Cardiovascular Rehabilitation in Ontario (Canada)

Hospitals, YM-YWCAs, regional health units, and university physical education and athletics departments (n = 423) were surveyed to determine the number and locations of existing cardiovascular rehabilitation units (CRUs). A total of 43 CRUs were identified by these inquiries and 135 additional institutions expressed interest in future establishment of a CRU. Hospitals and medical clinics (n = 25) were the most common sponsoring institutions for CRUs, followed by YM-YWCAs (n = 10), community organizations (n = 5) and university physical education/kinesiology departments (n = 3). Contact persons at 37 of the 43 existing CRUs subsequently completed and returned written questionnaires which described their unit's status and operating procedures. The replies suggested the following conclusions: (1) an outpatient (OP) exercise program was the most commonly offered program component; (2) nutritional counselling, stress management, smoking cessation programs, and exercise programs for inpatients were also frequently offered; (3) the majority of patients treated were post-myocardial infarction and post-cardiac-surgery patients, with lesser numbers of angina and coronary-prone patients; (4) adequate facilities and equipment were usually available; (5) considerable variability existed regarding qualifications of staff and methods for enhancing staff education; (6) respondents were often unfamiliar with the CASS/ACSM, Exercise Specialist Certification program, and few certified individuals were employed; and (7) health insurance and professional liability insurance coverage, were often inadequate suggesting an urgent need for development of a Canadian procedural guidelines and better communication among practitioners in this field.