title: Improving cardiac rehabilitation services--challenges for cardiac rehabilitation coordinators.
abstract: BACKGROUND
  Cardiac rehabilitation (CR) is a long term multifactorial rehabilitation program aimed at the secondary prevention of cardiovascular events. However, delivery of CR services is less than optimal.
  
  
  OBJECTIVE
  This study explored the perceptions of cardiac rehabilitation (CR) coordinators relating to challenges for improving the delivery of CR services.
  
  
  METHODS
  The study design used qualitative, semi-structured in-depth telephone interviews with 20 CR coordinators from NSW Australia. Interviews were transcribed verbatim and thematic content analysis was undertaken to identify common themes.
  
  
  RESULTS
  Twenty CR coordinators participated in the study. Three major themes including obstacles to delivering cardiac rehabilitation services, challenges in achieving continuity and coordination, and complexities in delivering evidence-based health care were identified. Study findings indicate that limited service capacity due to a lack of investment and planning, rurality, lack of knowledge, and communication difficulties, are major challenges that CR coordinators need to overcome to provide effective services.
  
  
  CONCLUSIONS
  The experiences of participants provide some detailed insight into the barriers encountered in providing CR services. The main message from this study is that providing CR services is a complex process and is collectively influenced by the health care system; professional and provider issues; and program characteristics.
authors.affiliation: Family and Community Health, College of Health and Science, Campbelltown Campus, University of Western Sydney, Penrith South, NSW, Australia. r.fernandez@uws.edu.au
authors.forename: Ritin S
authors.initials: RS
authors.lastname: Fernandez
authors.forename: Patricia
authors.initials: P
authors.lastname: Davidson
authors.forename: Rhonda
authors.initials: R
authors.lastname: Griffiths
authors.forename: Yenna
authors.initials: Y
authors.lastname: Salamonson
mesh_terms: D001315:Australia; D003266:Continuity of Patient Care / Q000592:standards; D058006:General Practice / Q000458:organization & administration / Q000592:standards; D006297:Health Services Accessibility / Q000592:standards; D006331:Heart Diseases / Q000451:nursing* / Q000534:rehabilitation*; D006801:Humans; D036301:Qualitative Research; D012047:Rehabilitation Centers / Q000458:organization & administration / Q000592:standards*; D019145:Rehabilitation Nursing / Q000458:organization & administration / Q000592:standards*; D019035:Rural Health Services / Q000458:organization & administration / Q000592:standards