Referral to and discharge from cardiac rehabilitation: key informant views on continuity of care.
OBJECTIVE
To assess the system-level barriers and facilitators of continuity of care from acute care to cardiac rehabilitation (CR), and from CR discharge to follow-up with primary health care providers.


METHODS
Semi-structured individual interviews with 24 key informants including CR staff, research scientists, policy makers, cardiologists and other doctors from a regional to international level were conducted regarding the processes of referral to and discharge from cardiac rehabilitation. Key informant interviews were audio taped, transcribed, and imported into QSR N6 software for Grounded analysis.


RESULTS
Themes that emerged related to communication, referral and discharge processes, health care provider practices, inter- and intra-institutional relationships, and alternative models of delivery to improve continuity.


CONCLUSIONS
Ramifications for enhancing referral of patients to beneficial CR services and follow-up by primary care providers to ensure maintenance of functional and health-related gains are discussed.
Grace
Sherry L
SL
University Health Network Women's Health Program, Toronto General Hospital, Toronto, ON, Canada. sgrace@yorku.ca
Krepostman
Suzan
S
Brooks
Dina
D
Jaglal
Susan
S
Abramson
Beth L
BL
Scholey
Pat
P
Suskin
Neville
N
Arthur
Heather
H
Stewart
Donna E
DE
D003142:Communication; D003266:Continuity of Patient Care / Q000592:standards*; D003327:Coronary Disease / Q000534:rehabilitation* / Q000628:therapy; D006297:Health Services Accessibility; D006801:Humans; D007407:Interviews as Topic / Q000379:methods; D010351:Patient Discharge; D012017:Referral and Consultation; D012047:Rehabilitation Centers / Q000706:statistics & numerical data