Welcome to this learning activity entitled Cardiac Rehabilitation Referral. The content in this educational presentation was developed by myself. I am John Gerout, and I will also be narrating each lesson. The objectives of this presentation are to review the history of cardiac rehab, utilization in the modern era, and health benefits, understand key components required to meet the definition and support coding yes to sequence number 10116, examine the numerator and denominator exclusion criteria and clinical rationale of metric 45, recently updated to metric key 5003, cardiac rehabilitation referral, and identify smart phrase terminology that satisfies the cardiac rehab referral data definition and target value. Welcome to Lesson 1 of the CAF PCI Registry Metric Number 45 Cardiac Rehabilitation Referral in which we will cover the history, modern utilization, and health benefits of cardiac rehab. Cardiac rehabilitation, also called cardiac rehab, is a customized outpatient program comprised of exercise and education. Cardiac rehabilitation is designed to help patients improve their health and quality of life as they recover from cardiac events and disease. Cardiac rehabilitation often involves strengthening and conditioning through exercise, emotional support, and education about lifestyle changes to reduce heart disease risk, such as eating a heart-healthy diet, keeping a healthy weight, and quitting smoking. The goals of cardiac rehabilitation include establishing an individual care plan to help regain strength, preventing one's condition from worsening, as well as reducing the risk of future heart problems. The multidisciplinary nature of outpatient cardiac rehab brings healthcare professionals together in a collaborative setting with this goal in mind. Physicians, nurses, nutritionists, physical therapists, mental health professionals, and physical and occupational therapists work with patients to achieve a successful outcome. In 1772, English physician William Heberden reported a case of a patient who improved by working in the woods a half an hour per day. Despite some evidence of the benefits of physical activity, mobility restriction was imposed on patients with acute coronary events, often leading to serious decontagioning problems, decline in functional capacity, prolonged hospital stays, and increased morbidity and mortality. This incorrect attitude was reinforced for the better part of the mid-20th century. In the 1930s, patients with acute coronary events were advised to observe six weeks of bed rest. Chair therapy was introduced in the 1940s. In the early 1950s, a very short daily walk of three to five minutes was allowed four weeks after a coronary event. Gradually, it was recognized that early ambulation prevented many of the complications of bed rest and that it did not increase the risk. By the 1960s, early ambulation began to be accepted as a net health benefit for this population of patients on the grounds that it prevented complications of prolonged bed rest and also presented no increase in a patient's cardiac risk. Over time, cardiac rehabilitation has evolved from a simple monitoring program into a multidisciplinary program focused on post-operative patient care, the optimization of medical treatment, nutritional counseling, smoking cessation, risk stratification, stress management, and the management of hypertension, hyperlipidemia, and diabetes mellitus. In the modern era, cardiac rehab is typically divided into three phases. All phases of cardiac rehabilitation aim to facilitate recovery and to prevent further cardiovascular disease. Phase one, or the inpatient phase, is initiated while the patient is still in the hospital. It consists of early progressive mobilization of the stable cardiac patient to the level of activity required to perform simple household tasks. Phase two is a supervised ambulatory outpatient program of three to six months duration, which consists of outpatient monitored exercise and aggressive risk factor reduction. Phase three is a lifetime maintenance phase in which physical fitness and additional risk factor reduction are emphasized. It consists of home or gym-based exercise with the goal of continuing the risk factor modification and exercise program learned during phase two. Research has found that outpatient cardiac rehabilitation programs provide a wide breadth and depth of benefits to patients who partake in them. Cardiac rehab improves heart health by having a positive impact on cholesterol and blood pressure, a patient's ability to exercise, their likelihood of quitting smoking, and overall cardiac function. Patients see benefits in their general health and well-being, including an improved quality of life, adoption of healthy behaviors, increased strength and vitality, and the ability to return to work and social activities. There are also systemic societal benefits, including a reduction in hospital readmissions and emergency room visits, the need for cardiac medications, as well as the risk of further disability. When the benefits of cardiac rehab are weighed against the risk, it has been determined that it should be performed. Consequently, because of this class one recommendation status, the American Heart Association and American College of Cardiology recommend cardiac rehabilitation programs. The ACC AHA SCAI 2000 Focus Update of the Guidelines for Percutaneous Coronary Intervention advise medically supervised programs for high-risk patients. This concludes lesson one of the CAP PCI Registry metric number 45 cardiac rehabilitation referral, in which we covered the history, modern utilization, and health benefits of cardiac rehab. Thank you for your participation.

cardiac rehabilitation

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health benefits

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