Barriers and facilitators to national guideline implementation for palliative cancer care in a Danish cross‐sectoral healthcare setting: A qualitative study of healthcare professionals' experiences

Abstract

ObjectivePatients with incurable cancer should receive general palliative care according to their needs, as provided through collaboration between hospital departments, municipalities, and general practices and as outlined in national guidelines. However, the implementation of general palliative care in Denmark has been inadequate. This study aimed to investigate the healthcare professionals' (HCPs') perceptions on barriers to and facilitators of the implementation of the Danish National Guideline (NG) for general palliative care.MethodsThis descriptive, qualitative study was guided by the Consolidated Framework for Implementation Research (CFIR). Qualitative focus group and individual interviews were conducted with 23 HCPs. The interview guide, coding, analysis, and reporting of findings were developed within the CFIR framework.ResultsThe main barriers to implementing NG were as follows: lack of knowledge about the NG, lack of an implementation plan, and insufficient communication and collaboration across sectors. Important facilitators were as follows: HCP motivation to meet palliative care needs, HCPs with special functions taking responsibility for incorporating NG into local guidelines, and the role of district nurses specialised in palliative care as opinion leaders providing security and continuity for the HCPs working in palliative care.ConclusionsTo address the needs of patients with incurable cancer, greater efforts are required on implementing general palliative care. Although HCPs in our setting were motivated to improve NG implementation, financial resources and strategies are necessary to ensure sufficient knowledge uptake and accommodate identified barriers in order to translate the NG into practice.

Implementation science and psycho‐oncology: Advancing the translation of evidence into practice

“…3 In this issue, three papers explore barriers and facilitators across the topics of self-management support programs, 5 colorectal cancer survivors' experiences of shared care and telehealth models 6 and implementation of a national guideline for palliative care. 7 Interestingly, while these studies have been conducted in different contexts-Ireland, Australia and Denmark-there are notable similarities across barriers. In the Danish study of healthcare professionals 'lack of knowledge' about the national palliative care guideline was found to significantly impact guideline utility.…”