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Home-based Cardiac Rehabilitation

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The home-based cardiac rehabilitation program is a 12 week program where Veterans receive weekly video or telephone appointments from a cardiac rehabilitation professional. Individualized counseling on exercise, heart healthy nutrition, importance of medication adherence, tobacco cessation, and stress management is included in this multicomponent model. The program provides access to care for Veterans, particularly those in rural regions, who are unable to attend traditional cardiac rehab models due to personal or organizational barriers. The goal of this program is to provide support and education on self-management skills and their disease, so that Veterans feel confident in taking the necessary steps towards a heart healthy lifestyle.

This innovation is scaling widely with the support of national stakeholders. See more scaling innovations.

Adoptions:

36 successful, 3 in-progress

Awards and Recognition:

2018 AACVPR Linda K. Hall Innovation Award, Rural Promising Practice

Partners:

Office of Rural Health

Tags:

COVID-19 Rural Health Telehealth
Contact Team

Overview

Problem

Cardiac rehabilitation is an essential intervention for those diagnosed with cardiovascular disease. Despite the evidence of cardiac rehabilitation improving function and quality of life, reducing secondary events and cardiovascular mortality utilization of remains low. Within the VA, only 28% of medical centers have on-site cardiac rehabilitation services ... See more

Solution

To address access to cardiac rehabilitation services in the VA the home-based cardiac rehabilitation program was developed. This is a twelve week program delivered through video and/ or telephone appointments and provides individualized cardiac rehab care in the areas of: exercise prescription; nutritional counseling; medication adherence; stress management ... See more

Results

Over 30 VA facilities have adopted the home-based cardiac rehab program, and over 6,000 Veterans have been enrolled in the program.

Metrics

  • Number of Veterans Enrolled each fiscal year
  • Cardiac rehab patient outcomes (functional, psychosocial, nutritional, medication adherence, and risk factor management)
  • Completion rates of the home-based cardiac rehab program
  • Number of Rural Veterans served each fiscal year

Diffusion tracker

Does not include Clinical Resource Hubs (CRH)

Statuses

AL: Birmingham VA Medical Center (Birmingham, Alabama) AR: John L. McClellan Memorial Veterans' Hospital (Little Rock, Arkansas) AZ: Carl T. Hayden Veterans' Administration Medical Center (Phoenix, Arizona) CA: Jerry L. Pettis Memorial Veterans' Hospital (Loma Linda, California) CA: Palo Alto VA Medical Center (Palo Alto, California) CA: San Francisco VA Medical Center (San Francisco) CT: West Haven VA Medical Center (West Haven) DC: Washington VA Medical Center (Washington, District of Columbia) FL: Malcom Randall Department of Veterans Affairs Medical Center (Gainesville) FL: West Palm Beach VA Medical Center (West Palm Beach) GA: Joseph Maxwell Cleland Atlanta VA Medical Center (Atlanta, Georgia) IA: Iowa City VA Medical Center (Iowa City, Iowa) IL: Marion VA Medical Center (Marion, Illinois) KS: Colmery-O'Neil Veterans' Administration Medical Center (Topeka) MA: Jamaica Plain VA Medical Center (Jamaica Plain) ME: Togus VA Medical Center (Togus) MI: Lieutenant Colonel Charles S. Kettles VA Medical Center (Ann Arbor) MN: St. Cloud VA Medical Center (St. Cloud) MT: Fort Harrison VA Medical Center (Fort Harrison) NC: Charles George Department of Veterans Affairs Medical Center (Asheville) NC: Durham VA Medical Center (Durham) NC: W.G. (Bill) Hefner Salisbury Department of Veterans Affairs Medical Center (Salisbury) NH: Manchester VA Medical Center (Manchester) NM: Raymond G. Murphy Department of Veterans Affairs Medical Center (Albuquerque) NY: Buffalo VA Medical Center (Buffalo, New York) NY: Castle Point VA Medical Center (Castle Point) OH: Cincinnati VA Medical Center (Cincinnati, Ohio) OH: Louis Stokes Cleveland Department of Veterans Affairs Medical Center (Cleveland, Ohio) OK: Jack C. Montgomery Department of Veterans Affairs Medical Center (Muskogee, Oklahoma) PA: Pittsburgh VA Medical Center-University Drive (Pittsburgh) RI: Providence VA Medical Center (Providence) TX: Dallas VA Medical Center (Dallas) TX: Michael E. DeBakey Department of Veterans Affairs Medical Center (Houston) VA: Hampton VA Medical Center (Hampton) VA: Salem VA Medical Center (Salem, Virginia) WI: William S. Middleton Memorial Veterans' Hospital (Madison)

ID: Boise VA Medical Center (Boise) MO: Harry S. Truman Memorial Veterans' Hospital (Columbia, Missouri) TN: Lt. Col. Luke Weathers, Jr. VA Medical Center (Memphis)

There are no unsuccessful adoptions for this innovation.

Multimedia

Images

Home-based Cardiac Rehabilitation Enrollment Appointment

Videos

Office of Rural Health Home-based Cardiac Rehab Video

ORH Home-based CR & PR Program

Implementation

Departments

  • Cardiology
  • Telehealth
  • Physical medicine and rehabilitation

Core Resources

Resource type Resource description
PEOPLE
  • Clinical Application Coordinator required for note and consult development
  • Telehealth for development of telehealth clinics
  • Heath Information Medical Specialists for establishing encounter forms
  • MCA department for establishing coding for clinics
  • Medical media for printing and approval of patient and marketing materials
  • Human Resources for posting of any new FTEE
PROCESSES
  • Facilities receive mentored implementation on the steps to achieve successful adoption of the home-based cardiac rehab program from the Iowa City VA Home-based Cardiac Rehab core team.
TOOLS
  • Clinic Space for cardiac rehab provider
  • Telehealth video capability
  • Patient equipment for program

Links

Risks and mitigations

Risk Mitigation
Risk of the implementation not being successfully started due staffing issues. Possible mitigation: using existing staff
After successful implementation, possible shut down due to decreased funds available. Building partnerships with other departments for support and collaboration.

Contact

Comment

Comments and replies are disabled for retired innovations and non-VA users.

Email

Email with questions about this innovation.

About

Origin story

When Bonnie Wakefield was hired at the Iowa City VA Health Care System in 1983, she was surprised there was no cardiac rehabilitation program given the prevalence of cardiovascular disease in the VA. Almost 30 years later, we've implemented a solution for access to cardiac rehabilitation services with the Home-based Cardiac Rehabilitation Program.

Original team

Kariann Drwal, MS, CCRP, RCEP, ATC/LAT

Director of the Home-based Cardiac Rehabilitation Program

Ramzi El Accaoui, MD

Cardiologist, Medical Director of Home-based Cardiac Rehab Program

Adrienne Wagenblast, RN

Home-based Cardiac Rehabilitation Program Manager

Search tags

COVID-19 Rural Health Telehealth