Guiding Patients to Goal-Oriented Recovery Through the Return to Work Lab

Friday, March 11, 2016: 9:15 AM
Main Lobby Fountain (Coronado Springs Resort)
Stephanie McCray, ADN, RN-BC , Baylor Heart and Vascular Hospital, Dallas, TX
Jenny Adams, PhD, CCRP , Baylor Heart and Vascular Hospital, Dallas, TX
Purpose:
Historically, cardiac rehabilitation has consisted of moderate exercises using a treadmill, bike, and light hand weights. However, some patients require a more intense level of training to prepare them to return to physically demanding jobs or recreational activities.

Relevance/Significance:
By offering programs that serve each individual, we hope to pioneer a new mentality about cardiac rehabilitation and prevent future cardiac emergencies by enabling a greater range of patients to return safely to their physically demanding jobs or sports.

Strategy and Implementation:
Equipment for lab patients includes a stepmill, weights, training dummies, agility gear, a slide board, balance gear, boxing gloves, fire hoses, simulated red guns, a workstation and work sled, an indoor training golf net, and plyometric gear, in addition to the traditional cardiac rehabilitation exercise equipment. The outcome measurements that are evaluated and recorded are MET levels (Clinical Domain) and SF-12 scores (Health Domain). The tool for measuring the SF-12 quality of life index consists of two parts, the mental component and the physical component, and yields two scores that provide useful data when referring to the health and quality of life of the patient. The SF-12 survey is administered to the patient upon entry to and at completion of the program, the form is scored, and the data are entered into our tracking system.

Evaluation:
The Return to Work Lab showed a 54.5% increase in MET, 20.8% increase in mental score, and 27.8% physical score (N=12). By comparison, patients in traditional Cardiac Rehab showed a MET level increase of 36%, 14.4% for the mental component, and 19.7% for the physical component (N=33).

Implications for Practice:
We utilize a specificity of training principle, to develop custom training activities that mimic patients' daily tasks and activity goals. Registered nurses, exercise physiologists work with physicians to ensure training is safe and promotes an effective, goal-oriented recovery.