2022 Quality Summit ePosters (Non-CE) - CathPCI Registry-13. Cardiac Rehab Referral Placed Prior to Discharge

13. Cardiac Rehab Referral Placed Prior to Discharge

Pdf Summary

This research poster presentation discusses the use of a FOCUS-PDCA methodology to address a deficit in cardiac rehab referrals placed prior to discharge for acute myocardial infarction (AMI) patients. Through the use of the Accreditation Conformance Database Chest Pain Registry, it was discovered that only 20% of AMI patients received cardiac rehab referrals. A multi-disciplinary chest pain committee, including cardiologists, emergency physicians, case management, and cardiac rehab staff, identified obstacles to placing referrals and made recommendations for improvement. These recommendations included educating physicians, implementing hard stops in electronic health record order sets, and communicating deficiencies.<br /><br />To increase compliance, the Cardiac Service Line Administrator, Chest Pain Coordinator, and Cardiac Rehab Director met with physicians to emphasize the expectation of CR referrals being placed on all AMI discharges unless contraindicated. Orders were also modified so that CR was automatically checked, with a reason required if unchecked. A best practice advisory (BPA) was implemented to remind physicians to order CR if necessary. Compliance percentages were continuously evaluated and communicated with the chest pain committee, providers, and staff.<br /><br />The goal of this quality initiative was to increase CR referrals being placed prior to discharge for AMI patients from 20% to 50%. The value proposition for this increase was that it improves a patient's ability to participate in the program, leading to better long-term cardiac health outcomes. The implementation of education, auto-checked orders, continued monitoring, and communication of expectations resulted in significant increases in CR referrals, enrollments, and participation. As a result, the cardiac rehab facility is planning to expand to accommodate the increased volume.<br /><br />While this initiative has been successful, challenges remain, including resistance from some providers to ordering CR and difficulties with insurance authorization processes. The goal is to address these concerns and close the gap for cardiac patients.<br /><br />Overall, this research poster presentation highlights the successful use of a FOCUS-PDCA methodology to improve the compliance of placing CR referrals prior to AMI discharge, leading to increased participation in cardiac rehab and supporting the expansion of the rehab facility.

Keywords

FOCUS-PDCA methodology

cardiac rehab referrals

acute myocardial infarction

physician education

compliance percentages

auto-checked orders

patient participation

long-term cardiac health outcomes

increased volume

cardiac rehab facility expansion