Cardiac Rehab embraces virtual care
For Wayne Moore of Strathroy, the virtual connection to his cardiac rehabilitation care team at St. Joseph’s meant everything to his recovery from heart surgery in February. As the pandemic evolved and in-person hospital visits were not possible, the Cardiac Rehabilitation team embraced technology tools and moved to a virtual care model. With Wayne’s six-month program now complete, all done at home via video conferences and phone calls, he’s feeling well and back to his active life.
“My hospital care was excellent, and all my contacts and follow-up care are really great. I highly recommend the St. Joseph’s rehabilitation program to other patients, and I give this program 5 stars,” says Wayne.
“We care for patients who’ve had a heart attack, needed a stent, or undergone heart surgery. We also see some patients who are living with heart failure or certain heart rhythms,” explains Kate Grattan, Nurse Practitioner/Clinical Nurse Specialist, Cardiac Rehabilitation and Secondary Prevention Program. “Patients are part of our program for 6 months. They receive personalized medical assessment, exercise prescription and planning, nutrition support, mental health care and education resources.”
St. Joseph’s Cardiac Rehabilitation and Secondary Prevention program started in 2001 to help patients who have experienced a heart attack or heart surgery. The focus is to help them recover from the event, and make positive lifestyle and medical changes to help reduce the risk of another event. The care team is interdisciplinary, including cardiologists, registered nurses, rehabilitation trainers, and a registered dietitian, social worker, psychologist and nurse practitioner – all supported by dedicated admin staff.
Before the pandemic, the program included a combination of hospital visits, telephone calls, YMCA exercise sessions supervised by our staff and home-based practice. The program’s current virtual delivery model is entirely home-based for patients, and includes telephone and video conference sessions via Webex or OTN. There are group sessions and individual sessions depending on the patient.
How the program works
- All patients are now seen virtually, first by both a registered nurse and cardiologist.
- Patients then attend an online group orientation.
- A six-month online education series then focuses on personal goal setting, safe exercise, healthy nutrition and managing stress.
- Patients also receive one-to-one care and counselling throughout the series from our interdisciplinary team members by phone, video or in person if needed.
Learning together with patients
“When patients first learn about our virtual program, their reactions are mixed. Some are excited to get started - they have a lot of questions about how their health and how they can improve,” Kate reports. “Some patients feel quite disconnected from the health system since their event, particularly during the pandemic, so they feel relieved to get connected to our program.”
Most people are a little nervous about the technology before they get started. The care team members are getting better at troubleshooting connection issues and, with the help of their IT colleagues, this is getting easier. “This has been a true team effort, and we’re learning too. We’re still working on creative ways to support our patients who do not have access to technology needed for video conferencing,” says Kate. “We’re recording our education series to be available any time and creating resources that patients can use to follow along in the program if they can/t use video. “
Wayne navigated the technology well, with support from his spouse Diane. He found the program convenient and comfortable to do from home. Wayne also appreciated that the program is comprehensive from diet, exercise and mental health aspects – all important elements for Wayne after his surgery. Wayne now uses a FitBit (he’s a big walker and gets his steps in), is a constant gardener, and both he and Diane eat healthy following Mediterranean diet principles.
“We’re all thrilled to be able to work with and support our patients during this extraordinary time,” Kate says. “Changing to virtual care delivery has certainly challenged us as providers. We’ve learned new skills, and adapted assessments to be thoughtful and innovative in our recommendations for patients. For example, when and where to do safe aerobic exercise if you’re self-isolating, or how to help a patient monitor their blood pressure if they don’t have their own cuff at home.
“We’re also very excited to now deliver a group education program, something we’d been trying to establish before the pandemic, but had difficulty gaining traction with. We continue to experience stressful moments when things don’t go as planned, but we’re also discovering the depth of our resilience and adaptability.”
When it’s safe to do so, the program team hopes to move to a hybrid model of care delivery, where they can provide virtual and in-person options for patients based on their needs and preferences. The team is also working on stream-lined ways to capture how and what the patient is doing; for example, an app to help track steps per day or aerobic minutes.
Kate adds, “We know that community is an important aspect of our previous in-person classes, and community can look and feel quite different in the virtual world. No matter how our program evolves, we hope there will always be a way for patients to connect with one another for support and encouragement.”
Tell us about your virtual care appointment experience
If you’ve had a virtual care appointment at St. Joseph’s recently, we want to hear from you. Please take 5-10 minutes to complete this patient survey about virtual care. Your participation is voluntary and your responses are anonymous.
Your feedback will help us understand how we can continue to improve the experience for our patients and their family members, and improve our services. Thank you for your time.