The Montana cardiac rehabilitation regional outcomes project

Outcomes evaluation is a critical component in early outpatient cardiac rehabilitation (CR). The goal of this project was to develop a regional CR outcomes program to help facilitate quality improvement.

The Montana Outcomes Project initiated data collection on a uniform set of outcomes indicators. Each participating program submitted de-identified data for analysis on a quarterly basis. Results were sent back to each program with its individual program data plotted against the regional mean.

Year 1 data collection included outcomes information from 22 facilities and 850 patients. Mean age was 68 years, 96% were white, 68% were men, and the mean number of CR visits was 24. The mean resting blood pressure at program completion was 118/68 mm Hg, with 90% of patients meeting criteria for blood pressure control (<140/90 or <130/80 mm Hg for patients at high risk). Mean low-density lipoprotein was 87 mg/dL; 94% were on lipid-lowering medications; and 73% achieved low-density lipoprotein values of less than 100 mg/dL. Upon program completion, significant improvements (P < .001) were noted in prescore versus postscore for functional capacity measured by the Duke Activity Status Index (5.5 metabolic equivalents vs 7.3 metabolic equivalents), Medical Outcomes Study SF-36 Health Status Questionnaire physical (36.9 vs 45.8) and mental (47.2 vs 52.2) composite scores, Dartmouth Primary Care Cooperative questionnaire (22 vs 15.9), and fat intake measured by the Block Dietary Fat Screener (19.6 vs 14.7).

Our findings suggest that the development of a regional CR outcomes project is feasible and could aid in the development of quality improvement projects.