q000175:diagnosis / Q000188:drug therapy; D008297:Male; D017063:Outcome Assessment, Health Care; D010353:Patient Education as Topic; D011320:Primary Health Care; D011795:Surveys and Questionnaires
D000959:Antihypertensive Agents