Key result
A nurse-delivered automatic bedside referral process increased the proportion of patients receiving cardiac rehabilitation referrals from 26.7% to 79.0% and participation to 32.6%.
Why the study?
Does a nurse-delivered automatic bedside referral process improve referral and intake rates for cardiac rehabilitation in eligible patients following a cardiac event?
Observational
No
Does a nurse-delivered automatic bedside referral process improve referral and intake rates for cardiac rehabilitation in eligible patients following a cardiac event?
Implementing a nurse-delivered automatic bedside referral process significantly increases both referral and participation rates for cardiac rehabilitation.
Answers are grounded in this paper and cite their sources.
May increase cardiac rehabilitation participation post-event; hypothesis-generating and requires randomized confirmation before practice change.
In Brief PURPOSE: Despite well-documented positive benefits, cardiac rehabilitation (CR) is an underutilized resource for patients following a cardiac event or intervention. Bias in the CR referral process has led to programs designed to ensure that all eligible patients receive a referral. The purpose of the current investigation was to describe the implementation of a nurse-delivered automatic bedside referral process and to examine the effectiveness on referral and intake rates for CR. METHODS: In 2007, an automatic CR referral system was implemented at the University of Ottawa Heart Institute. A nurse-delivered automatic bedside referral process was implemented in 2008. A CR nurse screened all inpatient charts, discussed CR benefits and program options with patients, triaged the patient to the appropriate program, and facilitated booking of the CR intake appointment. Data were analyzed to determine the effectiveness of this approach. RESULTS: Only 15.5% to 19.7% of eligible patients participated in CR program prior to 2006. Implementation of an automatic referral process increased participation to 26.7%. The nurse-delivered bedside automatic referral process increased participation to 32.6%. The proportion of patients receiving CR referrals almost tripled following the implementation of the nurse-delivered referral process from 26.7% in 2003 to 79.0% in 2008. CONCLUSIONS: A nurse-delivered automatic bedside referral process had a positive impact on both referral and intake to CR. Future challenges for CR programs will be to ensure optimal participation in programs, while managing the growth associated with increased rates of involvement. The purpose of this study was to describe the implementation of a nursedelivered automatic bedside referral process for cardiac rehabilitation (CR). Following implementation, the proportion of patients receiving CR referrals almost tripled, while intake nearly doubled. A nurse-delivered automatic bedside referral process positively impacted both referral and intake to CR.
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Leger-Caldwell et al. (2013) conducted an observational in Cardiac event or intervention. Nurse-delivered automatic bedside referral process vs. Standard referral process (historical control) was evaluated on Cardiac rehabilitation referral rate. A nurse-delivered automatic bedside referral process increased the proportion of patients receiving cardiac rehabilitation referrals from 26.7% to 79.0% and participation to 32.6%.
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