Resources for Professionals

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Resources for Cardiovascular & Pulmonary Rehabilitation Professionals

 

Additional resources by interest area:


Resources for Cardiovascular Professionals

 


Resources for Pulmonary Professionals

 


Resources for Behavioral Medicine & Nutrition Professionals

 

 


  Resources for Cardiovascular & Pulmonary Rehabilitation Professionals

*Resources marked with an asterik are available exclusively to AACVPR members.
AACVPR Members: Please log in on the right-hand side of this page to access your member-only resources.


AACVPR Member Directory*

AACVPR members have easy, direct access to other cardiovascular and pulmonary rehab professionals across the country and throughout the world.

Regulatory and Legislative Actions & Updates*

AACVPR members receive are regular, timely Reimbursement Updates via e-mail and on the website for members to access as needed.

Discussion Forum*

The AACVPR Discussion Forum provides AACVPR members the opportunity to contribute best practices, share expertise and learn from one another's unique experiences.

Pulmonary Rehabilitation Reimbursement Toolkit

AACVPR led a multi-society effort to address the payment reduction by Medicare that has been in effect for pulmonary rehabilitation programs since January 1, 2012. This comprehensive toolkit explains the issues associated with this payment reduction, along with a very specific  approach that must be taken as soon as possible to address this payment aberration.


AACVPR members have access to a comprehensive guide to outcomes including how to collect, analyze and report outcomes as well as assessment tools, calculations, and other valuable resources.

Individual Treatment Plan (ITP) Templates*

AACVPR members have access to Individual Treatment Plan (ITP) templates intended to be used as best practice examples.

AACVPR partnered with Life Systems International (LSI) on an educational documentary produced by the Discovery Channel's Profile Series. This video spotlights cardiac rehabilitation, specifically, the overwhelmingly positive outcomes for patients and the equally surprising underutilization of this healthcare service throughout the USA.


Peripheral Arterial Disease (PAD) Exercise Training Toolkit

This toolkit was developed to allow cardiac rehabilitation and other exercise and rehabilitation health care professionals to work within their communities to improve access to supervised exercise programs for people with intermittent claudication resulting from PAD.

Performance Measures

The Performance Measures Toolkit and fact sheets are available for all professionals

AACVPR members have access to detailed performance measures fact sheets, toolkits, scientific position statements, reports and much more.


Outpatient Cardiac & Pulmonary Rehabilitation Data Registries

The AACVPR Outpatient Data Registries will be unique and powerful tools for tracking patient outcomes and program performance in meeting evidence-based guidelines for secondary prevention of cardiovascular and pulmonary disease. They will provide rehabilitation programs with national outcomes data for benchmarking and demonstrate the positive impact of  rehabilitation on the morbidity, mortality, physical function, and quality of life of cardiac and pulmonary patients across the United States.

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Resources for Cardiovascular Professionals

Cardiac Rehabilitation Fact Sheet - available in English or Spanish

Tools for Increasing Referrals

AACVPR is proud to partner with the American College of Cardiology (ACC) on their Hospital to Home (H2H) Initiative by providing resources in the H2H "See You in 7 Tool Kit."

Check out the new Cardiac Rehabilitation Resources in the “See You in 7” toolkit! The American College of Cardiology's Hospital to Home program and the American Association of Cardiovascular and Pulmonary Rehabilitation have developed resources to emphasize the importance of cardiac rehab, including the Cardiac Rehabilitation Performance Measures Highlights, CardioSmart Video: Journey Back To Heart Health, and the AACVPR Cardiac Rehabilitation Fact Sheet! Cardiac Rehabilitation after cardiac events such as a Myocardial Infarction is highly recommended in clinical practice guidelines as a means to improve mortality, quality of life and functional capacity.

The Hospital to Home (H2H) Initiative, led by the ACC and the Institute for Healthcare Improvement, is an important resource for hospitals and cardiovascular care providers interested in improving transitions from hospital to “home,” and equally important in avoiding any federal penalties associated with high readmission rates. H2H is an online learning community of individuals and facilities committed to reducing readmissions and improving patient care. 

The goal of the H2H SY7 Challenge is for all patients discharged with a diagnosis of HF/AMI to have a follow-up appointment scheduled/cardiac rehab referral made within 7 days of hospital discharge.  To achieve this goal, H2H Community members are challenged to meet eight success metrics that break improvement approaches down into small, simple, and targeted strategies.

Click Here to learn more.

"Cardiac Rehabilitation: Low Cost, Low Technology, Great Medicine!" (PowerPoint® presentation)

This presentation provides a comprehensive overview of cardiac rehabilitation and a convincing argument to help your program increase referrals. You may also download this personalizable Title Slide.

Marketing your Cardiac Rehab Program

AACVPR members have access to PowerPoint© presentations created by the Marketing Committee to assist our members with promoting their cardiac rehabilitation programs. The presentations are focused on three groups critical to the success of a cardiac rehab program: Physicians, Third party payers and Community groups. The presentations are accompanied by speaker notes and supporting information and statistics.

Scientific Position Statements

AACVPR members have access to these scientific position statements and more, including archived resources.

Educational and Psychological Interventions to Improve Outcomes for Recipients of Implantable Cardioverter Defibrillators and Their Families : A Scientific Statement From the American Heart Association

On behalf of the American Heart Association Council on Cardiovascular Nursing, Council on Clinical Cardiology, and Council on Cardiovascular Disease in the Young. Circulation. Published online September 24, 2012; Circulation is published by the American Heart Association, 7272 Greenville Avenue, Dallas, TX 75231. Copyright © 2012 American Heart Association, Inc. All rights reserved. Print ISSN: 0009-7322. Online ISSN: 1524-4539. The online version of this article, along with updated information and services, is located on the World Wide Web by Clicking Here.

AACVPR Position Statement: Depression Screening in Cardiac Rehab (2005)
AACVPR appointed a task force to develop a statement concerning screening for depression in cardiac rehabilitation and secondary prevention programs.

Cardiac Rehabilitation and Secondary Prevention of Coronary Heart Disease: An American Heart Association Scientific Statement From the Council on Clinical Cardiology (Subcommittee on Exercise, Cardiac Rehabilitation, and Prevention) and the Council on Nutrition, Physical Activity, and Metabolism (Subcommittee on Physical Activity), in collaboration with the American Association of Cardiovascular and Pulmonary Rehabilitation
This article updates the 1994 American Heart Association scientific statement on cardiac rehabilitation. It provides a review of recommended components for an effective cardiac rehabilitation/secondary prevention program.
Circulation, 2005, 111: 369-376, doi:10.1161/01.CIR.0000151788.08740.5C.

AHA Diet and Lifestyle Recommendations Revision 2006: A Scientific Statement From the American Heart Association Nutrition Committee
Improving diet and lifestyle is a critical component of the American Heart Association’s strategy for cardiovascular disease risk reduction in the general population.This document presents recommendations designed to meet this objective.
Circulation 114: 82-96; published online before print as doi:10.1161/CIRCULATIONAHA.106.176158.

Core Competencies for Cardiac Rehabilitation/Secondary Professionals: 2010 Update, Position Statement of AACVPR
This update to the previous statement identifies 10 areas of core competencies for CR/SP health care professionals and identifies specific knowledge and skills for each core competency. These core competency areas are consistent with the current list of core components for CR/SP programs published by the AACVPR and the American Heart Association.
Hamm et al. Journal of Cardiopulmonary Rehabilitation and Prevention 2011;  31:2-10.
  
Medical Director Responsibilities for Outpatient Cardiac Rehabilitation/Secondary Prevention Programs: A Scientific Statement from the American Heart Association and the American Association for Cardiovascular and Pulmonary Rehabilitation
This document will serve as a guide for the Medical Director of an outpatient cardiac rehabilitation/secondary prevention program to link the clinical aspects of physician involvement to the provision of services by program staff, while maintaining compliance with regulatory requirements.
King ML et al. Journal of Cardiopulmonary Rehabilitation 2005; 25:315-320.

Cardiovascular Rehabilitation Performance Measures

Performance measures are used to identify and correct gaps in care. They are often utilized by external agencies such as third party payers and the National Quality Forum (NQF), which reviews and endorses performance measures that are considered for use by the Centers for Medicare and Medicaid Services. AACVPR members have access to the most up-to-date performance measures developed by AACVPR in partnership with the American College of Cardiology (ACC) and the American Heart Association (AHA).

Cardiovascular Rehabilitation Performance Measures Toolkit

The Cardiac Rehabilitation Performance Measures Toolkit is designed for professionals to gain knowledge and provide resources for use to encourage enrollment of appropriate patients into cardiac and peripheral vascular rehabilitation programs.

Scientific Studies

AACVPR members have access to these scientific studies and more, which are routinely reviewed and updated by the Research Committee.

Davis, M. M., Taubert, K., Benin, A. L., Brown, D. W., Mensah, G. A., Baddour, L. M., Dunbar, S., & Krumholz, H. M. (2006). Influenza Vaccine as a Secondary Prevention for Cardiovascular Disease
Circulation, 48(7), 1498–1502e.

Flynn, K. E., Piña, I. L., Whellan, D. J. (2009). Effects of Exercise Training on Health Status in Patients With Chronic Heart Failure: HF-ACTION Randomized Controlled Trial
JAMA
. 301(14), 1451-1459. doi:10.1001/jama.2009.457.

Herridge, M. L., Stimler, C. E., Southard, D. R., and King, M. L. (2005). Depression Screening in Cardiac Rehabilitation: AACVPR Task Force Report
Journal of Cardiopulmonary Rehabilitation
, 25:11-13.

Mosca, L. et al. (2007). Evidence-Based Guidelines for Cardiovascular Disease Prevention in Women: 2007 Update
Circulation
, 115. 1481-1501. doi: 10.1161/CIRCULATIONAHA.107.181546.

Mozaffarian, D., Wilson, P. W. F., & Kannal, W. B. (2008). Beyond Established and Novel Risk Factors: Lifestyle Risk Factors for Cardiovascular Disease
Circulation
. 117, 3031-3038. doi: 10.1161/CIRCULATIONAHA.107.738732

O’Connor, C. M., et al. (2009). Efficacy and Safety of Exercise Training in Patients With Chronic Heart     Failure: HF-ACTION Randomized Controlled Trial
JAMA. 301(14), 1439-1450. doi: 10.1001/jama.2009.454.

Papadakis, S., Reid, R. D., Coyle, D., Beaton, L., Angus, D. and Oldridge, N. (2008). Cost-effectiveness of cardiac rehabilitation program delivery models in patients at varying cardiac risk, reason for referral, and sex
European Journal of Cardiovascular Prevention and Rehabilitation. 15:347–353.

Suaya, J., Shepard, D., Normand, S. T., Ades, P., Prottas, J. & Stason, W. B. (2007) Use of Cardiac Rehabilitation by Medicare Beneficiaries After Myocardial Infarction or Coronary Bypass Surgery
Circulation, 116: 1653-1662. doi:10.1161/CIRCULATIONAHA.107.701466.

Practice Guidelines

2012 ACCF/AHA/ACP/AATS/PCNA/SCAI/STS Guideline: for the Diagnosis and Management of Patients With Stable Ischemic Heart Disease

A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines, and the American College of Physicians, American Association for Thoracic Surgery, Preventive Cardiovascular Nurses Association, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons.

JACC Vol. 60, No. 24, 2012 Fihn et al. December 18, 2012:xxx

These recommendations are evidence based on literature through 2011. They detail diagnosis, risk assessment, and treatment of adults with stable known or suspected IHD, including new onset chest pain or patients with stable pain syndromes.

AHA/ACC Guidelines for Secondary Prevention for Patients With Coronary and Other Atherosclerotic Vascular Disease: 2006 Update: Endorsed by the National Heart, Lung, and Blood Institute
Circulation 113: 2363-2372, doi:10.1161/CIRCULATIONAHA.106.174516

Compelling evidence from recent clinical trials and revised practice guidelines provided the impetus for this update of the 2001 recommendations with evidence-based results.

AHA 2007 Chronic Angina Focused Update of the ACC/AHA 2002 Guidelines for the Management of Patients With Chronic Stable Angina: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines Writing Group to Develop the Focused Update of the 2002 Guidelines for the Management of Patients With Chronic Stable Angina
Circulation 116: 2762-2772; published online before print as doi:10.1161/CIRCULATIONAHA.107.187930

These updated guideline recommendations reflect a consensus of expert opinion after a thorough review primarily of late-breaking clinical trials identified through a broad-based vetting process as being important to the relevant patient population, and of other new data deemed to have an impact on patient care.

*ACC/AHA 2005 Guidelines for the Management of Patients With Peripheral Arterial Disease (Lower Extremity, Renal, Mesenteric, and Abdominal Aortic): A Collaborative Report among many professional organizations created a Task Force on Practice Guidelines for the Management of Patients With Peripheral Arterial Disease
J Am Coll Cardiol 2006 47: e1-192.

The American College of Cardiology (ACC) and the American Heart Association (AHA) have jointly engaged in the production of guidelines for practitioners in the care and management of patients with peripheral arterial disease.

*ACC/AHA 2007 Guidelines for the Management of Patients With Unstable Angina/Non-ST-Elevation Myocardial Infarction: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 2002 Guidelines for the Management of Patients With Unstable Angina/Non-ST-Elevation Myocardial Infarction)

The ACC/AHA Task Force on Practice Guidelines was formed to make recommendations regarding the diagnosis and treatment of patients with known or suspected cardiovascular disease (CVD). Coronary artery disease (CAD) is the leading cause of death in the United States. Unstable angina (UA) and the closely related condition of non–ST-segment elevation myocardial infarction (NSTEMI) are very common manifestations of this disease.

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Resources for Pulmonary Professionals

 
Pulmonary Rehabilitation Fact Sheet - available in English or Spanish

Pulmonary Rehabilitation Outcomes Toolkit

The Pulmonary Rehabilitation (PR) Outcome toolkit was developed by Chris Garvey FNP, MSN, MPA, Gerene Bauldoff, RN, PhD and colleagues to provide AACVPR members with a resource of evidence-based PR outcome measures and related information. Expert opinion and input was sought from volunteers of AACVPR, ATS, ACCP, APTA, AARC, and ERS. The toolkit offers resources for program quality improvement, AACVPR certification/recertification and, ultimately, National Quality Forum Performance Measures for PR.

The toolkit contains several of the most widely used measures in each domain; however, not all possible tools are included. If PR providers utilize outcome measures not included in this toolkit, those tools should be widely used and validated in chronic lung disease whenever possible.

Relevant Scientific Studies

Benefits of Intensive Treadmill Exercise Training on Cardiorespiratory Function and Quality of Life in Patients With Pulmonary Hypertension

Chan L, Chin L, Kennedy M, Woolstenhulme J, Nathan, S. Benefits of Intensive Treadmill Exercise Training on Cardiorespiratory Function and Quality of Life in Patients with Pulmonary Hypertension. CHEST.2013,143(2):333-343.

Pulmonary rehabilitation improves functional capacity, cardiorespiratory function, and general medical and PH specific HRQoL in patients with group 1 pulmonary hypertension. Participants were randomized to either an education only (EDU) or education/exercise group (EXE).  The EXE group underwent 10 weeks of aerobic exercise training at intensities and volumes commonly seen in outpatient pulmonary rehabilitation in the United States. Significant improvements were noted in the EXE group, as noted above, without change in the EDU group.

The Effects of Pulmonary Rehabilitation in the National Emphysema Treatment Trial*

The National Emphysema Treatment Trial provided an opportunity to evaluate pulmonary rehabilitation in a large cohort of patients who were treated in centers throughout the United States. Within are outcomes related to a total of 1,218 patients with severe emphysema underwent pulmonary rehabilitation before and after randomization to lung volume reduction surgery (LVRS) or continued medical management.
Chest December 2005 128:3799-3809; doi:10.1378/chest.128.6.3799

Practice Guidelines

ACCP/AACVPR Evidence-Based Guidelines for Pulmonary Rehabilitation

A systematic, evidence-based review of the pulmonary rehabilitation literature that updates the 1997 guidelines published by the American College of Chest Physicians (ACCP) and the American Association of Cardiovascular and Pulmonary Rehabilitation. Ries AL. Editorial in Journal of Cardiopulmonary Rehabilitation and Prevention 2007;27:233-236 
Full article in Chest 2007;131;4-42

Clinical Competency Guidelines for Pulmonary Rehabilitation Professionals: AACVPR Position Statement

An outline of clinical competencies recommended for personnel providing comprehensive services in pulmonary rehabilitation, complementing the American Association of Cardiovascular and Pulmonary Rehabilitation Guidelines for Pulmonary Rehabilitation Programs. Individuals wishing to provide PR services should possess a common core of professional and clinical competencies regardless of their academic discipline.
Nici L et al. Journal of Cardiopulmonary Rehabilitation and Prevention 2007;27:355-358

National Guideline Clearinghouse, COPD Part III., Pulmonary Rehabilitation, June 2008

A direct comparison of the American College of Chest Physicians/American Association of Cardiovascular and Pulmonary Rehabilitation (ACCP/AACVPR), Global Initiative for Chronic Obstructive Lung Disease (GOLD), the National Collaborating Centre for Chronic Conditions, and Singapore Ministry of Health (SMOH) recommendations for pulmonary rehabilitation of patients with COPD is provided within.

Performance Measures

Performance measures are used to identify and correct gaps in care. They are often utilized by external agencies such as third party payers and the National Quality Forum (NQF), which reviews and endorses performance measures that are considered for use by the Centers for Medicare and Medicaid Services.

Clinical Performance Measures: Chronic Obstructive Pulmonary Disease; Tools Developed by Physicians for Physicians

This measurement tool provides physicians with evidence-based clinical performance measures, including a data collection flow sheet, that may be useful for quality improvement activities within physician practices.
Physician Consortium for Performance Improvement (2006).

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Resources for Behavioral Medicine & Nutrition Professionals

 

Over the decades, it has become increasingly clear the significant role that psychosocial factors play in heart disease.  The primary psychosocial risk factors that have been found to be the most prominent are:

  • Depression
  • Anxiety
  • Anger/Hostility
  • Social Isolation

Different mood states and behavioral patterns impact our chemistry in ways that are toxic to our hearts.

Patients respond to their heart disease and its consequent medical procedures and surgeries with a variety of psychological reactions that can warrant intervention in the rehab program.  However, these psychosocial risk factors also impact patients’ risk of heart disease before the diagnosis, and can impact morbidity and mortality after the diagnosis. 

Therefore, the psychosocial needs of all of our patients need to be addressed as an integral component of our rehab programs. This resource page is designed to assist rehab staff in attending to these needs.

Wellness Coaching Resources

Coaching competencies are designed for a new kind of partnership, one which enables your clients/patients to get into the driver's seat, get motivated, confident, and resilient, and navigate a journey to lasting changes in mindset and behavior one engaging step at a time.

Not only will coaching improve your mindfulness, empathy, curiosity, creativity, and listening skills, you will help your clients dig down to discover heartfelt motivation, harvest their strengths, and generate new perspectives and insights that are critical to learning that sticks.

AACVPR members have free access to archived webinars, presented by Wellcoaches Corporation in partnership with the American College of Sports Medicine, that gives a glimpse into the world of coaching.

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