{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,25]],"date-time":"2026-09-25T22:44:57Z","timestamp":1790376297453,"version":"4.1.0"},"reference-count":42,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2020,8,20]],"date-time":"2020-08-20T00:00:00Z","timestamp":1597881600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2020,8,20]],"date-time":"2020-08-20T00:00:00Z","timestamp":1597881600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Health Serv Res"],"published-print":{"date-parts":[[2020,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>A policy statement recommending that healthcare providers (HCPs) encourage cardiac patients to enroll in cardiac rehabilitation (CR) was recently endorsed by 23 medical societies. This study describes the development and evaluation of a guideline implementation tool.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Methods<\/jats:title>\n                <jats:p>A stepwise multiple-method study was conducted. Inpatient cardiac HCPs were recruited between September 2018\u2013May 2019 from two academic hospitals in Toronto, Canada. First, HCPs were observed during discharge discussions with patients to determine needs. Results informed selection and development of the tool by the multidisciplinary planning committee, namely an online course. It was pilot-tested with target users through a think-aloud protocol with subsequent semi-structured interviews, until saturation was achieved. Results informed refinement before launching the course. Finally, to evaluate impact, HCPs were surveyed to test whether knowledge, attitudes, self-efficacy and practice changed from before watching the course, through to post-course and 1\u2009month later.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Results<\/jats:title>\n                <jats:p>Seven nurses (71.4% female) were observed. Five (62.5%) initiated dialogue about CR, which lasted on average 12\u2009s. Patients asked questions, which HCPs could not answer. The planning committee decided to develop an online course to reach inpatient cardiac HCPs, to educate them on how to encourage patients to participate in CR at the bedside. The course was pilot-tested with 5 HCPs (60.0% nurse-practitioners). Revisions included providing evidence of CR benefits and clarification regarding pre-CR stress test screening. HCPs did not remember the key points to convey, so a downloadable handout was embedded for the point-of-care. The course was launched, with the surveys. Twenty-four HCPs (83.3% nurses) completed the pre-course survey, 21 (87.5%) post, and 9 (37.5%) 1\u2009month later. CR knowledge increased from pre (mean\u2009=\u20092.71\u2009\u00b1\u20090.95\/5) to post-course (mean\u2009=\u20094.10\u2009\u00b1\u20090.62; <jats:italic>p<\/jats:italic>\u2009\u2264\u2009.001), as did self-efficacy in answering patient CR questions (mean\u2009=\u20092.29\u2009\u00b1\u20090.95\/5 pre and 3.67\u2009\u00b1\u20090.58 post; <jats:italic>p<\/jats:italic>\u2009\u2264\u20090.001). CR attitudes were significantly more positive post-course (mean\u2009=\u20094.13\u2009\u00b1\u20090.95\/5 pre and 4.62\u2009\u00b1\u20090.59 post; <jats:italic>p<\/jats:italic>\u2009\u2264\u20090.05). With regard to practice, 8 (33.3%) HCPs reported providing patients CR handouts pre-course at least sometimes or more, and 6 (66.7%) 1\u2009month later.<\/jats:p>\n              <\/jats:sec><jats:sec>\n                <jats:title>Conclusions<\/jats:title>\n                <jats:p>Preliminary results support broader dissemination, and hence a genericized version has been created (<jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/learnonthego.ca\/Courses\/promoting_patient_participation_in_CR_2020\/promoting_patient_participation_in_CR_2020EN\/story_html5.html\">http:\/\/learnonthego.ca\/Courses\/promoting_patient_participation_in_CR_2020\/promoting_patient_participation_in_CR_2020EN\/story_html5.html<\/jats:ext-link>). Continuing education credits have been secured.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12913-020-05619-2","type":"journal-article","created":{"date-parts":[[2020,8,20]],"date-time":"2020-08-20T05:26:04Z","timestamp":1597901164000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Implementing recommendations for inpatient healthcare provider encouragement of cardiac rehabilitation participation: development and evaluation of an online course"],"prefix":"10.1186","volume":"20","author":[{"given":"Carolina","family":"Santiago de Ara\u00fajo Pio","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Gagliardi","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Neville","family":"Suskin","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Farah","family":"Ahmad","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7063-3610","authenticated-orcid":false,"given":"Sherry L.","family":"Grace","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2020,8,20]]},"reference":[{"key":"5619_CR1","unstructured":"World Health Organization. Cardiovascular Diseases (CVDs) [Internet]. 2017. Available from: www.who.int\/news-room\/fact-sheets\/detail\/cardiovascular-diseases-(cvds) [cited 2019 11 May]."},{"issue":"2 Suppl","key":"5619_CR2","first-page":"S36","volume":"15","author":"DM Kolansky","year":"2009","unstructured":"Kolansky DM. Acute coronary syndromes: morbidity, mortality, and pharmacoeconomic burden. Am J Manag Care. 2009;15(2 Suppl):S36\u201341.","journal-title":"Am J Manag Care"},{"issue":"1","key":"5619_CR3","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.jacc.2017.04.052","volume":"70","author":"GA Roth","year":"2017","unstructured":"Roth GA, Johnson C, Abajobir A, Abd-Allah F, Abera SF, Abyu G, et al. Global, regional, and National Burden of cardiovascular diseases for 10 causes, 1990 to 2015. J Am Coll Cardiol. 2017;70(1):1\u201325.","journal-title":"J Am Coll Cardiol"},{"issue":"6","key":"5619_CR4","doi-asserted-by":"publisher","first-page":"e195","DOI":"10.1016\/S0828-282X(09)70098-4","volume":"25","author":"J-E Tarride","year":"2009","unstructured":"Tarride J-E, Lim M, DesMeules M, Luo W, Burke N, O\u2019Reilly D, et al. A review of the cost of cardiovascular disease. Can J Cardiol. 2009;25(6):e195\u2013202.","journal-title":"Can J Cardiol"},{"issue":"17","key":"5619_CR5","doi-asserted-by":"publisher","first-page":"1403","DOI":"10.1136\/heartjnl-2017-312809","volume":"104","author":"GE Shields","year":"2018","unstructured":"Shields GE, Wells A, Doherty P, Heagerty A, Buck D, Davies LM. Cost-effectiveness of cardiac rehabilitation: A systematic review. Heart. 2018;104(17):1403\u201310.","journal-title":"Heart."},{"issue":"3","key":"5619_CR6","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.pcad.2016.08.004","volume":"59","author":"SL Grace","year":"2016","unstructured":"Grace SL, Turk-Adawi KI, Contractor A, Atrey A, Campbell NRC, Derman W, et al. Cardiac rehabilitation delivery model for low-resource settings: an International Council of Cardiovascular Prevention and Rehabilitation consensus statement. Prog Cardiovasc Dis. 2016;59(3):1\u201320.","journal-title":"Prog Cardiovasc Dis"},{"issue":"1","key":"5619_CR7","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1016\/j.jacc.2015.10.044","volume":"67","author":"L Anderson","year":"2016","unstructured":"Anderson L, Oldridge N, Thompson DR, Zwisler A-D, Rees K, Martin N, et al. Exercise-based cardiac rehabilitation for coronary heart disease: Cochrane systematic review and meta-analysis. J Am Coll Cardiol. 2016;67(1):1\u201312.","journal-title":"J Am Coll Cardiol"},{"issue":"5","key":"5619_CR8","doi-asserted-by":"publisher","first-page":"320","DOI":"10.1016\/j.hrtlng.2013.07.001","volume":"42","author":"S Brady","year":"2013","unstructured":"Brady S, Purdham D, Oh P, Grace S. Clinical and sociodemographic correlates of referral for cardiac rehabilitation following cardiac revascularization in Ontario. Hear Lung. 2013;42(5):320\u20135.","journal-title":"Hear Lung"},{"key":"5619_CR9","doi-asserted-by":"publisher","first-page":"95","DOI":"10.1016\/j.ahj.2016.04.002","volume":"178","author":"RW Harrison","year":"2016","unstructured":"Harrison RW, Simon D, Miller AL, De Lemos JA, Peterson ED, Wang TY. Association of hospital myocardial infarction volume with adherence to American College of Cardiology\/American Heart Association performance measures: insights from the National Cardiovascular Data Registry. Am Heart J. 2016;178:95\u2013101.","journal-title":"Am Heart J"},{"key":"5619_CR10","doi-asserted-by":"publisher","first-page":"1899","DOI":"10.1161\/CIRCULATIONAHA.117.029471","volume":"137","author":"AL Beatty","year":"2018","unstructured":"Beatty AL, Truong M, Schopfer DW, Shen H, Bachmann JM, Whooley MA. Geographic variation in cardiac rehabilitation participation in medicare and veterans affairs populations: an opportunity for improvement? Circulation. 2018;137:1899\u2013908.","journal-title":"Circulation."},{"issue":"6","key":"5619_CR11","doi-asserted-by":"publisher","first-page":"636","DOI":"10.1177\/2047487315569401","volume":"23","author":"K Kotseva","year":"2016","unstructured":"Kotseva K, Wood D, De Bacquer D, De Backer G, Ryd\u00e9n L, Jennings C, et al. EUROASPIRE IV: A European Society of Cardiology survey on the lifestyle, risk factor and therapeutic management of coronary patients from 24 European countries. Eur J Prev Cardiol. 2016;23(6):636\u201348.","journal-title":"Eur J Prev Cardiol"},{"issue":"4","key":"5619_CR12","first-page":"270","volume":"87","author":"H Ilarraza-Lomel\u00ed","year":"2017","unstructured":"Ilarraza-Lomel\u00ed H, Garc\u00eda-Saldivia M, Rojano-Castillo J, Justiniano S, Cer\u00f3n N, Aranda-Ayala ZL, et al. National registry of cardiac rehabilitation programs in Mexico II (Renaprec II). Arch Cardiol Mex. 2017;87(4):270\u20137.","journal-title":"Arch Cardiol Mex"},{"issue":"10","key":"5619_CR13","doi-asserted-by":"publisher","first-page":"948","DOI":"10.1177\/0269215513481046","volume":"27","author":"AM Clark","year":"2013","unstructured":"Clark AM, King-shier KM, Spaling MA, Duncan AS, Stone JA, Susan B, et al. Factors influencing participation in cardiac rehabilitation programmes after referral and initial. Clin Rehabil. 2013;27(10):948\u201359.","journal-title":"Clin Rehabil"},{"key":"5619_CR14","first-page":"CD007131","volume":"2","author":"C Santiago de Ara\u00fajo Pio","year":"2019","unstructured":"Santiago de Ara\u00fajo Pio C, Chaves GS, Davies P, Taylor RS, Grace SL. Interventions to promote patient utilisation of cardiac rehabilitation. Cochrane Database Syst Rev. 2019;2:CD007131.","journal-title":"Cochrane Database Syst Rev"},{"issue":"6","key":"5619_CR15","first-page":"209","volume":"11","author":"C Santiago de Araujo Pio","year":"2019","unstructured":"Santiago de Araujo Pio C, Beckie T, Sarrafzadegan N, Babu A, Baidya S, Buckley J, et al. Promoting patient utilization of outpatient cardiac rehabilitation: A joint international council and Canadian Association of Cardiovascular Prevention and Rehabilitation position statement. Int J Cardiol. 2019;11(6):209\u201328.","journal-title":"Int J Cardiol"},{"issue":"2","key":"5619_CR16","doi-asserted-by":"publisher","first-page":"79","DOI":"10.1097\/HCR.0000000000000474","volume":"40","author":"C Santiago De Ara\u00fajo Pio","year":"2020","unstructured":"Santiago De Ara\u00fajo Pio C, Beckie TM, Varnfield M, Sarrafzadegan N, Babu AS, Baidya S, et al. Promoting patient utilization of outpatient cardiac rehabilitation:A joint international council and Canadian Association of Cardiovascular Prevention and Rehabilitation Position Statement. J Cardiopulm Rehabil Prev. 2020;40(2):79\u201386.","journal-title":"J Cardiopulm Rehabil Prev."},{"issue":"1","key":"5619_CR17","first-page":"8","volume":"2","author":"RG Tabak","year":"2013","unstructured":"Tabak RG, Khoong EC, Chambers D, Brownson RC. Models in dissemination and implementation research: useful tools in public health services and systems research. Front Public Heal Serv Syst Res. 2013;2(1):8.","journal-title":"Front Public Heal Serv Syst Res"},{"key":"5619_CR18","first-page":"CD010669","volume":"8","author":"G Flodgren","year":"2016","unstructured":"Flodgren G, Hall AM, Goulding L, Eccles MP, Grimshaw JM, Leng GC, et al. Tools developed and disseminated by guideline producers to promote the uptake of their guidelines. Cochrane Database Syst Rev. 2016;8:CD010669.","journal-title":"Cochrane Database Syst Rev"},{"key":"5619_CR19","doi-asserted-by":"publisher","first-page":"E839","DOI":"10.1503\/cmaj.090449","volume":"182","author":"MC Brouwers","year":"2010","unstructured":"Brouwers MC, Browman G, Cluzeau F, Davis D, Feder G, Graham I, et al. AGREE II: advancing guideline development, reporting and evaluation in healthcare. Can Med Assoc J. 2010;182:E839\u201342.","journal-title":"Can Med Assoc J"},{"key":"5619_CR20","unstructured":"Institute of Medicine. Standards for Developing Trustworthy Clinical Practice Guidelines. Washington, D.C.; 2011."},{"issue":"3","key":"5619_CR21","doi-asserted-by":"publisher","first-page":"E123","DOI":"10.1503\/cmaj.131237","volume":"186","author":"HJ Schunemann","year":"2014","unstructured":"Schunemann HJ, Wiercioch W, Etxeandia I, Falavigna M, Santesso N, Mustafa R, et al. Guidelines 2.0: systematic development of a comprehensive checklist for a successful guideline enterprise. Can Med Assoc J. 2014 Feb 18;186(3):E123\u201342.","journal-title":"Can Med Assoc J"},{"issue":"1","key":"5619_CR22","first-page":"E127","volume":"3","author":"AR Gagliardi","year":"2015","unstructured":"Gagliardi AR, Brouwers MC, Bhattacharyya OK. The development of guideline implementation tools: a qualitative study. Can Med Assoc J Open. 2015;3(1):E127\u201333.","journal-title":"Can Med Assoc J Open"},{"issue":"3","key":"5619_CR23","doi-asserted-by":"publisher","first-page":"36","DOI":"10.3390\/healthcare4030036","volume":"4","author":"F Fischer","year":"2016","unstructured":"Fischer F, Lange K, Klose K, Greiner W, Kraemer A. Barriers and strategies in guideline implementation\u2014A scoping review. Healthcare. 2016;4(3):36.","journal-title":"Healthcare."},{"key":"5619_CR24","doi-asserted-by":"publisher","first-page":"418","DOI":"10.1136\/bmj.315.7105.418","volume":"315","author":"R Grol","year":"1997","unstructured":"Grol R. Beliefs and evidence in changing clinical practice. BMJ. 1997;315:418\u201321.","journal-title":"BMJ."},{"issue":"1","key":"5619_CR25","doi-asserted-by":"publisher","first-page":"9","DOI":"10.1186\/1471-2458-11-9","volume":"11","author":"F Zwerver","year":"2011","unstructured":"Zwerver F, Schellart AJ, Anema JR, Rammeloo KC, van der Beek AJ. Intervention mapping for the development of a strategy to implement the insurance medicine guidelines for depression. BMC Public Health. 2011;11(1):9.","journal-title":"BMC Public Health"},{"key":"5619_CR26","unstructured":"Bartolomew LK, Parcel GS, Kok G, Gottlieb N. Designing theory and evidence-based health promotion programs. In: intervention mapping. Columbus, OH: Mountain View; 2001."},{"issue":"1","key":"5619_CR27","first-page":"54","volume":"50","author":"D Kirkpatrick","year":"1996","unstructured":"Kirkpatrick D. Great ideas revisited: revisiting Kirkpatrick\u2019s four-level model. Train Dev. 1996;50(1):54\u20139.","journal-title":"Train Dev"},{"issue":"4","key":"5619_CR28","doi-asserted-by":"publisher","first-page":"140","DOI":"10.1002\/j.2048-7940.2005.tb00097.x","volume":"30","author":"PR Mitoff","year":"2005","unstructured":"Mitoff PR, Wesolowski M, Abramson BL, Grace SL. Patient-provider communication regarding referral to cardiac rehabilitation. Rehabil Nurs. 2005;30(4):140\u20136.","journal-title":"Rehabil Nurs"},{"issue":"9","key":"5619_CR29","doi-asserted-by":"publisher","first-page":"924","DOI":"10.2340\/16501977-1852","volume":"46","author":"S Pourhabib","year":"2014","unstructured":"Pourhabib S, Kentner AC, Grace SL. The impact of patient-healthcare provider discussions on enrollment in cardiovascular rehabilitation. J Rehabil Med. 2014;46(9):924\u201331.","journal-title":"J Rehabil Med"},{"issue":"6998","key":"5619_CR30","doi-asserted-by":"publisher","first-page":"182","DOI":"10.1136\/bmj.311.6998.182","volume":"311","author":"N Mays","year":"1995","unstructured":"Mays N, Pope C. Qualitative research: observational methods in health care settings. BMJ. 1995;311(6998):182\u20134.","journal-title":"BMJ."},{"issue":"1","key":"5619_CR31","doi-asserted-by":"publisher","first-page":"136","DOI":"10.1186\/s13012-017-0668-7","volume":"12","author":"L Liang","year":"2017","unstructured":"Liang L, Abi Safi J, Gagliardi AR. Number and type of guideline implementation tools varies by guideline, clinical condition, country of origin, and type of developer organization: content analysis of guidelines. Implement Sci. 2017;12(1):136.","journal-title":"Implement Sci"},{"issue":"1","key":"5619_CR32","doi-asserted-by":"publisher","first-page":"98","DOI":"10.1186\/s13012-014-0098-8","volume":"9","author":"AR Gagliardi","year":"2014","unstructured":"Gagliardi AR, Brouwers MC, Bhattacharyya OK. A framework of the desirable features of guideline implementation tools (GItools): Delphi survey and assessment of GItools. Implement Sci. 2014;9(1):98.","journal-title":"Implement Sci"},{"issue":"4","key":"5619_CR33","doi-asserted-by":"publisher","first-page":"514","DOI":"10.1080\/2159676X.2017.1331501","volume":"9","author":"DW Eccles","year":"2017","unstructured":"Eccles DW, Arsal G. The think aloud method: what is it and how do I use it? Qual Res Sport Exerc Heal. 2017;9(4):514\u201331.","journal-title":"Qual Res Sport Exerc Heal"},{"issue":"3","key":"5619_CR34","first-page":"173","volume":"1","author":"TD Wilson","year":"1981","unstructured":"Wilson TD, Streatfield DR. Structured observation in the investigation of information needs. Soc Sci Inf Stud. 1981;1(3):173\u201384.","journal-title":"Soc Sci Inf Stud"},{"issue":"1","key":"5619_CR35","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1111\/j.1365-2648.2007.04569.x","volume":"62","author":"S Elo","year":"2008","unstructured":"Elo S, Kyng\u00e4s H. The qualitative content analysis process. J Adv Nurs. 2008;62(1):107\u201315.","journal-title":"J Adv Nurs"},{"issue":"4","key":"5619_CR36","doi-asserted-by":"publisher","first-page":"430","DOI":"10.1177\/104973239300300403","volume":"3","author":"ME Fonteyn","year":"1993","unstructured":"Fonteyn ME, Kuipers B, Grobe SJ. A description of think aloud method and protocol analysis. Qual Health Res. 1993;3(4):430\u201341.","journal-title":"Qual Health Res"},{"key":"5619_CR37","doi-asserted-by":"crossref","unstructured":"Hutchison P, Monaghan I, Morgan R. A multidimensional analysis method for think-aloud protocol data: Physics Education Research Conference Proceedings. American Association of Physics Teachers; 2015. p. 147\u201350.","DOI":"10.1119\/perc.2015.pr.032"},{"issue":"2","key":"5619_CR38","doi-asserted-by":"publisher","first-page":"1","DOI":"10.26522\/brocked.v12i2.38","volume":"12","author":"E Charters","year":"2003","unstructured":"Charters E. The use of think-aloud methods in qualitative research an introduction to think-aloud methods. Brock Educ J. 2003;12(2):1\u201315.","journal-title":"Brock Educ J"},{"issue":"597","key":"5619_CR39","doi-asserted-by":"publisher","first-page":"213","DOI":"10.3399\/bjgp12X636236","volume":"62","author":"G Naik","year":"2012","unstructured":"Naik G, Ahmed H, Edwards AG. Communicating risk to patients and the public. Br J Gen Pract. 2012;62(597):213\u20136.","journal-title":"Br J Gen Pract"},{"issue":"1","key":"5619_CR40","doi-asserted-by":"publisher","first-page":"45","DOI":"10.1186\/1748-5908-3-45","volume":"3","author":"T Turner","year":"2008","unstructured":"Turner T, Misso M, Harris C, Green S. Development of evidence-based clinical practice guidelines (CPGs): comparing approaches. Implement Sci. 2008;3(1):45.","journal-title":"Implement Sci"},{"issue":"4","key":"5619_CR41","doi-asserted-by":"publisher","first-page":"226","DOI":"10.1097\/HCR.0000000000000396","volume":"39","author":"M Moghei","year":"2019","unstructured":"Moghei M, Oh P, Chessex C, Grace SL. Cardiac rehabilitation quality improvement: A narrative review. J Cardiopulm Rehabil Prev. 2019 Jan;39(4):226\u201334.","journal-title":"J Cardiopulm Rehabil Prev"},{"issue":"12","key":"5619_CR42","doi-asserted-by":"publisher","first-page":"1454","DOI":"10.1016\/j.pec.2015.05.015","volume":"98","author":"JE Sansoni","year":"2015","unstructured":"Sansoni JE, Grootemaat P, Duncan C. Question prompt lists in health consultations: A review. Patient Educ Couns. 2015;98(12):1454\u201364.","journal-title":"Patient Educ Couns"}],"container-title":["BMC Health Services Research"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12913-020-05619-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12913-020-05619-2\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12913-020-05619-2.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,8,19]],"date-time":"2021-08-19T23:33:15Z","timestamp":1629415995000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmchealthservres.biomedcentral.com\/articles\/10.1186\/s12913-020-05619-2"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,8,20]]},"references-count":42,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2020,12]]}},"alternative-id":["5619"],"URL":"https:\/\/doi.org\/10.1186\/s12913-020-05619-2","relation":{},"ISSN":["1472-6963"],"issn-type":[{"value":"1472-6963","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,8,20]]},"assertion":[{"value":"2 December 2019","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"3 August 2020","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 August 2020","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"On the basis of the A pRoject Ethics Community Consensus Initiative (ARECCI; ) tool, an ethics waiver was granted by the University Health Network research ethics board, and then York University\u2019s Office of Research Ethics, as this was a quality improvement initiative. Procedures outlined to minimize and mitigate ethical risks (e.g., privacy \/ confidentiality; data storage \/security; informed consent) were strictly followed. All HCPs voluntarily agreed to participate and verbal consent was obtained. Written consent was not required by the ethics board considering also participants were providers and that the project was minimal risk. All patients observed also voluntarily agreed to participation, after the purpose of the observation was explained to them (except we focused on the full discharge discussion, rather than CR specifically), and they remained anonymous.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"Not applicable.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare that they have no competing interests related to this study.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"768"}}