Additional Resources and References

If you are new to continuous quality improvement (QI), there are many useful QI tools that can assist you in your efforts. For example, the Institute for Healthcare Improvement (IHI) provides a number of QI tools that support its Model for Improvement. Their Quality Improvement Essentials Toolkit is a good primer for those beginning their quality improvement journey. It includes the Improvement Project Planning Form to help teams think systematically about their improvement project and the PDSA Worksheet for testing change, which walks the user through documenting a test of change. These resources may be helpful for planning, assigning responsibilities, and carrying out small tests of change for improving CR utilization.

Another useful QI reference and toolkit is the Guide to Improving Care Processes and Outcomes in Health Centers, available from the Health Resources and Services Administration (HRSA), which supports the U.S. health care safety net. This resource includes worksheets, such as the Clinical Decision Support-enabled Quality Improvement Worksheet [Word – 702K], for analyzing current workflows and information flows and considering improvements for targets such as increasing CR utilization. CRCP can help identify promising, evidence-based approaches to enhancing care processes to achieve this goal.

Finally, the Healthcare Information and Management Systems Society (HIMSS) publishes a guidebook series on improving care delivery and outcomes with clinical decision support (CDS).23,24 These guidebooks can help you apply the CDS Five Rights framework to ensure that all the right people (including patients) get the right information in the right formats via the right channels at the right times to optimize health-related decisions and actions. The guidebooks help health care practices and their partners set up programs that reliably deliver outcome-improving CDS interventions. They also provide detailed guidance on how to successfully develop, launch, and monitor such interventions so that all stakeholders benefit.


AACVPR: American Association of Cardiovascular and Pulmonary Rehabilitation
ACC: American College of Cardiology
AHA: American Heart Association
AMI: Acute myocardial infarction
BP: Blood pressure
CDC: Centers for Disease Control and Prevention
CDS: Clinical decision support
CME: Continuing medical education
CMS: Centers for Medicare & Medicaid Services
CR: Cardiac rehabilitation
CRCP: Cardiac Rehabilitation Change Package
ECG: Electrocardiogram
EHR: Electronic health record
EMR: Electronic medical record
HFrEF: Heart failure with reduced ejection fraction
HHS: Department of Health and Human Services
HIMSS: Healthcare Information and Management Systems Society
HRSA: Health Resources and Services Administration
ICU: Intensive care unit
IHI: Institute for Healthcare Improvement
ONC: Office of the National Coordinator for Health Information Technology
PAD: Peripheral artery disease
PDSA: Plan-Do-Study-Act
QI: Quality improvement
SET: Supervised exercise training

Page last reviewed: October 24, 2019