Cardiac rehabilitation: beginning at the bedside

Area of Science:

• Cardiology
• Healthcare Management
• Patient Care

Background:

• Cardiac rehabilitation (CR) offers significant benefits but suffers from low utilization.
• Referral bias contributes to underutilization, necessitating improved referral processes.
• Automatic referral systems aim to ensure all eligible patients are offered CR.

Purpose of the Study:

• To describe the implementation of a nurse-delivered automatic bedside referral process for CR.
• To evaluate the effectiveness of this process on CR referral and intake rates.

Main Methods:

• An automatic CR referral system was implemented in 2007, with a nurse-delivered bedside process introduced in 2008.
• A CR nurse screened patients, discussed benefits, triaged, and booked intake appointments.
• Data were collected and analyzed to assess the impact on participation rates.

Main Results:

• Pre-2006 CR participation ranged from 15.5% to 19.7%.
• An automatic referral process increased participation to 26.7%.
• The nurse-delivered bedside process further increased participation to 32.6%, with referral rates rising from 26.7% to 79.0%.

Conclusions:

• A nurse-delivered automatic bedside referral process positively impacted CR referral and intake.
• Future CR programs must manage increased participation and ensure optimal engagement.
• This model demonstrates a successful strategy to overcome CR underutilization.