title: The quality of cardiac rehabilitation in Canada: a report of the Canadian Cardiac Rehab Registry.
abstract: Cardiac rehabilitation (CR) significantly reduces morbidity and mortality compared with usual care. CR quality indicators (QIs) have recently been established in Canada. This article presents an assessment of real-world CR program achievement of process and outcome QIs in Canada, using the Canadian Cardiac Rehab Registry (CCRR). The CR QIs were developed through the Canadian Cardiovascular Society's Best Practice Methodology. After reconciling the QI with CCRR definitions, it was identified that 14 (46.7%) of the 30 QIs could be assessed through the CCRR. There were 5447 patient records from 11 CR programs in the CCRR. Wait times exceeded the 30-day QI target, at a median of 84 days from referral to enrollment. Assessment of QIs of blood pressure (90%) and adiposity (85%) were high, however assessment of QIs for lipids (41%), blood glucose among patients with diabetes (23%), and depression overall (13%) were low. A majority of the participants (68%) achieved the half metabolic equivalent increase in the exercise capacity QI from CR program entry to exit. Of smokers, only 61% were offered smoking cessation therapy. Thirty percent of participants were offered stress management. The CR program completion QI was met in 90% of patients. Areas for care and quality improvement have been identified for the CR community in Canada. Efforts to engage more CR programs assess a greater number of QIs, and to feed back the findings to participating programs quarterly are currently under way.
authors.affiliation: School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada; Toronto Western Hospital, and GoodLife Fitness Cardiovascular Rehabilitation Unit, University Health Network, Toronto, Ontario, Canada. Electronic address: sgrace@yorku.ca.
authors.forename: Sherry L
authors.initials: SL
authors.lastname: Grace
authors.affiliation: Faculty of Health Sciences, Queen's University, Kingston, Ontario, Canada.
authors.forename: Trisha L
authors.initials: TL
authors.lastname: Parsons
authors.affiliation: Faculty of Kinesiology and Recreation Management, University of Manitoba and Institute of Cardiovascular Sciences, St Boniface Hospital Research Centre, Winnipeg, Manitoba, Canada.
authors.forename: Todd A
authors.initials: TA
authors.lastname: Duhamel
authors.affiliation: School of Kinesiology and Health Science, York University, Toronto, Ontario, Canada.
authors.forename: Deborah S
authors.initials: DS
authors.lastname: Somanader
authors.affiliation: Cardiac Rehabilitation and Secondary Prevention Program of St. Joseph's Health Care London, and Department of Medicine (Cardiology) and Program of Experimental Medicine, Western University, London, Ontario, Canada.
authors.forename: Neville
authors.initials: N
authors.lastname: Suskin
mesh_terms: D000368:Aged; D002170:Canada; D000072038:Cardiac Rehabilitation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019984:Quality Indicators, Health Care / Q000592:standards*; D012017:Referral and Consultation; D012042:Registries