Universal access: But when? Treating the right patient at the right time: Access to cardiac rehabilitation

Dafoe, William; Arthur, Heather M.; Stokes, Helen; Morrin, Louise; Beaton, Louise J.

doi:10.1016/s0828-282x(06)70309-9

Cited by 77 publications

(67 citation statements)

References 35 publications

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“…When put in context, the results of the present study, in combination with the work of others, 14,15 suggest that national guidelines 11,12 should emphasize that an early appointment is preferable in medically stable patients and that long delays should be avoided. In addition, staff for each program should evaluate their program's time interval between hospital discharge and CR enrollment.…”

Section: Discussionsupporting

confidence: 56%

“…11,12 However, the time from hospital discharge to CR enrollment currently averages ≈35 days 13,14 and represents a modifiable factor that could potentially affect participation. Preliminary retrospective studies suggest that for every day of delay between hospital discharge and CR attendance, there is an associated 1% decrease in participation.…”

Section: Clinical Perspective On P 355mentioning

confidence: 99%

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An Early Appointment to Outpatient Cardiac Rehabilitation at Hospital Discharge Improves Attendance at Orientation

et al. 2013

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Background-Outpatient cardiac rehabilitation (CR) decreases mortality rates but is underutilized. Current median time from hospital discharge to enrollment is 35 days. We hypothesized that an appointment within 10 days would improve attendance at CR orientation. Methods and Results-At hospital discharge, 148 patients with a nonsurgical qualifying diagnosis for CR were randomized to receive a CR orientation appointment either within 10 days (early) or at 35 days (standard). The primary end point was attendance at CR orientation. Secondary outcome measures were attendance at ≥1 exercise session, the total number of exercise sessions attended, completion of CR, and change in exercise training workload while in CR. Average age was 60±12 years; 56% of participants were male and 49% were black, with balanced baseline characteristics between groups. Median time (95% confidence interval) to orientation was 8.5 (7-13) versus 42 (35 to NA [not applicable]) days for the early and standard appointment groups, respectively (P<0.001). Attendance rates at the orientation session were 77% (57/74) versus 59% (44/74) in the early and standard appointment groups, respectively, which demonstrates a significant 18% absolute and 56% relative improvement (relative risk, 1.56; 95% confidence interval, 1.03-2.37; P=0.022). The number needed to treat was 5.7. There was no difference (P>0.05) in any of the secondary outcome measures, but statistical power for these end points was low. Safety analysis demonstrated no difference between groups in CR-related adverse events. Conclusions-Early

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Section: Discussionsupporting

confidence: 56%

Section: Clinical Perspective On P 355mentioning

confidence: 99%

An Early Appointment to Outpatient Cardiac Rehabilitation at Hospital Discharge Improves Attendance at Orientation

et al. 2013

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“…The cause and variance between jurisdictions of CR underuse relate to patient and health system factors (23). Factors that have been associated with increased CR referral and attendance are discharge diagnosis of acute myocardial infarction or coronary artery bypass surgery, age less than 65 years, previous participation in CR (24) and male sex (25).…”

Section: Implementation Challengesmentioning

confidence: 99%

The Canadian Heart Health Strategy and Action Plan: Cardiac rehabilitation as an exemplar of chronic disease management

Arthur¹,

Suskin²,

Bayley³

et al. 2010

Canadian Journal of Cardiology

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“…The multidisciplinary nature of the rehabilitation process complicates planning and control. Naturally, the best quality of care is realized when the right treatments are provided at the right time [5]. Rehabilitation care professionals indicate that a short access time [6], a simultaneous start with the various disciplines, and the continuity of the rehabilitation process should be guaranteed.…”

Section: Introductionmentioning

confidence: 99%

Integral multidisciplinary rehabilitation treatment planning

Braaksma

Kortbeek

Post

et al. 2014

Operations Research for Health Care

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This paper presents a methodology to plan treatments for rehabilitation outpatients. These patients require a series of treatments by therapists from various disciplines. In current practice, when treatments are planned, a lack of coordination between the different disciplines, along with a failure to plan the entire treatment plan at once, often occurs. This situation jeopardizes both the quality of care and the logistical performance.The multidisciplinary nature of the rehabilitation process complicates planning and control. An integral treatment planning methodology, based on an integer linear programming (ILP) formulation, ensures continuity of the rehabilitation process while simultaneously controlling seven performance indicators including access times, combination appointments, and therapist utilization. We apply our approach to the rehabilitation outpatient clinic of the Academic Medical Center (AMC) in Amsterdam, the Netherlands. Based on the results of this case, we are convinced that our approach can be valuable for decision-making support in resource capacity planning and control at many rehabilitation

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Universal access: But when? Treating the right patient at the right time: Access to cardiac rehabilitation

Cited by 77 publications

References 35 publications

An Early Appointment to Outpatient Cardiac Rehabilitation at Hospital Discharge Improves Attendance at Orientation

An Early Appointment to Outpatient Cardiac Rehabilitation at Hospital Discharge Improves Attendance at Orientation

The Canadian Heart Health Strategy and Action Plan: Cardiac rehabilitation as an exemplar of chronic disease management

Integral multidisciplinary rehabilitation treatment planning

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