Examining Patient Outcome Quality Indicators Based on Wait Time From Referral to Entry Into Cardiac Rehabilitation: A PILOT OBSERVATIONAL STUDY.
OBJECTIVE
The purpose of this study was to examine whether meeting the Canadian Cardiovascular Society (CCS) ≤60-day wait time from cardiac rehabilitation (CR) referral to enrollment is associated with CCS patient-level quality indicator outcomes.


METHODS
This pilot observational study consisted of 69 participants entering CR separated into 2 groups based on wait time (≤60-day, n = 45; >60-day, n = 24). Data were collected at baseline, and 1, 4 (CR completion), 6, and 12 months after baseline. Quality indicators for achieving a 0.5 peak metabolic equivalent (MET) improvement at CR completion, physical activity of 150 min/wk of moderate-vigorous physical activity, and CR adherence were assessed. Depressive symptoms were assessed with the Patient Health Questionnaire.


RESULTS
Sixty participants completed the study (≤60-day, n = 40; >60-day, n = 20). In the ≤60-day group, 92% of participants achieved the 0.5 MET improvement upon CR completion; whereas 60% of the >60-day group met this criteria (P ≤ .05). For the 150 min/wk of moderate-vigorous physical activity and CR adherence, both groups were not significantly different at any time. Elevated depressive symptoms were initially observed in 45% of participants in the ≤60-day group and 35% in the >60-day group (NS) and decreased to 8% in the ≤60-day group compared with 30% in the >60-day group at 12 months (P ≤ .05).


CONCLUSIONS
Meeting the CCS 60-day acceptable wait time is associated with improvements in METs and depressive symptoms, but not with physical activity or CR adherence. A larger observational study is warranted to explore patient-level CCS quality indicators during and after CR.
Faculty of Kinesiology & Recreation Management, Health, Leisure & Human Performance Research Institute, University of Manitoba, Winnepeg, Canada (Messrs Kehler and Kent, Drs Strachan and Duhamel, and Ms Chapman); St. Boniface Hospital Research Centre, Institute of Cardiovascular Sciences, Winnepeg, Manitoba, Canada (Messrs Kehler, Kent, and Wangasekara, Ms Chapman, and Dr Duhamel); Department of Clinical Health Psychology, University of Manitoba, Winnepeg, Canada (Dr Beaulac); St. Boniface General Hospital, Winnipeg, Manitoba, Canada (Mr Hiebert); Reh-Fit Centre, Winnipeg, Manitoba, Canada (Mss Lamont and Boreskie, and Dr Lerner); Winnipeg Regional Health Authority Cardiac Sciences Program, Winnipeg, Manitoba, Canada (Dr Avery); and Department of Physiology, University of Manitoba, Winnipeg, Canada (Dr Duhamel).
Dustin Scott
DS
Kehler
Dave
D
Kent
Julie
J
Beaulac
Leisha
L
Strachan
Nilu
N
Wangasekara
Soyun
S
Chapman
Brett
B
Hiebert
Darlene
D
Lamont
Neal
N
Lerner
Sue
S
Boreskie
Lorraine
L
Avery
Todd A
TA
Duhamel
D002170:Canada; D000072038:Cardiac Rehabilitation / Q000706:statistics & numerical data*; D005500:Follow-Up Studies; D006801:Humans; D017063:Outcome Assessment, Health Care / Q000379:methods*; D010865:Pilot Projects; D019984:Quality Indicators, Health Care / Q000706:statistics & numerical data*; D012017:Referral and Consultation / Q000706:statistics & numerical data*; D013997:Time Factors; D014850:Waiting Lists