Guidelines for Cardiac Rehabilitation Programs

Founded in 1985, the American Association of Cardiovascular and Pulmonary Rehabilitation (AACVPR) is a multidisciplinary professional association comprised of health professionals who serve in the field of cardiac and pulmonary rehabilitation. AACVPR is dedicated to improving the quality of life for patients and their families by reducing morbidity, mortality, and disability from cardiovascular and pulmonary disease through education, prevention, rehabilitation, research, and disease management. AACVPR provides educational, networking, and professional development opportunities, such as live webcasts and online modules, an annual conference and affiliate meetings, professional and program certifications, outpatient data registries, legislative advocacy, leadership opportunities, and more. AACVPR membership is comprised of cardiovascular and pulmonary physicians, nurses, clinical exercise physiologists, physical therapists, behavioral scientists, respiratory therapists, dieticians, and nutritionists.  

Chapter 1. Cardiac Rehabilitation: An Evolving Model of Care in the Era of Healthcare Reform
Ana Mola, PhD, ANP-BC
CR and Population Health Management
CR and Value-Based Care
CR and Care Coordination
Summary

Chapter 2. The Continuum of Care: From Inpatient and Outpatient CR to Long-Term Secondary Prevention
Cathie Biga, MSN, FACC
CVD Continuum of Care
Efforts to Reduce Gaps in the Continuum of Care
The Role of CR in the Continuum of Care
Putting It All Together
Summary

Chapter 3. CR in Inpatient and Transitional Settings
Mary Dolansky, PhD, RN, FAAN; Ana Mola, PhD, ANP-BC
Assessment, Mobilization, and Risk Factor Management
Discharge Planning
Clinical Pathways
Staffing
Space and Equipment
Transitional Settings
Summary

Chapter 4. Medical Evaluation and Exercise Testing for Outpatient CR
Sherrie Khadanga, MD
Physical Examination
Risk Stratification and Identification of Contraindications for Exercise Training
Summary

Chapter 5. Outpatient CR and SP
Philip A. Ades, MD, FACC, MAACVPR
Structure of CR and SP
Assessment and Management of Risk Factors for CVD Progression
Coaching, Case Management, and Counseling
Innovation in CR
Maintenance CR
Future Directions
Summary

Chapter 6. Physical Activity and Exercise
Jonathan Myers, PhD
Cardiorespiratory Endurance Training
Exercise Recommendations for Patients Without a Recent Exercise Test
PA Outside of CR
Resistance Training
Flexibility Training
Summary

Chapter 7. Nutrition Guidelines
Ellen Schaaf Aberegg, MA, LD, RD, FAACVPR
Key Nutrition Principles
Diet Patterns of Nutrition Intake
Evidence-Based Nutrition Guidelines for CVD Risk Factors
Nutrition in the CR Care Process
Dietitian–CR Professional Partnership
Summary

Chapter 8. Behavior Modification for Risk Factor Reduction: Guiding Principles and Practice
Diann Galeema, PhD
Overview of Health-Related Behavior Change
Summary

Chapter 9. Modifiable CVD Risk Factors
Sheri R. Colberg, PhD, FACSM; Emma Fletcher, MS, MVB; Carly Goldstein, PhD; Paul M. Gordon, PhD, MPH, FACSM; Joel Hughes, PhD, FAACVPR; Jonathan Myers, PhD; Quinn R. Pack, MD, MsC, FAACVPR; Killian Robinson, MD, FAHA, FACC, FACP
Physical Inactivity
Dyslipidemia
Diabetes
Tobacco Use
Hypertension
Overweight and Obesity
Psychosocial Considerations
Environmental Considerations
Summary

Chapter 10. Cardiac Disease Populations
Alison L. Bailey, MD, FACC; Alexis L. Beatty, MD, MAS; Brian Carlin, MD, FCCP, MAACVPR, FAARC; Dennis J. Kerrigan, PhD, FACSM; Steven J. Keteyian, PhD; Kirstine Laerum Sibilitz, MD, PhD; Karen Lui, RN, MS, MAACVPR; Ryan Mays, PhD, MPH; Jonathan Powell, MD; Ray W. Squires, PhD; Diane J. Treat-Jacobson, PhD, RN, FAAN
CR for Patients With CVD
Heart Valve Replacement and Repair Surgery
Dysrhythmias
Heart Failure and Left Ventricular Assist Devices
Heart Transplantation
Peripheral Artery Disease
Chronic Lung Disease
Summary

Chapter 11. Special Demographic Populations
Justin M. Bachmann, MD, MPH, FACC; Daniel Forman, MD; Naomi Gauthier, MD; Alexander Opotowsky, MD, MPH, MMsc; Marta Supervia MD, MSc, CCRP; Carmen Terzic, MD, PhD
Younger Adults
Older Adults
Women and Men
Race and Culture
Socioeconomic Considerations
Summary

Chapter 12. Program Administration
Karen Lui, RN, MS, MAACVPR
Program Priorities
Facilities and Equipment
Organizational Policies and Procedures
Insurance and Reimbursement
Documentation
Personnel
Continuum of Care and Services
Summary

Chapter 13. Outcomes Assessment and Utilization
Sherry L. Grace, PhD, FCCS, FAACVPR, CRFC
Purposes for Measuring Outcomes
Outcomes Matrix
Measuring, Documenting, Analyzing, and Reporting Program Outcomes
Resources
Summary

Chapter 14. Management of Medical Problems and Emergencies
Jason L. Rengo, MS, FAACVPR
Potential Risks in Outpatient CR
Intervention Summary
Phase 3 CR Programs
Alternative Models of SP
Summary

Appendix A. Example of Standing Orders to Initiate Outpatient CR
Appendix B. Example of Outpatient CR Emergency Standing Orders
Appendix C. Cardiac Rehabilitation Untoward Event—Physician Notification
Appendix D. Daily Emergency Cart Checklist
Appendix E. Monthly Emergency Cart Checklist
Appendix F. Emergency Equipment Maintenance Log