Evidence map›Paper›PMID 41651533›Full record

ArticleBMJ open2026

Development of a resilience assessment tool for cardiac care pathways in Europe: a mixed-methods study.

Ana Sofia V Carvalho, Óscar Brito Fernandes, Jan J Piek, Josepa Mauri, Ariadna Sanz Escartin, William Wijns, Niek Klazinga, Dionne Kringos

Abstract read
In one paragraph

Article in BMJ open, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Ana Sofia V CarvalhoPublic and Occupational Health, Amsterdam UMC Locatie AMC, Amsterdam, The Netherlands a.s.carvalho@amsterdamumc.nl.ORCID http://orcid.org/0000-0002-1640-9957
Óscar Brito FernandesPublic and Occupational Health, Amsterdam UMC Locatie AMC, Amsterdam, The Netherlands.ORCID http://orcid.org/0000-0002-3212-373X
Jan J PiekDepartment of Clinical and Experimental Cardiology, Amsterdam Cardiovascular Sciences, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands.ORCID http://orcid.org/0009-0003-0681-5534
Josepa MauriGeneralitat de Catalunya Servei Català de la Salut, Barcelona, Spain.
Ariadna Sanz EscartinGeneralitat de Catalunya Servei Català de la Salut, Barcelona, Spain.ORCID http://orcid.org/0000-0001-6648-7438
William WijnsLambe Institute for Translational Medicine, University of Galway, Galway, Ireland.ORCID http://orcid.org/0000-0002-7267-4376
Niek KlazingaPublic and Occupational Health, Amsterdam UMC Locatie AMC, Amsterdam, The Netherlands.
Dionne KringosPublic and Occupational Health, Amsterdam UMC Locatie AMC, Amsterdam, The Netherlands.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesTo develop a resilience assessment tool for cardiac care pathways in Europe, informed by stakeholder insights on the impact of COVID-19, emerging innovations and recommendations to enhance resilience.

designMixed-methods study comprising three phases: (1) survey among European cardiac care providers; (2) five multistakeholder focus groups and (3) participatory tool development. Quantitative data were analysed using descriptive statistics, and qualitative data were analysed thematically.

settingThe survey targeted cardiology professionals from the 27 European Union Member States and Ukraine who worked during the COVID-19 pandemic. Focus group participants were purposefully sampled to represent clinical, organisational and policy perspectives.

participantsA total of 177 survey respondents and 40 informants in focus groups.

resultsSix key resilience dimensions of cardiac care pathways were identified: workforce, organisation of care delivery, governance and trust, communication and cooperation, medical devices and products, and data collection and use. Staff shortages and infrastructure capacity were key challenges during the pandemic. The most frequent measures were the reallocation of health staff (75%; n=133) and repurposing infrastructures (38%; n=32). Participants discussed the six resilience dimensions around a total of 17 subdimensions and 39 recommended actions to enhance resilience were identified. The resulting resilience assessment tool included four components: (1) mapping a context-specific cardiac care pathway; (2) stakeholder identification critical to participate in collective self-assessment; (3) a preparedness checklist generating a visual heat map and (4) a resource toolkit.

conclusionsThe resilience assessment tool offers step-by-step guidance to strengthening cardiac care pathways across six key resilience dimensions, supported by actionable recommendations. The tool enables the identification of context-specific vulnerabilities and improvement priorities, thereby supporting healthcare professionals and policymakers in enhancing preparedness and ensuring care continuity before, during and after crises. Its implementation is currently being piloted in European hospitals to evaluate and refine its practical applicability.

Indexed as

CardiologyCOVID-19Critical PathwaysHealth PersonnelResilience, PsychologicalDelivery of Health CareEuropeFemaleFocus GroupsHumansMalePandemicsSARS-CoV-2Surveys and QuestionnairesCardiologyCardiovascular DiseaseDelivery of Health Care, IntegratedHEALTH SERVICES ADMINISTRATION & MANAGEMENTQuality in health care

Identifiers

PMID41651533
PMCPMC12887496

What Socratic holds

Textmetadata
LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.