Focus Area: Enrollment and Participation

change concept, change idea, tools and resources.Enrollment and participation strategies are approaches that health systems can use to encourage enrollment and participation in cardiac rehabilitation (CR). These include various modes of patient education and engagement and different ways in which cardiac rehabilitation (CR) programs can be modified to better accommodate patient needs and preferences.

Note: Change concepts are general notions that are useful in the development of more specific ideas for changes that lead to improvement. Change ideas are actionable, specific ideas or strategies for changing a process. Each change idea lists evidence- or practice-based tools and resources that can be adapted by or adopted in a health care setting to improve CR utilization.

Enrollment and Participation: Change Concepts

Educate Patients About the Benefits of Outpatient CR

Change Idea:
Deploy an inpatient “liaison” to help educate, refer, schedule, and enroll eligible patients in outpatient CR

Tools & Resources:


Change Idea:
Use videos to describe your CR program and the impact of CR on health outcomes before hospital discharge or at the beginning of outpatient CR

Tools & Resources:


Change Idea:
Provide patient education materials that convey CR benefits

Tools & Resources:

Reduce Delay from Discharge to First CR Appointment

Change Idea:
Before hospital discharge establish an early, within 12 days of discharge, outpatient appointment

Tools & Resources:

Use Data to Drive Improvement in Enrollment or Participation

Change Idea:
Determine CR enrollment or participation metrics

Tools & Resources:


Change Idea:
Regularly provide a dashboard with enrollment or participation metrics, goals, and performance

Tools & Resources:

Reduce Cost-Sharing Barriers for CR Services

Change Idea:
Assist patients with high out-of-pocket costs or economic burden to navigate payment options

Tools & Resources:


Change Idea:
Establish a philanthropic fund to partly underwrite CR costs for patients with high co-payments or without insurance

Tools & Resources:

Improve Efficiency of Enrollment

Change Idea:
Incorporate group orientations

Tools & Resources:

Develop Flexible Models That Better Accommodate Patient Needs

Change Idea:
Offer accelerated CR programs

Tools & Resources:


Change Idea:
Modify program structure and hours of operation to match patient preferences, to accommodate more patients

Tools & Resources:


Change Idea:
Shift from class structure to open-gym model

Tools & Resources:


Change Idea:
Develop hybrid model of home-based and facility-based program that includes key components of CR

Tools & Resources:

Modify Some Program Procedures Based on Clinical Need

Change Idea:
Match frequency and/or use of ECG telemetry monitoring to clinical need

Tools & Resources:


Change Idea:
Improve operational efficiency with BP management

Tools & Resources:

Use Clinician Follow-up to Bolster Enrollment or Participation

Change Idea:
Engage referring clinicians by providing letters that highlight non-enrolled patients for clinician follow-up

Tools & Resources:


Change Idea:
Engage referring clinicians by providing progress reports and completion of program outcomes

Tools & Resources:

Bold font indicates CR programs that contributed content.

Note: References for citations on this page can be found under Additional Resources and References.


Additional Focus Areas

Learn more about the other Cardiac Rehabilitation Change Package (CRCP) focus areas:

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