title: Cardiac rehabilitation: beginning at the bedside.
abstract: OBJECTIVE
  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.
authors: Division of Prevention and Rehabilitation, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
authors: Sueann
authors: S
authors: Tiller
authors: Louise
authors: L
authors: Leger-Caldwell
authors: Patricia
authors: P
authors: OʼFarrell
authors: Andrew L
authors: AL
authors: Pipe
authors: Amy E
authors: AE
authors: Mark
mesh_terms: D001071:Appointments and Schedules; D001513:Beds; D002170:Canada; D000072038:Cardiac Rehabilitation; D006801:Humans; D007297:Inpatients; D009726:Nurses; D015397:Program Evaluation; D012017:Referral and Consultation / Q000706:statistics & numerical data*