Center for life

1. Center for life Kate Blanchette Clinical Manager Cardiac Pulmonary Rehabilitation

2. Cardiac Pulmonary Rehabilitation Centre for Life

3. Cardiac Rehabilitationis the enhancement and maintenance of cardiovascular health through individualized programs designed to optimize physical, psychological, social, vocational and emotional status. This process includes the facilitation and delivery of secondary prevention through risk factor identification and modification in an effort to prevent disease progression and the recurrence of cardiac events. (Stone & Arthur, CACR 2004)

4. Enrollment/inclusion criteria for Cardiac Rehabilitation • Acute Myocardial Infarction • Cardiomyopathy • Pericarditis, Myocarditis, and Endocarditis • Acute Coronary Syndrome • Heart Failure • Cardiac Transplant • Atrial Fibrillation • Coronary Artery Disease • Angina Pectoris • Supraventicular Tachycardia • Percutaneous Cardiac Intervention • Percutaneous Coronary Angioplasty • Peripheral Vascular Disease • Valvular replacement or repairs • Permanent Pacemaker Insertion • Coronary Artery Bypass Grafting • Implantable Cardioverter Defibrillator

5. Regional Cardiac Rehabilitation Program The Regional Coordinator acts as a liaison between the discharged client and Cardiac Rehabilitation services. These services can include Cardiac Rehabilitation education and supervised exercise programs across North Eastern Ontario. There are six satellite programs in the North East region, where on site education and supervised exercise are provided. Services can be provided by OTN. • Espanola • Little Current • New Liskeard • Sturgeon Falls • Kirkland Lake • Sault Ste Marie

6. How canyou refer to Cardiac Rehab? Order under Category CAR under Procedure RFSCAR

7. Pulmonary Rehabilitationis a set of tools and disciplines that attends to the multiple needs of COPD patients and their families. It extends beyond standard care by addressing the disabling features of chronic and progressive lung disease. Centering on self-management, exercise, functional training, psychosocial skills, and contributes to the optimization of medical management. Optimal disease management includes rehabilitative elements including patient self-management and regular exercise (CHEST, 1997).

8. Enrollment/Inclusion Criteria for Pulmonary Rehabilitation • Obstructive Lung Disease: COPD, Asthma, Cystic Fibrosis, Bronchiectasis, Bronchiolitis Obliterans • Alpha 1 Antitrypsin Deficiency • Restrictive Lung Disease • Interstitial Lung Disease: Pulmonary Fibrosis, Pulmonary Manifestations due to Collagen-Vascular • Disease, Sarcoidosis, Occupational Lung Disease • Chest Wall Diseases • Neuromuscular Diseases affecting pulmonary function • Lung Cancer: Post-surgical, Medically Managed • Primary Pulmonary Hypertension • Hypo-Ventilation Syndrome with Morbid Obesity

9. How canyou refer to Pulmonary Rehab? Order under Category PUR. Procedure RFSPUR

10. Cardiac Pulmonary Rehabilitation-Center for life Recovery Program 8 weeks Supervised/Individualized Tailored Exercise Prescription- Target HR range: HR @ AT-80% V02 max/ 6 min walkstudy/Karvonen’s Maintenance Program 4 months Focus on independence and self-management Supervision within a community setting Home Program Exercise prescription for home with regular follow-up Passport to Wellness-post graduate reduced rate YMCA membership Adult Asthma Clinic Pre-operative thoracic teaching program

11. Multi-Disciplinary team Nurse Practitioner Registered NurseRespiratory TherapistPhysiotherapistKinesiologistRegistered DieticianPsychological Associate • ACSM Exercise Specialists • TEACH certified smoking cessation counsellors • Certified COPD and Asthma educators • ADP Authorized • HSEP certified

12. What do we offer? • Exercise based program-V02 metabolic testing • Resistance/strength program • Falls Prevention • Hydrotherapy program • Education : risk factor modification and goal setting • Smoking cessation program-T.E.A.C.H. (training enhancement in applied cessation counselling and health) • Home Program • Return to work/vocational assessment • Nutritional counseling • Psychological counselling • Regional Program • Chronic Disease patient self management • Electronic Documentation • OTN • YMCA Passport to wellness

13. Cardiac Education topics Heart healthy Nutrition Food labelling Physical Activity How the heart works Stress and your heart Medications Risk factors and goal setting ** All sessions available via live webcasts-see program website

14. Pulmonary Education topics Lung Anatomy and PhysiologyLung Disease and Its ImplicationsMedications and Proper Inhaler UseManaging Shortness of BreathBenefits of Exercise/Safe exerciseNutritionCough and Chest Clearance TechniquesSigns of a Lung InfectionAction PlansTravelling with Lung DiseaseEnergy ConservationAir QualityStress ManagementCommunity Resources ** All sessions available via live webcasts-see program website

15. HSN Cardiac Pulmonary Rehabilitation Program Pillars Disease-Specific Management • Clinician/Case manager working with the patient and their Family Physician and/or Specialist • Evidence-based optimal care delivery Patient Self-Management Skills • Peer-led group classes and support “Optimizing Life” • Enhanced self-management skills and decision-making Group Exercise and Rehabilitation • Small medically supervised classes • Social support during exercise to enhance compliance • Community exercise program available for patient’s support system

16. Center for life goals • Self-management/family centered • Symptom recognition and control • Safe exercise • Improve QOL • Enhanced linkages/communication • Decrease ER visits/admissions

17. http://www.hsnsudbury.ca/PortalEn/CardiacPulmonaryRehabilitationProgram/tabid/256/Default.aspxhttp://www.hsnsudbury.ca/PortalEn/CardiacPulmonaryRehabilitationProgram/tabid/256/Default.aspx