Cardiac Rehabilitation

Cardiac Rehabilitation Department

The Cardiac Rehabilitation Department provides inpatient and outpatient cardiac rehabilitation services, including evaluation, treatment, and education. The department is also responsible for cardiac stress testing.

Patient Care Practice Guidelines

The American Association of Cardiovascular and Pulmonary Rehabilitation has standards that are incorporated into patient care policies and procedures.

Scope of Services

Services provided by the department include:

1. Interview patients appropriate for cardiac rehabilitation and assess risk factors, medical and physical status, learning needs, and goals of treatment.
2. Conduct monitored exercise training program according to exercise prescription as determined by staff and program policies.
3. Assist physician with exercise and chemical stress testing.
4. Recognize and interpret cardiac dysrhythmia and modify exercise appropriately.
5. Respond to emergency situations appropriately per ACLS standards.
6. Assess patient as each exercise session and report changes in patient status to the physician.
7. Inform physician of patient progress through monthly reports.
8. Conduct patient/family education sessions and programs, including home exercise routines, equipment, dietary modification, stress management, recognition of signs and symptoms, etc. In-patient assessment, education, and progressive monitored exercise.
9. In-patient assessment, education, and progressive monitored exercise.

Cardiac or Coronary Artery Disease

The department serves all adult patients with known cardiac or coronary artery disease. The primary diagnoses of patients served are: myocardial infarction (heart attack), coronary artery bypass grafting, angioplasty with and without stent placement, stable angina, and those that have had heart valve replacement or repair, and some patients with cardiomyopathy, and some with congestive heart failure. Patients may have secondary (additionally to their cardiac diagnosis) diagnoses of peripheral vascular disease, diabetes, lung disease, stroke, obesity, arthritis, musculoskeletal and neurological problems, and/or renal failure.

In the case of a patient requiring care that is beyond the normal scope of the department, patients may be transported to the Emergency Department as directed by their physician. Patients requiring information on counseling beyond the expertise of the staff are referred to the appropriate practitioner.

Evaluation of Patient Care Services and Quality

The quality of patient care and service is monitored through QA and CQI monitors. Patients have the opportunity to evaluate the program regarding the environment, equipment, staff competency, courtesy, availability of educational material and more. Input from physicians and other healthcare entities are utilized in development of plan of treatment. The department's policies and procedures are evaluated and approved by the medical director prior to implementation.

Interdepartmental Collaboration

Other departments with which we collaborate include:

1. Nursing, through responsiveness to referrals, scheduling of stress tests, and reporting of results of interventions to the patient's primary nurse.
2. Diagnostic imaging, through diagnostic testing with radioisotopes or ultrasound.
3. Pharmacy, through provision of drugs required for stress testing and emergency procedures.
4. Physical Therapy and Dietary, through referral of appropriate patients for evaluation.

Identification of Patient Care Needs

The following mechanisms are utilized to identify patient care needs:

• Initial interview - establish goals and identify cardiovascular risk factors
• Review of exercise stress test results and medical records pertaining to cardiovascular status
• Review of test results including laboratory values for cholesterol and lipid levels
• Review of medications.
• Evaluation of risk factors and guidelines for reduction or modification of risk factors.

Ongoing needs are assessed through review of the patient's progress during each session and at the time of the monthly progress report to physicians.

Staffing Plan

All staffing is variable and is dependent upon patient volume. Department staff includes specialists from the fields of nursing, physical therapy, exercise physiology, and respiratory therapy.

For more information call (805) 489- 4261 Ext. 4276