Program Information
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Session Descriptions
Wenesday, October 6, 2010
Pre-meeting Events
Opening Keynote
8:00am – 9:30am
Diversity in Healthcare
Louis W. Sullivan, National Health Museum
Louis W. Sullivan, M.D., is chairman of the board of the National Health Museum in Atlanta, Georgia, whose goal is to improve the health of Americans by enhancing health literacy and advancing healthy behaviors. He also is chairman of the Washington, D.C.-based Sullivan Alliance to Transform America’s Health Professions. He served as chair of the President’s Commission on Historically Black Colleges and Universities from 2002-2009, and was co-chair of the President’s Commission on HIV and AIDS from 2001-2006.
9:45am – 11:15am
Educational Breakouts
Management of Special Populations in Cardiovascular Rehabilitation: Focus on Function
Matthew N. Bartels, Columbia University; Michael L. Puthoff, St. Ambrose University; Tom Spring, William Beaumont Hospital; Patrick Savage, Fletcher Allen Health Care
Many participants in cardiovascular rehabilitation have special needs that require proper screening and individualized programming to optimize their gains in health and function. This session will focus on screening, program design, goal setting, and referral to other healthcare providers, especially for participants who are obese, at risk for falls, or have common neurological or musculoskeletal co-morbidities.
Long-term Adherence to Pulmonary Rehabilitation
Gerilynn Connors, Inova Fairfax Hospital; Roberto Benzo, Mayo Clinic
Long-term adherence in comprehensive pulmonary rehabilitation is essential for improved patient outcomes. A pulmonary rehabilitation disease management program that is self-pay and offered at an offsite location from the comprehensive PR program gets PR into the patients’ "back yard." A step-by-step guide in program development, securing a gym in the community, and program implementation is vital.
Best Practice Physical Therapy Guidelines and Assessments in Pulmonary Rehabilitation
Rebecca Crouch, Duke University Medical Center; Ellen Hillegass, North Georgia University
This session will review the anatomy and physiology of the cardiovascular and pulmonary system, various diagnoses, physical therapy evaluation, and treatment. Evidence-based guidelines will be presented for monitoring and prescribing safe exercise protocols for medical and pre/post surgical pulmonary patients, and cardiovascular/pulmonary patients with co-morbidities such as diabetes, obesity, and musculoskeletal abnormalities. Outpatient settings will be described within the content of the course.
Using Cardiovascular Rehabilitation Expertise in Worksite Wellness Programs
Carl Lavie, Jr., John Ochsner Heart and Vascular Institute, Department of Cardiovascular Diseases, Ochsner Medical Center; Barbra A. Fagan, Froedtert and Community Health
With nearly 150 million Americans employed across the United States, work places provide a large audience for activities aimed at preventing cardiovascular diseases. This course will provide a summary of the American Heart Association policy statement regarding worksite wellness programs for cardiovascular disease prevention, including: components of wellness programs, environmental modifications, regulations/policy approaches, and attention directed at high-risk populations. In addition, we will review the impact of a comprehensive worksite wellness program utilizing staff from cardiovascular rehabilitation programs and discuss the impact of such a program on cardiovascular risk factors and overall one-year health costs.
Applying Contemporary Self-management Strategies to CR Programs
Shirley M. Moore, Case Western Reserve University; Mary A. Dolansky, Case Western Reserve University
Successful self-management is marked by engaged and activated patients and their families who fully participate in the management of their chronic condition. This presentation includes self-management theory, the fundamental processes essential for successful self-management, and innovative ways to include self-management philosophy and strategies in cardiovascular rehabilitation programs.
Certification…The New and Improved Process
Mark D. Senn, Beaufort Memorial Hospital; Gayla Oakley, Boone County Health Center
This certification session is designed to give practical information to the attendee regarding the standards of each component page of the application and to allow the participant to ask questions regarding the content and standards that are relative to their specific program.
12:45pm - 2:15pm
Educational Breakouts
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How to Expand the Reach of Cardiovascular Rehab into Underserved Populations
Vera Bittner, University of Alabama at Birmingham; Sherry L. Grace, York University; Theresa M. Beckie, University of South Florida
Explore ways to help improve the reach of cardiovascular rehabilitation into underserved populations. This session will present data about barriers to referral, enrollment, and participation by women and the elderly, with practical information about how to minimize these barriers. At the broader level, it also will present results from the first trial of women-only cardiovascular rehabilitation.
Disability and Job Task Assessments: Opportunities for Cardiovascular Rehab Programs
Larry F. Hamm, The George Washington University Medical Center; Patrick McBride, University of Wisconsin School of Medicine and Public Health; Danielle Strauss, Baylor Heart & Vascular Institute
Cardiovascular rehabilitation programs are ideal settings to help physicians and patients with issues related to disability and job task assessments. This session will help cardiovascular rehabilitation professionals understand disability assessment for patients with cardiovascular disease. It also will focus on appropriate VO2max measurement and estimate, disability assessment for specific job-related tasks, and use of cardiovascular rehabilitation to reverse disability in selected patients.
New Approaches to the Patient with Restrictive or Hypertensive Lung Disease
Edwin Neil Schachter, Mount Sinai School of Medicine; Angela Binns-Lindsey, Mount Sinai Medical Center
The session will focus on understanding the patient with restrictive lung disease, including pulmonary hypertension, and use of individually tailored model to maximize effective management. Patient monitoring, hypoxemia, oxygen use and rehabilitation strategies to promote maximum stamina and lifestyle will be included in the discussion.
Best Practices Roundtable – Cardiovascular Rehabilitation
Claire Lamorte, Massachusetts General Hospital’s Cardiovascular Disease Prevention Center; Jeanne Williamson, Massachusetts General Hospital’s Cardiovascular Disease Prevention Center; Barbara C. Dalrymple, Monadnock Community Hospital; Chuck Kitchen, Havasu Regional Medical Center; Lynne H. Weir, Inova Health System
This session will review cardiac rehabilitation best practices from institutions around the country.
Assessing and Managing Depression in Cardiopulmonary Rehabilitation: An Optimistic Perspective
Joel W. Hughes, Kent State University; Kent Eichenauer, Delta Psychology Center; Glenn Feltz, Delta Psychology Center
Depression is shown to be associated with poorer outcomes for rehabilitation patients. This session will address depression management strategies for rehabilitation programs that include the impact of depression on patient participation and outcomes, assessing depression, and practical steps to manage it in cardiopulmonary rehabilitation.
New Investigator Oral Presentations
2:30pm – 3:30pm
Educational Breakouts
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Physical Activity, Fitness and Rehabilitation: The Year in CR Research
Murray Low, Stamford Hospital
This session reviews landmark articles published in 2009 and 2010 that professionals who treat patients with cardiovascular disease need to understand in order to improve patient care.
Exercise Physiology for the Non-physiologist
Chuck Kitchen, Havasu Regional Medical Center
Participants will learn basic concepts of exercise physiology and how these concepts can be applied when forming an exercise prescription. Participants will understand the F.I.T.T. principle for exercise prescription for various types of cardiovascular rehabilitation patients. This session is intended primarily for non-exercise physiologists who wish to gain a basic understanding of exercise physiology and exercise prescription.
Innovative Approaches to Pulmonary Rehabilitation: Application of Technology
Eileen Collins, University of Illinois – Chicago and Edward Hines Jr., VA Hospital
This session will focus on the use of technologies such as computerized biofeedback, interactive health systems, and telehealth in improving outcomes of pulmonary rehabilitation.
Individualized Treatment Plan: Putting Together the Pieces of the Puzzle
Gayla Oakley, Boone County Health Center
The Individualized Treatment Plan (ITP) is a key component of the program certification/recertification process and will help coordinate the multidisciplinary care necessary to achieve evidence-based outcome. This session will explain and demonstrate the new ITP best practice created by the Program Certification Committee.
Beyond the Headlines: Making Sense of the Dietary Recommendations
Deborah Krivitsky, Massachusetts General Hospital’s Cardiovascular Disease Prevention Center
This presentation will focus on how to begin each nutrition counseling session with your patients. It will include questions that you may want ask to assess the patient’s readiness to receive nutrition information. Recommendations pertinent to helping patients improve their diets and eating patterns also will be included. The latest evidence-based nutrition recommendations to prevent and manage heart disease will be reviewed as well.
Coaching the Difficult Patient
Michael Burke, Mayo Clinic Nicotine Dependence Center
This one-hour workshop will use didactic, discussion, and interactive case examples to provide participants with an overview of the literature and useful clinical tools to effectively help patients change health behaviors. The focus of the discussion and case examples will highlight change processes that can work with patients who are traditionally considered “difficult” in that they exhibit resistance, seem discouraged, or have difficulty adhering.
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8:00am – 9:30am
Educational Breakouts
Managing the Complex Cardiovascular Patient
Dennis J. Esterbrooks, Creighton University School of Medicine; Susan Schima, Creighton University School of Medicine
This 90-minute session will provide attendees with the opportunity to gain in-depth knowledge of complex medical presentations in the area of secondary prevention of coronary heart disease and will allow attendees to become more familiar with treatment strategies.
Cardiovascular Oral Presentations
Overview of the 4th Edition of the AACVPR Guidelines for Pulmonary Rehabilitation Programs
Rebecca Crouch, Duke University Medical Center
This session will highlight the new features of the recently published 4th Edition of the AACVPR Guidelines for Pulmonary Rehabilitation Programs.
Update on the CR and PR Registry Projects
Carl N. King, Cardiovascular Consulting; Mark D. Senn, Beaufort Memorial Hospital; Chris Garvey, Seton Pulmonary and Cardiac Rehabilitation Programs and University of California San Francisco Sleep Disorders; Gerene Bauldoff, The Ohio State University
This lecture and discussion will introduce and provide an update on the development of the Web-based AACVPR Outcomes Data Registry. The overall goal of the Registry is to provide research-quality data and reporting mechanisms that present such a compelling argument for the benefits of cardiovascular rehabilitation that physicians, hospital administrators, third-party payers, and government agencies will demand that their patients participate.
Medicare Policy and Reimbursement for Cardiovascular and Pulmonary Rehabilitation Services in 2010
Karen Lui, GRQ Consulting, LLC; Phillip Porte, GRQ Consulting, LLC
This session will review the implementation of 2010 Medicare rules by local Medicare contractors.
9:45am – 10:30am
General Session
Michael L. Pollock Established Investigator Award and Award of Excellence Winner
1:30pm – 2:30pm
Educational Breakouts
Heart Disease and the American Presidency: Lessons Learned for Our Patients
Franklin H. Zimmerman, Phelps Memorial Hospital Center
Cardiovascular disease has greatly impacted 20th century U.S. presidents. Many suffered from hypertension, hyperlipidemia, coronary disease, and congestive heart failure. A surprising number received substandard medical care. These dramatic examples can help healthcare professionals better explain heart disease to our patients and how modern advances have improved prognosis.
Past and Present Research Directions in Pulmonary Rehabilitation
Brian Carlin, Allegheny General Hospital
In celebration of the 25th year of the AACVPR, this session will review the most important contributions to the field of pulmonary rehabilitation that have been published in the Journal of Cardiopulmonary Rehabilitation and Prevention and how these contributions have shaped our current practice of pulmonary rehabilitation. A look toward the future of research in the field also will be discussed.
Behind the Scenes: The Art and Science of Applying, Writing, and Reviewing Scientific Manuscripts
Mark Williams, Creighton University School of Medicine; Bonnie Sanderson, Auburn University
Peer-reviewed scientific manuscripts are essential in modern science and professional practice. However, it is recognized that many health professionals may not have a working knowledge or skills for some basic issues needed in evaluating scientific publications. This session will provide an overview of a systematic approach to critically evaluate a scientific manuscript, discuss the editorial peer review process at the Journal of Cardiopulmonary Rehabilitation and Prevention and describe the reviewer’s role and responsibilities.
3:30pm – 4:30pm
Educational Breakouts
Pulmonary Oral Presentations
2010 Innovation Award Winner and 2009 Award Winner
Quality of Life in CHD Patients: Introducing a New Questionnaire, the HeartQoL
Neil Oldridge, University of Wisconsin
The HeartQoL health-related quality of life questionnaire was developed on the basis of three validated and routinely used questionnaires in patients with angina, myocardial infarction or heart failure. The HeartQoL consists of 14 items in two domains, a physical and an emotional domain, together with the two general health items from the RAND 36-item short form health survey. The HeartQoL demonstrates acceptable reliability and validity but responsiveness needs to be documented in a prospective study.
Update on the AACVPR Recertification Process
Mark D. Senn, Beaufort Memorial Hospital; Pat Benfield, Catawba Valley Medical Center
Review the application process for cardiovascular and pulmonary recertification during this session. This will include an overview of each section of the application, strategies for successful completion of the application, helpful resources, review of trouble-prone areas for the applications as observed by recertification examiners, and an open discussion of questions from attendees.
4:45pm – 5:45pm
Educational Breakouts
Triggers of Acute Cardiovascular Events: Novel Preventive Strategies
Barry A. Franklin, William Beaumont Hospital; Carl Lavie, Jr., John Ochsner Heart and Vascular Institute, Department of Cardiovascular Diseases, Ochsner Medical Center
In the 1980s, several studies, together with the discovery of the circadian variation in the onset of acute myocardial infarction, renewed interest in the triggering hypothesis of acute cardiovascular events. This lecture will review recent evidence that physical, psychological, and chemical stressors can trigger the onset of acute cardiovascular events. The potential underlying pathophysiologic mechanisms will be discussed, as well as novel preventive strategies aimed at severing the link between everyday stressors and the occurrence of acute cardiovascular events.
EACPR/AACVPR Joint Position Paper: Standards for the Assessment and Prescription of Aerobic Exercise Intensity in CR
Pantaleo Giannuzzi, Salvatore Maugeri Foundation, IRCCS, Scientific Institute of Veruno
Chronic heart failure (CHF) is the final clinical and pathophysiological stage of several heart diseases and a significant cause of worldwide mortality and morbidity. Aerobic exercise training is a well-established non-pharmacological tool for improving the CHF patient and adequate exercise training intensity is crucial to obtain both exercise-induced benefits and a reasonable control of exercise-related risk. This presentation will review the benefits of continuous and interval training and moderate to high intensity exercise in CHF patients.
ADLs and Pulmonary Rehabilitation: Implementation and Evaluation
Janet Larson, University of Michigan
This presentation will include a discussion of activities of daily living and lifestyle physical activities in people with COPD, assessment of physical activity and interventions to promote physical activity in people with COPD.
Fats and Cholesterol: The Good, the Bad, and the Ugly
Michael D. Shapiro, Oregon Health & Science University
This session will review optimal nutritional strategies for cardiovascular prevention and treatment. It also will debunk many of the myths associated with fats and cholesterols. The Mediterranean-style diet will be highlighted both in terms of content and efficacy.
What Dying Taught Me About Healing and Living
John Otterbacher, Saint Louis University
Dr. John Otterbacher, who describes himself as "arguably the worst patient in medical lore," tells the story of his "long, steep, tortured, and unseemly descent down into death" by way of cardiovascular misadventures and medical interventions to which he responded poorly. Instead of dying he went sailing. Six years at sea taught him "a few things they didn't cover in graduate school."
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8:30 – 11:45am
Clinical and Scientific Poster Viewing
8:30am – 9:30am
Educational Breakouts
Mechanical Approaches to Heart Failure Management – Implications for Exercise Therapy
Ileana Piña, Case Western Reserve University; Marianne Vest, University Hospitals Case Medical Center
Many patients with congestive heart failure are now treated with mechanical devices, such as biventricular pacemakers for resynchronization therapy or left-ventricular assist devices, in addition to optimal medical management. Participants will learn how these devices work, hear evidence about their effectiveness, and gain an understanding of the implications for exercise and rehabilitation.
Resistance Exercise in Cardiovascular Rehabilitation
Kerry J. Stewart, Johns Hopkins School of Medicine
This presentation will cover the rationale, benefits, guidelines, and precautions for the use of resistance training in cardiovascular rehabilitation.
Pulmonary Rehabilitation: The Year in Review 2010
Brian Carlin, Allegheny General Hospital
This session will focus on the most important research articles that have been published in the field of pulmonary rehabilitation. Implications for the use of research in the current practice on one's own rehabilitation program will be presented.
Update on the Clinical Exercise Physiologist
Carl Foster, University of Wisconsin at La Crosse; Larry F. Hamm, The George Washington University Medical Center
This session, a follow-up to the 2008 Indianapolis AACVPR meeting, will cover work patterns, educational, certification, and professional issues relevant to CEPs.
How to Develop and Implement an Institute of Community Health Research to Build Healthcare Bridges to the Community
Mariano J. Rey, New York University Langone Medical Center; Ana Mola, New York University Medical Center
This session will review funding sources for healthcare disparities research and program outcomes. The New York University Medical Center will be illustrated as a model of translational medicine in delivering the principles of diversity care into minority communities.
Omega 3 and Cardiovascular Diseases – A Fish Tale with Growing Credibility
Carl Lavie, Jr., John Ochsner Heart and Vascular Institute, Department of Cardiovascular Diseases, Ochsner Medical Center
There is substantial evidence from epidemiological and randomized clinical trials supporting the benefits of omega-3 fatty acids or fish oils in preventive cardiology. There are numerous mechanisms for the potential benefits of EPA and DHA. Based on current evidence, all healthy people should consume on average 500-600 mg of EPA/DHA daily, whereas the dose in patients with established cardiovascular disease should be 800-1,000 mg daily.
9:45am – 10:45am
Featured Speakers
Past and Present Research Directions in Cardiovascular Rehabilitation
Philip A. Ades, University of Vermont; Patrick Savage, Fletcher Allen Health Care; Kathy Berra, Stanford Prevention Research Center; Todd Brown, University of Alabama at Birmingham
Research has helped to establish that cardiovascular rehabilitation is a critically important component in the long-term management of individuals with coronary heart disease. Going forward, the future of cardiovascular rehabilitation is dependent upon research to improve patient outcomes beyond that which is currently achievable. This session will review the role that research played in developing the foundation of present-day cardiovascular rehabilitation. Additionally, current and future research needs will be explored.
Pro/Con Debate: Should More or Fewer COPD Patients Receive Long-term Oxygen Therapy?
Richard Casaburi, Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center; Neil MacIntyre, Duke Medical Center
More than one million people in the United States receive long-term oxygen therapy, and most of them are COPD patients. It can be argued that many more COPD patients have the potential to benefit from this therapy. Alternately, it can be argued that long-term oxygen therapy is substantially overused. This pro/con debate will highlight these contrasting arguments and provide a framework for evaluating these alternatives.
Good Luck is Something You Create: 10 Behavioral Skills of Highly Successful People
Barry A. Franklin, William Beaumont Hospital
This session will present key behavioral success strategies that are especially relevant for young healthcare professionals. The strategies include: look for the “good” in people and situations; believe and succeed; set goals (in writing); overcome fear of failure and procrastination (TAKE ACTION!); be ferociously persistent; ask and you shall receive; constantly strive to improve your communication skills; enter into partnerships or collaborations with others; develop excellent people skills; and, work hard.
11:45am – 1:00pm
Closing Keynote
"Keeping the Main Thing, the Main Thing" ...Why We Do What We Do
William Petasnick, Froedtert Hospital and the Froedtert & Community Health System
The challenges have never been greater and the need for strong leadership at all levels has never been more important. Mr. Petasnick’s remarks will focus on transformational leadership and why it is key to fixing today’s problems which threaten not just the health and healthcare of our nation, but its economic future.
William Petasnick is president and chief executive officer of Froedtert Hospital and the Froedtert & Community Health system based in Milwaukee, Wisc. Froedtert & Community Health (F&CH) is a regional hospital system made up of Froedtert Hospital, Milwaukee; Community Memorial Hospital, Menomonee Falls; St. Joseph’s Hospital, West Bend; and the West Bend Clinic. In 2007, combined adult patient admissions for the three hospitals exceeded 39,800.
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