Background and Aims: Previous focus groups conducted with WRHA hospital staff caring for cardiac patients reveal that staff identifies a 2-week interval, from hospital discharge to first medical contact as a particularly vulnerable time for cardiac patients. Of particular concern for staff is ensuring that patients are aware of community resources to maintain heart health and are aware of the importance of participating in a structured cardiac rehabilitation program (CRP) to improve health outcomes.
Methods and Materials: The next steps heart program was established as a pilot during December 2006 at a WRHA acute care facility. The program is explained and offered to acute myocardial infarction and cardiac surgery patients prior to hospital discharge by a staff physiotherapist. A reminder letter is mailed to participants 2 weeks prior to the event. The program is offered twice monthly and consists of a group discussion related to general heart health concepts followed by a video that elaborates on key heart health topics (managing cardiac risk factors, emotional health, nutrition, activity, sexual relationships, medications, and CRP). Patients and family members are invited to talk with staff and peruse cardiac reading material and resources made available to them. Patients are asked to complete an anonymous evaluation form consisting of 8 questions immediately following the program.
Results: Overall, 42% (62/146) of patients agreed to participate in the pilot while in the hospital (66% cardiac surgery and 34% AMI). Of the total number of referrals (n = 62), 73% are male (average age 61) and 27% female (average age 69). Overall 63% (39/62) participated in the program. Program evaluations reveal high level of satisfaction with the service received. Sixty percent of respondents report they are mostly or very satisfied with the service. Sixty-four percent (64%) of respondents would recommend the service to others. The pilot site had a total of 119 CRP referrals during the same time frame as the pilot of which 40% (48/119) participated in the next steps heart program. To date, 15% have started the CRP. It is anticipated that actual CRP starts will be greater as February and March 2007 program participants enter the April 2007 CRP classes.
Conclusions: The next steps heart program appears to meet the heart health needs of cardiac surgery and acute myocardial infarction patients. Evaluations reveal a high level of satisfaction with the quality of the service received. It is unclear at this time if the program will increase enrollment in the CRP. Perhaps patients who attend the program are those who are more likely and motivated to enroll in a CRP. A future goal is to introduce the next steps heart program model to the other acute care regional sites within the WRHA.