To provide standardized Supervised Exercise Programs across the province.

TITLE ALBERTA HEALTHY LIVING PROGRAM SUPERVISED EXERCISE PROGRAM DOCUMENT # HCS-67-01 APPROVAL LEVEL Executive Director Primary Health Care SPONSOR Senior Consultant Central Zone, Primary Health Care CATEGORY Health Care and Services INITIAL APPROVAL DATE June 3, 2014 INITIAL EFFECTIVE DATE June 25, 2014 REVISION EFFECTIVE DATE N/A NEXT REVIEW June 25, 2017 If you have any questions or comments regarding the information in this standard, please contact the Policy and Forms Department at policy@albertahealthservices.ca. The Policy and Forms website is the official source of current approved policies, procedures and directives. PURPOSE/OBJECTIVES To provide standardized Supervised Exercise Programs across the province. APPLICABILITY Compliance with this standard is required by all Alberta Health Services employees, members of the medical and midwifery staffs, students, volunteers, and other persons acting on behalf of Alberta Health Services (including contracted service providers as necessary). This standard does not limit any legal rights to which you may otherwise be entitled. PROGRAM NAME Supervised Exercise Programs are a component of the Alberta Healthy Living Program (AHLP). The AHLP is a chronic disease management program offered in all Alberta Health Services zones. The AHLP is known as Living Well with a Chronic Condition in Calgary Zone. STANDARD 1. Participant Intake 1.1. Individuals seeking enrollment in the Supervised Exercise Program must meet the following criteria: a) have at least one chronic disease; or b) have at least one risk factor for chronic disease and is seeking to prevent chronic disease; Alberta Health Services 2014 PAGE: 1 of 17

ALBERTA HEALTHY LIVING PROGRAM SUPERVISED EXERCISE PROGRAM June 25, 2014 HCS-67-01 2 of 17 c) be 18 years of age or older; and d) participate in the Alberta Health Care Insurance Plan and have an Alberta Personal Health Care Card and a Personal Health Number. Note: A support person may accompany the participant. 1.2. Based on specific program criteria, the following may exclude an individual from program enrollment: a) uncontrolled or unstable chronic disease state; b) recent surgery; c) acute musculo-skeletal injury or event; d) developmental disabilities, memory deficiencies, cognitive deficiencies or mental health issues that may put the person at risk for injury or that prevent self-management; e) previous attendance in the program without significant changes in the chronic disease state or development of new chronic disease(s); or f) inability to attend a majority of sessions and/or complete the program. 1.3. Referrals to the program may be a result of: a) interest expressed in or recommendation for participation by the individual, a physician or other health care providers; b) individual, physician or other health care provider referral; c) telephone, fax or electronic means; or d) other means of participant information acceptable to the program. Note: Referral by a physician or another health care provider may be substituted for a formal consent if such is required for the particular program. 1.4. The following information shall be collected upon registration and entered into the program system as part of the participant database: a) name; b) mailing address with postal code and email address, if available; c) birth date; d) personal health number;

ALBERTA HEALTHY LIVING PROGRAM SUPERVISED EXERCISE PROGRAM June 25, 2014 HCS-67-01 3 of 17 e) gender; f) self-reported chronic condition(s); and g) date of first in-person appointment. 1.5. Program staff will provide the referring health care provider with the following: a) program start date; and b) information regarding the program plan. 1.6. All participants enrolled in the supervised exercise program must sign a Consent and Waiver. 2. Pre-Participation Evaluation 2.1. The appropriate health care provider(s) shall be consulted to provide the following assessments prior to the participant s initiating exercise: a) risk-stratification determination of the likelihood of an adverse event or exacerbation of symptoms during exercise: there is insufficient evidence of risk to support broad application of exercise stress testing prior to starting a supervised exercise program; more targeted use of this test should be directed to appropriate candidates; b) health status evaluation of health and physical functioning to guide participant-specific programming. Information to be collected during the assessment is as follows: relevant medical history, diagnosis, and medications; and previous and current physical activity level and physical activity goal(s); c) vital signs, including heart rate, blood pressure, oxygen saturation, and relevant measurements such as blood glucose, height, weight, waist circumference, body mass index, and range of motion; d) baseline outcome measures used to determine the function and ability of the participant, such as endurance, strength and balance; and e) baseline information regarding quality of life, self-efficacy and experience with the program. 2.2. Data collection tools should be consistent with provincial AHLP evaluation and measurement work.

ALBERTA HEALTHY LIVING PROGRAM SUPERVISED EXERCISE PROGRAM June 25, 2014 HCS-67-01 4 of 17 3. Program Delivery 3.1. Program focus a) Group-focussed programming is: facility, centre, community, or aquatic-based; integrated across diseases; and available with one-on-one guidance. b) Individual-focussed programming is: facility, centre, community, aquatic, home, and/or electronic-based; and independent-focussed. 3.2. Program duration, frequency, and length 4. Providers a) Program length may vary across programs and may range in: duration (8-12 weeks); frequency (2-3 sessions per week for group-focus and may vary in length for individual-focus, depending on the participant); or length (60-120 minutes per session). 4.1. Working titles may vary across program, however, roles and qualifications are standardized. a) See Appendix A - Exercise Professional and Discipline Classifications for specific information. 4.2. All AHLP Supervised Exercise Programs must include an Exercise Professional. This health care provider delivers the supervised exercise program. Providers that fill this role are: a) exercise specialists; b) kinesiologists; c) occupational therapists; d) physiotherapists; e) recreation therapists;

ALBERTA HEALTHY LIVING PROGRAM SUPERVISED EXERCISE PROGRAM June 25, 2014 HCS-67-01 5 of 17 f) registered nurses, and g) respiratory therapists. 4.3. The AHLP supervised exercise program may also include the following positions: a) Team Leads, who are responsible for the following: program planning, development, leadership, administration, evaluation and quality improvement; staff recruitment, selection, employment, orientation, supervision and evaluation; and community and primary care integration, partnerships, and collaboration; b) Exercise Assistants / Therapist Assistants, who practice under the supervision of the Exercise Professional to assist and support program delivery and to supervise the exercise sessions; and c) Fitness Leaders, who are not Alberta Health Services employees, but are staffed by community organizations. These individuals may assist in the Supervised Exercise Program under the supervision of and to support the Exercise Professional in locations where a partnership exists with the community facility. Fitness Leaders may have an opportunity to complete Fitness Leader training which is developed specifically for the AHLP. 5. Exercise Intensity Level, Level of Supervision and Monitoring of Symptoms 5.1. The appropriate health care provider must be consulted to determine the following participant-specific program elements: a) exercise intensity level b) level of supervision and c) monitoring of symptoms 6. Participant Education and Self-Management Supports 6.1. Participants should be provided with information regarding: a) the effects of exercise on their chronic condition; b) symptom monitoring; c) exercise intensity monitoring and adaptations;

ALBERTA HEALTHY LIVING PROGRAM SUPERVISED EXERCISE PROGRAM June 25, 2014 HCS-67-01 6 of 17 d) when to seek health care provider support; and e) self-management tools and information. 7. Outcome Measures Follow-up 7.1. The appropriate health care provider shall be consulted to provide relevant measures of the participant s physical function at various intervals during the program (as applicable), and at program completion. 7.2. Baseline measures are repeated at an interval appropriate for the individual to determine changes in function and ability. 7.3. Information will be collected to evaluate participants quality of life, self-efficacy and experience with the program. Data collection tools should be consistent with provincial AHLP evaluation and measurement work. 8. Program Completion 8.1. The program completion date is the date the participant is no longer actively participating in the program. 8.2. Participants may still access other program services and may still be booked for follow up appointment(s) after completion. 8.3. Program completion can be based on a time frame (i.e. program is 8 weeks in length) or when participant has achieved his/her goals a) specific criteria are at the discretion of the program, the health care provider and the participant. 9. Communication of Participant Information 9.1. The following information shall be provided to the referring physician or other health care provider at appropriate times during the course of the program: a) confirmation of receipt of the referral and what classes the participant has been registered in b) any issues concerning participant attendance c) the number of sessions attended and the completion date d) attainment of participant goals e) discharge recommendations

ALBERTA HEALTHY LIVING PROGRAM SUPERVISED EXERCISE PROGRAM June 25, 2014 HCS-67-01 7 of 17 10. Participant Safety 10.1. All staff shall be trained in first aid, cardiopulmonary resuscitation (CPR) and the use of an automated external defibrillator (AED). 11. Conflict of Interest 11.1. The actions of staff and volunteers shall be guided by the Alberta Health Services Code of Conduct. 11.2. Alberta Health Services Representatives are expected to fulfill their responsibilities in a manner that avoids involvement in any potential, perceived, or real conflict of interest situations, and to promptly disclose and address any conflicts should they arise. 12. Collection, Use, and Protection of Health Information 12.1. Health information is collected by Alberta Health Services in accordance with the Health Information Act (HIA). 12.2. AHLP staff must post a copy of the poster developed by the Information & Privacy department, which outlines details about the collection, use, and protection of health information. 13. Non-Alberta Health Services Facility License Agreement Information 13.1. Any arrangement that deals with property or property matters (physical space) requires the involvement of Real Estate (Contracts Policy). In order to adhere to Alberta Health Services procedures and to mitigate the potential risk associated with Alberta Health Services staff offering, and patients receiving, Alberta Health Services sponsored services in non-alberta Health Services facilities, license agreements must be approved by Alberta Health Services Real Estate. DEFINITIONS Health care provider means any person who provides goods or services to a patient, inclusive of health care professionals, staff, students, volunteers and other persons acting on behalf of or in conjunction with Alberta Health Services REFERENCES Appendix A: Supervised Exercise Program Exercise Professional and Discipline Classifications Health Information Act (Alberta) Alberta Health Services Code of Conduct Alberta Health Services Conflict of Interest Bylaw Alberta Health Services Consent to Treatment and Procedure Alberta Health Services Contracts Policy

ALBERTA HEALTHY LIVING PROGRAM SUPERVISED EXERCISE PROGRAM June 25, 2014 HCS-67-01 8 of 17 Alberta Health Services Emergency/Disaster Management Department Alberta Health Services Planning & Design Services Alberta Health Services-Alberta Healthy Living Program Waiver Alberta Health Services webpage o external: http://www.albertahealthservices.ca/ o internal: http://insite.albertahealthservices.ca/ The Alberta Healthy Living Program Supervised Exercise Program Guide

ALBERTA HEALTHY LIVING PROGRAM SUPERVISED EXERCISE PROGRAM June 25, 2014 HCS-67-01 9 of 17 Supervised Exercise Program Exercise Professional and Discipline Classifications APPENDIX A Exercise Specialist AHLP Common Role Performs pre-participation evaluation of the patient, including patient risk stratification, determination of patient exercise intensity level, level of supervision, additional testing/screening, referral to external testing, level of assessment and types of outcome measures Conducts assessment of patient health status, including collecting information such as medical history, diagnosis, medication, physical activity levels, physical activity goals, and anthropometric measurements Conducts outcome measure tests, such as endurance, strength and balance tests. Monitors patient s responses to testing and exercises in the areas of symptoms, vital signs and exertion Develops, supervises and monitors the exercise, including giving advice, guidance, motivation, program adaptation/modification, and exercise progression Supervises patients in a group-focused programming Meets the needs of a variety of chronic diseases in an exercise setting Guides patients towards achieving improvements in their health and physical functioning Provides patient education in the areas of chronic conditions, effects of exercise on chronic conditions, monitoring and adapting, modifying and progression of exercise programs, general health and lifestyle information, and motivation Provides self-management support such as skill, confidence and commitment building and use of self-management tools Conducts patient-centered follow up sessions or appointments Documents, reports and refers patient according to program processes Works collaboratively in an interdisciplinary team, and with external partners Supervises Program Assistants and Fitness Leaders. Additional Competencies The Exercise Specialist performs exercise tolerance testing, physical assessments and interpretation of test results for the purpose of developing, implementing, evaluating and maintaining appropriate exercise programs for clients. In addition, this position instructs clients regarding physical fitness and active leisure activities. The Exercise Specialist also provides exercise-related consulting for research, community and other clinical programs. Assesses, monitors, interprets and evaluates information from diagnostic tests, lab findings, medications and health records for the purpose of developing individualized exercise prescriptions and monitoring

ALBERTA HEALTHY LIVING PROGRAM SUPERVISED EXERCISE PROGRAM June 25, 2014 HCS-67-01 10 of 17 Develops, implements and evaluates appropriate exercise therapy for patients with chronic disease Develops and conducts group exercise sessions and educational programs related to conditioning and healthy lifestyles Develops alternative exercise programs for individual patients or patient groups who have chronic disease Supervises patients in the individual-focus programming option Selection of appropriate exercise equipment Qualifications Education: Bachelor s degree in Kinesiology, Physical Education, Exercise Physiology or equivalent exercise science degree Registration: Not regulated Certification: As appropriate to discipline (could include Alberta/Canadian Kinesiology Association, Canadian Society of Exercise Physiologists, American College of Sport Medicine). CPR and AED certification Additional Qualifications, Training, Experience: Alberta Health Services CDM Provider Education Kinesiologist AHLP Common Role Performs pre -participation evaluation of the patient, including patient risk stratification, determination of patient exercise intensity level, level of supervision, additional testing/screening, referral to external testing, level of assessment and types of outcome measures Conducts assessment of patient health status, including collecting information such as medical history, diagnosis, medication, physical activity levels, physical activity goals, and anthropometric measurements Conducts outcome measure tests, such as endurance, strength and balance tests. Monitors patient s responses to testing and exercises in the areas of symptoms, vital signs and exertion Develops, supervises and monitors the exercise, including giving advice, guidance, motivation, program adaptation/modification, and exercise progression Supervises patients in a group-focused programming Meets the needs of a variety of chronic diseases in an exercise setting Guides patients towards achieving improvements in their health and physical functioning Provides patient education in the areas of chronic conditions, effects of exercise on chronic conditions, monitoring and adapting, modifying and progression of exercise programs, general health and lifestyle information, and motivation Provides self-management support such as skill, confidence, commitment building, and use of self-management tools

ALBERTA HEALTHY LIVING PROGRAM SUPERVISED EXERCISE PROGRAM June 25, 2014 HCS-67-01 11 of 17 Conducts patient-centered follow up sessions or appointments Documents, reports and refers patient according to program processes Works collaboratively in an interdisciplinary team, and with external partners Supervises Program Assistants and Fitness Leaders. Additional Competencies The Kinesiologist position involves exercise tolerance testing and measurement procedures for the purpose of development, implementing, evaluating and maintaining appropriate exercise programs. This includes patient education, counselling, and exercise. Assesses, monitors, interprets and evaluates information from diagnostic tests, lab findings, medications and health records for the purpose of developing individualized exercise prescriptions and monitoring Develops, implements and evaluates appropriate exercise therapy for patients with chronic disease Develops and conducts group exercise sessions and educational programs related to conditioning and healthy lifestyles Develops alternative exercise programs for individual patients or patient groups who have chronic disease Supervises patients in the individual-focus programming option Selection of appropriate exercise equipment. Qualifications Education: Bachelor s degree in Kinesiology or equivalent exercise science degree Registration: Not regulated Certification/membership: As appropriate to discipline (could include Alberta/Canadian Kinesiology Association, Canadian Society of Exercise Physiologists). CPR and AED certification Additional Qualifications, Training, Experience: ALBERTA HEALTH SERVICES CDM Provider Education Occupational Therapist AHLP Common Role Performs pre-participation evaluation of the patient. This may include patient risk stratification, determination of patient exercise intensity level, level of supervision, additional testing/screening, referral to external testing, level of assessment and types of outcome measures Conducts assessment of patient health status. This may include collecting information such as medical history, diagnosis, medication, physical activity levels, physical activity goals, and anthropometric measurements Conducts outcome measure tests, such as endurance, strength and balance tests. Monitors patient s responses to testing and exercises in the areas of symptoms, vital signs and exertion Develops, supervises and monitors the exercise. This includes advice, guidance, motivation, program adaptation/modification, and exercise progression Supervises patients in a group-focused programming Meets the needs of a variety of chronic diseases in an exercise setting

ALBERTA HEALTHY LIVING PROGRAM SUPERVISED EXERCISE PROGRAM June 25, 2014 HCS-67-01 12 of 17 Guides patients towards achieving improvements in their health and physical functioning Provides patient education in the areas of chronic conditions, effects of exercise on chronic conditions, monitoring and adapting, modifying and progression of exercise programs, general health and lifestyle information, and motivation Provides self-management support such as skill, confidence, commitment building, and use of self-management tools Conducts patient-centered follow up sessions or appointments Documents, reports and refers patient according to program processes Works collaboratively in an interdisciplinary team, and with external partners Supervises program assistants and fitness leaders. Additional Competencies The Occupational Therapist (OT) is responsible for facilitating the occupational performance process using a patient/family-centered model of practice. Through assessing, analyzing, modifying and adapting the activities in which their clients engage the OT optimizes health and functional independence. Reviews clinical referrals, accepts, screens, and assesses patient needs from an occupational therapy perspective in cooperation with other health disciplines as appropriate In collaboration with their clients, develops and implements programs to meet every day needs in self-care, leisure and productivity Operates a variety of monitoring, recording, diagnostic, therapeutic, and associated equipment Additional areas of assessment: self-care, productivity, function, gait, cognition. Develops education and strategies in the identified areas of patient s needs, such as energy conservation, daily activities, stress management, emotional coping and pain management. Qualifications Education: Master s Degree (or equivalent combination of education and experience) in Occupational Therapy Registration: Alberta College of Occupational Therapists Certification/membership: CPR and AED certification Additional Qualifications, Training, Experience: Alberta Aids to Daily Living (AADL) Authorizer status. ALBERTA HEALTH SERVICES CDM Provider Education Physiotherapist (Physical Therapist) AHLP Common Role Performs pre-participation evaluation of the patient. This may include patient risk stratification, determination of patient exercise intensity level, level of supervision, additional testing/screening, referral to external testing, level of assessment and types of outcome measures Conducts assessment of patient health status. This may include collecting information such as medical history, diagnosis, medication, physical activity levels, physical activity goals, and anthropometric measurements Conducts outcome measure tests, such as endurance, strength and balance tests.

ALBERTA HEALTHY LIVING PROGRAM SUPERVISED EXERCISE PROGRAM June 25, 2014 HCS-67-01 13 of 17 Monitors patient s responses to testing and exercises in the areas of symptoms, vital signs and exertion Develops, supervises and monitors the exercise. This includes advice, guidance, motivation, program adaptation/modification, and exercise progression Supervises patients in a group-focused programming Meets the needs of a variety of chronic diseases in an exercise setting Guides patients towards achieving improvements in their health and physical functioning Provides patient education in the areas of chronic conditions, effects of exercise on chronic conditions, monitoring and adapting, modifying and progressing of exercise programs, general health and lifestyle information, and motivation Provides self-management support such as skill, confidence, commitment building, and use of self-management tools Conducts patient-centered follow up sessions or appointments Documents, reports and refers patient according to program processes Works collaboratively in an interdisciplinary team, and with external partners Supervises Program Assistants and Fitness Leaders. Additional Competencies The Physiotherapist (PT) is responsible for performing physical therapeutic rehabilitation services using a patient/family-centered model of practice. Through primary activities of assessment, intervention, treatment, consultation, education, and follow-up, the PT enables the patient to perform physical functions that are useful and meaningful to the patient/family. Reviews clinical referrals, accepts, screens, and assesses patient needs from a physical therapy perspective in cooperation with other health disciplines as appropriate Develops, plans, implements and provides follow-up of physical therapy services for clients in cooperation with other disciplines in the hospital and community Operates a variety of monitoring, recording, diagnostic, therapeutic, and associated equipment Additional areas of assessment: physical impairment, functional limitations, injuries and disabilities Develops education and strategies in the identified areas of need, such as falls prevention and osteoporosis. Qualifications Education: Master s Degree (or equivalent combination of education and experience) in Physiotherapy Registration: College of Physical Therapists of Alberta Certification/membership: CPR and AED certification Additional Qualifications, Training, Experience: Alberta Aids to Daily Living (AADL) Authorizer status, ALBERTA HEALTH SERVICES CDM Provider Education Recreation Therapist AHLP Common Role Performs pre-participation evaluation of the patient. This may include patient risk stratification, determination of patient exercise intensity level, level of supervision, additional

ALBERTA HEALTHY LIVING PROGRAM SUPERVISED EXERCISE PROGRAM June 25, 2014 HCS-67-01 14 of 17 testing/screening, referral to external testing, level of assessment and types of outcome measures Conducts assessment of patient health status. This may include collecting information such as medical history, diagnosis, medication, physical activity levels, physical activity goals, and anthropometric measurements Conducts outcome measure tests, such as endurance, strength and balance tests. Monitors patient s responses to testing and exercises in the areas of symptoms, vital signs and exertion Develops, supervises and monitors the exercise. This includes advice, guidance, motivation, program adaptation/modification, and exercise progression Supervises patients in a group-focused programming Meets the needs of a variety of chronic diseases in an exercise setting Guides patients towards achieving improvements in their health and physical functioning Provides patient education in the areas of chronic conditions, effects of exercise on chronic conditions, monitoring and adapting, modifying and progressing of exercise programs, general health and lifestyle information, and motivation Provides self-management support such as skill, confidence and commitment building, and use of self-management tools Conducts patient-centered follow up sessions or appointments Documents, reports and refers patient according to program processes Works collaboratively in an interdisciplinary team, and with external partners Supervises Program Assistants and Fitness Leaders. Additional Competencies The Recreation Therapist is responsible for providing therapeutic recreation services in the area of functional intervention, leisure education and recreation participation. This role is responsible for assessing client s recreation and leisure needs, developing treatment plans and providing therapeutic programs/ activities to meet these needs. Completes recreation therapy assessments on clients and evaluates needs and capabilities to determine goals and treatment plans Screens, assesses and treats clients individually and/or in groups Facilitates, instructs and motivates patients in therapeutic recreation activities Evaluates patient progress and intervention modalities and modifies treatment plan as required Liaises with community groups and resources Supports the program and the patients in exploring community program options, integration and partnering. Qualifications Education: Bachelor s degree in Recreation Therapy, Leisure Studies, Recreation Administration or related field Registration: Not regulated Certification/membership: Alberta Therapeutic Recreation Association. CPR and AED certification

ALBERTA HEALTHY LIVING PROGRAM SUPERVISED EXERCISE PROGRAM June 25, 2014 HCS-67-01 15 of 17 Additional Qualifications, Training, Experience: Additional group or individual fitness certification or relevant experience. Alberta Aids to Daily Living (AADL) Authorizer status. ALBERTA HEALTH SERVICES CDM Provider Education Registered Nurse AHLP Common Role Performs pre-participation evaluation of the patient. This may include patient risk stratification, determination of patient exercise intensity level, level of supervision, additional testing/screening, referral to external testing, level of assessment and types of outcome measures Conducts assessment of patient health status. This may include collecting information such as medical history, diagnosis, medication, physical activity levels, physical activity goals, and anthropometric measurements Conducts outcome measure tests, such as endurance, strength and balance tests. Monitors patient s responses to testing and exercises in the areas of symptoms, vital signs and exertion Develops, supervises and monitors the exercise. This includes advice, guidance, motivation, program adaptation/modification, and exercise progression Supervises patients in a group-focused programming Meets the needs of a variety of chronic diseases in an exercise setting Guides patients towards achieving improvements in their health and physical functioning Provides patient education in the areas of chronic conditions, effects of exercise on chronic conditions, monitoring and adapting, modifying and progressing of exercise programs, general health and lifestyle information, and motivation Provides self-management support such as skill, confidence, and commitment building, and use of self-management tools Conducts patient-centered follow up sessions or appointments Documents, reports and refers patient according to program processes Works collaboratively in an interdisciplinary team, and with external partners Supervises Program Assistants and Fitness Leaders. Additional Competencies The Registered Nurse utilizes the nursing process, critical thinking, problem solving and decision making skills to provide care to individuals and groups with chronic disease. The RN teaches, counsels and advocates to enhance health and well-being through the creation, interpretation, dissemination and implementation of care and practices. Focus is on additional areas of assessment: medications, emergent medical issues Develops education and strategies in the following areas: cardiovascular health and diseases, medication management, chronic disease interventions. Qualifications Education: Bachelor s degree (or equivalent) in Nursing Registration: College & Association of Registered Nurses of Alberta Certification/membership: CPR and AED certification

ALBERTA HEALTHY LIVING PROGRAM SUPERVISED EXERCISE PROGRAM June 25, 2014 HCS-67-01 16 of 17 Additional Qualifications, Training, Experience: Additional group or individual fitness certification or relevant experience. ALBERTA HEALTH SERVICES CDM Provider Education Respiratory Therapist AHLP Common Role Performs pre-participation evaluation of the patient. This may include patient risk stratification, determination of patient exercise intensity level, level of supervision, additional testing/screening, referral to external testing, level of assessment and types of outcome measures Conducts assessment of patient health status. This may include collecting information such as medical history, diagnosis, medication, physical activity levels, physical activity goals, and anthropometric measurements Conducts outcome measure tests, such as endurance, strength and balance tests. Monitors patient s responses to testing and exercises in the areas of symptoms, vital signs and exertion Develops, supervises and monitors the exercise. This includes advice, guidance, motivation, program adaptation/modification, and exercise progression Supervises patients in a group-focused programming Meets the needs of a variety of chronic diseases in an exercise setting Guides patients towards achieving improvements in their health and physical functioning Provides patient education in the areas of chronic conditions, effects of exercise on chronic conditions, monitoring and adapting, modifying and progressing of exercise programs, general health and lifestyle information, and motivation Provides self-management support such as skill, confidence, commitment building, and use of self-management tools Conducts patient-centered follow up sessions or appointments Documents, reports and refers patient according to program processes Works collaboratively in an interdisciplinary team, and with external partners Supervises Program Assistants and Fitness Leaders. Additional Competencies The Respiratory Therapist is responsible for assessment, therapeutic intervention and follow - up. The RT educates patients, families and healthcare professionals regarding cardiopulmonary diseases, respiratory disorders, and use of respiratory equipment. Reviews clinical referrals, accepts, screens, and assesses patient needs from a respiratory therapy perspective in cooperation with other health care providers as appropriate Performs diagnostic tests Develops and implements respiratory therapy care plans for patients Monitors patient progress, modifies respiratory care plans as required, informs appropriate individual(s) of any serious concerns, and refers when appropriate Takes initial action in response to unusual or complex cases, situations or concerns and attempts to resolve them Operates a variety of monitoring, recording, diagnostic, therapeutic, and associated equipment Educates patients, families and health care professionals with regard to relevant disease, medications, equipment, and the purpose, steps, benefits and risks of treatment procedures

ALBERTA HEALTHY LIVING PROGRAM SUPERVISED EXERCISE PROGRAM June 25, 2014 HCS-67-01 17 of 17 Develop education strategies in the following areas: pulmonary diseases such COPD, asthma, and smoking cessation. Qualifications Education: Diploma in Respiratory Therapy Registration: College and Association of Respiratory Therapists of Alberta Certification/membership: CPR and AED certification Additional Qualifications, Training, Experience: Additional group or individual fitness certification or relevant experience. Certified Asthma Educator. Certified Respiratory Educator. Alberta Health Services CDM Provider Education