UBC Postgraduate Program in Cardiology Goals and Objectives, Cardiac Rehabilitation July 1, 2013 Roles Medical Expert/ Clinical Decision Maker • • • • • • • • • Objectives To understand the role of risk factors in the development of vascular disease To understand the principles and practice of cardiac rehabilitation Learn to screen patients who are referred for cardiac rehabilitation efficiently and effectively. To gain knowledge and understanding regarding the risk stratification of patients referred for cardiac rehabilitation. To develop knowledge and skills necessary to monitor patients throughout their Cardiac Rehabilitation Program. Learn the appropriate risk stratification strategies for patients with or at risk for cardiovascular disease. To gain knowledge and experience in appropriately treating patients with or at risk for cardiovascular disease. Learn to safely and expertly apply non- pharmacologic therapies to patients in a Cardiac Rehabilitation Program. To learn what resources are available to manage patients with cardiovascular disease following discharge from a Cardiac Rehabilitation Program. Strategies • Study appropriate references and/or do literature searches to become familiar with the basic science and clinical aspects of a wide variety of cardiac conditions relevant to cardiac rehabilitation. • Attend the Cardiac Rehabilitation Intake Clinic. • Take a history and perform a physical examination on all patients referred to the Cardiac Rehabilitation Clinic, including identification of cardiac risk factors, medications, allergies and past/other medical issues. • Supervision of exercise stress tests of patients entering the cardiac rehab program • Provide appropriate follow-up for patients while they work through the Cardiac rehabilitation Program. • Reassess patients prior to discharge from the Cardiac Rehabilitation Program, including a review of blood work, stress test etc. The discharge plan is then discussed with the patient. • Present cases encountered during the Cardiac Rehabilitation Rotation at one or more of the scheduled Cardiology Training Program rounds. • UBC Postgraduate Program in Cardiology Goals and Objectives, Cardiac Rehabilitation July 1, 2013 Communicator • • • • Acquire the knowledge and skills required to inform and discuss the cardiovascular diagnosis with the patient and family. To be able to discuss and inform the patient and family regarding the role of the Cardiac Rehabilitation Program in the patient management, including the roles of the individual members of the Cardiac Rehabilitation Team. To be able to inform and discuss with the patient and family the goals of the Cardiac Rehabilitation Program and the process by which these goals will be achieved. To maintain appropriate contact with the patient and family throughout the cardiac rehabilitation process and to keep the Health Care Team, including the Family Doctor appropriately informed. Collaborator • Learn to work closely and cooperatively with other members of the Cardiac Rehabilitation Team, including the Family Doctor. Manager • Learn to use the resources of the Cardiac Rehabilitation Facility appropriately. • Understand the cost effectiveness of the various management strategies used in the management of • Initiate contact with patients at the time of their initial presentation and provide information regarding diagnosis and management plan. • Be available whenever possible to discuss the patient’s clinical course with the patient or the patient’s family as appropriate. • Keep complete and accurate notes in the patient’s Cardiac Rehabilitation Clinic File. • Maintain verbal communication when appropriate with nursing staff and other members of the Health Care Team in the Cardiac Rehabilitation Program regarding the patient’s condition and management plan. • Contact Referring/Family Doctor directly when appropriate to provide details of the patient’s progress in the Cardiac Rehabilitation Program and discharge/follow-up plan. • Respect the roles of all members of the Health Care Team. • Seek consultation from other members of the Health Care Team when appropriate. • With supervision of the Attending Cardiologist in the Cardiac Rehabilitation Clinic, allocate the resources of the Cardiac Rehabilitation Program efficiently, recognizing the limited UBC Postgraduate Program in Cardiology Goals and Objectives, Cardiac Rehabilitation July 1, 2013 cardiac rehabilitation patients. Health Advocate Scholar Professional • • Learn strategies to effectively educate patients and their families regarding the pathophysiology of the patient’s illness and the importance of compliance and the potential for future risk. resources available. • Initiate discussion or be available for patients and their families to discuss the patient’s illness with regards to pathophysiology and the importance of compliance to the prescribed regimen. • Learn strategies to educate patients and their families regarding healthy cardiac behaviors. • Initiate or be available to discuss with patients and their families regarding healthy cardiac behaviors as appropriate. • Enhance knowledge base regarding a variety of cardiac conditions in the context of cardiac rehabilitation. • Establish and maintain reference resources including textbooks, journals and internet (e.g. Medline). • Develop a strategy for literature review/search for a wide variety of cardiac conditions with reference to cardiac rehabilitation issues. • Establish and adhere to a study program as it relates to the care of a variety of cardiac conditions relevant to cardiac rehabilitation. • To deliver care of the highest quality with integrity, honesty and compassion. • Maintain professional relationships with all members of the Health Care team. • To learn the ethical, legal and professional obligations in the context of cardiac rehabilitation. • When appropriate seek advice and assistance. • Present and discuss case/s at Cardiology Rounds with a focus on the legal or ethical aspects of the Case.