August 7, 2015Open Access
View Full PaperFeasibility of Assessing 2 Cardiac Rehabilitation Quality Indicators
Key Result
Pilot testing of two cardiac rehabilitation quality indicators across three sites found referral rates ranged from 51.0% to 68.4% and wait times were 22-27 days, requiring 1.8-4.2 hours to compile.
Structured PICO
P
Population
3 academic cardiac rehabilitation (CR) sites
E
Exposure
Pilot testing of 2 quality indicators (QI-1: % of eligible inpatients referred, and QI-2b: median wait time from CR referral receipt to enrollment)
O
Outcome
Technical feasibility, workload required, and acceptability of measuring the QIs
Measurement of cardiac rehabilitation quality indicators for referral and wait times is acceptable but requires improved information-tracking processes for national implementation.
Limitations
- It was not considered feasible for CR programs to assess all potentially CR-eligible inpatients for CR referral exclusions.
- Changes in practice would be needed at each site to implement the QIs.
- CR programs may require enhancement of information-tracking processes to enable QI measurement.
Abstract
In Brief PURPOSE: The Canadian Cardiovascular Society initiated a pan-Canadian process for development of quality indicators (QIs) for cardiac rehabilitation (CR). Before implementation, the QIs underwent pilot testing to ensure they were acceptable and feasible for field implementation. The objectives of this test were to assess (1) the technical feasibility of measuring the QIs; (2) the workload required to measure the QIs; and (3) acceptability of measuring the QIs and issues with their implementation. METHODS: The 2 indicators chosen for field testing were QI-1 (% of eligible inpatients referred) and 2b (median wait time from CR referral receipt to enrollment). The approach consisted of 3 steps: (1) data extraction to test technical feasibility; (2) completing a workload diary; and (3) providing input through a semistructured interview regarding acceptability and implementation issues. Three academic CR sites were selected to undertake the field test. RESULTS: QI-1 ranged from 51.0% to 68.4%, and QI-2b was reported as 27 days (median) by one site, and 22 days (mean) by another. It was not considered feasible for CR programs to assess all potentially CR-eligible inpatients for CR referral exclusions. Compilation required 4.2 hours for QI-1 and 1.8 hours for QI-2b. QI assessment was acceptable to the programs, but changes in practice would be needed at each site to implement the QIs. CONCLUSIONS: CR programs may require enhancement of information-tracking processes to enable QI measurement. It was recommended that the QIs be implemented, but should undergo minor revisions to enhance feasibility. Two Canadian cardiac rehabilitation (CR) quality indicators (QI), namely inpatient referral and wait time, underwent pilot-testing for acceptability and implementation feasibility. QI assessment was highly acceptable to the academic CR community. There were issues raised regarding inclusions and exclusions for the first QI, which should be addressed before national roll-out.