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Keynote Speakers | Education Sessions  | Pre and Post-meeting Events | Hands-on Sessions  
Advance Program Speaker Index | Scientific & Clinical Abstracts

Wednesday, September 3: Pre-meeting Events



8:30 AM – 5:30 PM

Motivational Interviewing

Lucy Rathier, PhD; Maria Buckley, PhD


Motivational Interviewing (MI) is an effective evidence-based approach to overcoming the ambivalence that      prevents many people from making desired behavioral changes.  First developed by Drs. Miller and Rollnick, MI has been successfully used with ethnically and culturally diverse populations. MI skills are practical and accessible while being grounded in theory and research. Addition of MI to a practitioner’s repertoire can help them better address the challenges of perceived resistance from patients and more successfully provide support and strategies to engage the patient in achieving their goals. This workshop involves 8-hours of training in Motivational Interviewing tenets, spirit, and specific strategies. It will be broken into two 4-hour sessions. Participants must enroll in both sessions in order to obtain comprehensive training and supervised practice. In order to allow for supervised practice, enrollment should cap at 12. Dr. Maria Buckley has agreed to help for 2 hours of supervised practice should enrollment go up to 24. 



1:00 AM – 5:00 PM

Detailed Review of Cardiac Rehabilitation Core Competencies 4, 5, 6 & 7

Larry F. Hamm, PhD, MAACVPR; Mark Williams, PhD, MAACVPR; Vera Bittner, MD, FAACVPR; Ray Squires, PhD, FAACVPR; Ana Mola, MA, RN, ANP, FAACVPR


This workshop is the second installment of 3 pre-meeting workshops planned for the AACVPR Annual Meeting between 2013 and 2015. Professional enhancement is an important issue for all health care professionals, both those new to the field and those with years of experience. Insuring that clinical personnel demonstrate the recommended core competencies is important for the delivery of high quality services. This workshop will also discuss the relationship between core competencies and both program and the new AACVPR professional certifications. Presenters will review in detail 4 of the core competencies including suggestions for assessing them.




1:00 PM – 5:00 PM

Stress Reduction

Ann Knocke, MS, PT; Aggie Casey, RN; Giselle Bousquet, Ms, RN


This pre-conference workshop will enable participants to incorporate stress management skills necessary in their cardiac rehabilitation programs to reduce their participants’ risk of coronary heart disease. Participants will be provided with scientific evidence of the efficacy of teaching stress management skills and concrete suggestions for incorporating these offerings in a variety of cardiac rehabilitation settings. A variety of 'tools' will be introduced for participants to use in their own clinical practices.   The session will include a one hour formal presentation with several skills presented during this time for practicing first hand. This will be followed by breakout experiential sessions, including gentle yoga, meditation, and effective communication. The session will conclude with a roundtable discussion where the presenters will share experiences implementing these techniques in three different Partners Hospital rehabilitation programs, take questions and share strategies around barriers and facilitators, as well as potential for marketing and revenue for these services.




1:00 PM – 5:00 PM

Community COPD Education Workshop

Scott Cerreta, BS, RRT; Jane Martin, BA, LRT, CRT; Gerene Bauldoff, PhD, RN, FAACVPR


Discuss effective methods for educating your patients about their chronic obstructive pulmonary disease (COPD) in the professional education track of this workshop. Meanwhile, a patient education track will provide “COPD 101” to local patients to help them better manage their lung disease. The professional and patient groups will then come together to network and hear from an inspirational speaker.

Presented in partnership with


Thursday, September 4

8:00 AM – 9:30 AM

Opening Keynote: Blue Zones – Secrets of a Long, Healthy Lifestyle 

Amy Tomczyk, Outreach Director, BlueZones


The Blue Zones team traveled the globe to uncover the best strategies for longevity and happiness. They identified places that have the greatest life expectancy – and distilled these culture and lifestyle secrets into nine common denominators. What should you be doing to live a longer life? Amy Tomczyk will debunk the most common myths and offer a science-backed blueprint that’s been applied in communities and workplaces around the country for the average American to live another 12 quality years.



9:45 AM – 10:45 AM

Depression AHA

James B. Blumenthal, PhD, ABPP


A systematic literature review on depression and adverse medical outcomes after acute coronary syndrome was conducted that included all-cause mortality, cardiac mortality, and composite outcomes for mortality and nonfatal events. The review assessed the strength, consistency, independence, and generalizability of the published studies. Despite limitations in some individual studies, our review identified generally consistent associations between depression and adverse outcomes. The evidence supports the recommendation that the American Heart Association should elevate depression to the status of a risk factor for adverse medical outcomes in patients with acute coronary syndrome.




9:45 AM – 10:45 AM

Physical Activity, Fitness and Cardiac Rehabilitation: The Year in Research



This presentation will review important recent research that health professionals who treat patients with cardiovascular disease need to understand in order to improve patient care.   Specifically; 1. The presentation will review recently published scientific literature related to the role of physical activity and physical fitness as significant predictors for total and cardiovascular mortality. 2. The presentation will analyze the interactions of physical activity, physical fitness, and its pleiotropic benefits for prevention & treatment of cardiovascular disease 3. The presentation will enable clinicians to better understand the scientific basis for delivery of Cardiac Rehabilitation service as a powerful therapeutic modality for primary and secondary prevention of cardiovascular disease.




9:45 AM – 10:45 AM

The Impact of Innovavation and Creativity on Program Growth and Services

Loren Stabile, M; Vonda Shaw, MS, MPH 





9:45 AM – 10:45 AM

Significant Musculoskeletal and Neurological Impairments: Can these patients be integrated into Pulmonary Rehabilitation?

Rebecca H. Crouch, PT, DPT, MS, CCS, FAACVPR; Carl Fairburn, DPT; Karlyn Schiltgen, PT


There is a growing body of evidence that musculoskeletal patients (multiple joint replacement, chest wall deformities, scoliosis/severe kyphosis, rheumatoid arthritis, etc.) and neurological patients (cerebral vascular accident, multiple sclerosis, myasthenia gravis, spinal cord injury, etc.) benefit from the components included in a program of pulmonary rehabilitation. The literature indicates that breathing re-training, airway clearance, and exercise modification improves the quality of life and respiratory mechanics of these populations.   It is important that pulmonary rehabilitation staff understand the special adaptations and treatment elements important to offer these patients an improved pulmonary status through rehabilitation.



9:45 AM – 10:45 AM

Cardiac Rehab Registry: Progressing toward National Benchmarks

Bonnie Sanderson, PhD, RN MAACVPR; Mark Vitcenda, MS, RCEP, FAACVPR


Since its introduction just over 3 years ago, the AACVPR national registry for cardiac rehab outcome data has accumulated information from thousands of patients. The registry has now progressed to the point of being able to provide valuable feedback to users. After a brief overview of project status and data input questions & issues, this session will focus on what/how participants can get useful information back from the registry. Highlights of accumulated data will be presented and practical tips on how to use the registry’s Performance Report and Data Extraction utility will be emphasized. Current & future plans for the data collection will also be shared.



9:45 AM – 10:45 AM

Lean Thinking: Removing Waste and Improving Quality in Cardiac Rehab

Jennifer LeFresne, MS, CCES; Steven William Walsh, BS CCES


The session will focus on using LEAN thinking and principles (a Toyota based quality improvement method) in cardiac rehab to identify areas of waste. Lean defines waste as redundancy, extra material and wait time; any component that does not add value to the process. We initially set out to streamline the processes in cardiac rehab, specifically, our charting process. After success with our charting process, we then shifted focus to our orientation and referral processes. During the session, we plan to review the results of our process improvements for charting, orientation and referrals which include increased patient satisfaction, improved referral rates (pending) and patient care, simplified new start process, 100% of ITPs signed on time and better communication and time management among staff. We would like to introduce basic Lean tools that can be used in other cardiac rehab programs. Our team used LEAN tools such as Gemba walks, root cause analysis and value stream mapping to determine the non-value added steps in our processes. We will show how other programs can start to look at their current processes or value stream to identify areas of waste or processes that are not being completed as expected.



11:00 AM – 12:30 PM

Scientific and Clinical Abstract Poster Presentations


Describe outcomes of new scientific and clinical research related to pulmonary and cardiac rehabilitation.



1:30 PM – 2:30 PM

Health Policy & Reimbursement: 2014 Update

Karen Lui, RN, MS, MAACVPR; Phillip Porte


A working knowledge of Medicare rules/regulations is essential for anyone working in contemporary cardiac or pulmonary rehabilitation. This session will provide an update of the latest Medicare information including coverage considerations for Heart Failure, progress with PR cost reporting, and status of AACVPR’S efforts to change legislation to allow daily “medical supervision” to be provided by non-physician practitioners (NPs or PAs). In additions, common coding/billing challenges for programs and for local Medicare contractors will be covered. Time will be available for questions & answers.



1:30 PM – 2:30 PM

Oxygen Therapy and the Rehabilitation Professional (Joint Session of the AACVPR and the AARC-American Association of Respiratory Care)

Brian Carlin, MD, FCCP, FAARC, MAACVPR; Tom Kallstrom, MBA, RRT


Oxygen therapy is an integral part of the care of patients who have cardiac and pulmonary disease who are hypoxemic. Many of these patients could benefit from rehabilitation. As a person who uses oxygen becomes involved in either cardiac or pulmonary rehabilitation, it is essential that the staff of the program is familiar with the science behind oxygen administration and delivery. This session will focus on the science behind the use of oxygen and will then discuss the various types of oxygen delivery systems that are currently available.



1:30 PM – 2:30 PM

Healthcare Reform and ACOs: Key Implications for Cardiopulmonary Providers Moving from Fee-For-Service to Value-Based Care

Michael Murphy, MS, MBA, FACHE, CMPE


This talk will focus on the creation and use of bundled payments as a payment model in cardiovascular services. Focus on the process and inclusion of cardiac rehabilitation as part of the bundle will be of primary importance. Talk would include viewpoints from hospital administrators and insurers, who would speak on the criteria for inclusion of CR/PR in payment models, shifting payment paradigms associated with payers, and the design of bundled payments that include Cardiac Rehab. This presentation would include the description of how bundled payments work, how to create one, and additional practical knowledge for CR program directors and managers. It would allow program administrators to move theory into action, address the demand for innovative payment options, and to respond to patient and administration demands for alternative payment models.



1:30 PM – 2:30 PM

6-Minute Walk Testing or Graded Exercise Testing Before Cardiac Rehabilitation? A Point-Counterpoint Discussion

Vera Bittner, MD, MSPH, FAACVPR; Larry F. Hamm, PhD, MAACVPR; Patrick D. Savage, MS, FAACVPR


A functional exercise evaluation for patients entering cardiac rehabilitation is recommended in both the AACVPR Core Components for Cardiac Rehabilitation/ Secondary Prevention Programs and the Core Competencies for Cardiac Rehabilitation/Secondary Prevention Professionals. Historically, graded exercise testing has been considered an important element in the comprehensive assessment of cardiac rehabilitation patients. However, anecdotal evidence suggests that graded exercise testing for this purpose is being performed less frequently and a 6-minute walk test is often used instead. This point-counterpoint session will review the clinical and scientific evidence from both perspectives of this exercise assessment issue. Additionally, the impact of the exercise assessment on developing an exercise prescription will be reviewed, and practical programmatic implications of this clinical exercise testing question will be considered.



1:30 PM – 2:30 PM

In Sickness and in Health: The Importance of Relationships in Behavioral Change, Stress Management, and Quality of Life

Amy Knight, PhD


This session will review the important role of primary relationships, family and social support in the health and well-being of cardiopulmonary patients. Many of the behavioral changes being asked of the individual patient affect the spouse and other family members, as well as these social supports strongly influencing the likelihood of success in making and sticking with healthy behaviors. Stress and coping responses of the spouse and other primary caregivers may weigh just as heavily on our patients and are important to address as well.




1:30 PM – 2:30 PM

Beginning Investigator Scientific Abstract Award Presentations 

Describe outcomes of new research related to pulmonary and cardiac rehabilitation.

3:30 PM – 4:30 PM
How to Know if Your Staff Is the Best: Staff Competencies for Pulmonary Rehab, 2014 Update
Eileen G. Collins, PhD, RN, FAACVPR; Charles Emery, PhD, FAACVPR; Trina Limberg, BS, RRT, FAARC, MAACVPR

AACVPR has led the way in setting expectations for staff who work in outpatient pulmonary rehab settings through its publication of Clinical Competencies for Pulmonary Rehabilitation Professionals in 1995 & 2007. Since then the evidence base for pulmonary rehab has expanded providing valuable information to guide best practices in the field. Building on these changes, the 3rd edition of PR core competencies is now available. This session will introduce the updated core competencies and discuss their rationale. Emphasis will be on the individual expectations and importance of using these as a guide to assess current staff capabilities and to plan for future staff development.




3:30 PM – 4:30 PM

Overview of Statins: A Clinical Update

Daniel E. Forman, MD. FACC, FAHA; Carl J. Lavie, MD


Broader indications for the use of statin medications are resulting in larger numbers of patients utilizing these medications. Simultaneously, recommendations to increase exercise training (ET) as a means of decreasing cardiovascular disease (CVD) as well as improving other parameters of fitness continue to be strongly advocated by healthcare professionals. The combined use of statins and ET can result in health gains and decreased CV risk; however multiple factors may increase the risk of adverse events with this combination therapy. Some of the events that have been reported include decreased athletic performance, muscle injury, myalgias, joint problems, decreased muscle strength, and fatigue. The type of statin, the drug dosage, drug interactions, genetic variants, coenzymeQ10 deficiency, vitamin D deficiency, and underlying muscle diseases are among the factors that predispose to intolerance. Patients who suffer from untoward side effects of the simultaneous administration of statin and ET may benefit from a number of effective therapeutic strategies which might allow for their continued combined administration.



3:30 PM – 4:30 PM

Nutritional Considerations in Pulmonary Rehabilitation

Ellen Aberegg, MA, LD, RDN


Nutritional considerations in Pulmonary Rehabilitation are different than those of Cardiac Rehabilitation. Nutritional behaviors likely did not contribute to the development of disease; rather the treatment of the disease contributes to malnutrition, negative consequences on energy and bone metabolism, changes in body composition and higher nutrient needs. Prolonged ill health contributes to changes in appetite. Further, size of meals and nutrient composition may affect breathing efficiency. Tools to evaluate the pulmonary patient’s diet, recommendations for education class session content, and criteria for referral to dietitian will be presented.



3:30 PM – 4:30 PM

Keep Them Coming Back: Eight Principles to Bolster Phase 2 Program Adherence

Donald Shaw, PT, PhD, D.Min., FAACVPR


Although Phase 2 cardiac rehabilitation programs are widely accepted as medically efficacious, the task of securing and maintaining adequate patient enrollment is frequently problematic. A myriad of dynamics such as lack of physician referral, competition with area hospitals, and insurance coverage all affect program status. These issues will most likely always remain as threats to program viability but are generally well understood. However sometimes overlooked are the more substantive threats from 'within' such as staffing, space, equipment, and location. These variables, and many others too numerous to mention, can impact patient satisfaction and affect program adherence. Indeed, patients are acutely aware of their surroundings and seemingly small concerns to staff may be program-ending events for patients. The purpose of this presentation is to visit – or perhaps revisit – the topics of facility environment and patient sensitivity to “keep them coming back.”



3:30 PM – 4:30 PM

Pulmonary Rehab Registry: Tips for New Users and Ideas for Old Pros

Gerene Bauldoff, PhD, RN, FAACVPR; Chris Garvey, FNP, MSN, MPA, FAACVPR


The AACVPR national outcome registry for pulmonary rehab is just 2 years old and continues to build its base of programs & patients. This session will be of interest to new & old users alike. Easy tips for new users and those considering participating will be reviewed, including basic operations and system tools. And for those who have been involved for a year or two, ideas for getting the most out of registry data and reports will be emphasized.



3:30 PM – 4:30 PM

High Intensity Interval Training in the Cardiac Rehabilitation Setting

Ray Squires, PhD, MAACVPR; Steve Keteyian, PhD, FAACVPR


This session will provide an overview of published evidence regarding the safety and effectiveness of high intensity interval exercise training in the cardiac rehabilitation setting. Attendees will be given specific strategies that will help them implement safe and effective interval training in their programs.



4:45 PM – 6:00 PM

L. Kent Smith Award Presentation

Larry F. Hamm, PhD, MAACVPR



Friday, September 5

6:45 AM - 7:45 AM
Educational Breakfast Roundtables


During breakfast, facilitators will lead discussions on hot topics including but not limited to:

  • Individualized Treatment Plans (ITPs)

  • Interval Training: How and Where to Start

  • Writing Exercise Prescription: With and Without a Stress Test

  • Advanced Directives – Goals of Care

  • Sexual Functioning: Having Difficult Discussions with Patients

  • How to Handle Difficult Patients

  • Acceptable Assessment Tools, by the AACVPR Registry Standards

  • Caring for Patients with Ventricular Assist Devices (VAD)

  • Utilizing Doppler Blood Pressures

  • The Role of Palliative Care

  • AACVPR Committee Involvement

  • AACVPR State Affiliate Involvement

 Supported by ScottCare Cardiovascular Solutions



8:00 AM – 9:30 AM

How to Implement a Heart Failure Rehabilitation Program

Steven Keteyian, PhD, FAACVPR; Karen Lui, RN, MS, MAACVPR; Ray Squires, PhD, MAACVPR; Randal J. Thomas, MD, MS, FAACVPR


The recent news that CMS has designated heart failure as a covered indication for cardiac rehabilitation services represents both an opportunity and a challenge. It is an opportunity in that it makes it possible for cardiac rehabilitation programs to deliver important preventive care to an entirely new group of patients. However, it is also a challenge in that cardiac rehabilitation programs must adapt in capabilities as well as in capacity to meet the needs of this complex and numerous group of patients. This session is designed to give cardiac rehabilitation professionals the basic tools they will need to adapt their programs in order to provide a high quality heart failure rehabilitation program.



8:00 AM – 9:30 AM

Pulmonary Rehabilitation: Guidelines and Implementation

Brian Carlin, MD, FCCP, FAARC, MAACVPR; Chris Garvey, FNP, MSN, MPA, FAACVPR


This session will review the evolution of the guidelines (evidence based and statements) regarding pulmonary rehabilitation over the last three decades. This will begin with the initial scientific statement issued in 1989 and conclude with a review of the latest statement released by the ATS/ERS in November of 2013. Strategies for implementation of the latest recommendations will then be discussed.



8:00 AM – 9:30 AM

Information Overload! Helping Patients Distinguish Evidence-Based vs. Anecdotal Nutrition Strategies

Karen Collins, MS, RDN, CDN


Patients are inundated with information about nutrition and heart health, but much of what they see on the Internet and in magazines is based on anecdotal stories or single studies. How can we help them focus on the choices most likely to make a difference? In this presentation, we will look at examples of what patients may be hearing, examine these ideas in light of current nutrition research and recommendations, and discuss how we might respond when people ask or make statements about what they see in the media.






8:00 AM – 9:30 AM

Patient and Family Centered Care in Cardiac and Pulmonary Rehab

Theresa Gracik, MBA, CCES; Linda Larin, MBA, FACHE, FACCA; J. Greg Merritt, Ph.D.


This presentation will focus on the utilization of Patient and Family Centered Care. In this care model, patients affect how programs are run and assist the caregivers in making decisions on their own care. A focus on how this impacts the organization and overall care of the patient. The talk will be highlighted by both program administration and program management, as well as from the view of a patient that has experienced this model.



8:00am – 9:30am

Improving Health Literacy in Pulmonary and Cardiac Rehabilitation

Kimberly Clark, EdD, RRT-NPS; Paul Oh, MD, MSc, FRCPC, FACP


Have you ever considered that non-compliance with treatment was due to something other than our preconceived notions? The nature of chronic diseases, such as COPD, and the complex treatment regimens influence how well patients manage their care. Low health literacy has been termed the “silent epidemic” that adversely affects millions of patients. Patients with low health literacy and chronic disease have less knowledge of their disease and associated treatment. This presentation will provide an in-depth look at the impact low health literacy has on patients with chronic lung disease, the association with non-compliance, and how we can address low health literacy through pulmonary rehabilitation to improve patient understanding and health outcomes. This will be a fun and interactive presentation that will put your health literacy knowledge and evaluation skills to the test.




8:00 AM – 9:30 AM

Scientific Oral Abstract Presentations


Describe outcomes of new research related to pulmonary and cardiac rehabilitation.



9:45 AM – 10:30 AM

Michael L. Pollock Award Presentation

Vera Bittner, MD, MSPH, FAACVPR


10:45 AM – 11:45 AM

CCRP: Why, What, & How To Prepare

Larry F. Hamm, PhD, MAACVPR; Steven Lichtman, EdD, MAACVPR; Karen Lui, RN, MS, MAACVPR


The inaugural exam for the new professional credential – Certified Cardiac Rehabilitation Professional (CCRP) is being offered at the 2014 annual meeting. The new individual certification is intended to provide a process that helps ensure that the knowledge and skills required for high quality care by cardiac rehab professionals are achieved and maintained by each practitioner in the field, regardless of their academic background or professional experience. This session will review the rationale for the exam, explain its development, & outline plans for future exam offerings. Emphasis will be on how cardiac rehab staff members can prepare to take the exam.



10:45 AM – 11:45 AM

Healthcare Reform and Cardiac Rehabilitation in Post-Acute Care

Mary A. Dolansky, RN, PhD; Melissa D. Zullo, PhD, MPH, MS; Ana M. Mola, MA, RN, ANP-C, FAACVPR


As healthcare reform focuses on readmission avoidance, an opportunity for cardiac rehabilitation (CR) exists to design innovative disease management programs, impacting CV disabilities, readmissions, and providing CR in lower cost post-acute care (PAC) settings. During the past 10 years, referrals to PAC, specifically skilled nursing facilities (SNFs) has increased by 30% which has doubled the costs of care in PAC. The PAC cost has been attributed to readmissions rates from SNFs. Among 4101 hospitals readmissions from SNFs, from 2006-2008, HF comprised 24.7%, and for acute myocardial infarction re-admission among 2453 hospitals were 19.9%. A recent analysis of Medicare data demonstrated that disability played a major role in re-hospitalizations and the use of outpatient cardiac rehabilitation services. This presentation will describe: (1) the current state of cardiac rehabilitation services in PAC, (2) the relationships among PAC use, disability, re-hospitalizations and cardiac rehabilitation. (3) a hospital and SNF collaborative that integrates cardiac rehabilitation in a special unit as a prototype and its impact on readmissions, disability , and use of outpatient cardiac rehabilitation services.


10:45 AM – 11:45 AM
Success and Survival in Pulmonary Rehabilitation: 34 Years of Experience and Still Growing!
Valerie K. McLeod, RRT



This session explores the growth over 3 decades of a program in midmichigan in a blue collar community. Learn how to showcase your program to hospital administrators and understand how to diversify and survive in everchanging hospital environments.



10:45 AM – 11:45 AM

Cardiopulmonary Rehabilitation for Older Patients with Double Disability: Adapting Rehabilitation for Patients with Comorbid Physical Disabilities

Matthew N. Bartels, MD, MPH


As the population ages, patients with dual disabilities are becoming more common. Whether it is patients with an existing disability who are aging and developing cardiac and pulmonary disease, or patients who are older with cardiac or pulmonary disease becoming further disabled with a secondary stroke, amputation or other condition, this is a population that has special needs and precautions. Being familiar with modifications of exercise prescriptions for patient with a second disability in addition to their cardiac and pulmonary disease is important, including precautions, use of adaptive equipment and modification of exercise programs. Participants will learn how to approach these patients with the ability to maximize functional return and cardiopulmonary conditioning, while minimizing potential risks and hazards and helping staff to incorporate these more common ly seen patients into their cardiopulmonary rehabilitation program.



10:45 AM – 11:45 AM

Integrating Group Mind-Body Self-Care Practices into Cardiac Rehabilitation

Claire Costello, PhD, RN, PMHCNS-BC


For several decades now, we have known the value of engaging the relaxation response to protect us from the ravages of stress and the inflammatory diseases it causes. Recent contributions in neuroscience, mindfulness meditation, and health psychology give us effective compassionate tools that can decrease this inflammatory response in the body, return us to vitality, and turn us toward heart health. We know that depression, anger, and anxiety may play a role in our cardiac health. With practice, we can develop skills that help us become more capable of bearing witness to and metabolizing our difficult yet natural emotions of fear, sadness, anger, grief, and loneliness. We are enlivened when we build our sense of self-competency to manage our health, to prevent and to recover from disease. This presentation recounts some significant research that supports the use of mind-body self care practices for cardiac health. Also, it teaches how to integrate 5 specific practices into cardiac rehabilitation that the author has found most useful in her cardiac clinical work these last 18 years. Boost your group program, including your new heart failure patient program, and get paid utilizing expanded cardiac rehab codes.



10:45 AM – 11:45 AM

Cardio-Oncology – Chemotherapy and Thoracic Radiotherapy: The Heart of the Matter

Dennis J. Esterbrooks, MD, FACC, FACP


This presentation will describe the potential impact of radiotherapy and chemotherapy on cardiac function and long term cardiac disease risk and provide guidance on the cardiac evaluation of cancer patients treated with chemotherapy and chest radiotherapy.




1:15 PM – 2:45 PM

Home-Based Delivery of Cardiac Rehabilitation

Randal J. Thomas, MD, MS, FAACVPR; Mark Vitcenda, MS, RCEP, FAACVPR; Mary Whooley, MD


Learning Objectives:

1) Review the benefits of home-based vs. center-based cardiac rehabilitation.

2) Describe examples of successful home-based cardiac rehabilitation programs.

3) Discuss the key components of home-based cardiac rehabilitation



1:15 PM – 2:45 PM

Recognizing our Patients’ Psychological Obstacles to Behavior Change

Kent A. Eichenauer, PsyD


Motivational Interviewing (MI) can be a powerful tool that helps our patients to find ways to change their lives and their behaviors in wonderful ways. MI instructs us to roll with the client’s resistance. But, what if that resistance is actually due to psychological issues such as depression or anxiety or anger? Sometimes these concerns are easy to see in our clients. Other times, they can be subtle and hidden behind our patient’s defenses. This presentation is intended to present some basic background on MI, but primarily provide information about the subtleties of these psychological obstacles. We want to help staff to recognize these potential concerns and make a successful determination of how to proceed in the best interest of the patient. Finally, if a referral to a mental health practitioner is appropriate, we will offer tools to establish contact with a referral and how to discuss this referral with the patient.



1:15 PM – 2:45 PM

Exercise is Preventive Medicine: Motivational Interviewing as an Intervention

Reed Humphrey, PT, PhD, MAACVPR; Robert Scales, Ph.D., FAACVPR


Physical inactivity is the singularly most important modifiable risk factor in the prevention of non-communicable diseases. Importantly, it also has the highest prevalence of any risk factor and is prevalent in both developing and developed countries worldwide. In this breakout session, participants will review the latest trends in physical inactivity and research approaches to intervention. The session will focus on the use of motivational interviewing to empower clients to adopt an active lifestyle when they leave the clinic. Purpose: To give a group of healthcare professionals recommended options to promote physical activity and exercise during a clinical consultation.



3:00 PM – 3:45 PM

Thomas L. Petty Award Presentation

Eileen G. Collins, PhD, RN, FAACVPR

Have you ever driven several miles without noticing anything on the road, or read a page in a book without registering any of it? Do the day's worries and disappointments crowd your mind as you're trying to fall asleep at night? Do you feel stressed much of the time and aren’t sure how to find peace? Amit Sood, a Mayo Clinic specialist in stress and resiliency, reveals how the mind’s instinctive restlessness and shortsightedness generate stress and anxiety and presents strategies for living a more peaceful life. The book is based on the highly popular stress management program offered at Mayo Clinic that Dr. Sood developed after two decades of work with tens of thousands of people.


4:00 PM – 5:00 PM

Quality, Value, and Accountability in Healthcare Reform: Implications for Cardiovascular and Pulmonary Rehabilitation

Marjorie King, MD, FACC, MAACVPR; Randal Thomas, MD, FAACVPR; Mark A. Levine, MD, FACP


Key concepts in healthcare payment reform include shared accountability, promoting cost effective care that is based on scientific evidence, and improving coordination of care among providers.  These concepts are not foreign to cardiovascular and pulmonary rehabilitation professionals, but it is not clear how the trickle-down effect of healthcare payment reform may affect delivery of rehabilitation and prevention services.  This session will include an overview of emerging concepts related to healthcare payment reform, including episode groupers, accountable care, and quality indicators, from both the perspective of payers and providers, and will concentrate on how these concepts relate to current and future practice of cardiovascular and pulmonary rehabilitation.





4:00 PM – 5:00 PM

Heart Nutrition Guidelines – 2014 update

Georgia Kostas, MPH, RDN, LD


Every year we learn more about ways to successfully lower lipids, blood pressure, weight. New federal guideless are expected to be released in 2014. Do you know the latest? Come to this practical session by a registered dietitian nutrition with 30 years experience in preventive and therapeutic nutrition counseling, and 25 years at the Cooper Clinic, Cooper Aerobics Center. Learn her tips and tricks to help your patients apply the latest guidelines and make sustainable lifestyle changes.



4:00 PM – 5:00 PM

Implementing a New Pulmonary Rehabilitation Program in the Era of the G0424 Code

Kimberly Clark, Ed.D., RRT-NPS; Connie Paladenech, RRT, RCP


The implementation of HCPCS code G0424 in 2010 for reimbursement of pulmonary rehabilitation services was a positive step in the right direction in recognizing pulmonary rehabilitation as an integral part of managing COPD. Fast forward to four years later, not only do we continue to lobby for increasing the reimbursement rate but many pulmonary rehabilitation programs in some parts of the country are being denied reimbursement for the majority of their G0424 code claims. This presentation will provide an overview of the common errors pulmonary rehabilitation programs have experienced that resulted in G0424 denied claims and tips on how to make sure your pulmonary rehabilitation services get reimbursed.



4:00 PM – 5:00 PM

Developing a High Performance Outpatient Provider Network in the New Health Reform Era

Curt Meyer, MS, FACHE


This presentation will explore how staff competencies and program components compare to traditional CR and PR programs. An explanation will be provided on how PHM programs can be incorporated into existing programs using current staffing models and available facilities. Lastly the development of a Clinical Integration Network (CIN) will be discussed.



4:00 PM – 5:00 PM

Scientific Oral Abstract Presentations


Describe outcomes of new scientific and clinical research related to pulmonary and cardiac rehabilitation.


Saturday, September 6



8:00 AM – 9:30 AM

The New Cardiovascular Prevention Guidelines

Robert H. Eckel, MD; Quinn Pack, MD MSc 


In late 2013, after more than five years in development, five new and updated guidelines for the prevention of heart disease were released. They were 1) Lifestyle Management, 2) Assessment of Cardiovascular Risk, 3) Management of Overweight and Obesity, 4) Treatment of Blood Cholesterol, and 5) Management of High Blood Pressure. These new guidelines took a strict systematic and evidence-based approach to making and grading recommendations. This resulted in guidelines with a stronger evidence base, less expert opinion, and a more narrow scope. It also allowed the committees to freshly examine the evidence and emerge with several new paradigms for the prevention of cardiovascular disease. This session will discuss each new guideline in detail, their limitations, their direct applicability to cardiac rehabilitation, and key recommendations for implementation in programs across the United States.



8:00am – 9:30am

Program Certification/Recertification: Preparing for 2015 Submission

Kim Beyer, BS, FAACVPR; Mark Stout, MS


Program certification/recertification has come to be recognized as a marker of program quality by peers, physicians, patients, & payers alike. Many programs use the preparation process as a quality improvement activity to engage the entire CR or PR staff in the process. This session will detail the revised requirements for 2015 submission. Presenters are the co-chairs of the Certification Committee with first-hand knowledge of the requirements and the review process. Emphasis will be on common reasons for denial with recommendations on how to avoid them. Time for discussion and Q&A will be available.



8:00 AM – 9:30 AM

COPD Pathology and Respiratory Pharmacology for Treatment of COPD

Scott Cerreta, BS, RRT


This lecture is a look at COPD pathology and exercise limitations for all health care professionals. It compares disease pathology in COPD to asthma and other chronic lung diseases. A 3D Interactive is used to captivate the audience and further appreciate the physical injury that occurs in COPD and not asthma. The 3D Interactive is also used to describe exercise limitations and advanced shortness of breath that occurs with progressive disease.



8:00 AM – 9:30 AM

Diabetes and Physical Activity: Prevention and Treatment of Hypoglycemia

Marion J. Franz, MS, RDN, CDE


There are many benefits from physical activity (PA) for persons with diabetes. In persons without diabetes, blood glucose (BG) remains normal during PA due to a decrease in insulin and an increase in counterregulatory hormones causing an increase in glucose production by the liver. For persons with diabetes on insulin and/or insulin secretagogues this balance is disrupted and hyperglycemia and/or hypoglycemia can occur. Hyperglycemia, which is less common, can occur as a result of excessive hepatic glucose production mediated by “stress” hormones. It is most common after a high intensity PA. More common is hypoglycemia after the PA session and/or PA after periods of relative inactivity. Hypoglycemia from activity can be prevented by decreasing insulin or increasing carbohydrate. For treatment of hypoglycemia, persons with diabetes are commonly taught the 15:15 rule—treat with 15 grams of carbohydrate and test BG again after 15 min to determine if additional carbohydrate is needed. However, BG begins to drop in about 40 to 60 min so BG must be tested again to see if additional treatment is needed. There is no “fast-acting” carbohydrate and adding protein does not help in the treatment.



9:45 AM – 10:45 AM

Moving from Our Reactive Sick Care Model to Proactive Healthcare 

Barry A. Franklin, PhD, MAACVPR


Medications and revascularization procedures are often used as a first-line strategy to prevent cardiac events; however, these interventions do not address the most proximal risk factors for CHD – poor dietary habits, physical inactivity, and cigarette smoking. The traditional visit-based, reactive health-care model (outpatient visits/hospitalizations) falls short not just because it is expensive, but because health outcomes are primarily explained by individual behaviors which occur outside healthcare encounters. As patients typically spend >5000 hours each year independent of medical/rehab providers, it is critical to connect them with health-promoting resources throughout the day. Future preventive initiatives will incentivize behavior change to help patients embrace healthier lifestyle choices/options via worksite wellness offerings, community resources, and home-based programs. As healthcare providers, we need to become champions of achieving healthy lifestyle overhauls in our patients – well beyond the traditional, abbreviated thrice-weekly rehab experience. The paradigm shift will move from helping patients (3 h/wk) to “helping patients help themselves” (24/7). This session will provide innovative ideas to do just that!



9:45 AM – 10:45 AM

Why Is My Patient so Short of Breath? Understanding Dyspnea

Gerene S. Bauldoff, PhD, RN, FAACVPR; Eileen G. Collins, PhD, RN, FAACVPR


Dyspnea is commonly experienced by patients with COPD. It is thought that one of the effects of pulmonary rehabilitation is to desensitize patients to the sensation of dyspnea. Much research has been conducted on the physiology of the dyspnea experience i.e., the role of the brain in the experience of dyspnea. The goal of this presentation is to provide an overview of dyspnea. Areas to be covered are the physiology of dyspnea, dyspnea with exertion, the psychosocial aspects of dyspnea, and the measurement of dyspnea.



9:45 AM – 10:45 AM

Behavior Change- Practical Applications for Use in CR and PR Programs

Jody Hereford, MS, BSN, MAACVPR; Zack Klint, MS, CES


The ongoing transition of cardiopulmonary rehabilitation to a patient centered, behavior change intervention continues to challenge even the best programs. This session will provide an overview of the latest science and practical solutions for applying behavior change techniques in a cardiopulmonary rehab setting. The session will culminate in a collaborative discussion inviting the audience to share experiences, solutions and obstacles related to helping patients make meaningful, lasting change.



11:00 AM – 12:30 PM

Closing Keynote: Big Goals in Short Order

Vince Poscente, CEO, The Goal Acceleration Institute


Vince Poscente, CEO of The Goal Acceleration Institute, is frequently invited to help organizations reach big goals in less time. His talent as a master communicator is illustrated by his personal formula, which he used to go from recreational skier to Olympian in four years. As a New York Times bestselling author, Vince combines his signature wit and wisdom with a high-energy message.


Through insights from his experience, Vince inspires audiences to align their vision with an emotional buzz, to do what the competition is not willing to do and to increase efficiency in an entertaining way.


Thursday, September 4: Hands-On Sessions


9:45 AM – 11:00 AM

1:15 PM – 2:30 PM

3:15 PM – 4:30 PM

Pulmonary and Cardiac Rehab Exercise Prescriptions

Kim Eppen, PT, PhD


Learning objective: Practice techniques in pulmonary and cardiac exercise prescription.



9:45 AM – 11:00 AM

1:15 PM – 2:30 PM

3:15 PM – 4:30 PM

Being Breathed - A Workshop on Breath Control
Sarah White, LMHC

Learning objective: Practice techniques for building better breath control to improve patient response to stress.



12:00 PM – 2:45 PM

Beans, Greens and Grains Culinary Workshop

Alisa Krizan, MS, RD, LD


One of the most dramatic changes on the culinary scene in recent years has been the rediscovery of grains and legumes.  Everyday grains – wheat, rice, corn – are appearing in many new forms, and beans have become more popular as well.  In addition, exotic grains, such as millet and quinoa, and beans that were once rarely seen, including flageolets and borlottis, are appearing more frequently.

Legumes and grains are more affordable than meat. They are high in soluble fiber, which most Americans lack in their diets.  A high fiber diet helps lower cholesterol and assists with lipid and blood sugar control. A high-fiber diet may also be associated with lower blood pressure when consumed at doses of 12g to 22g of fiber per day and with lower serum lipids when consumed at 12g to 33g of fiber per day. These diets may also be associated with improvements in apolipoproteins and inflammation.

During this hands on workshop, the members will work in small groups to prepare several simple dishes with beans, greens and grains.  Following the completion of all the tasty recipes, the participants will share their methods of preparation before they enjoy the exciting new recipes they created.  



8:15 AM – 10:00 AM

10:45 AM – 12:00 PM

1:30 PM – 2:45 PM

High Intensity Aerobic Interval Training in the Early Outpatient Cardiac Rehabilitation Setting

Melissa J Bowman, BS, CES; Kent J Dudycha, BS, CES


Learning objective: Practice techniques for engaging in effective high intensity interval training for cardiac patients.



8:15 AM – 10:00 AM

10:45 AM – 12:00 PM

1:30 PM – 2:45 PM

Progressive Resistive Exercise Training Group for Pulmonary

Joann Beim, OTR/L


Learning objective: Practice techniques for engaging in effective Progressive Resistive Exercise Training for pulmonary patients.


Saturday, September 6: Post-meeting Event


1:00 PM – 4:00 PM

Heart and Mind: The Practice of Cardiac Psychology

Robert Allan, PhD


Dr. Allan will describe seminal research from the world’s foremost authorities on the major psychosocial risk factors linked with CHD, including depression, social isolation, and anger, as well as several emerging factors, such as “Type D” (distressed) personality, anxiety, posttraumatic stress disorder, and work stress. Dr. Allan is Clinical Assistant Professor of Psychology in Medicine at Weill Cornell Medical College and Professional Associate at New York- Presbyterian Hospital.


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