Cardiac Rehabilitation During the COVID-19 Era: Guidance on Implementing Virtual Care
Cardiac rehabilitation programs across Canada have suspended in-person services as a result of large-scale physical distancing recommendations designed to flatten the COVID-19 pandemic curve. Virtual cardiac rehabilitation (VCR) offers an alternate mechanism of care delivery, capable of providing si...
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| Vydáno v: | Canadian journal of cardiology Ročník 36; číslo 8; s. 1317 - 1321 |
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| Médium: | Journal Article |
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England
Elsevier Inc
01.08.2020
Canadian Cardiovascular Society. Published by Elsevier Inc |
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| ISSN: | 0828-282X, 1916-7075, 1916-7075 |
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| Abstract | Cardiac rehabilitation programs across Canada have suspended in-person services as a result of large-scale physical distancing recommendations designed to flatten the COVID-19 pandemic curve. Virtual cardiac rehabilitation (VCR) offers an alternate mechanism of care delivery, capable of providing similar patient outcomes and safety profiles compared with centre-based programs. To minimize care gaps, all centres should consider developing and implementing a VCR program. The process of this rapid implementation, however, can be daunting. Centres should initially focus on the collation, utilization, and repurposing of existing resources, equipment, and technology. Once established, programs should then focus on ensuring that quality indicators are met and care processes are protocolized. This should be followed by the development of sustainable VCR solutions to account for care gaps that existed before COVID-19, and to improve cardiac rehabilitation delivery, moving forward. This article reviews the potential challenges and obstacles of this process and aims to provide pragmatic guidance to aid clinicians and administrators during this challenging time.
En raison des recommandations concernant l’éloignement physique à grande échelle visant à aplatir la courbe pandémique de la COVID-19, tous les services offerts en personne dans le cadre de programmes de réadaptation cardiaque au Canada ont été suspendus. La réadaptation cardiaque virtuelle (RCV) constitue une solution de rechange pour la prestation des soins, dont les résultats pour les patients et les profils d’innocuité se comparent à ceux des programmes offerts en établissement. Afin de réduire le plus possible l’interruption ou le report des soins, tous les établissements devraient envisager de mettre au point et d’instaurer un programme de RCV. La mise en œuvre rapide d’un tel programme peut toutefois être intimidante. Il faut d’abord se concentrer sur la compilation, l’utilisation et le recyclage des ressources, des technologies et de l’équipement existants. Une fois les programmes en place, il faut veiller à ce que les critères de qualité soient satisfaits et à établir des protocoles pour la prestation des soins. Vient ensuite la mise au point de solutions de RCV durables comblant les lacunes qui existaient avant la COVID-19 et améliorant la prestation des soins de réadaptation cardiaque. Les auteurs passent en revue les défis et les obstacles potentiels d’une telle entreprise et tentent de formuler des conseils pragmatiques pour aider les cliniciens et les administrateurs en ces temps difficiles. |
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| AbstractList | Cardiac rehabilitation programs across Canada have suspended in-person services as a result of large-scale physical distancing recommendations designed to flatten the COVID-19 pandemic curve. Virtual cardiac rehabilitation (VCR) offers an alternate mechanism of care delivery, capable of providing similar patient outcomes and safety profiles compared with centre-based programs. To minimize care gaps, all centres should consider developing and implementing a VCR program. The process of this rapid implementation, however, can be daunting. Centres should initially focus on the collation, utilization, and repurposing of existing resources, equipment, and technology. Once established, programs should then focus on ensuring that quality indicators are met and care processes are protocolized. This should be followed by the development of sustainable VCR solutions to account for care gaps that existed before COVID-19, and to improve cardiac rehabilitation delivery, moving forward. This article reviews the potential challenges and obstacles of this process and aims to provide pragmatic guidance to aid clinicians and administrators during this challenging time. Cardiac rehabilitation programs across Canada have suspended in-person services as a result of large-scale physical distancing recommendations designed to flatten the COVID-19 pandemic curve. Virtual cardiac rehabilitation (VCR) offers an alternate mechanism of care delivery, capable of providing similar patient outcomes and safety profiles compared with centre-based programs. To minimize care gaps, all centres should consider developing and implementing a VCR program. The process of this rapid implementation, however, can be daunting. Centres should initially focus on the collation, utilization, and repurposing of existing resources, equipment, and technology. Once established, programs should then focus on ensuring that quality indicators are met and care processes are protocolized. This should be followed by the development of sustainable VCR solutions to account for care gaps that existed before COVID-19, and to improve cardiac rehabilitation delivery, moving forward. This article reviews the potential challenges and obstacles of this process and aims to provide pragmatic guidance to aid clinicians and administrators during this challenging time. En raison des recommandations concernant l’éloignement physique à grande échelle visant à aplatir la courbe pandémique de la COVID-19, tous les services offerts en personne dans le cadre de programmes de réadaptation cardiaque au Canada ont été suspendus. La réadaptation cardiaque virtuelle (RCV) constitue une solution de rechange pour la prestation des soins, dont les résultats pour les patients et les profils d’innocuité se comparent à ceux des programmes offerts en établissement. Afin de réduire le plus possible l’interruption ou le report des soins, tous les établissements devraient envisager de mettre au point et d’instaurer un programme de RCV. La mise en œuvre rapide d’un tel programme peut toutefois être intimidante. Il faut d’abord se concentrer sur la compilation, l’utilisation et le recyclage des ressources, des technologies et de l’équipement existants. Une fois les programmes en place, il faut veiller à ce que les critères de qualité soient satisfaits et à établir des protocoles pour la prestation des soins. Vient ensuite la mise au point de solutions de RCV durables comblant les lacunes qui existaient avant la COVID-19 et améliorant la prestation des soins de réadaptation cardiaque. Les auteurs passent en revue les défis et les obstacles potentiels d’une telle entreprise et tentent de formuler des conseils pragmatiques pour aider les cliniciens et les administrateurs en ces temps difficiles. Cardiac rehabilitation programs across Canada have suspended in-person services as a result of large-scale physical distancing recommendations designed to flatten the COVID-19 pandemic curve. Virtual cardiac rehabilitation (VCR) offers an alternate mechanism of care delivery, capable of providing similar patient outcomes and safety profiles compared with centre-based programs. To minimize care gaps, all centres should consider developing and implementing a VCR program. The process of this rapid implementation, however, can be daunting. Centres should initially focus on the collation, utilization, and repurposing of existing resources, equipment, and technology. Once established, programs should then focus on ensuring that quality indicators are met and care processes are protocolized. This should be followed by the development of sustainable VCR solutions to account for care gaps that existed before COVID-19, and to improve cardiac rehabilitation delivery, moving forward. This article reviews the potential challenges and obstacles of this process and aims to provide pragmatic guidance to aid clinicians and administrators during this challenging time.Cardiac rehabilitation programs across Canada have suspended in-person services as a result of large-scale physical distancing recommendations designed to flatten the COVID-19 pandemic curve. Virtual cardiac rehabilitation (VCR) offers an alternate mechanism of care delivery, capable of providing similar patient outcomes and safety profiles compared with centre-based programs. To minimize care gaps, all centres should consider developing and implementing a VCR program. The process of this rapid implementation, however, can be daunting. Centres should initially focus on the collation, utilization, and repurposing of existing resources, equipment, and technology. Once established, programs should then focus on ensuring that quality indicators are met and care processes are protocolized. This should be followed by the development of sustainable VCR solutions to account for care gaps that existed before COVID-19, and to improve cardiac rehabilitation delivery, moving forward. This article reviews the potential challenges and obstacles of this process and aims to provide pragmatic guidance to aid clinicians and administrators during this challenging time. |
| Author | Légaré, Jean-François Singh, Gurmeet Leong-Poi, Howard Coutinho, Thais Wood, David A. Krahn, Andrew D. Clarke, Brian Roifman, Idan Hardiman, Sean Oh, Paul Fournier, Anne Suskin, Neville Gupta, Anil Mansour, Samer Bewick, David Virani, Sean Ruel, Marc Lau, Benny Moulson, Nathaniel Gin, Kenneth Turgeon, Ricky Jackson, Simon Lamarche, Yoan Marelli, Ariane Zieroth, Shelley Quraishi, Ata ur Rehman Cowan, Simone Small, Gary Harris, Jennifer Chow, Chi-Ming Fordyce, Christopher B. Sapp, John Selway, Tracy |
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organization: Department of Medicine, Centre Hospitalier de l’Université de Montréal, Université de Montréal, Montréal, Québec, Canada – sequence: 23 givenname: Ariane surname: Marelli fullname: Marelli, Ariane organization: McGill University Health Center, Department of Medicine, McGill University, Montréal, Québec, Canada – sequence: 24 givenname: Ata ur Rehman surname: Quraishi fullname: Quraishi, Ata ur Rehman organization: QEII Health Sciences Center, Division of Cardiology, Dalhousie University, Halifax, Nova Scotia, Canada – sequence: 25 givenname: Idan surname: Roifman fullname: Roifman, Idan organization: Schulich Heart Program, Sunnybrook Health Sciences Centre, Toronto, Ontario, Canada – sequence: 26 givenname: Marc surname: Ruel fullname: Ruel, Marc organization: University of Ottawa Heart Institute, Ottawa, Ontario, Canada – sequence: 27 givenname: John surname: Sapp fullname: Sapp, John organization: QEII Health Sciences Center, Division of Cardiology, Dalhousie University, Halifax, Nova Scotia, Canada – sequence: 28 givenname: Gary surname: Small fullname: Small, Gary organization: University of Ottawa Heart Institute, Ottawa, Ontario, Canada – sequence: 29 givenname: Ricky surname: Turgeon fullname: Turgeon, Ricky organization: Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, British Columbia, Canada – sequence: 30 givenname: David A. surname: Wood fullname: Wood, David A. organization: Centre for Cardiovascular Innovation, Division of Cardiology, University of British Columbia, Vancouver, British Columbia, Canada – sequence: 31 givenname: Shelley surname: Zieroth fullname: Zieroth, Shelley organization: University of Manitoba, Winnipeg, Manitoba, Canada – sequence: 32 givenname: Sean surname: Virani fullname: Virani, Sean organization: Centre for Cardiovascular Innovation, Division of Cardiology, University of British Columbia, Vancouver, British Columbia, Canada – sequence: 33 givenname: Andrew D. surname: Krahn fullname: Krahn, Andrew D. organization: Centre for Cardiovascular Innovation, Division of Cardiology, University of British Columbia, Vancouver, British Columbia, Canada |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/32553606$$D View this record in MEDLINE/PubMed |
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| References | Arena, Myers, Williams (bib5) 2007; 116 Thomas, Beatty, Beckie (bib1) 2019; 74 Grace, Poirier, Norris (bib4) 2014; 30 Babu, Arena, Ozemek, Lavie (bib2) 2020; 36 Grace, Turk-Adawi, Santiago de Araujo Pio, Alter (bib3) 2016; 32 Grace (10.1016/j.cjca.2020.06.006_bib3) 2016; 32 Grace (10.1016/j.cjca.2020.06.006_bib4) 2014; 30 Arena (10.1016/j.cjca.2020.06.006_bib5) 2007; 116 Babu (10.1016/j.cjca.2020.06.006_bib2) 2020; 36 Thomas (10.1016/j.cjca.2020.06.006_bib1) 2019; 74 |
| References_xml | – volume: 74 start-page: 133 year: 2019 end-page: 153 ident: bib1 article-title: Home-based cardiac rehabilitation: a scientific statement from the American Association of Cardiovascular and Pulmonary Rehabilitation, the American Heart Association, and the American College of Cardiology publication-title: J Am Coll Cardiol – volume: 116 start-page: 329 year: 2007 end-page: 343 ident: bib5 article-title: Assessment of functional capacity in clinical and research settings: a scientific statement from the American Heart Association Committee on Exercise, Rehabilitation, and Prevention of the Council on Clinical Cardiology and the Council on Cardiovascular Nursing publication-title: Circulation – volume: 36 start-page: 792 year: 2020 end-page: 794 ident: bib2 article-title: COVID-19: a time for alternate models in cardiac rehabilitation to take centre stage publication-title: Can J Cardiol – volume: 32 start-page: S358 year: 2016 end-page: S364 ident: bib3 article-title: Ensuring cardiac rehabilitation access for the majority of those in need: a call to action for Canada publication-title: Can J Cardiol – volume: 30 start-page: 945 year: 2014 end-page: 948 ident: bib4 article-title: Pan-Canadian development of cardiac rehabilitation and secondary prevention quality indicators publication-title: Can J Cardiol – volume: 30 start-page: 945 year: 2014 ident: 10.1016/j.cjca.2020.06.006_bib4 article-title: Pan-Canadian development of cardiac rehabilitation and secondary prevention quality indicators publication-title: Can J Cardiol – volume: 116 start-page: 329 year: 2007 ident: 10.1016/j.cjca.2020.06.006_bib5 publication-title: Circulation doi: 10.1161/CIRCULATIONAHA.106.184461 – volume: 74 start-page: 133 year: 2019 ident: 10.1016/j.cjca.2020.06.006_bib1 article-title: Home-based cardiac rehabilitation: a scientific statement from the American Association of Cardiovascular and Pulmonary Rehabilitation, the American Heart Association, and the American College of Cardiology publication-title: J Am Coll Cardiol doi: 10.1016/j.jacc.2019.03.008 – volume: 36 start-page: 792 year: 2020 ident: 10.1016/j.cjca.2020.06.006_bib2 article-title: COVID-19: a time for alternate models in cardiac rehabilitation to take centre stage publication-title: Can J Cardiol – volume: 32 start-page: S358 year: 2016 ident: 10.1016/j.cjca.2020.06.006_bib3 article-title: Ensuring cardiac rehabilitation access for the majority of those in need: a call to action for Canada publication-title: Can J Cardiol |
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| SubjectTerms | Betacoronavirus Canada Cardiac Rehabilitation - methods Cardiac Rehabilitation - trends Cardiovascular Diseases - epidemiology Cardiovascular Diseases - prevention & control Coronavirus Infections - epidemiology Coronavirus Infections - prevention & control COVID-19 Humans Infection Control - organization & administration Models, Organizational Organizational Innovation Pandemics - prevention & control Pneumonia, Viral - epidemiology Pneumonia, Viral - prevention & control Risk Assessment SARS-CoV-2 Telerehabilitation - methods Telerehabilitation - organization & administration Training/Practice |
| Title | Cardiac Rehabilitation During the COVID-19 Era: Guidance on Implementing Virtual Care |
| URI | https://www.clinicalkey.com/#!/content/1-s2.0-S0828282X20305341 https://dx.doi.org/10.1016/j.cjca.2020.06.006 https://www.ncbi.nlm.nih.gov/pubmed/32553606 https://www.proquest.com/docview/2415290643 https://pubmed.ncbi.nlm.nih.gov/PMC7293761 |
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