Cardiovascular prevention and rehabilitation: from guidelines to implementation, a novel patient-based initiative from Sweden

According to guidelines from The National Swedish Board of Health and Welfare, cardiovascular prevention and rehabilitation should be available for all coronary patients. Yet, the provision of this service varies considerably between Swedish hospitals. In this paper, an initiative from a patient organisation to improve the quality of cardiac care is presented. Over the past years, the National Heart and Lung Patients’ Association has been engaged in a major staff training and research effort. In assuring the quality of these efforts, hospitals have been audited using a grading system of 1–5 hearts: one heart meaning an unsatisfactory level, five hearts an optimal level of care. An evaluation has shown that the support and grading may have contributed to an improvement of preventive and rehabilitation care, though the ultimate goal of “five hearts for all” still remains to be achieved.