This study aims to explore how to improve the outpatient cardiac rehabilitation rate and CPET rate among HF patients.This study aims to explore how to improve the outpatient cardiac rehabilitation rate and CPET rate among HF patients.
Through the cyclic management method, including Plan, Do, Check, and Act (PDCA), the main issues identified were: 1) After discharge, the appointment times for cardiology and outpatient follow-up visits were often different, leading to low willingness to attend rehabilitation; 2) Most patients left the clinic immediately after their cardiology follow-up without attending the rehabilitation department; 3) Irregular follow-up visits to the rehabilitation department made it impossible to schedule CPET. The solutions implemented were to schedule concurrent follow-up appointments for cardiology and rehabilitation after discharge. Case managers would personally escort patients to the rehabilitation department after their cardiology visit. If the patient had no contraindications for CPET, the test would be pre-scheduled, and physical therapists would guide patients to the outpatient cardiac rehabilitation room for rehabilitation.
Implementation began in December 2019, and follow-up results showed that outpatient cardiac rehabilitation rates for 2019, 2020, 2021, 2022, and 2023 were 10.51%, 30.38%, 23.11%, 27.92%, and 28.27%, respectively. CPET rates for 2019, 2020, 2021, 2022, and 2023 were 3.98%, 4.23%, 2.83%, 3.05%, and 5.36%, respectively. The process improvements led to increased outpatient cardiac rehabilitation and CPET rates in 2020. Although the outpatient cardiac rehabilitation rate declined during the severe COVID-19 outbreak from 2021 to 2022, it remained above 20%. With the easing of the pandemic, CPET rates also rose to 5.36%
Optimizing interdisciplinary care processes can improve outpatient cardiac rehabilitation rates and CPET rates in HF patients. For older patients or those unwilling to participate in outpatient rehabilitation, we recommend encouraging them to at least visit the rehabilitation department once to learn how to safely perform home-based cardiac rehabilitation. This approach helps improve the quality of life for HF patients.
By improving the participation and adherence to outpatient cardiac rehabilitation among HF patients, personalized exercise prescriptions can be provided based on patients' abilities, further enhancing their quality of life and reducing rehospitalization and mortality rates associated with heart failure.
utpatient Cardiac Rehabilitation Rate
Cardiopulmonary Exercise Testing Rate
