Transcatheter Heart Valve Postprocedural Care: Improving the Cardiac Rehabilitation Referral Process Before Discharge

Cardiac rehabilitation (CR) referral following transcatheter heart valve procedures was suboptimal at a tertiary hospital in Northern California due to the absence of standardized internal processes.

The Society of Thoracic Surgeons and American College of Cardiology Transcatheter Valve Therapy Registry identify documentation of CR referral as a key quality metric. In Q4 2022, a quality-improvement initiative was launched to standardize referrals before discharge for patients undergoing transcatheter heart valve procedures.

A multidisciplinary team implemented a Plan-Do-Study-Act framework to modify workflow changes, including electronic health record optimization and bedside consult protocols. Over 7 quarters, documentation for CR referrals reached and sustained 100% across 530 patients. This initiative aligned institutional practices with evidence-based recommendations and American Association of Cardiovascular and Pulmonary Rehabilitation certification standards.

Key barriers included staffing limitations and documentation inconsistencies, while facilitators included electronic health record optimization, multidisciplinary collaboration, and alignment with certification goals.