Date of Doctor of Nursing Practice Project Completion
2024
Faculty Advisor
Dr. Linda Cole
Abstract
PURPOSE This quality improvement project aimed to increase patient participation and program completion rates in cardiac rehabilitation (CR) following percutaneous coronary intervention (PCI) by 10% of the historical baseline within 3 months.
BACKGROUND Heart disease is the leading cause of death in the United States. PCI is a standard treatment for symptomatic heart disease. CR is a post-PCI secondary strategy proven to reduce mortality and improve quality of life. The project addressed below-average CR attendance at a community hospital in the greater Houston area.
METHODOLOGY An evidence-based, multidisciplinary bundle that included education, signage, defined quality metrics and dashboard, patient-centered care, and non-monetary patient incentives was implemented. The Model for Improvement’s Plan-Do-Study-Act methodology was used to make changes using qualitative patient data collected throughout the project. Outcomes were measured using frequencies and percentages, comparing data from 2023 to 2024.
RESULTS The intervention sample included 142 patients. Patient enrolment increased by 10%, from 17.3% to 19%. Program completion (36 visits) increased by 40%, from 5.5% to 7.7%. AMI 30-day readmissions rose from 6.3% to 17.5%; no CR patients were readmitted. An unintended consequence was a 64.3% increase in volume for all diagnoses, resulting in 478 additional billable visits.
IMPLICATIONS Patient-centered care with personal connection and individualization drives participation in CR, as evidenced by the total volume and completion rate increases. Promoting CR within the facility, strategic patient scheduling, frequent one-on-ones, and celebrating patient milestones increases participation. Staff awareness of quality metrics and goals drives improvement and should be integrated into department culture.
Keywords
Cardiac rehabilitation, quality improvement, percutaneous coronary intervention, PCI, coronary artery disease
Recommended Citation
Vela, Rebecca, "Improving Patient Engagement Post-Percutaneous Coronary Intervention Using the Systematic Introduction of a Cardiac Rehabilitation Bundle in a Community Hospital: A Quality Improvement Project" (2024). Doctor of Nursing Practice Final Project Abstract. 11.
https://digitalcommons.library.tmc.edu/dnp_abstract/11