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Teamwork in cardiac rehabilitation

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Cathy Trodden, RN.

Sister, Cardiac Rehabilitation Service, Luton and Dunstable Hospital, Bedfordshire

In 1999 the cardiac rehabilitation service at Luton and Dunstable Hospital in Bedfordshire received funding from the Luton Health Action Zone (HAZ) for expansion and improvement. In just two years this has proved to be one of the most successful of the HAZ projects - waiting times for cardiac patients to be seen by the rehabilitation service have fallen by two-thirds while, at the same time, referrals have increased by 83%. (Comparing figures from January-June 1999 and January-June 2001.)

 

In 1999 the cardiac rehabilitation service at Luton and Dunstable Hospital in Bedfordshire received funding from the Luton Health Action Zone (HAZ) for expansion and improvement. In just two years this has proved to be one of the most successful of the HAZ projects - waiting times for cardiac patients to be seen by the rehabilitation service have fallen by two-thirds while, at the same time, referrals have increased by 83%. (Comparing figures from January-June 1999 and January-June 2001.)

 

 

Those targeted include post-myocardial infarction, post-revascularisation and other cardiac surgery patients.

 

 

The core elements of this ‘phase three’ rehabilitation programme are education, relaxation and exercise, and all elements are incorporated into each session with patients. Exercise is a key component of cardiac rehabilitation, leading the team to set-up and develop community-based exercise classes.

 

 

A pilot scheme, carried out in May and June this year, involved running a series of gym classes, supervised by a qualified instructor and a member of the cardiac rehabilitation team. Following the success of this scheme, five fitness instructors are now being trained through an extensive course accredited by the British Association of Cardiac Rehabilitation to enable more cardiac patients to take up classes.

 

 

In line with the integrated approach to cardiac rehabilitation care, patients are also referred to other services, such as the Luton HAZ smoking cessation project and clinical psychology services. The service also encourages relatives to get involved through a partner support group. The service provides help and advice, as well as an educational programme covering all aspects of rehabilitation, including resuscitation training.

 

 

The team consists of cardiac rehabilitation co-ordinator Jenny Cadman, cardiac rehabilitation nurse Cathy Trodden, occupational therapist Debbie Smith, physiotherapist Helen Corvesor and a full-time coronary heart disease dietitian, Sarah Hetherington.

 

 

As a multidisciplinary team, the extra funding is helping us to work towards providing a seamless, integrated and patient-focused approach to cardiac rehabilitation.

 

 

At the outset of the project, additional funds were provided to develop the existing service. As the work unfolded, it was possible to see the dramatic difference that this was having on both waiting times and the standard of cardiac rehabilitation services provided. On the back of this initial success, the service received an extra £80 000 of HAZ funding last year to expand and improve the service further.

 

 

The success of the project was highlighted at the National Institute for Clinical Excellence conference in November last year, when the team was invited to present its results. The team has since made further improvements and can now show that the average waiting time from receiving a referral to attending assessment clinic for phase three cardiac rehabilitation, is now 2.7 weeks, compared to 8.1 weeks in the same period in 1999 (Table 1).

 

 

While the waiting times drop, the number of referrals to the service continues to increase. The team has received 271 referrals since the start of this year, compared to 225 for the same period in 2000 and 148 in 1999.

 

 

We attribute the success of the project to the level of teamwork involved. We have a team that spans across all cardiac rehabilitation-related disciplines and so is able to provide a ‘one-stop’ approach to cardiac rehabilitation. Also, every member of the team is fully committed to using the funds provided to achieve positive and accountable results.

 

 

- The team can be contacted on 01582-497469.

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