Cardiac Rehabilitation a work in progress

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Charla Singleton
10 years ago
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1 Poster Session HRT11420 Innovation Awards November 2014 Melbourne Cardiac Rehabilitation a work in progress Presenter(s): Kylie Fisher Hospital Code Name: Western Health

2 Wait times to commence a Cardiac Rehabilitation Program decreased from 5-6 weeks to within 2 weeks of discharge for patients presenting to Western Health with ST elevation AMI.

3 Presenters Summary Western Health was not meeting best the practice guidelines for Cardiac rehabilitation for patients post a cardiac event. AIM : to reduce the current wait times for cardiac patients weeks before commencing a cardiac rehabilitation, and to have enrolment to a cardiac rehabilitation program determined by need, risk or urgency rather than by postcode. This was achieved by Design of a new referral form/tool for cardiac rehab reflecting selection criteria for appropriateness, risk assessment and priority. Patients are now triaged depending on acuity Patients attending Cardiac rehab at Footscray and Williamstown now commence the program within 1 week of having their initial assessment. Patients at Sunshine now have their initial assessment at around 17 days post discharge, however they have to wait a further 5weeks prior to commencing their rehab programs as they are at full capacity.

4 KEY PROBLEM Western Health was not meeting best the practice guidelines for Cardiac rehabilitation for patients post a cardiac event. Patients were waiting 4-6 weeks before being assessed and commencing the outpatient cardiac rehabilitation program. The wait time to enrolment in a cardiac rehabilitation program was campus specific. And the waiting time to appointment and enrolment into cardiac rehab was determined by postcode...not by need, risk or urgency!

5 AIM OF THIS INNOVATION Improvement Sought To reduce the current wait times for cardiac patients from 4-6 weeks before being assessed and commencing the outpatient cardiac rehabilitation program to 1-2 weeks, incompliance with current best practice guidelines. To have appointments and enrolment to a cardiac rehabilitation program determined by need, risk or urgency rather than by postcode. Improve work flow processes for Cardiac rehabilitation referrals across the divisions.

6 BASELINE DATA - OUR AIM : Improved access to cardiac rehabilitation service to all Western Health patients 7 Previous Cardiac Rehab appointment wait times by campus WEEKS weeks 5-6 weeks 4 weeks 2 Goal 2 weeks Goal 2 weeks Goal 2 weeks 1 0 Footscray Sunshine Williamstown

7 KEY CHANGES IMPLEMENTED Update the clinical pathway as a tool for all nursing, medical and allied health to reflect the needs of the Cardiac Patient for early enrolment and participation in a Cardiac Rehabilitation program. Design a new referral form/tool for cardiac rehab reflecting selection criteria for appropriateness to attend cardiac rehab, on risk assessment and priority.

triage cardiac patients according to risk and that takes into

8 KEY CHANGES IMPLEMENTED The Design of a new rehabilitation referral tool has enabled CCU nursing staff to effectively triage cardiac patients according to risk and that takes into account selection criteria for appropriate cardiac rehab enrolment

9 OUTCOMES SO FAR 7 Current Cardiac rehab wait times to first appointment by campus weeks weeks WEEKS weeks PREVIOUS CURRENT TARGET 2 2 weeks 1 1 week 1 week 0 Footscray Sunshine Williamstown

10 LESSONS LEARNT Work is ongoing to further improve the rehabilitation referral process. The current paper referral system has room for error, causing it to be inefficient when collating data to track improvement. An electronic referral form has been designed and we are currently awaiting implementation and staff training Development of visual aides to promote the importance of cardiac rehabilitation has been paramount. these visual aides include a video on recognising the signs of heart attack (run on a dedicated channel on the hospital Television system), and through posters displayed in patients rooms as well as prominent positions in the Cardiac Care Unit.

11 If you require further information on this innovation. Please don't hesitate to contact: Kylie Fisher Nurse Unit Manager Cardiac Care Unit Western Health Footscray Joanne Saliba Cardiac & CHF Exercise Rehabilitation Nurse Western Health Footscray Rosemary Ortiz-Gutierrez Clinical Nurse Specialist Cardiac Care Unit Western Health Footscray Kathryn Barker Senior Clinician Physiotherapist - Exercise Rehabilitation Western Health, Sunshine Hospital

Smartphone based home-care delivery of Cardiac Rehabilitation

Poster Session HRT11420 Innovation Awards November 2014 Melbourne Smartphone based home-care delivery of Cardiac Rehabilitation Presenter(s): Anita Keightley (Metro North HHS) Mohan Karunanithi (CSIRO)